Competitiveness of surgical residency programs

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LizzyM

LizzyM

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Obviously, I've come over from pre-allo and hope that you will indulge me.

Do surgical residencies and surgical subspecialties always require very high board scores or is there a range?

Also, does anyone know of a correlation between old MCAT scores and Step 1 and 2 scores?
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LizzyM said:
Obviously, I've come over from pre-allo and hope that you will indulge me.

Do surgical residencies and surgical subspecialties always require very high board scores or is there a range?

Also, does anyone know of a correlation between old MCAT scores and Step 1 and 2 scores?
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I believe there was a correlation between MCAT verbal scores and Step 1. looked it up long time ago when I was still in college. Im not in a surgical specialty, but had classmates match into competitive subsurgical specialties with average step scores. they were outgoing, had im assuming great away rotations, had research +/- AOA
 
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LizzyM said:
Obviously, I've come over from pre-allo and hope that you will indulge me.

Do surgical residencies and surgical subspecialties always require very high board scores or is there a range?

Also, does anyone know of a correlation between old MCAT scores and Step 1 and 2 scores?
Click to expand...

They don't REQUIRE high board scores, but it can be difficult to differentiate yourself otherwise when there are stacks of AOA applicants with 250-270 board scores.
 
HelpPleaseMD said:
I believe there was a correlation between MCAT verbal scores and Step 1. looked it up long time ago when I was still in college. Im not in a surgical specialty, but had classmates match into competitive subsurgical specialties with average step scores. they were outgoing, had im assuming great away rotations, had research +/- AOA
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I find this slightly odd, mainly because I think the correlation between MCAT bio/physics and step 1 would be much stronger than for verbal. Also M2 currently in the process of preparing for Step 1.
 
The data can say whatever it wants. MCAT questions are completely different from STEP 1 questions. STEP questions are insanely objective. MCAT questions on the other hand, even after reading the explanation, I would still not understand why the answer was what it was entirely (especially the reading comprehension type questions). I personally think verbal is a terribly written section and doesn't prove anything.

These are two different exams.

Much better, is to see how you did during pre-clinicals. Similar material and board style questions (at least where I am from).

To the OP, check out NRMP match data:
http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf
you can see clearly that higher step scores greatly increase chances of matching in surgical subspecialites, whereas, the likelihood of matching breaks great than 90% for much lower step scores in less competitive specialties.
 
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Goro said:
I've seen a fair number of papers showing a correlation between the MCAT and Step I.
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There is one, which is what you would expect. But it is not that high. For some reason I remember a .55. Which I could have just made up completely.
 
Do you mean this one?


Donnon T, Paolucci EO, Violato C. The predictive validity of the MCAT for medical school performance and medical board licensing examinations: a meta analysis of the published research. Acad Med. 2007;82(1):100-106. http://journals.lww.com/academicmedicine/Fulltext/2007/01000/The_Predictive_Validity_of_the MCAT_for_Medical.15.aspx. Accessed March 6, 2010.

Here's one for COMLEX:
Dixon D. Relation between variables of preadmission, medical school achievement, and COMLEX-USA Levels 1 and 2 achievement. J Am Osteopath Assoc. 2004;104(8):332-336.




cbrons said:
There is one, which is what you would expect. But it is not that high. For some reason I remember a .55. Which I could have just made up completely.
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masaraksh said:
I find this slightly odd, mainly because I think the correlation between MCAT bio/physics and step 1 would be much stronger than for verbal. Also M2 currently in the process of preparing for Step 1.
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Well data has a funny way of not conforming to your expectations
 
LizzyM said:
Obviously, I've come over from pre-allo and hope that you will indulge me.

Do surgical residencies and surgical subspecialties always require very high board scores or is there a range?

Also, does anyone know of a correlation between old MCAT scores and Step 1 and 2 scores?
Click to expand...

I would say that it would be an uphill battle to get into any of the surgical subspecialties with a Step I score of <240, however general surgery is not nearly as competitive and is extremely attainable as long as the student as a board score around the national average and no major academic flaws.
 
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LizzyM said:
Obviously, I've come over from pre-allo and hope that you will indulge me.

Do surgical residencies and surgical subspecialties always require very high board scores or is there a range?

Also, does anyone know of a correlation between old MCAT scores and Step 1 and 2 scores?
Click to expand...

General surgery residency is not considered competitive. Plastic Surgery is considered competitive but most who become a plastic surgeon don't go directly into it and do a Gen Surgery residency first. Urology and Orthopedic surgery are considered moderately competitive, ENT is mildly competitive, and ophthalmology is not competitive.
 
Im going to look like a fool for asking this, but what's the point in going for a top surgical residency? What is the practical advantage over a lower ranked surgical residency?
 
SouthernSurgeon said:
This is pretty much entirely wrong.

Less than 1/3 of plastics training slots are available via the gen Surg to plastics fellowship route. Overwhelming majority are through integrated plastics reaidencies.

Urology and ENT are both extremely competitive.
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I was going to say. That sounds completely different than anything I've ever heard.
 
SouthernSurgeon said:
This is pretty much entirely wrong.

Less than 1/3 of plastics training slots are available via the gen Surg to plastics fellowship route. Overwhelming majority are through integrated plastics reaidencies.

Urology and ENT are both extremely competitive.
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They weren't "extremely competitive" for my medstudents, they had a 95% match rate and they're not at a top 10 school.
 
The surgical subspecialties are all highly competitive. Urology is historically the most competitive (having a 75% match rate overall). Ortho/NSGY/ENT all sit around an 80% match rate. Plastics is a little higher I believe but also self-selecting (really all of them are). Median Step 1 scores for matching at all are ~245 (plastics is 249). At the top programs, this can be in the mid 250s or possibly higher (though I'm told that past 255 it doesn't really matter). Many students at my school going into neurosurgery or ENT take research years. Ophtho I'm less informed about, but the median step 1 score is in the 240s as well. Unsure about match rate.

All in all, the surgical subspecialties are the most competitive specialties. The only others I would rank at this level are derm (duh) and perhaps rad onc (other than niche specialties like pediatric neurology and programs like CT surgery that aren't quite sure whether they want to be residencies or fellowships).

General surgery is kind of middle of the road in terms of competition for residency, but some of the fellowships (like peds) are very competitive to get into. Obviously you have more competition at the top (BWH, Michigan, etc).
 
Dr Tony T. Chopper said:
Im going to look like a fool for asking this, but what's the point in going for a top surgical residency? What is the practical advantage over a lower ranked surgical residency?
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One advantage is if you go to a program with a high volume of rarer procedures, you'll be trained to do those procedures (eg: aneurysm clipping for neurosurgery). You'll also have better networking opportunities, better research resources, the inbreeding effect for academic medicine job placement, and often more case variety.
 
lazers said:
They weren't "extremely competitive" for my medstudents, they had a 95% match rate and they're not at a top 10 school.
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According to the NRMP report, they are extremely competitive by every metric available. By the match rate metric ENT had 277 US seniors match, 91 who did not in 2014. By comparison internal medicine had 3,300 match and 105 who did not. That is not even getting into Step 1, AOA, research, etc.

Also consider that those who went unmatched in ENT were more competitive with regards to Step 1, AOA, research experiences etc. than the average matched US senior across all specialties (table 2 vs table OTO-1). Note: picked on ENT and IM for simplicity.
 
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Some data (all for US Seniors only) from Charting Outcomes 2014

All Applicants (Control)
Numbers: 15127 (M), 1245 (UM), 92%
Mean Step 1 Score: 230 (M), 221 (UM)
AOA: 16% (M), 5.8% (UM

Internal Medicine (Control)
Numbers: 3300 (M), 105 (UM), 97%
Mean Step 1 Score: 231 (M), 210 (UM)
AOA: 16.5% (M), 0% (UM)

General Surgery
Numbers: 871 (M), 156 (UM), 85%
Mean Step 1 Score: 232 (M), 213 (UM)
AOA: 15.3% (M), 2.3% (UM)

Neurological Surgery
Numbers: 188 (M), 50 (UM), 79%
Mean Step 1 Score: 244 (M), 232 (UM)
AOA: 28.3% (M), 8.5% (UM)

Orthopedic Surgery
Numbers: 648 (M), 190 (UM), 77%
Mean Step 1 Score: 245 (M), 231 (UM)
AOA: 32.2% (M), 3.3% (UM)

ENT
Numbers: 277 (M), 91 (UM), 75%
Mean Step 1 Score: 248 (M), 239 (UM)
AOA: 38.9% (M), 18.6% (UM)

Plastic Surgery
Numbers: 126 (M), 52 (UM), 71%
Mean Step 1 Score: 245 (M), 236 (UM)
AOA: 39.0% (M), 14.6% (UM)
 
hatsoff9900 said:
You are neglecting to take student self-selection into account...
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THIS. If you have a 210 step 1 you aren't going to apply for ENT/Derm/Plastics. And if your advisors didn't try to convince you that your chances were extremely slim, they are doing you a disservice. I'm assuming the 95% was very high performing students that knew they had a chance.
 
Zedor said:
There's a slide about mcat and step correlation
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Yeah, I saw that. I just meant that it seems like one of the big conclusions that they made was that doing questions from a question bank was a good thing (who would have guessed?)

As for the MCAT, and I'll preface this by saying that I have a very limited amount of stats knowledge, it seems that the spread of MCAT scores isn't very wide which may make it difficult to make a very strong correlation. I mean, most students will have their MCAT in the range 30-38. Few below 30 since thats just med school admissions selections and few >38 since just very few people score above that.


Tri723 said:
I love the negative correlation between hours studied and step 1 score
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Thats just hilarious. That correlation is flat-lining. But really though, I guess its because a) people probably suck at calculating their total 'step 1 prep hours' and b) one hour for one person can be VERY different from an hour for another person. Even for a single person, one hour of studying can range from 'super productive' to 'nothing happened' since they're so many other factors like i) being tired, ii) who you're studying with if anyone, iii) mood, iv) distractions, etc. I like that they published that 'correlation' though. Takes balls.

Goro said:
Pre-clinical GPA is the best indicator of step performance at our school, and many others. I don't have the pubs to cite right now, though.
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Who would have ever thought that how well you do answering questions about medicine correlates with how well you will do answering other questions about medicine 😉
 
Tired said:
We have talked about that study before, and take it seriously.

In my program, historically there was an unofficial "floor" below which our leadership wouldn't consider applicants, no matter how strong the rest of their application was. Years ago, 220 was considered bare minimum, with the general expectation that serious contenders would be above 230. Of course, back then the mean score for all test takers was 221, so not sure what we're doing now (I've been busy).

Board scores are very very important to my leadership. We see many personable, hard working applicants with lower-end scores who believe that research, work ethic, and extracurricular activities will land them a spot.

Then we end up taking personable, hard working applicants who have all those things + high board scores. There are plenty of those students as well.
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Can you comment on if there's been a drastic change in approach this year in terms of who your program interviewed? Seems like there's a lot of hype going on about how significantly things changed in 1 year (I believe you're Ortho right)? I'm wondering if it's something that's being seen across the board or it's just a few people without many interviews who are causing a bunch of unnecessary hoopla.
 
WedgeDawg said:
Some data (all for US Seniors only) from Charting Outcomes 2014

All Applicants (Control)
Numbers: 15127 (M), 1245 (UM), 92%
Mean Step 1 Score: 230 (M), 221 (UM)
AOA: 16% (M), 5.8% (UM

Internal Medicine (Control)
Numbers: 3300 (M), 105 (UM), 97%
Mean Step 1 Score: 231 (M), 210 (UM)
AOA: 16.5% (M), 0% (UM)

General Surgery
Numbers: 871 (M), 156 (UM), 85%
Mean Step 1 Score: 232 (M), 213 (UM)
AOA: 15.3% (M), 2.3% (UM)

Neurological Surgery
Numbers: 188 (M), 50 (UM), 79%
Mean Step 1 Score: 244 (M), 232 (UM)
AOA: 28.3% (M), 8.5% (UM)

Orthopedic Surgery
Numbers: 648 (M), 190 (UM), 77%
Mean Step 1 Score: 245 (M), 231 (UM)
AOA: 32.2% (M), 3.3% (UM)

ENT
Numbers: 277 (M), 91 (UM), 75%
Mean Step 1 Score: 248 (M), 239 (UM)
AOA: 38.9% (M), 18.6% (UM)

Plastic Surgery
Numbers: 126 (M), 52 (UM), 71%
Mean Step 1 Score: 245 (M), 236 (UM)
AOA: 39.0% (M), 14.6% (UM)
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Anything that has a greater than 2 out of every 3 people getting in who apply isn't competitive in my book. I read on CNN there was a a government based job in India that the chances for getting that job was like 1 in 1 million. Now that's competitive!
 
lazers said:
Anything that has a greater than 2 out of every 3 people getting in who apply isn't competitive in my book. I read on CNN there was a a government based job in India that the chances for getting that job was like 1 in 1 million. Now that's competitive!
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You can pretty much get into any field you want to as long as you put the work in. The only exception to that might be derm but even then you can get in if you work a little extra and do a year of research.
 
SouthernSurgeon said:
This is just stupid. Your chances of winning the lottery are pretty low too; that has about as much to do with the question at hand.

Relative to other fields in medicine, surgical specialties are among the most competitive.
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I disagree, and don't get your panties in a bunch. I know you're a surgeon, but most medstudents don't think getting into general surgery is difficult.
 
lazers said:
Anything that has a greater than 2 out of every 3 people getting in who apply isn't competitive in my book. I read on CNN there was a a government based job in India that the chances for getting that job was like 1 in 1 million. Now that's competitive!
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So in that case 0 specialties are competitive based on your definition
 
lazers said:
Plastic Surgery is considered competitive but most who become a plastic surgeon don't go directly into it and do a Gen Surgery residency first. Urology and Orthopedic surgery are considered moderately competitive, ENT is mildly competitive, and ophthalmology is not competitive.
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Please do not provide this wisdom to your students
 
Pretty sure lazers is trolling, or he is a recent graduate of Hollywood Upstairs Medical College.
 
I think that I recall that there was only about a 30% correlation between the MCAT and the Step 1. I have a link somewhere from an apropos, salient study.

People often miss this arcane point...everybody who aspires to become an M.D. must take the MCAT, but only about 40% of MCAT takers get into an American medical school. BUT, all American medical students will take the Steps. A 33 on the old MCAT was 90th percentile among all medical school aspirants, but a 255, e.g., on Step 1 is 90%+ among all actual medical students (those 40% who went beyond the MCAT and matriculated at an American medical school).

There was some surprise and skepticism above about a possible correlation between SAT Verbal scores and the Steps...here is why perhaps.

The Steps are marathon exams where you are reading and interpreting LONG, exhausting paragraphs. One person I know very well, who made a nearly perfect 780 verbal SAT also made 93rd percentile on both Step 1 and 2. She had had a mildly disappointing 33 on the MCAT. I would say that in her case (just 1 example to be sure) the MCAT way under-predicted her success on the Steps. But her exceptionally high SAT verbal showed that she could intuit answers from often exhausting, long, nebulous paragraphs. Food for rumination/thought.
 
akwho said:
Pretty sure lazers is trolling, or he is a recent graduate of Hollywood Upstairs Medical College.
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Lol why don't you look up the facts or ask the plastic surgery forum if most match directly or get in after gen surg residency. Also, unlike you, I've been through the match so I know what I'm talking about. The only people I know that wanted to get into gen. surgery but weren't able to were IMGs.
 
lazers said:
Lol why don't you look up the facts or ask the plastic surgery forum if most match directly or get in after gen surg residency. Also, unlike you, I've been through the match so I know what I'm talking about. The only people I know that wanted to get into gen. surgery but weren't able to were IMGs.
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You tell him bro. Everyone knows if you can back up your resume with a 500 dead lift matching surgery is a snap.
 
lazers said:
Lol why don't you look up the facts or ask the plastic surgery forum if most match directly or get in after gen surg residency. Also, unlike you, I've been through the match so I know what I'm talking about. The only people I know that wanted to get into gen. surgery but weren't able to were IMGs.
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Then why is everything you say completely wrong?
 
Psai said:
Then why is everything you say completely wrong?
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LOL, ok maybe you live in an alternate universe. Either that or you goto a shi.tty medschool so students have a hard time matching.
 
Lazers we apologize for offending you or anything and no ones trying to be rude but it's counter productive to give out completely wrong information and claim you're an expert on the matter, especially to those who are less informed. If someone had stopped reading at your initial comment they might think ENT was moderately competitive which is absurd. It's VERY competitive so just maybe try doing a bit more research before commenting, thanks.
 
lazers said:
General surgery residency is not considered competitive. Plastic Surgery is considered competitive but most who become a plastic surgeon don't go directly into it and do a Gen Surgery residency first. Urology and Orthopedic surgery are considered moderately competitive, ENT is mildly competitive, and ophthalmology is not competitive.
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What? What are you basing this off of? ENT is extremely competitive.
 
So @lazers -- What ARE the most competitive specialties if they're not Plastics, ENT, Urology & Ortho ?
 
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