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[Biscuit799]

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Okay, So I'm a little confused about the competitiveness of Gen Surg. On this board, I hear about how it's tough and only getting tougher, and from what I understand the board scores look up only to Derm and Plastics; however, on Careers in Medicine, it notes only 56% of spots were filled by US Grads. That is much more comparable to Internal Medicine than to Plastics, Derm, or even EM. Am I missing something? Or are the individual programs just that varied (with super-duper ultra competitive top programs and anybody can match please rank us please oh please low end programs)?

 

[pseudoknot]

Median step I 222. Percent of unfilled categorical spots rounds to zero. GS is competitive, for sure. As far as board scores, there are more competitive specialties (plastics, derm, ENT, radonc, rads, ortho).

Per Charting Outcomes '07 I think much more than 56% matched were US grads (812 vs 352*).

* US Seniors vs Independent, but likely a good proxy.

PS If you're too lazy to look this up you probably shouldn't be a surgeon 😉

 

[ddmo]

The fact that the avg board score for general surgery is 222 and the average for the exam is about 217 gives a good indication that for the most part the competitiveness is mostly program dependent. Certain specialties you have to be competitive to match anywhere. Whereas, GS has a high variability in the competitiveness of its programs. For the most part if you are a US grad you can match somewhere in general surgery.

 

[pseudoknot]

Actually, doesn't that average Step I include the (much less competitive) prelim spots? Cause that would make a huge difference...

 

[zeitgeist]

i think that it is highly program dependent. some places get their #1 through #8 (if they have 8 spots) and other places go much farther down their rank list. at those programs that match the top of their list, getting an interview is usually super competitive (<10% of all applicants), and the top of their list is comprised of very successful students (who would be competitive for uro, rad onc, ophtho, ortho, nsgy). but, the MAIN difference, in truth, between GS and urology, for example, is, i think, that there are many many more spots. in uro, for example, they had 400 applicants for 260 spots. you can bet that the top uro applicants were ballers... but you can also bet that you have to be pretty strong just to match. for gs, there are over 1000 spots. so, while you may have to be great to match at a top program, the bar for those who "just want to match" is lower than it is for urology.

 

[Pir8DeacDoc]

Actually, doesn't that average Step I include the (much less competitive) prelim spots? Cause that would make a huge difference...

Most of those spots aren't matched so I would doubt it.

 

[travoltage]

could somebody explain the prelim system?

 

[Winged Scapula]

Careers in Medicine info is outdated. 70% of those matching into General Surgery are US allopathic students. The data tables are available at: http://www.nrmp.org/data/chartingoutcomes2007.pdf

 

[Winged Scapula]

could somebody explain the prelim system?

See the FAQ at the top of the forum for an explanation.

 

[Dr. V]

In 2006 there were over 6000 applications for the 2000 general surgery spots. There was only one spot available for the scramble.

I'd say that's pretty competitive.

Looking only at what percentage are US grads is not a good indicator because many programs will give a deserving prelim a spot in the next years class. Many times those deserving prelims may not be from a US medical school. (Although if I remember correctly in 06 the US grads got 80% or more of the spots).

 

[Biscuit799]

Per Charting Outcomes '07 I think much more than 56% matched were US grads (812 vs 352*).



PS If you're too lazy to look this up you probably shouldn't be a surgeon 😉

Careers in Medicine info is outdated. 70% of those matching into General Surgery are US allopathic students. The data tables are available at: http://www.nrmp.org/data/chartingoutcomes2007.pdf

Ah, makes sense. I was surprised to see that number, so it makes sense that CiM is outdated.

Too lazy to look this up? All my confusion stems from the fact that I did look this up...

 

[-Goose-]

There was only one spot available for the scramble.

This is what really baffles me. Neurosurgery this year had like around a half dozen or so spots available for the scramble and has only a fraction of the PGY1 spots. Crazy.

 

[Dr. V]

"Many" may be a bit of an overstatement, don't you think?

You're probably right.

I know our program as a general rule keeps 1 prelim a year, and has for many years. I know other programs that do the same thing, an audition so to speak. Personally I think this is a good thing as it rewards hard work.

My n= is pretty low though so it could be far fewer programs than I think. It makes sense to do it that way though because you never know what you are going to get in the match (maybe your #1 pick had 250 board scores but is lazy as ****.) This way you know you are getting at least one excellent resident.

This may be more difficult to do at a smaller program (we have 5 categoricals and 4 prelims per year), but it works out great for us and the other programs that I know of that do this (about n=5)

 

[-Goose-]

.

 

[Winged Scapula]

This is what really baffles me. Neurosurgery this year had like around a half dozen or so spots available for the scramble and has only a fraction of the PGY1 spots. Crazy.

This is why it can be difficult to use number of positions available after the match to judge competitiveness. Neurosurgery is probably highly self-selected, so unless you were able to realistically compete with other applicants, you probably aren't going to apply.

 

[Southpaw]

You're probably right.

I know our program as a general rule keeps 1 prelim a year, and has for many years. I know other programs that do the same thing, an audition so to speak. Personally I think this is a good thing as it rewards hard work.

My n= is pretty low though so it could be far fewer programs than I think. It makes sense to do it that way though because you never know what you are going to get in the match (maybe your #1 pick had 250 board scores but is lazy as ****.) This way you know you are getting at least one excellent resident.

This may be more difficult to do at a smaller program (we have 5 categoricals and 4 prelims per year), but it works out great for us and the other programs that I know of that do this (about n=5)

for your program and others like it, if you keep a prelim then are they a pgy-2 the next year or do they have to repeat their intern year? how about for students who use a prelim year to determine what field of surgery they want to go into?

 

[Winged Scapula]

for your program and others like it, if you keep a prelim then are they a pgy-2 the next year or do they have to repeat their intern year?

Depends on the program. Ours went into PGY-2. Our Ortho program however, had them repeat their intern year except in one situation where they put the Prelim into the lab for a year and gave him a Categorical PGY-2 the following year (so that had matched one fewer person the year before to accomodate).

how about for students who use a prelim year to determine what field of surgery they want to go into?

That doesn't make a lot of sense.

Prelim surgery is general surgery without a lot of electives at most places. You cannot spend months doing ENT, Neurosurg, etc to decide what field of surgery you want to go into. In addition, those subspecialties require a certain number of months to be completed on subspecialty rotations. If you end up matching into ENT but did no ENT rotations during your Prelim year, you will either match as a Prelim (having to repeat a designated Prelim intern year) or will have to make up those required rotations at some other point in time (ie, by giving up electives or finishing residency late).

 

[Dr. V]

for your program and others like it, if you keep a prelim then are they a pgy-2 the next year or do they have to repeat their intern year? how about for students who use a prelim year to determine what field of surgery they want to go into?

It depends on the situation.

Sometimes they get a PGY II slot, but that's only if a slot opens up, which is unusual.

So the great majority of the time they repeat PGYI year.

Obviously they are good or you wouldn't be keeping them and you would LIKE to give them a PGYII spot, but there has to be one open first and that is very unusual as most people keep their categorical spots.

 

[Southpaw]

Prelim surgery is general surgery without a lot of electives at most places. You cannot spend months doing ENT, Neurosurg, etc to decide what field of surgery you want to go into. In addition, those subspecialties require a certain number of months to be completed on subspecialty rotations. If you end up matching into ENT but did no ENT rotations during your Prelim year, you will either match as a Prelim (having to repeat a designated Prelim intern year) or will have to make up those required rotations at some other point in time (ie, by giving up electives or finishing residency late).

I see. Thank you, Dr. Cox.

It depends on the situation.

Sometimes they get a PGY II slot, but that's only if a slot opens up, which is unusual.

So the great majority of the time they repeat PGYI year.

Obviously they are good or you wouldn't be keeping them and you would LIKE to give them a PGYII spot, but there has to be one open first and that is very unusual as most people keep their categorical spots.

That makes sense. Thanks for the explanation.