Couple of Questions, MS4 Gen Surg Applicant

[Popular Glen7]

Hey everyone, hoping for some insight, suggestions, etc.


I am at a top 25 (when I matriculated, I don't look anymore) medical school in the southeast (with a very academic surgery dept ) and am applying general surgery this year. I am a pretty good student but not elite by any means:

P/F preclinical
3rd year A-'s in Medicine/Surgery (given clinical honors on evals but letter grade hurt by non-stellar shelfs, and then a mix of A's/A-'s/2 B+'s

239 step 1
262 step 2ck

Some research, a pub, a couple abstracts/poster etc. The usual.

I am just a couple years older, come from a blue collar background before going to school at a slightly later age (im not noticeably old), and have a family. I am not interested in academia so I am not making an app list just based off name/prestige aka my match ideology is not to match into the "best" program I can get but the "best program for me" (reasonably collegial, great clinical training: as in graduating chiefs are ready to go if they don't want to do fellowship, but they get the fellowships they want). THIS EXPLODES PEOPLE'S HEADS. So now, when it's *not* all based on perceived tiers that we all discuss ad nauseum, it has been harder to come up with my list; because 95% of my classmates are only interested in the most elite match they can get regardless of anything else (whether they even want to do academics or not). I find myself a bit alone in navigating my program list. Same for faculty: they all suggest the other major academic programs.

I want to apply to a mix of not-quite-as-hardcore-academic-and-can-finish-in-5-if-you-want university programs and also university affiliated programs. We would really like to be in NYC but for as much as I have heard about Mt. Sinai (main teaching site) and St. Lukes-Roosevelt (I think these might be two great examples of the two flavors of programs I am into) I have no idea if I am competitive for either one. I have heard big Mt. Sinai likes monster Step 1's so my 239 might hurt. St. Lukes I have no clue. But I digress.

More than anything, what are some of the respected university affiliated programs? I have been told St. Lukes is good, as I said, and have heard similar things about Carolinas down in Charlotte. But those are the two that people keep telling me. Can anyone add some more? On Freida I obviously can see the list of programs but I don't know how most of these non-big university programs stand. Basically- non-hardcore-academic/academic affiliate/community programs popular with applicants who are still good applicants.

Any discussion is helpful- thanks! It's not so much a WAMC, which is fine to comment on, but a where do I even start.

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[ThoracicGuy]

Hey everyone, hoping for some insight, suggestions, etc.


I am at a top 25 (when I matriculated, I don't look anymore) medical school in the southeast (with a very academic surgery dept ) and am applying general surgery this year. I am a pretty good student but not elite by any means:

P/F preclinical
3rd year A-'s in Medicine/Surgery (given clinical honors on evals but letter grade hurt by non-stellar shelfs, and then a mix of A's/A-'s/2 B+'s

239 step 1
262 step 2ck

Some research, a pub, a couple abstracts/poster etc. The usual.

I am just a couple years older, come from a blue collar background before going to school at a slightly later age (im not noticeably old), and have a family. I am not interested in academia so I am not making an app list just based off name/prestige aka my match ideology is not to match into the "best" program I can get but the "best program for me" (reasonably collegial, great clinical training: as in graduating chiefs are ready to go if they don't want to do fellowship, but they get the fellowships they want). THIS EXPLODES PEOPLE'S HEADS. So now, when it's *not* all based on perceived tiers that we all discuss ad nauseum, it has been harder to come up with my list; because 95% of my classmates are only interested in the most elite match they can get regardless of anything else (whether they even want to do academics or not). I find myself a bit alone in navigating my program list. Same for faculty: they all suggest the other major academic programs.

I want to apply to a mix of not-quite-as-hardcore-academic-and-can-finish-in-5-if-you-want university programs and also university affiliated programs. We would really like to be in NYC but for as much as I have heard about Mt. Sinai (main teaching site) and St. Lukes-Roosevelt (I think these might be two great examples of the two flavors of programs I am into) I have no idea if I am competitive for either one. I have heard big Mt. Sinai likes monster Step 1's so my 239 might hurt. St. Lukes I have no clue. But I digress.

More than anything, what are some of the respected university affiliated programs? I have been told St. Lukes is good, as I said, and have heard similar things about Carolinas down in Charlotte. But those are the two that people keep telling me. Can anyone add some more? On Freida I obviously can see the list of programs but I don't know how most of these non-big university programs stand. Basically- non-hardcore-academic/academic affiliate/community programs popular with applicants who are still good applicants.

Any discussion is helpful- thanks! It's not so much a WAMC, which is fine to comment on, but a where do I even start.

First you should think about what you want to do. If you know you only want to do private practice/community based general surgery, you can look at the range of program types. If you know you want a fellowship in something competitive, you should only look at university programs. If you are interested in maybe some noncompetitive, then university and university affiliated programs would be options. If you aren't sure what exactly you might want at the end of your five years of training, then you certainly can't go wrong with a university program. If you look at university programs, there's a wide range of programs out there of different rankings and quality. Second, you should narrow down what areas of the country that you want to possibly live for the next 5+ years. After you do that, you can put together the two to see what programs are out there. You mention both NYC and Charlotte as possible areas which are both very different places to live. Does your spouse need a certain area for a job?

So once you can narrow things down a bit like that, we might be able to have some more thoughts for you on it. It sounds like you're looking at mid-tier university and university affiliated programs, just narrow down that location a bit for us if possible.

 

[Popular Glen7]

Thank you so much for your thoughtful reply.

My goal is to be a community based general surgeon and I envision myself doing one or two 1 year fellowships in something complimentary i.e. colorectal, MIS, critical care, etc.

My wife works/has licenses as both a teacher and school administrator so hopefully she can be flexible as those opportunities exist to some degree throughout the country?

We are most interested in the northeast (NYC/Boston/other New England) and parts of the southeast (particularly NC/VA), although open to essentially all of the East coast. I know I haven't been on the trail yet so I want to be open minded: for instance, I was told by a recent UAB grad (and now fellow at my home) (and who knows my goals) whose service I clerked on that I would fit in well there and should apply--so good example = I never previously considered moving to Alabama (and UAB at the time not on my radar) but I suppose I would happily go if I apply, get an interview, love it, etc.

To apply enough places I certainly may have to look Midwest, but not a top choice. No west coast.

If you or anyone else do have suggestions feel free (only if you wish) to speculate on if I am a reasonable applicant for the program--I do want to try and keep a balanced application with plenty of appropriate choices; a handful of reaches is fine but again that is not my main goal.

 

[ThoracicGuy]

Thank you so much for your thoughtful reply.

My goal is to be a community based general surgeon and I envision myself doing one or two 1 year fellowships in something complimentary i.e. colorectal, MIS, critical care, etc.

My wife works/has licenses as both a teacher and school administrator so hopefully she can be flexible as those opportunities exist to some degree throughout the country?

We are most interested in the northeast (NYC/Boston/other New England) and parts of the southeast (particularly NC/VA), although open to essentially all of the East coast. I know I haven't been on the trail yet so I want to be open minded: for instance, I was told by a recent UAB grad (and now fellow at my home) (and who knows my goals) whose service I clerked on that I would fit in well there and should apply--so good example = I never previously considered moving to Alabama (and UAB at the time not on my radar) but I suppose I would happily go if I apply, get an interview, love it, etc.

To apply enough places I certainly may have to look Midwest, but not a top choice. No west coast.

If you or anyone else do have suggestions feel free (only if you wish) to speculate on if I am a reasonable applicant for the program--I do want to try and keep a balanced application with plenty of appropriate choices; a handful of reaches is fine but again that is not my main goal.

Colorectal is becoming more and more competitive these days. @SLUser11 could give more insight from that area. MIS and Trauma/CC are not as hard to get and should be open to people coming from most any program these days.

Your step scores are pretty competitive for alot of programs, particularly that 262 Step 2 score. Another consideration when looking is if you want a large, medium, or small program. Programs can range from 1-2 residents up to 13 or more residents. Does that matter for you? Different sizes have different pros and cons to them.

 

[SouthernSurgeon]

A few thoughts

1. I think as much as you criticize your classmates for seeking out prestige above all else, you sound like you are at risk of taking the opposite extreme - assuming there is something "wrong" with university based programs and that you can find superior training at a lesser-known communiversity or community program. Sometimes a known quantity is actually a good thing - i.e. don't be so quick to dismiss the programs that your advisors can recommend and are familiar with. Seeking out a diamond in the rough might lead you too far out in the weeds.

2. University program means a lot of different things. There are a lot of university programs with strong clinical training and some but not a ton of research (i.e. if you want no part of it, that's fine). You don't have to apply to the UCLA/Michigan/UCSF/Hopkins of the world where it's basically a mandatory seven years. There is a spectrum.

3. It sounds like you need to do a lot more research into programs. Period. You say you're at a top 25 school in the south, and you'd never thought of UAB? They are one of the best schools in the south and a highly regarded program with a long history. Do some more digging. In this regard, I would also encourage you to try and develop some more contacts/advising relationships at your school. A top school with an academic department should have some well connected people who can help you.

4. Re: NYC. Lots has been written here about the various NY programs and some of the pros and cons of training in new york in general. I suggest searching some of @thedrjojo 's posts on this forum as he has written at length on this. I have some anecdotal concerns about Sinai; I know next to nothing about St. Luke-Roosevelt.

5. Re: Fellowship. I would echo @ThoracicGuy 's advice. Make sure you aren't closing any doors prematurely. See the threads on this forum on fellowship matching - 63% match rate for MIS this year. CRS very competitive as well.

 

[thedrjojo]

There are far better options in the Nyc area for being able to practice coming straight out. In fact, between sinai and Cornell, I'm not sure which one has the worst reputation in that regard. NYU is probably the best, with Einstein, Downstate (which is bad for other reasons), and Columbia as other options within Nyc, and Rutgers Newark (Homer alter, as this is my program) another program that you definitely can practice straight from residency.

5 years ago, you would have been below the average step 1 score at the sinai interview (they posted it at like 245 iirc).

 

[Popular Glen7]

Thank you all for thoughtful replies. I certainly took all of your advice and wisdom to heart. I have decided to be much more open minded about university programs in general, and the prospect of formal research should it come up. To put it simply: you guys are right about keeping doors open and about not knowing what kind of opportunities could come out of doing so. I was able to meet with my advisor (who is also PD) this past week and we came up with an initial list of programs to apply to that represent a spectrum of competitiveness, and are a bit colored by institutional and personal relationships, as these things can be. If anyone feels any of these programs are way way out of reach (and a few are admittedly serious reaches) or poor choices for some other reason--as well as any additional program suggestions--comments are welcomed.

UAB
U of Colorado
UCONN
Georgetown
GW
Emory
Medical College of Georgia
Rush
UIChi
Loyola
Tulane
Maine medical center
Tufts
BU
Lahey Clinic
Dartmouth
Mt. Sinai Beth Israel
Mt. Sinai
St. Lukes-Roosevelt
NYU
Cornell
Carolinas Medical Center
UNC
Wake Forest
U of Oregon
Temple
Jefferson
Brown
MUSC
Vanderbilt
UVA
VCU
EVMS
Penn state
Ohio state
Stony Brook

 

[doc05]

I have suggested this before: talk to mentors at your home program. apply where they have contacts. this will help you (1) get "real" information about programs; (2) match where you want, because so much comes down to who makes a phone call on your behalf.

 

[thedrjojo]

Thank you all for thoughtful replies. I certainly took all of your advice and wisdom to heart. I have decided to be much more open minded about university programs in general, and the prospect of formal research should it come up. To put it simply: you guys are right about keeping doors open and about not knowing what kind of opportunities could come out of doing so. I was able to meet with my advisor (who is also PD) this past week and we came up with an initial list of programs to apply to that represent a spectrum of competitiveness, and are a bit colored by institutional and personal relationships, as these things can be. If anyone feels any of these programs are way way out of reach (and a few are admittedly serious reaches) or poor choices for some other reason--as well as any additional program suggestions--comments are welcomed.

UAB
U of Colorado
UCONN
Georgetown
GW
Emory
Medical College of Georgia
Rush
UIChi
Loyola
Tulane
Maine medical center
Tufts
BU
Lahey Clinic
Dartmouth
Mt. Sinai Beth Israel
Mt. Sinai
St. Lukes-Roosevelt
NYU
Cornell
Carolinas Medical Center
UNC
Wake Forest
U of Oregon
Temple
Jefferson
Brown
MUSC
Vanderbilt
UVA
VCU
EVMS
Penn state
Ohio state
Stony Brook

I'm going to again plug my program (Rutgers New Jersey Medical School). I think we match all of your original comments of what you want and I'd put us (as far as prestige or competitiveness) in the middle of your list. You can PM me if you want to ask some specific questions or anything.

 

[mikeGR]

Talking about plugging programs...
- community-based, university-affiliated program in DC based on a >900 bed hospital (~30 ORs, ~70 SICU beds, Level 1 Trauma)
- each year some of the residents go straight to private practice
- 2 of 5 residents per year are doing elective research year(s)
- last year 2 of 5 chiefs went to private practice, 3 to fellowship (Colorectal @ UPenn, Cardiothoracic @ UCLA, Plastics @ UTSW)
- in house Trauma/CC, CRS, Vascular, Breast fellowships

Washington Hospital Center in DC. You can PM me for more details (see http://forums.studentdoctor.net/threads/washington-hospital-center-avoid.241527/#post-15868459 for more info).