Easier path for DO: GS -> CT or IM -> CVD -> IC

[Mitral_Prolapse]

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Title kinda sums it up. I don't mean for this to come as some starry eyed med student already thinking about being some ultra specialist, but if someone loves heart and surgery/procedures what would be more realistic coming from the DO side of things as the merger and everything going on right now? I know CT fellowships have started dying off in competitiveness a bit in favor of the integrated path and feel like everyone and their mother wants to hop on the interventional train. What are some thoughts by those who have done/considering some of these fields?

 

[putmeincoach]

Both are doable with the right app. There's differences tho as one is more medical and the other surgical. So figure out what you love more and do what you gotta do to get a spot. Best of luck!

 

[AnatomyGrey12]

Decide if you want to do surgery or not and go from there. Both are possible, don't just pick one because you think it will be easier to get to.

 

[Lexdiamondz]

Both are fairly competitive from either route and you shouldn't pick one or the other based off of the assumption that you will successfully obtain a fellowship. Decide whether or not you're willing to potentially have a career as strictly a general surgeon or strictly an internist/hospitalist first

 

[InternistDO]

I'm going to disagree a little bit with everyone and say that as a DO, getting a decent academic IM position is much much easier than getting a general surgery position, especially a GS spot that will set you up for fellowship. Only 55% of DOs applying ACGME surgery matched in 2018 (the last charting outcomes), while like 90% of those who applied IM did.

Scanning over my class match list, about half of the people going into IM are at academic or strong community programs that send people into cardiology fellowships every year. Conversely only two people matched GS, both at small, former AOA programs which would not leave you set up well for getting a CT spot. This has been fairly consistent over the last few years.

Now, if you love surgery I'm not saying don't go for it--other schools have a better surgery match than mine, I'm sure--and its worth giving it a shot if its what you want to do. But it will be harder than getting an internal medicine spot at a decent academic program.

 

[Mitral_Prolapse]

Decide if you want to do surgery or not and go from there. Both are possible, don't just pick one because you think it will be easier to get to.

Both are doable with the right app. There's differences tho as one is more medical and the other surgical. So figure out what you love more and do what you gotta do to get a spot. Best of luck!

Definitely much rather be a surgeon than internal medicine!!!

 

[Mitral_Prolapse]

I'm going to disagree a little bit with everyone and say that as a DO, getting a decent academic IM position is much much easier than getting a general surgery position, especially a GS spot that will set you up for fellowship. Only 55% of DOs applying ACGME surgery matched in 2018 (the last charting outcomes), while like 90% of those who applied IM did.

Scanning over my class match list, about half of the people going into IM are at academic or strong community programs that send people into cardiology fellowships every year. Conversely only two people matched GS, both at small, former AOA programs which would not leave you set up well for getting a CT spot. This has been fairly consistent over the last few years.

Now, if you love surgery I'm not saying don't go for it--other schools have a better surgery match than mine, I'm sure--and its worth giving it a shot if its what you want to do. But it will be harder than getting an internal medicine spot at a decent academic program.

This was my concern, it would be far harder I think to break into surgery than medicine. The former AOA surgery spots I don’t think are impossible but none have CT fellowships.

 

[AnatomyGrey12]

Definitely much rather be a surgeon than internal medicine!!!

Then work for general surgery.

This was my concern, it would be far harder I think to break into surgery than medicine. The former AOA surgery spots I don’t think are impossible but none have CT fellowships.

Harder to get into yes, but if you would rather be a surgeon than a hospitalist then I don't really see why you would go for medicine->cards route if it's not really what you want to do. General surgery is competitive, but it's not to the same level as the surgical subs. Also, CT isn't on the same level as Surg Onc, Peds, or even Plastics in terms of fellowship competitiveness. Of course it does increase a bit each year, but that's just the natural ebb and flow of fellowship competitiveness and it's currently on an upswing. CT surgery is a possible match even from the former AOA programs, we have a senior that matched CT at Brigham and Women's this year. Getting into any general surgery residency will allow you to go into fellowship, albeit maybe not the forementioned super competitive ones like peds or onc, it will just come down to how much you want it and work for it.

Bottom line, don't pick medicine just because it's easier. If you want to be a surgeon then work your butt off to be a surgeon.

 

[Mitral_Prolapse]

Then work for general surgery.


Harder to get into yes, but if you would rather be a surgeon than a hospitalist then I don't really see why you would go for medicine->cards route if it's not really what you want to do. General surgery is competitive, but it's not to the same level as the surgical subs. Also, CT isn't on the same level as Surg Onc, Peds, or even Plastics in terms of fellowship competitiveness. Of course it does increase a bit each year, but that's just the natural ebb and flow of fellowship competitiveness and it's currently on an upswing. CT surgery is a possible match even from the former AOA programs, we have a senior that matched CT at Brigham and Women's this year. Getting into any general surgery residency will allow you to go into fellowship, albeit maybe not the forementioned super competitive ones like peds or onc, it will just come down to how much you want it and work for it.

Bottom line, don't pick medicine just because it's easier. If you want to be a surgeon then work your butt off to be a surgeon.

Thank you!!! At the moment that sounds like more of the path I would prefer to go down so I’ll just keep plugging along

 

[InternistDO]

Thank you!!! At the moment that sounds like more of the path I would prefer to go down so I’ll just keep plugging along

Yeah, despite my doom and gloom post, if you wanna be a surgeon you should go for it. If you're reasonably competitive for a surgical spot and you fail to match, you should be in a competitive enough position to slide into IM as a backup anyway (though hopefully that wouldn't happen).

Also, idk how far along in school you are but keep an open mind. I thought surgery was going to up there with EM for my top two specialties and instead I'm going into internal medicine. Turns out I hated the OR, whoops.

 

[AlteredScale]

If you don’t like the idea of rounding for a good set of your time. You really shouldn’t consider the internal medicine pathway.


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