For those that want plastics, how do you handle GS interviews?

[slowthai]

So for the people that want to do plastics and have subzero interest in general surgery but don't have the app for integrated (or are using it as a backup), how do you answer "Why general surgery?" on interviews?

Do you just lie and say "General surgery is the greatest field on the planet. I couldn't imagine myself doing anything else. I was born for this."

Or do you say, "Let's cut the crap. I'm here for one reason and one reason only; to become a plastic surgeon. This is nothing more than a stepping stone. Capisce?"

Or do you say, "I like problem solving and working with my hands. I believe that I can have the greatest impact in medicine as aᵖˡᵃˢᵗᶦᶜ surgeon."

Please don't take this too seriously, I'm just having fun with this, lol

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[ACSurgeon]

So for the people that want to do plastics and have subzero interest in general surgery but don't have the app for integrated (or are using it as a backup), how do you answer "Why general surgery?" on interviews?

Do you just lie and say "General surgery is the greatest field on the planet. I couldn't imagine myself doing anything else. I was born for this."

Or do you say, "Let's cut the crap. I'm here for one reason and one reason only; to become a plastic surgeon. This is nothing more than a stepping stone. Capisce?"

Or do you say, "I like problem solving and working with my hands. I believe that I can have the greatest impact in medicine as aᵖˡᵃˢᵗᶦᶜ surgeon."

Please don't take this too seriously, I'm just having fun with this, lol

If you don’t do integrated plastics, general surgery training will be the foundation of your surgical knowledge and skills. You will learn how to handle tissue. You will learn how to assist in the OR and lead an operation, get exposure etc. you’ll do a lot of trauma (which will be a part of plastics training for hand/face call). You’ll do a lot of breast surgery. You’ll do soft tissue debridement (ie create the defects that you’ll later have to learn how to cover.

Some of this is a mindset. I can understand you having subzero interest in working a general surgeon in the future. If you’re set on plastics but can’t go the integrated route, general surgery training as a stepping stone should be something you have a lot of interest in. After all, 2-3 years in a plastics fellowship won’t be enough training without extensive surgical training before that.

I’m clearly not addressing the caveat that doing general surgery knowing you’d be miserable as a general surgeon if you couldn’t get a plastics fellowship is risky but that’s not the question you’re asking.

So how do you “spin it”? You emphasize the skills and knowledge you’ll gain in general surgery training as crucial to becoming a talented surgeon of whatever specialty you chose.

 

[Matthew9Thirtyfive]

Not feeling great about step, huh?

 

[FindersFee5]

So for the people that want to do plastics and have subzero interest in general surgery but don't have the app for integrated (or are using it as a backup), how do you answer "Why general surgery?" on interviews?

Do you just lie and say "General surgery is the greatest field on the planet. I couldn't imagine myself doing anything else. I was born for this."

Or do you say, "Let's cut the crap. I'm here for one reason and one reason only; to become a plastic surgeon. This is nothing more than a stepping stone. Capisce?"

Or do you say, "I like problem solving and working with my hands. I believe that I can have the greatest impact in medicine as aᵖˡᵃˢᵗᶦᶜ surgeon."

Please don't take this too seriously, I'm just having fun with this, lol

I think the move in this case is to blatantly hide your interest, especially if you're not dual-applying and the rest of your application doesn't scream PLASTICS. A lot of program directors will assume you're applying gen surg as a backup if you make your interest in plastics too obvious. If you're only applying gen surg, the less plastics specific stuff the better, probably. You can get enough research in 6 and 7 year programs to match fellowships if you're coming from a decent program (although the fellowship match is getting smaller and smaller, so it's still a pretty high risk proposition if you really hate general surgery).

People dual applying with good step scores and plastics specific research are going to have a harder time hiding it. I think in these cases, you do need to be honest, and also have a better explanation for why you're dual applying than "risk management." For instance, you could say you really needed to be in a specific region of the country for family reasons and would rather do a general surgery residency in that region than a plastics residency elsewhere.

 

[slowthai]

Not feeling great about step, huh?

Fingers crossed I won't be pulling a failedatlife ortho version this time next year loool. Gotta hope for the best but plan for the worst.

 

[slowthai]

So how do you “spin it”? You emphasize the skills and knowledge you’ll gain in general surgery training as crucial to becoming a talented surgeon of whatever specialty you chose.

Yeah, this is exactly what I had in mind; it allows you to be nonspecific/vague about your plastics focus while still showing that you'd like to gain all there is to gain from a surgical residency.

I think the move in this case is to blatantly hide your interest, especially if you're not dual-applying and the rest of your application doesn't scream PLASTICS. A lot of program directors will assume you're applying gen surg as a backup if you make your interest in plastics too obvious. If you're only applying gen surg, the less plastics specific stuff the better, probably. You can get enough research in 6 and 7 year programs to match fellowships if you're coming from a decent program (although the fellowship match is getting smaller and smaller, so it's still a pretty high risk proposition if you really hate general surgery).

I agree with this approach. Yeah, it's interesting how the independent pathway is getting phased out. The integrated pathway will become even more competitive, which is just insane.

For the record, I would just do DR if I couldn't do ortho for whatever reason. I just like to think through hypotheticals like this. In the off chance I fell in love with plastics during third year, I'd at least have a plan of attack.

 

[longhaul3]

I do have a question - I'm applying general surgery but did research in three subtypes of general surgery - endocrine, colorectal, and plastics. I am interested in plastics as a fellowship... but my other two (despite starting the projects at the same time) were not as productive as the plastics research. so now i have a BUNCH (10 fml) of plastics publications and just submitted endocrine/colorectal with one abstract published in colorectal. How do I defend this in the interview process? for the record, I have never taken a plastics rotation at school - all of them were community, colorectal, endocrine, and surg onc.
don't have a great step score (mid-230s), but am in the top quartile of the class and honored 4/5 rotations (including surgery). my letters are coming from colorectal and surg onc. i've never done a plastics rotation and my transcript will reflect this hahahha.

Why are you upset that you have 10 plastics pubs? That makes no sense. Just say you're involved in research in a few different areas of GS and have been most productive in plastics.

Your med school transcript will be part of your ERAS application. If you've never done a plastics rotation but have done all these GS rotations, it will be obvious you're not applying integrated plastics.

 

[FindersFee5]

Because of this post lol. I didn't realize it was a red flag till I read this thread. I thought it was a good thing to have as much research as possible. Thank you! That makes me feel better. I knew from the get-go I wasn't competitive for plastics, but wanted to get as much research experience as I could to be competitive. I appreciate it.

Not doing the plastics rotation + no plastics letters + mostly pre-step 1 plastics research makes this not a concern for you. At worst, PDs will think that you initially wanted plastics but decided to switch to gensurg after you got your step 1.

 

[efle]

It is so confusing to me that any surgeon's backup plan is DR

 

[slowthai]

It is so confusing to me that any surgeon's backup plan is DR

1. Applied anatomy, similar to surgery

2. Pure medicine; minimal BS

3. A better lifestyle and potentially similar pay

You have to understand that for me, the goal isn't to be a surgeon; it's to be an orthopod. Any other surgical field, especially GS, is not worth the follow through for the cost. It's just not. If you can't do what you love, you try to do something you can enjoy/tolerate with a significantly better lifestyle. That's not to say DR's a lifestyle specialty, because it's not. But it's still relatively better than a surgical specialty.

 

[efle]

1. Applied anatomy, similar to surgery

2. Pure medicine; minimal BS

3. A better lifestyle and potentially similar pay

You have to understand that for me, the goal isn't to be a surgeon; it's to be an orthopod. Any other surgical field, especially GS, is not worth the follow through for the cost. It's just not. If you can't do what you love, you try to do something you can enjoy/tolerate with a significantly better lifestyle. That's not to say DR's a lifestyle specialty, because it's not. But it's still relatively better than a surgical specialty.

Huh, I guess since general surg, ENT and plastics all seemed much more similar to me than different (and all a world apart from Rads) I'm surprised that someone would love the OR in one but not much like it in others

 

[slowthai]

Huh, I guess since general surg, ENT and plastics all seemed much more similar to me than different (and all a world apart from Rads) I'm surprised that someone would love the OR in one but not much like it in others

These fields are all very very different from each other. As for ortho, it's a completely different kind of mindset/approach. It's very mechanical and mathematical.

 

[T687]

It is so confusing to me that any surgeon's backup plan is DR

Not to derail too much, but my top 2 are ortho and rads and this is normally the response I get when I tell people that so I would agree with slowthai and add a few points:

1. I like physics more than I like chemistry.

2. I want to solve a problem and move on to the next one. Both specialties have the option to pump through cases without the same kind of longitudinal care and relationships that other surgical sub-specialties might necessitate, and your ability to truly solve your problem (fix with surgery/procedure or diagnose and move on) is more regular/reliable than other specialties.

3. Both are "whole body" specialties that have a huge variety of sub-specializations. To me, the difference between joint replacements vs. hand or NIR vs. musculoskeletal is much larger than choosing which meat sack in the abdomen you want to deal with.

That's all based on my own perception and experiences, but I think it helps explain why ortho in particular tends to have people that choose rads over other surgical specialties.

 

[OnePunchBiopsy]

So how do you “spin it”? You emphasize the skills and knowledge you’ll gain in general surgery training as crucial to becoming a talented surgeon of whatever specialty you chose.

This.

I didn’t know I wanted to do Plastics until the middle of my PGY-2 year. It’s not because I hate general surgery, quite the contrary, I just want to do more types of surgery (mostly recon).

If you have to apply GS, just think of plastics as one of the many fellowships that are possible after graduating. Specialties like vascular, breast oncology, and endocrine surgery don’r primarily operate in the abdomen.

Now, how do you interview for GS?
While some may say you should be fully upfront about your potential intention to do a GS to Plastics fellowship path, I wouldn’t. This would create doubt about your commitment to the specialty. What would stop you from getting 1-2 years into GS then moving to an integrated plastics program? A false notion among some general surgeons is that graduates go into plastics because of lifestyle alone, would that translate into a resident with less work ethic? Obviously not, but this notion is more prevalent among general surgeons than you may think.

Overall, if in an interview setting, just say you’re interested in a fellowship but are open to figuring out which one as you progress.

 

[Neopolymath]

Unfortunately, just like med school interviews, the best course is to be vague/lie because the system is set up to punish honest people.

 

[ACSurgeon]

Seems like the OP wants ortho and not even that sure about plastics, and would prefer DR over GS.

I wonder if this would be a scenario where applying ortho alone with prelim GS—>DR as back up plan makes more sense.

 

[Neopolymath]

Seems like the OP wants ortho and not even that sure about plastics, and would prefer DR over GS.

I wonder if this would be a scenario where applying ortho alone with prelim GS—>DR as back up plan makes more sense.

I'm pretty sure my dude just made this thread for conversation. He is gunning for Ortho, Sattar willing, if his Step 1 is good haha. "Please don't take this too seriously, I'm just having fun with this, lol"

 

[slowthai]

Seems like the OP wants ortho and not even that sure about plastics, and would prefer DR over GS.

I wonder if this would be a scenario where applying ortho alone with prelim GS—>DR as back up plan makes more sense.

Yeah, this is definitely a path I've been seriously considering, but I would probably do a TY before DR if I could swing it. If not, then IM prelim before DR. I don't want the hell of GS for even a week, lol.

I'm pretty sure my dude just made this thread for conversation. He is gunning for Ortho Sattar willing his Step 1 is good haha. "Please don't take this too seriously, I'm just having fun with this, lol"

Looool. Yes, Sattar willing lol. It's definitely some of both haha.

 

[slowthai]

Gun to my head, I'd pick plastics as the only other surgical sub I'd be willing to do because it's an amazing field and I can kind of maybe see myself doing it. But I won't be able to fully rule it out/in until third year. Same with ortho, even.

 

[ACSurgeon]

I'm pretty sure my dude just made this thread for conversation. He is gunning for Ortho, Sattar willing, if his Step 1 is good haha. "Please don't take this too seriously, I'm just having fun with this, lol"

And I’m conversing. Not taking “too seriously”, but trying to give advice that might become useful one day. Nothing better to do while spending a long weekend at the in laws.

 

[Neopolymath]

And I’m conversing. Not taking “too seriously”, but trying to give advice that might become useful one day. Nothing better to do while spending a long weekend at the in laws.

"Hmmmm, you have been on your phone for work for an awfully long time this weekend." haha