General Surgery getting more competitive

[Mr Cookie Pants]

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Newest charting outcomes has 205 US seniors go unmatched, with the average matched Step 1 being 227 (creeping up). General surgery had the highest overall # of people go unmatched, for an overall 80% US Senior match rate (830/1035).

As hours get better for Surgeons (floats, restrictions) and some of the boutique specialties see their money pools drying up, I anticipate GS will become more competitive every year. A cool specialty that has a high price floor for minimum salary, a stable future*, many subspecialties available, with better hours coming to a location near you...

*at least for the specialists or the rural GS people.

http://www.nrmp.org/data/chartingoutcomes2011.pdf

 

[ComfortableWolf]

Are attending lifestyles really improving overall? No work hour restrictions for an attending building a practice. Perhaps for "surgical hospitalists.

Better residency hours early on may mean you are destined to be forced into a fellowship to compensate for lost operative time/confidence...?

 

[Tig2575]

"Boutique" specialties?

 

[SLUser11]

Newest charting outcomes has 205 US seniors go unmatched, with the average matched Step 1 being 227 (creeping up). General surgery had the highest overall # of people go unmatched, for an overall 80% US Senior match rate (830/1035).

As hours get better for Surgeons (floats, restrictions) and some of the boutique specialties see their money pools drying up, I anticipate GS will become more competitive every year. A cool specialty that has a high price floor for minimum salary, a stable future*, many subspecialties available, with better hours coming to a location near you...

*at least for the specialists or the rural GS people.

http://www.nrmp.org/data/chartingoutcomes2011.pdf

To be honest, people have been saying surgery is "getting more competitive" every year for the last 6 years, but I'm unsure how much it has really changed.

When I have more time, I'll look at the NRMP charts in more detail, but I know we've discussed this before. In reality, there has been only minor variation in competitiveness over the last 6 years, but it is still much more competitive than it was prior to the 2003 ACGME work hour restrictions.

The Step 1 scores are going up, but so is the national mean for Step 1. Students have better study resources, and are figuring out the test. When I was in school, the average for US allos was 215-217. A 230 is still a good score, but it is much more common than it was 10 years ago.

Another thing to consider is self-fulfilling prophecies. Students are told that the specialty is more competitive, so they apply to more programs...then these programs see an increase in the quality and quantity of their applicants, and decide that things are getting more competitive.

When I have more time, I'll find the old thread.

 

[KinasePro]

Newest charting outcomes has 205 US seniors go unmatched, with the average matched Step 1 being 227 (creeping up). General surgery had the highest overall # of people go unmatched, for an overall 80% US Senior match rate (830/1035).

As hours get better for Surgeons (floats, restrictions) and some of the boutique specialties see their money pools drying up, I anticipate GS will become more competitive every year. A cool specialty that has a high price floor for minimum salary, a stable future*, many subspecialties available, with better hours coming to a location near you...

*at least for the specialists or the rural GS people.

http://www.nrmp.org/data/chartingoutcomes2011.pdf

Could you elaborate on the bolded text? Are there many (any?) viable career opportunities for general surgeons in desirable locations if they don't specialize?

 

[45408]

To be honest, people have been saying surgery is "getting more competitive" every year for the last 6 years, but I'm unsure how much it has really changed.

It's probably variable based on your location. I know for a fact that the year that I applied for residency, the match at my home program and current program were much more competitive than the year prior. Neither program reached as far as they had the year before on their rank lists to fill all of the slots.

So I get on SDN and say it's more competitive. The next year, some guy has the same thing happen by him, and he says the same thing. It might just be ebb and flow, and the people don't think to comment "Gee, the match was super easy. I'm fairly unqualified and I got into my top choice!"

 

[Mr Cookie Pants]

Could you elaborate on the bolded text? Are there many (any?) viable career opportunities for general surgeons in desirable locations if they don't specialize?

True GS (beyond lump and bump, appe/choles) in major metropolitan areas is almost a thing of the past. Too many specialists around. I have a GS friend of my dad that's been practicing since the 70s. He (all GS) used to do CEA, AAA, etc before vascular was around. The little of this, little of that General surgeon a) doesnt get trained as much (fellows take the cases or your hosp doesn't do them) and b) doesn't have the opportunity in regular practice to do the specialty stuff.

So IMO, GS in an urban area FOR A NEW GRAD is a tough proposition.

 

[SLUser11]

It's probably variable based on your location. I know for a fact that the year that I applied for residency, the match at my home program and current program were much more competitive than the year prior. Neither program reached as far as they had the year before on their rank lists to fill all of the slots.

So I get on SDN and say it's more competitive. The next year, some guy has the same thing happen by him, and he says the same thing. It might just be ebb and flow, and the people don't think to comment "Gee, the match was super easy. I'm fairly unqualified and I got into my top choice!"

I forgot to mention that general surgery is not the only specialty on SDN to get "more competitive this year" every year. Similar threads have popped up for ER, OBGYN (really?), Anesthesia, etc.

Here's an old thread I started to discuss the topic along with some cold hard facts.

 

[Smurfette]

I think it depends on what you are looking for as general surgery (vascular? CT?) and where you think is desirable. If only NYC or LA is acceptable, that's very different job market than big urban areas with cities of 4-500K+ (which still generally have metro areas over a million). Keep in mind that many cities have good jobs in the suburbs as well so you still get the urban amenities. I agree that vascular is usually not part of GS in urban areas, at least for recent grads.

Several people from my GS program who didn't do fellowships got jobs (right out of residency) in top 5 population cities (chicago, houston). If you expand that to top 20 cities, I can add several more to the list. And this is within the last 4 years. They found some good groups to join, but they were very aggressive about applying and looking for positions. It depends on what your view of a desirable place to live is.

I DO think that the crappy economy is making the job market tougher right now; lots of docs are putting off retirement and waiting to regain $$ lost when the markets crashed. When I was job hunting several recruiters told me their "open positions" were drastically down from 5 years ago and there was less 'movement in the market' FWIW, or that Dr. so-and-so had been planning to retire but decided to wait for now, making it harder to plan for openings.

 

[SLUser11]

So IMO, GS in an urban area FOR A NEW GRAD is a tough proposition.

Just to echo what Smurfette said, I'm in Houston, which is a very large city (?#5) that is well-known for its surgical specialists. That being said, I've seen plenty of young general surgeons here, some in their first year of practice, that are very busy.....and it's not just lumps and bumps.

 

[Winged Scapula]

Just to echo what Smurfette said, I'm in Houston, which is a very large city (?#5) ...

Houston - # 4; Phoenix - #5