Do you, when applying to residencies, apply to the subspeciality of surgery (neuro, ortho, etc.) and then they put you into the general surgery automatically? Or, do you apply first to general surgery, THEN apply during your first (or second or however many years you need of GS) to the sub- specialty? I think that is a little better.
The fields you have listed (neuro, ortho) along with others (ie, ENT, Uro, etc.) require a Preliminary year of general surgery, usually in a designated preliminary position.
The Neurosurgery match is administered through the San Francisco Match program (
http://sfmatch.org/residency/neurosurgery/index.htm). According to the SF match, since Nsgy is an early match (results in January), you know where you match for the PGY-2 year before the Rank Order List for your PGY-1 position. Many programs which have Nsgy residencies also have designated preliminary intern positions in the general surgery department; you can rank one of these, or spend your first year elsewhere. It will be department dependent as well as up to you. The Neurosurgery Forum here at SDN may be of more assistance to you.
Orthopedics is managed through the NRMP and most residencies provide the preliminary year in the same institution. You may find some help in the SDN Ortho forum as well, or also check out Ortho Residency Ring which is pretty popular (
http://osrr.orthosurg.net/).
So, the general answer is that for all residencies requiring a preliminary year (or more...which is unusual) of general surgery before going on to advanced training is that you apply to BOTH during your FINAL year of medical school. Thus, the PGY-2 spot is applied for TWO years in advance. If you match into a Prelim position but not a PGY-2 advanced training position (for those residencies which do not include it in their own training program), then you have to either go through the match again, which would entail taking a year off or doing another intern year (as you would again be applying for a position TWO years in advance), or hopefully find a PGY-2 position which had opened up (either because someone quit, was fired, died, etc.)
General Surgery spots are reserved for those who wish to complete the full training scheme. Non-designated Prelim general surgery spots are for those who didn't match into a Categorical position (in gen surg or other field) and designated prelim general surgery positions are spots reserved for residents going into the subspecialties offered at that hospital.
In your first post, you inquire about Plastics. Plastic Surgery is a different entity than Nsgy or Ortho. There are two paths...
1) Integrated - in which you apply during your final year of medical school and are matched into a combined general and plastic surgery program. You do not need to apply to either one separately.
2) Independent - the traditional track; you apply during your 4th year of general, ortho or ENT residency for a training program to start after you complete your basic surgical training.
Hope that helps.
