but even though any of the general surgery applicants that fail to match in to CT directly can go and do a dedicated 1 year research, get involved into the CT community and family and match next time.
So yes and no. There is still no guarantee you will match even after a 1 year research year. There are a ridiculous amount of overqualified candidates now for a very limited number of spots. Why should a program take someone who didn't match the first time around for whatever reason, when there are plenty of PGY 4's that are already involved with the CT community, have done dedicated CT research, etc etc? The applicant pool is absurdly impressive now a days.
We all know that all this goes down to "who knows you"
Agreed. Having a well known CT surgeon that will make a phone call for you (not just write a letter) is probably one of the most important things in applying. That can fix almost any red flag.
What I am saying is that if the person is "clever enough" in the real life and gets along with people, holding a general surgery licence is a guarantee to match CT maybe not from the first time.
In the current era, it is definitely NOT a guarantee. If anything, you are still behind the 8 ball because there was a reason you didn't match the first time around and programs are going to be looking for those red flags.
Is not a 5 year spent in general surgery enough to build a great CT application, know people, attend every single year the STS meetings instead of cruising on ships and partyiing 4 weeks a year? Of course if you are from middle tier program and decided to match into CT in your 5th year, probably you would not, as I know this is very small specialty and everyone knows everyone. This all is very logical, and this rules apply not only to surgery and medicine, but overall in life. You can overcome your low tier surgery program with a great application and making sure than a few giants know you. Maybe I am wrong.
You can 100% overcome a low tier gen surg program. What I'm saying is that there is absolutely no guarantee to get CT with how competitive it is now. If someone follows your plan -- goes into gen surg, goes to STS conferences and becomes well known (hard to do without someone to introduce you around -- time to let that charisma shine), gets decent absite scores, publishes a couple thoracic manuscripts, and gets a letter from a relatively well known CT surgeon -- then sure, you have a decent chance at matching. Not guaranteed (and not to any of the big name programs), but you'll match somewhere.
If you don't match, a 1 year research spot likely isn't going to help you. You'd have to file for ERAS in November, and you are unlikely to have any real meaningful research by that point. You'll also be unlikely to have a mentor willing to vouch for you 100% after just knowing you for a few months. Most successful people I know that have gone this route have done 2 years of research, so that by the time they apply in the second year they have some publications, and a mentor they've worked with for 15+ months already.
Look at the numbers from the 2017 match (2018 appointment year):
About 115 applicants for 84 spots. 73% match rate. no unfilled spots.
The number of spots continues to shrink too -- 5 years ago there were 102 positions and 30% less applicants.
I'm not trying to discourage anyone. Just know what you're up against if you are shooting for a traditional fellowship -- You need decent ABSITE, legitimate research, and letters from well known CT surgeons. Despite that, you still have a 30% chance of not matching. You need to treat your application as if you were applying for peds. It isn't what it was 10 years ago, and is only going to get more competitive as more traditional programs go I6.
