For the MSIVs:
I've gotten a couple PMs about what to look for, etc on the interview trail, and I am by no means an expert, but I wanted to share some general advice for how to approach the process, and what to look for on interview day. If you don't want it, don't read on.
1. First of all, you can never TRULY know how good a program is until you are there in it, and by then, it's too late. The best thing to do is go to interviews with your bulls@#t meter on high. The residents almost everywhere will lie, so all programs will sound excellent. This is due to 2 factors: 1) They think by landing good students it will improve their programs prestige and secondarily benefit them, 2) They want you to think that not only did they get their first choice, but that they made the right decision.
Common lies:
--We are strictly adherent to the 80 hour rule
--Nobody has ever wanted a fellowship and not gotten it.
--We have excellent resident camraderie.
You have to be able to tell when someone is lying, or when they don't have to lie. The best initial way to do this is to watch the residents from your home institution or place of away rotation lie like a bunch of lying liars, and learn from that.
----A similar point is that the harder they try to sell you the program, the more likely that program sucks. People at good programs know that the program sells itself.
2. Most residents from solid programs can match into the fellowship of their choice. The match rates are almost universally high, with the exception of Three: Plastics, Peds, and Surgical Oncology, the last 2 of which are relatively self-selecting.
Matching into Vascular, CT, Transplant, Trauma/CC, Breast, Hand (god forbid), burn, and Minimally invasive will be relatively easy from the majority of programs. In between specialties of moderate competitiveness likely include Colorectal, and maybe some others I'm not thinking of. Other residents, feel free to contribute.
---My point here is that the ## of residents going into fellowship can't be used to gauge a program. NOT EVERYONE WANTS TO GO INTO THE 3 COMPETITIVE SPECIALTIES! There are plenty of residents who enjoy the other ones, or want to be general surgeons. In my opinion, people who love vascular are crazy, but I promise that they exist (e.g. Castro).
--If you truly want to use fellowships to gauge competitiveness, look at the number going into plastics.
--Exception to my above rule: If you want to do Pediatric surgery, you will have to go to a big name academic program. They almost universally require 2 years of research, and there are only 35 or so spots per year. Most people who go into residency wanting this choose programs for that reason. This represents an overall small but very prestigious group of residents.
3. You need to ask the right questions at your interview to get enough info to make an educated decision. There are plenty of things, including geography, familiarity, prestige, etc, that factor into your decision, but here are some other important things to factor:
-----What are your ABSITE scores? What are your board pass rates? This is extremely important, and a lot of programs won't mention it (especially if their scores suck). Many programs will blame bad scores on lazy residents, but usually its a combo of weak residents (from poor match outcomes) and poor curriculums.
-----What sort of surgical curriculum do you have? How many hours per week are spent with this? Some people have a crappy grand rounds, and that's it, while others have excellent journal clubs, textbook review, ABSITE preps, etc. You can learn to operate anywhere, but you need to make sure you pick a program that focuses on academics.
-----What sort of critical care experience do you have? You need to know how involved the residents will be in critical care. Writing notes and fluffy superficial orders are not enough. If a program consults intensivists for those patients, or pulmonologists to run the ventilators, then you are being robbed of essential critical care experience.
-----Has anyone left the program? Where did they go? This answer will be yes in most instances, especially with surgery's 20% attrition rate. Dropouts heading to anesthesia and ER shouldn't sway you too much. However, if there's a large number, or people are leaving to do GENERAL SURGERY somewhere else, then there's a reason. Either the program fires people too often, or picks crappy residents that need to be fired, or the residents leave on their own accord because the place sucks.
---There's probably more, but I'm sure I'm losing most people's interest, so I'll go on to my final point.
4. Remember that it is still a buyer's market. Every year from now until 2020, you will here, "Surgery is really competitive this year!!" This is true to some extent, as matching now is way more difficult than in the early 2000's. However, a lot of this competitiveness is truly just people applying to a larger number of programs than previously done. In truth, it has hit a plateau, as evidenced by the # of US grads per position and match rates over the last 3 years.
----That means, if you are AVERAGE, then you can still match. Maybe not at your first choice, but stay confident. If you are above average, you are a commodity. You shouldn't ever go into interviews overly cocky or arrogant, but have confidence, and don't make quick decisions out of fear. The match was designed to benefit you, and it can work in your favor if you keep a cool head.
----Definitely a stupid idea is to rank programs that you think love you higher than the programs that you really want, in a stupid attempt to get your #1 and maintain your ego on match day. Rank the programs in the order that you truly like, otherwise you may end up at a #1 piece of crap.
I hope this helps, because it took me 20 minutes to write it out......
I've gotten a couple PMs about what to look for, etc on the interview trail, and I am by no means an expert, but I wanted to share some general advice for how to approach the process, and what to look for on interview day. If you don't want it, don't read on.
1. First of all, you can never TRULY know how good a program is until you are there in it, and by then, it's too late. The best thing to do is go to interviews with your bulls@#t meter on high. The residents almost everywhere will lie, so all programs will sound excellent. This is due to 2 factors: 1) They think by landing good students it will improve their programs prestige and secondarily benefit them, 2) They want you to think that not only did they get their first choice, but that they made the right decision.
Common lies:
--We are strictly adherent to the 80 hour rule
--Nobody has ever wanted a fellowship and not gotten it.
--We have excellent resident camraderie.
You have to be able to tell when someone is lying, or when they don't have to lie. The best initial way to do this is to watch the residents from your home institution or place of away rotation lie like a bunch of lying liars, and learn from that.
----A similar point is that the harder they try to sell you the program, the more likely that program sucks. People at good programs know that the program sells itself.
2. Most residents from solid programs can match into the fellowship of their choice. The match rates are almost universally high, with the exception of Three: Plastics, Peds, and Surgical Oncology, the last 2 of which are relatively self-selecting.
Matching into Vascular, CT, Transplant, Trauma/CC, Breast, Hand (god forbid), burn, and Minimally invasive will be relatively easy from the majority of programs. In between specialties of moderate competitiveness likely include Colorectal, and maybe some others I'm not thinking of. Other residents, feel free to contribute.
---My point here is that the ## of residents going into fellowship can't be used to gauge a program. NOT EVERYONE WANTS TO GO INTO THE 3 COMPETITIVE SPECIALTIES! There are plenty of residents who enjoy the other ones, or want to be general surgeons. In my opinion, people who love vascular are crazy, but I promise that they exist (e.g. Castro).
--If you truly want to use fellowships to gauge competitiveness, look at the number going into plastics.
--Exception to my above rule: If you want to do Pediatric surgery, you will have to go to a big name academic program. They almost universally require 2 years of research, and there are only 35 or so spots per year. Most people who go into residency wanting this choose programs for that reason. This represents an overall small but very prestigious group of residents.
3. You need to ask the right questions at your interview to get enough info to make an educated decision. There are plenty of things, including geography, familiarity, prestige, etc, that factor into your decision, but here are some other important things to factor:
-----What are your ABSITE scores? What are your board pass rates? This is extremely important, and a lot of programs won't mention it (especially if their scores suck). Many programs will blame bad scores on lazy residents, but usually its a combo of weak residents (from poor match outcomes) and poor curriculums.
-----What sort of surgical curriculum do you have? How many hours per week are spent with this? Some people have a crappy grand rounds, and that's it, while others have excellent journal clubs, textbook review, ABSITE preps, etc. You can learn to operate anywhere, but you need to make sure you pick a program that focuses on academics.
-----What sort of critical care experience do you have? You need to know how involved the residents will be in critical care. Writing notes and fluffy superficial orders are not enough. If a program consults intensivists for those patients, or pulmonologists to run the ventilators, then you are being robbed of essential critical care experience.
-----Has anyone left the program? Where did they go? This answer will be yes in most instances, especially with surgery's 20% attrition rate. Dropouts heading to anesthesia and ER shouldn't sway you too much. However, if there's a large number, or people are leaving to do GENERAL SURGERY somewhere else, then there's a reason. Either the program fires people too often, or picks crappy residents that need to be fired, or the residents leave on their own accord because the place sucks.
---There's probably more, but I'm sure I'm losing most people's interest, so I'll go on to my final point.
4. Remember that it is still a buyer's market. Every year from now until 2020, you will here, "Surgery is really competitive this year!!" This is true to some extent, as matching now is way more difficult than in the early 2000's. However, a lot of this competitiveness is truly just people applying to a larger number of programs than previously done. In truth, it has hit a plateau, as evidenced by the # of US grads per position and match rates over the last 3 years.
----That means, if you are AVERAGE, then you can still match. Maybe not at your first choice, but stay confident. If you are above average, you are a commodity. You shouldn't ever go into interviews overly cocky or arrogant, but have confidence, and don't make quick decisions out of fear. The match was designed to benefit you, and it can work in your favor if you keep a cool head.
----Definitely a stupid idea is to rank programs that you think love you higher than the programs that you really want, in a stupid attempt to get your #1 and maintain your ego on match day. Rank the programs in the order that you truly like, otherwise you may end up at a #1 piece of crap.
I hope this helps, because it took me 20 minutes to write it out......
