"Good" Surgical Prelim programs

[JetsSBXLIII]

Hi everyone,
Is anyone able to throw out a list of the ideal surgical prelim programs? "Ideal" meaning more OR time and less scut work. I'm currently a fourth year getting ready to apply and don't really know where to start looking for these sorts of programs.

I think I would prefer to do a surgery year over a medical year since I actually enjoyed surgery (even with the hours) and absolutely hated medicine. I know most programs will never let you see the inside of an OR as a surgical intern, but there may be few that do. Most of what I've read on these forums advise going for a medicine year, but my abhorrence for medicine can not be overstated. I obviously will apply for TY spots but wont count on getting one given their competitiveness. Any input will give me a place to start looking, thanks!

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[maxxor]

Hi everyone,
Is anyone able to throw out a list of the ideal surgical prelim programs? "Ideal" meaning more OR time and less scut work. I'm currently a fourth year getting ready to apply and don't really know where to start looking for these sorts of programs.

I think I would prefer to do a surgery year over a medical year since I actually enjoyed surgery (even with the hours) and absolutely hated medicine. I know most programs will never let you see the inside of an OR as a surgical intern, but there may be few that do. Most of what I've read on these forums advise going for a medicine year, but my abhorrence for medicine can not be overstated. I obviously will apply for TY spots but wont count on getting one given their competitiveness. Any input will give me a place to start looking, thanks!

Pick a TY with surgical electives.

 

[Radz123]

Baylor Dallas gives you massive OR time. I met a radiology resident who had logged over 200 cases in her intern year. Also from what I remember they have no ER Residents meaning when you get consulted the physicians you're talking to have basic competence.

 

[Radz123]

I'd also like to add that the faculty I met there seemed down to earth and nice.

 

[g8orlife]

Pick a TY with surgical electives.

I was just about to type ^This.

 

[Zico181]

Pick a TY with surgical electives.

Ive heard that Carney in Boston is pretty surgery heavy.
Maxxor, do you know of any other TYs that fall into this category?


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[maxxor]

Ive heard that Carney in Boston is pretty surgery heavy.
Maxxor, do you know of any other TYs that fall into this category?


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It really depends on what you want out of this. There's "surgery floors" heavy and "OR" heavy. Carney is more floors from what I hear.

Signature Healthcare / Brockton is probably the best TY in Massachusetts. You do a lot of medicine wards Q4 (6 months), but there's no overnights and you get 2 months of totally free electives. If you so wanted, you could do extra surgery, up to 3 months in total.

At Brockton, BIDMC residents provide the house staff for surgery with a PGY3 chief and another PGY-1 prelim. The Brockton intern can operate as much or as little as they want. I know people who were in the OR literally every day from 7:30 until 9-10 pm (particularly with the vascular surgeons). If you're good, the surgeons let you do a lot. There's 6 or 7 general and vascular surgeons in total and 3 residents, so there's more than enough cases. A PA mostly manages floor work, but the interns share some when the PA is off.

 

[GooseWing]

It really depends on what you want out of this. There's "surgery floors" heavy and "OR" heavy. Carney is more floors from what I hear.

Signature Healthcare / Brockton is probably the best TY in Massachusetts. You do a lot of medicine wards Q4 (6 months), but there's no overnights and you get 2 months of totally free electives. If you so wanted, you could do extra surgery, up to 3 months in total.

At Brockton, BIDMC residents provide the house staff for surgery with a PGY3 chief and another PGY-1 prelim. The Brockton intern can operate as much or as little as they want. I know people who were in the OR literally every day from 7:30 until 9-10 pm (particularly with the vascular surgeons). If you're good, the surgeons let you do a lot. There's 6 or 7 general and vascular surgeons in total and 3 residents, so there's more than enough cases. A PA mostly manages floor work, but the interns share some when the PA is off.

Great info. Thanks a ton. Anyone else with surgery prelim suggestions?

 

[Zico181]

Great info. Thanks a ton. Anyone else with surgery prelim suggestions?

Yes, thank you!


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[RadsonRads]

Just logged ~160 cases this past yr as a prelim. That's with me giving away A LOT of cases to my fellow categorical colleagues Bc some days I was too lazy to go to the OR. I was at a 'community' program in Manhattan. Hours were 6-6 x 6 days a wk, but i would choose it a million times over a TY or medicine prelim. I learned so much and operated so much and it made me feel like I'm actually a competent physician. Would recommend to anyone


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[JetsSBXLIII]

Just logged ~160 cases this past yr as a prelim. That's with me giving away A LOT of cases to my fellow categorical colleagues Bc some days I was too lazy to go to the OR. I was at a 'community' program in Manhattan. Hours were 6-6 x 6 days a wk, but i would choose it a million times over a TY or medicine prelim. I learned so much and operated so much and it made me feel like I'm actually a competent physician. Would recommend to anyone


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Thank you everyone for your responses!!

 

[WellWornLad]

University of Washington has a surgical prelim designed especially for rads-bound residents. I interviewed a while back and it seemed legit, but also heard some disconcerting opinions from some about faculty (i.e., not the nicest bunch). Also, they seem to put you on services at the expense of SICU rotations - at the time I thought that was a plus, but having since gone to a program where I was basically running the SICU alone at night I can tell you that I wouldn't trade that experience for OR time. Managing 2-4 fresh CABGs every night on top of the 10-20 other beds scared me like nothing else in life, but nothing made me feel like more of a doctor. Also got a ton of procedural skills that let me hit the ground running on IR as well as DR procedures, way more so than scrubbing in on my umpteenth appy. Just food for thought.

 

[Radz123]

MUSC also offers a rad specific surgery internship. From what I understand their internship is brutal, but the exposure to MUSC is probably worth it. You could use those connections to get a spot there for fellowship assuming you wanted to do one there.

 

[DrBowtie]

MUSC also offers a rad specific surgery internship. From what I understand their internship is brutal, but the exposure to MUSC is probably worth it. You could use those connections to get a spot there for fellowship assuming you wanted to do one there.

Or you could do a cushy year at Trident like a lot of people do.

 

[radisrad]

Just logged ~160 cases this past yr as a prelim. That's with me giving away A LOT of cases to my fellow categorical colleagues Bc some days I was too lazy to go to the OR. I was at a 'community' program in Manhattan. Hours were 6-6 x 6 days a wk, but i would choose it a million times over a TY or medicine prelim. I learned so much and operated so much and it made me feel like I'm actually a competent physician. Would recommend to anyone


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Your program sounds perfect. Would you care to share where you're at?

 

[Voodoo Chile]

Hi everyone,
Is anyone able to throw out a list of the ideal surgical prelim programs? "Ideal" meaning more OR time and less scut work. I'm currently a fourth year getting ready to apply and don't really know where to start looking for these sorts of programs.

I think I would prefer to do a surgery year over a medical year since I actually enjoyed surgery (even with the hours) and absolutely hated medicine. I know most programs will never let you see the inside of an OR as a surgical intern, but there may be few that do. Most of what I've read on these forums advise going for a medicine year, but my abhorrence for medicine can not be overstated. I obviously will apply for TY spots but wont count on getting one given their competitiveness. Any input will give me a place to start looking, thanks!

The title of this thread is cray cray. There is no such thing as a "good surgical prelim year" unless you went unmatched in categorical general surgery and need to kiss some booty to get a categorical gen surgery slave spot. Find the easiest TY or prelim medicine year possible, do electives in surgical specialties (preferably with community surgeons and NOT associated with a residency scut factory) where you actually learn something relevant to radiology, and enjoy not getting totally burned out before you start learning how to be a radiologist. Even if you are doing IR, the experience you'll gain as a prelim scutmonkey doing procedures or getting OR time in the presence of miserable categorical residents and psychopath surgery attending on a daily basis will make little, if any, difference in the long run. Hindsight is 20/20: 95% of rads residents, young attendings, and IR fellows will agree with the simple advice of doing the easiest intern year possible.

 

[irwarrior]

I think that a strong surgical preliminary year can make you a stronger IR physician as it reflects the day to day existence of a high end IR practice. This should include clinic, consults, ICU experience and consults. It is paramount to identify a program where you can do ICU rotations, vascular surgery (endovascular) , surgical oncology, Trauma etc. You should try to see the consults first and present to your attending. If there are too many trainees on service your education will be diluted. You should try to learn the anatomy , pathology, operative repairs, and common post operative complications. You should look at scans from the perspective of a surgical field, you can learn a lot of what makes a good radiologic report as well. If you take that year seriously and read about your surgeries and ask questions of your chiefs, fellows or attendings you can learn a ton. A surgical internship teaches how you to be more clinically and technically aggressive which is something that IR can potentially benefit from as most radiologists are rather passive by training and by nature.

Learn about chest tube management, mass transfusion protocols, common post operative complications . Learn about tumoral staging and which cases do well with surgical extirpation. Try to get in as many cases as feasible and try to learn how to suture well. These skills will pay dividends in a high end IR practice. The challenge is to identify the surgical programs that will give you a well rounded experience as not all surgical internships are the same. In my opinion transitional year gives you the least amount of preparation for IR as you are more of an observer vs part of the team.

If you are interested in doing high end IR or going to a high end IR residency, I would encourage a surgical internship. Most IR program directors are suggesting surgical preliminary year. I also think that you should continue to integrate many clinical rotations during your residency including ICU, cardiology consults, vascular surgery etc. This way you continue to refine your clinical acumen for the whole 6 years as opposed to having a 3 year break from doing patient care.

If you are not interested in IR or want to dabble in minor IR procedures , the intern year is not as relevant.

 

[Fab5Hill33]

@Voodoo Chile is 100% correct.

I learned 2x as much and did 2x the number of procedures as a medicine prelim than my friends who did surgery prelim at the same hospital. And I had my own clinic to boot. I now practice 100% IR at a large medical center. My friends who did surgery internships are actually started out a little behind me in terms of their comfort in running a clinic (though it's all a wash now). Don't do an internship just because it has the word "surgery" in it. Do your homework and find out which prelim program gives you the most useful experience and the least scut. You may find a good surgery internship like some of the posters above have reported. If so, good for you.

BUT... I find it very disingenuous to glamorize the surgery intern experience. This nonsense about a surgery internship helping you perform high end IR is complete horse crap.

 

[irwarrior]

Internship is a small but important component. You need to continue to see patients through out residency and fellowship (busy clinic, admitting patients and doing formal consults). It is important to do rotations such as vascular surgery, cardiology, ICU etc throughout the years of radiology residency.

Here are some useful youtube discussions that I would encourage you to listen to .

Listen to these IR program directors and radiology residents perspective on internship.

 

[preDoGuy24]

@Voodoo Chile is 100% correct.

I learned 2x as much and did 2x the number of procedures as a medicine prelim than my friends who did surgery prelim at the same hospital. And I had my own clinic to boot. I now practice 100% IR at a large medical center. My friends who did surgery internships are actually started out a little behind me in terms of their comfort in running a clinic (though it's all a wash now). Don't do an internship just because it has the word "surgery" in it. Do your homework and find out which prelim program gives you the most useful experience and the least scut. You may find a good surgery internship like some of the posters above have reported. If so, good for you.

BUT... I find it very disingenuous to glamorize the surgery intern experience. This nonsense about a surgery internship helping you perform high end IR is complete horse crap.

I would say this is abnormal as a medicine prelim-I don't know any who did more bedside procedures than myself as a surgical intern (I&Ds, CVCs, Alines, chest tubes,etc) not to mention the OR cases I logged-probably a bit over 200 for the year, I quit logging cases at 150.

I would agree that you don't NEED to have a surgery year for IR but from a procedure perspective I think a surgery year is going to likely give you better experience UNLESS you go to a turn and burn program where they just want scut monkeys. Now I agree a lot of the procedures are not necessary for high end IR.

I wouldn't trade my solid community gen Surg intern year for anything-I felt more ready to run a level 1 trauma or manage the SICU at night at the end of the year then start into radiology. I should mention the academic requirements were a lot higher than typical for my prelim program (I read all of sabistons, took inservice and required to score above average etc.)

Finding a solid program that doesn't use there interns for pure scut is key. Especially if you are likely going to be in the hospital for 20-30 hours longer than your medicine colleagues-which you most definitely have to be okay with if you choose surgery.

To each there own-I can easily give solid arguments for medicine prelim, my coresidents have lots of experience and knowledge I don't from doing a medicine year.

My one handed knot tying is on point though!




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[preDoGuy24]

@Voodoo Chile is 100% correct.

I learned 2x as much and did 2x the number of procedures as a medicine prelim than my friends who did surgery prelim at the same hospital. And I had my own clinic to boot. I now practice 100% IR at a large medical center. My friends who did surgery internships are actually started out a little behind me in terms of their comfort in running a clinic (though it's all a wash now). Don't do an internship just because it has the word "surgery" in it. Do your homework and find out which prelim program gives you the most useful experience and the least scut. You may find a good surgery internship like some of the posters above have reported. If so, good for you.

BUT... I find it very disingenuous to glamorize the surgery intern experience. This nonsense about a surgery internship helping you perform high end IR is complete horse crap.

I would say this is abnormal as a medicine prelim-I don't know any who did more bedside procedures than myself as a surgical intern (I&Ds, CVCs, Alines, chest tubes,etc) not to mention the OR cases I logged-probably a bit over 200 for the year, I quit logging cases at 150.

I would agree that you don't NEED to have a surgery year for IR but from a procedure perspective I think a surgery year is going to likely give you better experience UNLESS you go to a turn and burn program where they just want scut monkeys. Now I agree a lot of the procedures are not necessary for high end IR.

I wouldn't trade my solid community gen Surg intern year for anything-I felt more ready to run a level 1 trauma or manage the SICU at night at the end of the year then start into radiology. I should mention the academic requirements were a lot higher than typical for my prelim program (I read all of sabistons, took inservice and required to score above average etc.)

Finding a solid program that doesn't use there interns for pure scut is key. Especially if you are likely going to be in the hospital for 20-30 hours longer than your medicine colleagues-which you most definitely have to be okay with if you choose surgery.

To each there own-I can easily give solid arguments for medicine prelim, my coresidents have lots of experience and knowledge I don't from doing a medicine year.

My one handed knot tying is on point though!




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[Fab5Hill33]

I'm not trying to imply prelim Medicine is better than prelim Surgery. I apologize if that's how my post came across. The point is that the vast majority of internships - whether prelim med, prelim surgery or TY - are low yield experiences. I'm advising students to just look for programs -- medicine or surgery -- that get you the best teaching/experience with the least scut. It seems we both agree on that.

I just want to debunk this notion that a surgery year is critical to your future as an IR. The people on this forum touting this need to get of their soapbox. If you enjoy being a surgery intern more than medicine intern, then by all means do a surgery internship. The argument that a surgical internship has any bearing on your IR career is about as valid as saying a Biology major in college will affect how well you do in med school. I've been an attending IR at a large level 1 trauma center for nearly a decade. My experience as an intern has had no bearing on my ability to practice IR. None.

I would say this is abnormal as a medicine prelim-I don't know any who did more bedside procedures than myself as a surgical intern (I&Ds, CVCs, Alines, chest tubes,etc) not to mention the OR cases I logged-probably a bit over 200 for the year, I quit logging cases at 150.

I would agree that you don't NEED to have a surgery year for IR but from a procedure perspective I think a surgery year is going to likely give you better experience UNLESS you go to a turn and burn program where they just want scut monkeys. Now I agree a lot of the procedures are not necessary for high end IR.

I wouldn't trade my solid community gen Surg intern year for anything-I felt more ready to run a level 1 trauma or manage the SICU at night at the end of the year then start into radiology. I should mention the academic requirements were a lot higher than typical for my prelim program (I read all of sabistons, took inservice and required to score above average etc.)

Finding a solid program that doesn't use there interns for pure scut is key. Especially if you are likely going to be in the hospital for 20-30 hours longer than your medicine colleagues-which you most definitely have to be okay with if you choose surgery.

To each there own-I can easily give solid arguments for medicine prelim, my coresidents have lots of experience and knowledge I don't from doing a medicine year.

My one handed knot tying is on point though!




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[IRorBustguy]

I'm not trying to imply prelim Medicine is better than prelim Surgery. I apologize if that's how my post came across. The point is that the vast majority of internships - whether prelim med, prelim surgery or TY - are low yield experiences. I'm advising students to just look for programs -- medicine or surgery -- that get you the best teaching/experience with the least scut. It seems we both agree on that.

I just want to debunk this notion that a surgery year is critical to your future as an IR. The people on this forum touting this need to get of their soapbox. If you enjoy being a surgery intern more than medicine intern, then by all means do a surgery internship. The argument that a surgical internship has any bearing on your IR career is about as valid as saying a Biology major in college will affect how well you do in med school. I've been an attending IR at a large level 1 trauma center for nearly a decade. My experience as an intern has had no bearing on my ability to practice IR. None.

I'm not arguing with you, but I am curious - why are SIR leaders actively pushing the prelim surgery pathway then? I've been fortunate enough to interview at a lot of the "top" IR places and the majority of PDs I've spoken with are happy with my decision to apply prelim surgery (notable exceptions being Emory, Brown, and Yale).

 

[UChicagoIR]

I am the IR fellowship program director (and IR/DR residency program director) at our institution. We have never considered intern experience when deciding who to invite for an interview or in formulating our rank list. I don't believe there is any correlation with fellow performance. Other PDs might feel otherwise.

 

[PL198]

I'm not arguing with you, but I am curious - why are SIR leaders actively pushing the prelim surgery pathway then? I've been fortunate enough to interview at a lot of the "top" IR places and the majority of PDs I've spoken with are happy with my decision to apply prelim surgery (notable exceptions being Emory, Brown, and Yale).

Because it makes their specialty look more hardcore if you're choosing to do a surgery prelim yr (which no one wants) instead of a cush ty.

And who is running a sicu as an intern? Like independent call it's a whole different ball game when you have someone holding your hand. What intern is running an icu without a senior?

 

[preDoGuy24]

I'm not trying to imply prelim Medicine is better than prelim Surgery. I apologize if that's how my post came across. The point is that the vast majority of internships - whether prelim med, prelim surgery or TY - are low yield experiences. I'm advising students to just look for programs -- medicine or surgery -- that get you the best teaching/experience with the least scut. It seems we both agree on that.

I just want to debunk this notion that a surgery year is critical to your future as an IR. The people on this forum touting this need to get of their soapbox. If you enjoy being a surgery intern more than medicine intern, then by all means do a surgery internship. The argument that a surgical internship has any bearing on your IR career is about as valid as saying a Biology major in college will affect how well you do in med school. I've been an attending IR at a large level 1 trauma center for nearly a decade. My experience as an intern has had no bearing on my ability to practice IR. None.

I agree with this 100%.

I have told those below me interested in IR that a good clinical year is the best thing you can do-either surgery or medicine is up to you.

I couldn't stand long rounding and wanted more procedure experience so I went surgery. I know people who had great experiences in medicine and ones who had terrible experiences in surgery. To each their own.

I agree completely and am not holding on to any misconceptions of my intern year making me a great IR doc or a better IR applicant, I think the most important thing for IR and Radiology in general is getting the best clinical background you can during intern year.


And yeah no intern is running a ICU by themselves without a senior. That's crazy talk.


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[IR4thewin]

Due to new regulations, all surgery programs must have their residents do 250 cases by the end of second year. As you can guess, most places should have >100 cases in the intern year. From my small interview experience, finding a community or hybrid-academic surgery internship will provide the best clinical experience. Mainly, because these programs are more likely to treat all interns the same, again just in my limited experience of questioning prelims. Would be curious to hear others perspective on this, but I am very much interested in avoiding the large academic places for internship.


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[IR4thewin]

An important side note, the 250 number includes first assist.


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[IR4thewin]

I don't want to say names yet, but I did find a prelim surgery place that has a fair number of NPs and PAs to relieve the scut off the interns. Interns did a few discharge summaries at the beginning to learn how to do them and then mid levels took care of that for the rest of the year. I'd look for things like that in a program.


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[alopathik]

check out Presence St Joseph in Chicago. They have 2 spots for a prelim surgery resident every year. I did two months there as a transitional year resident. High case load for residents, even the interns. High level of autonomy. Good teaching and great resident camaraderie.

Jimmy
[email protected]

 

[JetsSBXLIII]

Anyone have any info regarding Stanford's Prelim Surgery year (OR time vs scut work)?

 

[PL198]

Anyone have any info regarding Stanford's Prelim Surgery year (OR time vs scut work)?

i mean being a major academic place I highly doubt it's gonna be the "holy grail surgical prelim." I think those exist more at community places