Grabb N Smith's--Good? The best plastics book?

[Strength&Speed]

For the size of this book, it has an ABSURD amount of info. Looks pretty good, but probably not 'in depth' enough for the actual practice of plastics. what is your guys thoughts.

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[kaineliu]

It's a great overview for medical students and junior residents. I've heard it's a good review for written boards. It is not in depth enough for specific cases. Mathes is more comprehensive (but it's 8 volumes).

 

[DrDre311]

For the size of this book, it has an ABSURD amount of info. Looks pretty good, but probably not 'in depth' enough for the actual practice of plastics. what is your guys thoughts.

I don't really like G&S that much. It's OK, but not my favorite, but that's what our department gives us. Mathes is a better text but it is huge and very expensive. Probably my favorite text (even though it isn't strictly plastics) is Green's hand surgery; another one along those lines is the perforator flap text by Blondeel et al.

Are you looking for a book for a rotation? All these are pretty expensive. Or are you thinking of trying to match into PRS?

 

[Strength&Speed]

I don't really like G&S that much. It's OK, but not my favorite, but that's what our department gives us. Mathes is a better text but it is huge and very expensive. Probably my favorite text (even though it isn't strictly plastics) is Green's hand surgery; another one along those lines is the perforator flap text by Blondeel et al.

Are you looking for a book for a rotation? All these are pretty expensive. Or are you thinking of trying to match into PRS?

possibly matching. Oh, and Dre, I didn't see a sticky, so if you're still around--do folks recommend applying to integrated as well as categorical surgery. Also, is it as tough to get into PRS from the surgery route (after getting a surg spot?) Are their match rates as low as those trying to get through the integrated way?

 

[DrDre311]

possibly matching. Oh, and Dre, I didn't see a sticky, so if you're still around--
(1) do folks recommend applying to integrated as well as categorical surgery.

(2) Also, is it as tough to get into PRS from the surgery route (after getting a surg spot?) Are their match rates as low as those trying to get through the integrated way?

(1) Most people who apply to integrated PRS also apply to general surgery. I think the answer to this question depends on how competitive an applicant you are. For me, I went through the whole hassle of dual-applying, got 2 separate sets of letters, had to deal with a weaker "generic" MSPE (because you can only have one MSPE, whereas you can have as many personal statements/LOR's as you want) and only did 2 GS interviews. Looking back, it was a waste of my time and money to apply to GS. The questions you need to ask yourself are "How competitive an applicant am I?" and "If I don't match in plastics, would I rather match into GS or not match at all?" I personally would have done GS and pursued an independent plastics residency but I have met integrated residents who hated GS and would rather have done something entirely different.

(2) Plastics is competitive no matter how you look at it. This year the match rate for independent residencies was 57%, and since 2004 has been between 44% and 55%. Compare this to a 63% match rate in integrated plastics in 2007 and a 50% match rate in integrated plastics in 2008. The caveat to interpreting data is that the NRMP calculates its data based on applicants who submit rank lists with plastics programs ranked first (i.e. to be included in this calculation, an applicant has to be extended an interview and subsequently rank a PRS program first)--it has no way of accounting for those who apply to integrated plastics and are not extended interviews, not to mention those who self-select out of the integrated match. Thus the actual match rate for people who apply to integrated plastics is probably quite a bit lower. SFMatch calculates its data in the same fashion but provides the number of people who apply for the independent match, yielding a match rate (for people who apply, not only those who interview and submit rank lists) of 38% in 2008.

The upshot of all this number-crunching is that there are 92 integrated/combined PRS spots, and 93 independent spots, and from what I've seen, between 250-300 people apply to each match each year (for the last several years). So the overall match rates for people who apply are similar.

The other confounding factor is that integrated plastics applicants, by and large, have better academic profiles (obviously not including ABSite scores or research/LOR's obtained in GS residency) than people who get into plastics via the independent match--making the integrated match tougher in a purely qualitative fashion. Having said this, I personally feel that right now,for different reasons, it's probably almost equivalent from a difficulty standpoint to get into plastics via either route (integrated may be more competitive from an applicant profile standpoint but I can't quantify this with available data).

Any way you slice it, it's tough to get into plastics. As more programs shift to the integrated/combined model (hard to say how many will continue to do this--I definitely don't think the independent training model will ever disappear), the independent match will get tougher simply due to a narrowing of available slots.

If you want to become a plastic surgeon, then you should apply to integrated plastics and (if you or your advisors think it's necessary) back it up with GS. That's the only way to have a shot at all 185 total plastics spots. But it's definitely a tough road no matter which route you take and every year each match gets more and more competitive.

If you have more questions, feel free to ask. Other plastics types with great input include: DrOliver, Moravian, GSResident, Maxheadroom, and Plastikos. I think Tristero is also an integrated plastics resident, and Winged Scapula may be able to provide some perspective as well.

 

[GSresident]

The single best source of boards type information I have seen compiled has been in the Selected Readings. I have a copy from like 2002 or something. I read G&S as well but I like Selected Readings better.

As far as whether or not to apply to a GS residency I would ask myself what I would do in the very likely event that I didn't match into an integrated/combined program. Every year there are stellar applicants who don't match into plastics. It is generally a very tough road from there.

I never applied to an integrated/combined program so I don't have any insight as to what a good backup plan after a failed match would be. My backup plan if I didn't match through the independant route was to go to law school.

 

[Strength&Speed]

(1) Most people who apply to integrated PRS also apply to general surgery. I think the answer to this question depends on how competitive an applicant you are. For me, I went through the whole hassle of dual-applying, got 2 separate sets of letters, had to deal with a weaker "generic" MSPE (because you can only have one MSPE, whereas you can have as many personal statements/LOR's as you want) and only did 2 GS interviews. Looking back, it was a waste of my time and money to apply to GS. The questions you need to ask yourself are "How competitive an applicant am I?" and "If I don't match in plastics, would I rather match into GS or not match at all?" I personally would have done GS and pursued an independent plastics residency but I have met integrated residents who hated GS and would rather have done something entirely different.

(2) Plastics is competitive no matter how you look at it. This year the match rate for independent residencies was 57%, and since 2004 has been between 44% and 55%. Compare this to a 63% match rate in integrated plastics in 2007 and a 50% match rate in integrated plastics in 2008. The caveat to interpreting data is that the NRMP calculates its data based on applicants who submit rank lists with plastics programs ranked first (i.e. to be included in this calculation, an applicant has to be extended an interview and subsequently rank a PRS program first)--it has no way of accounting for those who apply to integrated plastics and are not extended interviews, not to mention those who self-select out of the integrated match. Thus the actual match rate for people who apply to integrated plastics is probably quite a bit lower. SFMatch calculates its data in the same fashion but provides the number of people who apply for the independent match, yielding a match rate (for people who apply, not only those who interview and submit rank lists) of 38% in 2008.

The upshot of all this number-crunching is that there are 92 integrated/combined PRS spots, and 93 independent spots, and from what I've seen, between 250-300 people apply to each match each year (for the last several years). So the overall match rates for people who apply are similar.

The other confounding factor is that integrated plastics applicants, by and large, have better academic profiles (obviously not including ABSite scores or research/LOR's obtained in GS residency) than people who get into plastics via the independent match--making the integrated match tougher in a purely qualitative fashion. Having said this, I personally feel that right now,for different reasons, it's probably almost equivalent from a difficulty standpoint to get into plastics via either route (integrated may be more competitive from an applicant profile standpoint but I can't quantify this with available data).

Any way you slice it, it's tough to get into plastics. As more programs shift to the integrated/combined model (hard to say how many will continue to do this--I definitely don't think the independent training model will ever disappear), the independent match will get tougher simply due to a narrowing of available slots.

If you want to become a plastic surgeon, then you should apply to integrated plastics and (if you or your advisors think it's necessary) back it up with GS. That's the only way to have a shot at all 185 total plastics spots. But it's definitely a tough road no matter which route you take and every year each match gets more and more competitive.

If you have more questions, feel free to ask. Other plastics types with great input include: DrOliver, Moravian, GSResident, Maxheadroom, and Plastikos. I think Tristero is also an integrated plastics resident, and Winged Scapula may be able to provide some perspective as well.

Thanks Dre. That was REALLY nice of you to detail the process so smoothly. You should consider stickying this post.

 

[Strength&Speed]

The single best source of boards type information I have seen compiled has been in the Selected Readings. I have a copy from like 2002 or something. I read G&S as well but I like Selected Readings better.

As far as whether or not to apply to a GS residency I would ask myself what I would do in the very likely event that I didn't match into an integrated/combined program. Every year there are stellar applicants who don't match into plastics. It is generally a very tough road from there.

I never applied to an integrated/combined program so I don't have any insight as to what a good backup plan after a failed match would be. My backup plan if I didn't match through the independant route was to go to law school.

you were gonna quit after 3 yrs of general surg?

 

[droliver]

right now[/B],for different reasons, it's probably almost equivalent from a difficulty standpoint to get into plastics via either route (integrated may be more competitive from an applicant profile standpoint but I can't quantify this with available data).

I'd suggest it's actually the other way around re. applicants in that with the independent match you've selected out from the pool people who are both good on paper and have excelled clinically with much more substancial relevant resumes. The PD where I'm clinical faculty is now telling applicants that if you haven't done 1- 2 years in the lab or completed a fellowship prior to applng that your chances for consideration are diminishing as he's recieving more and more applications (and reapplications) from people with that level of credtentials.

I'd compare the two matches to the difference between drafting baseball players out of high school versus promoting them out of AAA baseball. There's a lot of talent in the best high school players but you don't know if they can hit a curveball yet

 

[totipocincy]

Back to the subject brought up by the OP...
I'm getting ready to start 4th year PS clerkships/aways, and want a reference book to read each night to best prepare for the next day's cases. One of my PS mentors recommended I use Current Therapy in Plastic Surgery (McCarthy/Galiano/Boutros), and having read a few chapters, it seems to be well suited for that purpose (clear, concise, nice pics/diagrams). But does it have adequate depth? I haven't read G&S, and wonder whether any of you have read both and can comment on which would be better.

A bit more info... I'm planning on entering the upcoming PS match.

 

[Strength&Speed]

I'd suggest it's actually the other way around re. applicants in that with the independent match you've selected out from the pool people who are both good on paper and have excelled clinically with much more substancial relevant resumes. The PD where I'm clinical faculty is now telling applicants that if you haven't done 1- 2 years in the lab or completed a fellowship prior to applng that your chances for consideration are diminishing as he's recieving more and more applications (and reapplications) from people with that level of credtentials.

I'd compare the two matches to the difference between drafting baseball players out of high school versus promoting them out of AAA baseball. There's a lot of talent in the best high school players but you don't know if they can hit a curveball yet

yikes. i think that just skewed me in favor of the integrated or nothing at all route.

 

[GSresident]

I'd suggest it's actually the other way around re. applicants in that with the independent match you've selected out from the pool people who are both good on paper and have excelled clinically with much more substancial relevant resumes. The PD where I'm clinical faculty is now telling applicants that if you haven't done 1- 2 years in the lab or completed a fellowship prior to applng that your chances for consideration are diminishing as he's recieving more and more applications (and reapplications) from people with that level of credtentials.

I'd compare the two matches to the difference between drafting baseball players out of high school versus promoting them out of AAA baseball. There's a lot of talent in the best high school players but you don't know if they can hit a curveball yet

I second that sentiment. You have to be a proven quantity, not a theoretical one to match in the independent match.

 

[GSresident]

you were gonna quit after 3 yrs of general surg?

Nah. I was always going to do 5 years. I was offered 2 spots that would involve my quitting after the 4th year and I stuck it out to be board certified in General Surgery. I believed then, and I still believe now that the final 2 years of general surgery add maturity and judgment that is lacking after 3 diluted years of general surgery. Having said that I have no idea if there is any difference 5 years into practice between a combined/integrated trained surgeon and a classically trained plastic surgeon. I suspect it evens out in the end.

 

[DrDre311]

I'd suggest it's actually the other way around re. applicants in that with the (1) independent match you've selected out from the pool people who are both good on paper and have excelled clinically with much more substancial relevant resumes. The PD where I'm clinical faculty is now telling applicants that if you haven't done 1- 2 years in the lab or completed a fellowship prior to applng that your chances for consideration are diminishing as he's recieving more and more applications (and reapplications) from people with that level of credtentials.

(2) I'd compare the two matches to the difference between drafting baseball players out of high school versus promoting them out of AAA baseball. There's a lot of talent in the best high school players but you don't know if they can hit a curveball yet

(1) I can't argue with that, and we're both theorizing, because we can't know what successful integrated applicants would do to get into independent residencies. What I mean is that I, personally, was going to become a plastic surgeon no matter what. I had a plan in place, and if I hadn't matched in integrated plastics, I would have done GS with an eye toward the independent match. You bet your ass that, from day one, I would have been doing plastics-related research, kissing the appropriate asses, killing the ABSite, excelling clinically/operatively (which I strive to do now anyway), etc. and by the time I needed to apply I'd have had the most impressive damn CV I possibly could have. And I consider myself pretty run-of-the mill as far as successful integrated applicants go.

(2) That's an excellent analogy, except I'd compare independent applicants to college ballplayers instead of those already in AAA with a shot at the bigs. And I promise I can knock a curve out of the park.

(3) Also, the issue of reapplicants is different between the 2 matches. With the integrated match, reapplying is associated with an almost nil success rate. I don't have any data on reapplicants and the SFMatch, but offhand I would think it would be easier for someone with the prospect of board eligibility and income to do a few years in a lab or a hand fellowship or whatever and then reapply. That is, I would think there would be less risk in applying through the independent match because you would actually have a feasible career/income through your backup plan (GS, oto, etc.) as opposed to sort of jumping off a cliff and hoping for the best in the integrated match. As mentioned before, (not that there's not risk, expense, etc. involved, I know that there is) failed independent applicants have the option of sort of continuing in a holding pattern and reapplying the following year, which would be a foolhardy move in the integrated match.

(4) My original point is that it's probably equivalent in difficulty at this point to become a plastic surgeon no matter what route you choose. If someone is sure that plastic surgery is the way to go, then the best strategy is to apply to integrated plastics (with a solid GS backup, followed by applying to the independent match). That's the only way to be considered for every spot possible.

 

[DrDre311]

yikes. i think that just skewed me in favor of the integrated or nothing at all route.

Being prepared for the possibility/likelihood of not matching in integrated PRS is a prerequisite for applying to integrated PRS. If you love surgery, and plastic surgery in particular, what's another 2 years? Don't be scared of GS. I've had several plastics attendings remind me that "plastic surgery is general surgery done well."

 

[Strength&Speed]

Nah. I was always going to do 5 years. I was offered 2 spots that would involve my quitting after the 4th year and I stuck it out to be board certified in General Surgery. I believed then, and I still believe now that the final 2 years of general surgery add maturity and judgment that is lacking after 3 diluted years of general surgery. Having said that I have no idea if there is any difference 5 years into practice between a combined/integrated trained surgeon and a classically trained plastic surgeon. I suspect it evens out in the end.

Interesting. Well congratulations on getting the double boarding. Maybe it does even out in the end, but you're probably right, you are probably a smarter guy at least at first. That's probably worth something.

 

[Strength&Speed]

Being prepared for the possibility/likelihood of not matching in integrated PRS is a prerequisite for applying to integrated PRS. If you love surgery, and plastic surgery in particular, what's another 2 years? Don't be scared of GS. I've had several plastics attendings remind me that "plastic surgery is general surgery done well."

2 extra years minimum . You are assuming 3 years GS + 1-2 yrs research, or in the extreme case, a fellowship after a full 5 yr GS residency. That would be like 7 yrs. Compare that to the 3 in the integrated route. I understand your reasoning, but its one to two years if you're lucky.

reference::: 'droliver was saying the competitive applicants have 1-2 yrs research or a fellowship'

P.S.S. thanks Dre and everyone else. Your help is appreciated more than you can imagine.

 

[DrDre311]

2 extra years minimum . You are assuming 3 years GS + 1-2 yrs research, or in the extreme case, a fellowship after a full 5 yr GS residency. That would be like 7 yrs. Compare that to the 3 in the integrated route. I understand your reasoning, but its one to two years if you're lucky.

reference::: 'droliver was saying the competitive applicants have 1-2 yrs research or a fellowship'

P.S.S. thanks Dre and everyone else. Your help is appreciated more than you can imagine.

I was assuming a full GS/oto/whatever residency. You actually can't switch to plastics after 3 years anymore, unless it's at the same institution at which you are doing GS. "Extra 2 years" is referencing the completion of a GS residency (i.e. 5 + 2-3) vs. the 3+3 integrated model.

So, if you want to total it up: possible 1-2 years in the lab + possible 1 year fellowship + 2 years spent completing GS/oto + possible change in independent residency from 2 years to 3 years = anywhere from 1-5 extra years (i.e. 7-11 total PG years vs 6 PG years integrated). But if all that were what it would have taken for me to get into plastics, I'd have signed on the dotted line at the first opportunity.

S&S, can you make your SN stop being red?

 

[Strength&Speed]

I
S&S, can you make your SN stop being red?

No, I got put on probationary status for showing an interest in the OB/GYN forum

 

[BlondeDocteur]

I want to re-rail (as opposed to de-rail) the thread... I got access to a large chunk of the Selected Readings and have been amazed. They're, in a word, awesome. Think UptoDate for plastic surgery. Comprehensive, interesting, well-written, with all the relevant literature.