GS intern with mediocre absite, but interested in PRS

[Salamechton]

Hello,

I am a GS intern interested in eventually going GS --> PRS. Recently got my absite score back, with a disappointing ~30-40 percentile. My original plan was to take 2 years for dedicated PRS research. However, given by mediocre absite, I was wondering if this was a "game over" for matching PRS down the line?

I am not very familiar with the competitiveness of PRS as an independent match and the typical "cut-off" absite score that are used. If my score is too low and I have next to no chance to match, then perhaps I should not take 2 years for research (eg, similar to scoring a 210 on Step 1 and hoping to match integrated PRS, which is not impossible, but highly unlikely)

I would appreciate any input from those familiar with the GS --> PRS route. As I am starting to look into research positions, this may impact my decision to pursue the research track.

Thank you

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[droliver]

There's no way to endorse someone doing two years in the lab with plastic surgery residencies now 3 years. 10 years of training after med school is just too long at that point.

 

[ram006]

Two comments:

1. ABSITE scores didn't seem to be all that important during my interview process. Step 1 still seems to be the most important exam. I wouldn't give up on the prospect altogether just bc of a bad ABSITE.

2. While I do agree that 10 years is an inordinately long and inefficient time to train. I disagree that there's "no way to endorse" the pathway. You just have to go in eyes wide open and realize you are sacrificing a key period of time in your life which will end up being a large sum of money over your career (likely over a million dollars of lost income). I chose the pathway for a couple reasons the most important being that I didn't enjoy general surgery enough to see myself doing it for 30 years. I'd rather have a 27 year career in plastics and they can keep that extra money. The sacrifice of time and money is real, though.

You should, however, prepare financially to the best of your ability (i.e. live well under your means, don't ignore your student loans, put money in a Roth, etc.). My first two years of residency I had a studio with no furniture. Just had my mattress on the floor and a TV on a cardboard box. I put almost 30-40% of my income away those two years. It was not really that big of a deal to live skinny and now that I'm married with a working spouse and a side hustle of my own I'm not worried so much about the financial aspect of it. I still won't make all the lost income back but enough so that money doesn't control every decision I make.

 

[Moravian]

As a previous program director, I have had to backfill PGY-4 positions either because of program expansion or losing a resident. I can tell you that the GS trained folks are generally really not competitive. By that I mean that the ABSITE scores are bad, the Step scores are low and there's very little to no research. I also have experience in that I came into plastics through the SF match. My advice to you if you stay in general surgery is to be the best resident your program has so you have great letters, improve your ABSITE score, and write a paper or two. This will make you way more competitive than your peers. If you still don't match, at least you'll have a job. There's also the option of doing a hand or burn fellowship after GS and then reapply, but usually the first time through the match is your best chance. If you don't want to do a full GS residency, and the integrated program at your institution has a track record of taking people out of their lab into their program, that might be a viable option. If that's not the case, then I agree with droliver.

I've been hearing about the death of independent programs for 20 years and they're still around. Also there's the open positions that come up every year, although that tends to be not as reliable. I would say finish GS, and do what I advised to be the best resident they've every had come through, kill the ABSITE and write some papers.

 

[ram006]

As a previous program director, I have had to backfill PGY-4 positions either because of program expansion or losing a resident. I can tell you that the GS trained folks are generally really not competitive. By that I mean that the ABSITE scores are bad, the Step scores are low and there's very little to no research. I also have experience in that I came into plastics through the SF match. My advice to you if you stay in general surgery is to be the best resident your program has so you have great letters, improve your ABSITE score, and write a paper or two. This will make you way more competitive than your peers. If you still don't match, at least you'll have a job. There's also the option of doing a hand or burn fellowship after GS and then reapply, but usually the first time through the match is your best chance. If you don't want to do a full GS residency, and the integrated program at your institution has a track record of taking people out of their lab into their program, that might be a viable option. If that's not the case, then I agree with droliver.

I've been hearing about the death of independent programs for 20 years and they're still around. Also there's the open positions that come up every year, although that tends to be not as reliable. I would say finish GS, and do what I advised to be the best resident they've every had come through, kill the ABSITE and write some papers.

Agree with all that.

I'd say about 50% have applications that would not have gotten an interview at my GS program. There are a lot of caribbean grads with mediocre step scores training at community programs in the mix this year for the independent program. When you compare that to the integrated cohort where nearly everyone is AOA with > 250 step scores and publications its easy to see why its being phased out at places that can do so. We actually just dropped ours. I have mixed emotions about it but I really was shocked at how shallow the applicant pool is now that I'm part of the review process.

Hand is not a realistic back up plan, though, particularly for someone who is concerned they are not competitive enough for plastics. The Hand match is much more competitive.