GS residency in California

[504196]

Hey everyone,

I'm a third year medical student interested in surgery. I am wondering how competitive are residencies in California? My step 1 was 237. I got "exceptional" on my surgery rotation (missed honors by a few points). My clinical eval was high but the shelf pushed me out of honors range. It was tough doing surgery as my first rotation without medicine. Anyways, just wondering if I'd be competitive at California programs. I did research with an oncologist my first two years. So far I'm coauthor on one paper. Trying to get another paper as co-author and have 2 poster presentations. Am willing to consider to do a month of research in surgery as an elective at the end of third year or beginning of fourth if you think it'd make me more competitive. Also is there anywhere online that lists step one averages for surgery programs?

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[doc05]

California is competitive for every specialty because it's California.

237 is competitive for most programs, and your research is good but shouldn't be your focus. Get more exposure to surgery and find a mentor. At this point, your character, motivation, personality will be the most important factors.

Most importantly, find a mentor.

 

[504196]

California is competitive for every specialty because it's California.

237 is competitive for most programs, and your research is good but shouldn't be your focus. Get more exposure to surgery and find a mentor. At this point, your character, motivation, personality will be the most important factors.

Most importantly, find a mentor.

Is doing an away rotation at a program in California a good idea? I talked to the head of surgery at my med school and he seemed to suggest that aways are not necessary and are a waste of money. He also discussed how he frequently goes to national surgery and education meetings and aways are discussed and the general consensus is that they are not necessary and can only hurt you if you do bad or don't get along with ppl you rotate with. Overall, I've heard mixed opinions on aways. I'd be willing to consider one this summer as I've heard it shows that you are willing to live and travel to a new part of the country. And perhaps network with people at that institution. What do you all think?

 

[Winged Scapula]

Away rotations are generally not required and probably in most cases hurt more than they help. I’m not sure that “ showing you’re willing to travel or live in other areas of the country” is valid or something that programs even consider. Do you have family or other connections to California?

 

[Dares Dareson]

Away rotations are generally not required and probably in most cases hurt more than they help.

Could you please explain more why they hurt?

My school does not offer a surgery sub-internship, so I was planning on doing one away, most likely out of state.

Thank you.

 

[Winged Scapula]

Think of it like a month long interview.

Even the most personable, hard working amongst us have a hard time keeping it together for that length of time. Envision that you are the new guy: you don't know how how to use the EMR, you don't know any phone extensions, how Dr. X likes to do things, let alone where the bathrooms are. You are being compared to students who have been there for 4 years. Students with good board scores typically don't look better in person (as much as we think we are so personable that everyone will love us) so they tend to fall in the rankings once the honeymoon period is over. Below average students might benefit from an away, only if they are "better in person than on paper". Its a double edge sword with more potential to hurt you.

 

[Dares Dareson]

Think of it like a month long interview.

Even the most personable, hard working amongst us have a hard time keeping it together for that length of time. Envision that you are the new guy: you don't know how how to use the EMR, you don't know any phone extensions, how Dr. X likes to do things, let alone where the bathrooms are. You are being compared to students who have been there for 4 years. Students with good board scores typically don't look better in person (as much as we think we are so personable that everyone will love us) so they tend to fall in the rankings once the honeymoon period is over. Below average students might benefit from an away, only if they are "better in person than on paper". Its a double edge sword with more potential to hurt you.

When I was first introduced to the concept of Sub-Is, my first thought was "but how will you learn the EMR?" I have a slightly above average student for matching general surgery. I really hoped to get a good LoR out of an away rotation. I wasn't sure if I could get a letter out of an elective that is not a Sub-I, and my school really doesn't have surgery Sub-Is.

I'm thinking I may just do a Sub-I at a hospital I'm not super into but wouldn't mind ending up at?

 

[Winged Scapula]

When I was first introduced to the concept of Sub-Is, my first thought was "but how will you learn the EMR?" I have a slightly above average student for matching general surgery. I really hoped to get a good LoR out of an away rotation. I wasn't sure if I could get a letter out of an elective that is not a Sub-I, and my school really doesn't have surgery Sub-Is.

I'm thinking I may just do a Sub-I at a hospital I'm not super into but wouldn't mind ending up at?

There are some specialties where an audition is practically required but that’s generally not true for GS.

If you want to do a Sub-I away, consider a place where you probably wouldn’t match but could get a power LOR out of.

 

[HighwayVagabond]

I'm probably the only person on the surgery forum that will say this, but doing visiting sub-I's was one of the best things I could have ever done as a medical student for a few reasons. I also chose to do mine in California in the hopes that I may match out west. I chose one on my own accord and another my surgical mentors suggested as a good fit for me. They were both much more competitive than I was on paper. The one I chose wasn't my style, and although the PD offered me an interview I explained I knew I wouldn't fit in and respectfully declined. The one my mentors chose was a perfect fit. Awkwardly, the interviews were sent out by that program during my last week and I had not met the PD yet. I wasn't offered an interview based on my application. However, the residents were strong supporters of mine, and apparently so many of them spoke with the PD that I ended up getting an informal interview with him, winning him over, and being invited for the real deal interview. I ultimately ranked another program #1 (not in the west!), but I believe I probably would have matched there otherwise.

For me, there is something MORE IMPORTANT about doing visiting sub-I's than all that. I learned so much about the variation of general surgery residencies by exploring other programs. There were so many things about the structure, size, focus, and environment that differ from program to program that I would have never appreciated going into the interview season. I believe I was able to ask very important questions during interviews, and really understand what I wanted out of residency, and where I might thrive in residency, based on these experiences. So for THAT reason, I think everyone should do visiting sub-I's, even if you screw up and lose out on an interview because of it. Asking faculty mentors that know you well for suggestions as to where to do these is key. Also, do a service that you can be helpful on, and that you understand well. I did trauma/acs, where residents are generally overworked and miserable, and where I felt quite comfortable, and was really able to help their daily work flow run more smoothly. You aren't going to necessarily work with the most famous attendings on a service like that if you're only looking for an LOR, but I ended up getting a great LOR that was genuine and reflective of my abilities from a less famous attending, which can often be more meaningful.

 

[Dares Dareson]

Thanks for advice, all. Sorry for partial thread hijack.

 

[504196]

thanks for all the replies. Unfortunately I do not have significant ties to CA. I do have a cousin that I'm not that close with going to dance/arts school in LA. Not sure if I could spin that as a connection. I feel that CA is so competitive that an away rotation is kind of necessary but I could be totally wrong and I guess there are about 20 gen surg programs in CA and I could apply to all. As for getting support from my home institution to do an away when I met with the program director this week he seemed pretty opposed to aways and said its not worth the money so it doesn't seem like he's too interested in trying to find some connections at programs where I could do away.

How long do I have before I have to decide on doing an away ? I'd like to do one in August, maybe September if I choose to do one. Also feel free to post if you've positive or bad experiences with aways.

 

[HighwayVagabond]

thanks for all the replies. Unfortunately I do not have significant ties to CA. I do have a cousin that I'm not that close with going to dance/arts school in LA. Not sure if I could spin that as a connection. I feel that CA is so competitive that an away rotation is kind of necessary but I could be totally wrong and I guess there are about 20 gen surg programs in CA and I could apply to all. As for getting support from my home institution to do an away when I met with the program director this week he seemed pretty opposed to aways and said its not worth the money so it doesn't seem like he's too interested in trying to find some connections at programs where I could do away.

How long do I have before I have to decide on doing an away ? I'd like to do one in August, maybe September if I choose to do one. Also feel free to post if you've positive or bad experiences with aways.

I should clarify something--I don't think doing an away in California is a requirement to obtain interviews in California. I obtained several interviews from programs there that I did not do aways at. Of course, there are regional biases throughout this entire process, but I doubt an away at 1 or 2 institutions in California will suddenly make you a more likely candidate at all programs in California.

I would do an away in August since interviews begin going out right away after application submission in mid-September.

 

[ThoracicGuy]

?

What's this about?

If you disagree with my advice about audition rotations, you can say so without threatening me.

Check out the Eugene thread for info. Apparently he found this thread and will respond very forcefully!

 

[SunsFun]

We're going to find out who you are in real life, Winged Scapula, and we are going to make sure your career and reputation is ruined. Ban me and there were with 100 thousand others. We're all going to make an account on SDN.

 

[heraclez]

Completely agree with Winged Scapula.

If you do decide to do an away rotation in third year, I'd recommend either getting a LOR out of it, or coming back fourth year for ANOTHER away rotation. So long as you're not one of those people that the more time people spend with you the more they hate you. Just treat it like an audition rotation where you are as helpful as possible and never get in anyone's way. (Which I know is the hardest thing to do as a dumb student, where you ALWAYS feel like youre in the way.)

But think of it this way, you want to be remembered, you want to be liked, and spending time with someone is one of the better ways of doing that- again, unless you are just really unlikable!

 

[smq123]

Think of it like a month long interview.

Even the most personable, hard working amongst us have a hard time keeping it together for that length of time. Envision that you are the new guy: you don't know how how to use the EMR, you don't know any phone extensions, how Dr. X likes to do things, let alone where the bathrooms are. You are being compared to students who have been there for 4 years. Students with good board scores typically don't look better in person (as much as we think we are so personable that everyone will love us) so they tend to fall in the rankings once the honeymoon period is over. Below average students might benefit from an away, only if they are "better in person than on paper". Its a double edge sword with more potential to hurt you.

thanks for all the replies. Unfortunately I do not have significant ties to CA. I do have a cousin that I'm not that close with going to dance/arts school in LA. Not sure if I could spin that as a connection. I feel that CA is so competitive that an away rotation is kind of necessary but I could be totally wrong and I guess there are about 20 gen surg programs in CA and I could apply to all. As for getting support from my home institution to do an away when I met with the program director this week he seemed pretty opposed to aways and said its not worth the money so it doesn't seem like he's too interested in trying to find some connections at programs where I could do away.

How long do I have before I have to decide on doing an away ? I'd like to do one in August, maybe September if I choose to do one. Also feel free to post if you've positive or bad experiences with aways.

I agree with WS. I did an away rotation for OB when I was an MS4. Even though I had had a good OB rotation and got a great grade, I found my away rotation harder than I anticipated. I had trouble being "useful" because it took so long to fumble through the EMR to find things (lab results, imaging results, etc.) The place where I did the away rotation is a real OB powerhouse, and they saw a LOT more volume than I had seen as an MS3, and I had trouble adapting to their pace. I did things the way that I had been taught to do them - but that was very different from how THEY did things, and so the residents spent much of my time there correcting me on small, basic things. I generally tried to be humble and personable, but I had so much trouble finding my rhythm that I just came off as awkward. The more awkward I felt, the more I fumbled, and the less personable I became. It wasn't a catastrophe, but it wasn't a stellar experience either.

If you're interested in an away just to see a different part of the country, for an excuse to travel a bit, or just to find out how they do things elsewhere - great! But if you're doing an away in the hopes of matching somewhere competitive (either program or location) it might shoot you in the foot.

 

[504196]

i've had more time to think about it and am kind of leaning towards doing an away.

Anyone have any opinions on these locations for aways?
- Cedar Sinai Medical Center LA
- Kaiser SCAL LA
- UC Irvine
- UC San Diego

 

[504196]

i've had more time to think about it and am kind of leaning towards doing an away.

Anyone have any opinions on these locations for aways?
- Cedar Sinai Medical Center LA
- Kaiser SCAL LA
- UC Irvine
- UC San Diego

Bump. Any thoughts? Or how do you decide where to do an away? Visit the residency websites and see which one you like the best?

 

[DarknightX]

i've had more time to think about it and am kind of leaning towards doing an away.

Anyone have any opinions on these locations for aways?
- Cedar Sinai Medical Center LA
- Kaiser SCAL LA
- UC Irvine
- UC San Diego

All of these programs will provide you with good training. UC Irvine, UCSD and Kaiser all post on their websites where there graduates end up.

They all have graduates who end up in good fellowship programs, and most who choose to enter practice after residency get jobs in California.

In terms of doing aways, I would see what fits your schedule and what is available. I think it's a great idea to do an away. You get exposure to a different hospital and system and see how they do things. It's not that difficult, in my opinion, to do well on an away. Just be the first to show up and the last to leave. Don't take a day off if it's someplace you really want to be. It's a great chance to see if you fit in with the residents and what the culture is like.