How competitive is integrated thoracic surgery?

[YCAGA]

I was always under the impression that I6 thoracic surgery was one of the most competitive residencies due to the <50% match rate for US MD's. However, I just saw this paper and, of the students surveyed, "Fifty-seven percent (49 of 86) scored above 230 on the USMLE Step 1 examination. Ninety-two percent (80 of 87) performed research during medical school, and 78% (62 of 80), specifically within cardiothoracic surgery; 76% (61 of 80) published their work." Seems pretty shocking that barely half were above average on Step 1 and almost 1/4th didn't even do research in CT surgery. This is from 2015 and only 90 out of the 180 people sent a survey responded, so I am curious what you all think about the competitiveness of I6 programs these days since this paper isn't super reliable or up to date. There is no Charting Outcomes data for I6 thoracic surgery due to the small sample size (I think that is why at least). Obviously there is competition for I6 spots as evidenced by the low match rate, but I am more curious about the actual strength of matched applicants compared to "traditional" competitive specialties like derm, ortho, neurosurgery, etc.

Follow up question, maybe I am just naive but is it not unfair for GS programs to hold an I6 resume against an applicant? GS is still a pathway to CT surgery so it is not like GS is a "backup" for CT applicants in the same way it is a backup for ortho, urology, or ENT applicants. If someone fails to match into CT surgery and ends up in GS, they presumably will be much more dedicated to the specialty (to get a CT fellowship) than someone who wanted to do an entirely different subspecialty.

I go to a mid-tier state school without an I6 program so I always figured I was better off shooting for the GS path instead of risking the super competitive I6 route, but maybe not?

Thanks!

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[mikeGR]

I do not know much about the I6 competitiveness per se, so take this with a grain of salt. I wouldn't read too much into this survey. There's huge selection bias and the most important variables in the "match" equation are not taken into account (i.e, personal relationships). As an IMG applying for Gen Surg some time ago, most of my IMG peers had way better qualifications on paper than the averages listed on NRMP (for matched IMGs)- yet, very few matched in categorical spots. For example, someone may have had average scores, but spent 5 years in the lab before matching at the same program. Someone else may have no publications but worked as a CV tech for several years and did a great job and met the right people. Someone else may have won a prestigious ASTS award. Someone else holds patents from biomed work related to CV surg. You get the picture. These are special individuals but none of that is reflected in the survey or NRMP data.

GS residencies don't want to be a backup plan for many reasons. Residency is hard and if you don't really love what you do, you will burn out easier and will likely not perform at your maximum. Attrition risk is higher. They may be reapplying or looking for positions outside of the match. They may be less excited to come in and drain a butt abscess at midnight while severely sleep-deprived and dreaming of nice elegant sleeve lobectomies (or whatever gets CT surgeons off). Sure, it's probably not as pronounced as NSGY/ortho etc but it still applies.

 

[Banco]

We have had a few I6 CT matches over the past few years. They were all pretty much stars and got top tier GS interviews alongside the I6 ones. Most matched I6, but a couple did match GS. Don't know how they went about making their ROL list though (i.e. all pure CT first or mix/match). A couple did say that though they applied to more GS places than I6 CT, they still received for I6 interviews and less GS interviews. So I think there is a bit of a bias. Regardless, I think it's foolish not to apply to GS too, the match rate for I6 CT is really low.

Overall I think the applicant to seat ratio makes it highly competitive. Also, you need strong backing from your home department via research/letters. That paper may already be outdated.

 

[YCAGA]

I do not know much about the I6 competitiveness per se, so take this with a grain of salt. I wouldn't read too much into this survey. There's huge selection bias and the most important variables in the "match" equation are not taken into account (i.e, personal relationships). As an IMG applying for Gen Surg some time ago, most of my IMG peers had way better qualifications on paper than the averages listed on NRMP (for matched IMGs)- yet, very few matched in categorical spots. For example, someone may have had average scores, but spent 5 years in the lab before matching at the same program. Someone else may have no publications but worked as a CV tech for several years and did a great job and met the right people. Someone else may have won a prestigious ASTS award. Someone else holds patents from biomed work related to CV surg. You get the picture. These are special individuals but none of that is reflected in the survey or NRMP data.

GS residencies don't want to be a backup plan for many reasons. Residency is hard and if you don't really love what you do, you will burn out easier and will likely not perform at your maximum. Attrition risk is higher. They may be reapplying or looking for positions outside of the match. They may be less excited to come in and drain a butt abscess at midnight while severely sleep-deprived and dreaming of nice elegant sleeve lobectomies (or whatever gets CT surgeons off). Sure, it's probably not as pronounced as NSGY/ortho etc but it still applies.

Thanks for your reply. I should have been more clear but this survey was more of a starting point for the thread than something I think is reliable. Just made me decide to post about a question I have had for awhile. I agree that connections and stuff that isn’t captured in NRMP data is important to matching, but there are also some pretty strong trends for the specialities that do release data like ortho and plastics. High step 1, lots of research, high percentage of AOA and top 40 NIH funded schools, etc.

 

[YCAGA]

We have had a few I6 CT matches over the past few years. They were all pretty much stars and got top tier GS interviews alongside the I6 ones. Most matched I6, but a couple did match GS. Don't know how they went about making their ROL list though (i.e. all pure CT first or mix/match). A couple did say that though they applied to more GS places than I6 CT, they still received for I6 interviews and less GS interviews. So I think there is a bit of a bias. Regardless, I think it's foolish not to apply to GS too, the match rate for I6 CT is really low.

Overall I think the applicant to seat ratio makes it highly competitive. Also, you need strong backing from your home department via research/letters. That paper may already be outdated.

Gotcha. To be clear the decision would be apply I6+general surgery or just apply general surgery, because obviously it’s better to match a good general surgery program and then be able to do CT fellowship instead of failing to match CT because it’s so competitive for spots, and then also failing to match GS due to bias.

 

[SpliceOfLife]

However, I just saw this paper and, of the students surveyed, "Fifty-seven percent (49 of 86) scored above 230 on the USMLE Step 1 examination. Ninety-two percent (80 of 87) performed research during medical school, and 78% (62 of 80), specifically within cardiothoracic surgery; 76% (61 of 80) published their work." Seems pretty shocking that barely half were above average on Step 1 and almost 1/4th didn't even do research in CT surgery. This is from 2015 and only 90 out of the 180 people sent a survey responded, so I am curious what you all think about the competitiveness of I6 programs these days since this paper isn't super reliable or up to date.

This paper surveyed applicants, not matriculants, at only 3 programs over 2 years prior to 2015. This is not what you should be basing your information off of.

At our program we don't interview people with less than a 230 unless they know someone. Most interviewed applicants are in the range of 240-260. Those with poor STEP 1 scores who did interview recently were ranked very low bc of their scores. We have been fortunate to match some pretty talented applicants and while our program is known it is certainly not the very best.

Some GS programs are less competitive than I6 programs, while others are more competitive. You cannot generalize like that. As I6 programs become more established and graduates continue to be competitive on the job market the staying power of these training programs will only increase and board score expectations will continue to rise. People may like or hate the I6 training pathway but there is no shortcut to one of the most lucrative and demanding fields in medicine.

You should absolutely apply to both gen surg and I6 programs.

 

[robellis]

This paper surveyed applicants, not matriculants, at only 3 programs over 2 years prior to 2015. This is not what you should be basing your information off of.

At our program we don't interview people with less than a 230 unless they know someone. Most interviewed applicants are in the range of 240-260. Those with poor STEP 1 scores who did interview recently were ranked very low bc of their scores. We have been fortunate to match some pretty talented applicants and while our program is known it is certainly not the very best.

Some GS programs are less competitive than I6 programs, while others are more competitive. You cannot generalize like that. As I6 programs become more established and graduates continue to be competitive on the job market the staying power of these training programs will only increase and board score expectations will continue to rise. People may like or hate the I6 training pathway but there is no shortcut to one of the most lucrative and demanding fields in medicine.

You should absolutely apply to both gen surg and I6 programs.

How lucrative we talking?

 

[SpliceOfLife]

How lucrative we talking?

This question needs to be more specific but among all-comers median salary is $650k-$780k depending on the survey and practice location. Here's an example:

 

[dienekes88]

Its competitive, and this manuscript under sells it.

The competitiveness is not just in terms of stats because the students matching with lower stats may have a ton of research or be just overall super well liked in the program. Its not just about high stats. Its about fitting in. If you match, they are stuck with you for 6-8 years.

 

[YCAGA]

Its competitive, and this manuscript under sells it.

The competitiveness is not just in terms of stats because the students matching with lower stats may have a ton of research or be just overall super well liked in the program. Its not just about high stats. Its about fitting in. If you match, they are stuck with you for 6-8 years.

Thanks for your reply. I assumed this manuscript was misleading which made me want to start this thread. I realize that might not have been clear. Being likable and easy to work with isn’t really something I expect to learn on a forum lol, but any tips for specific things to avoid doing/annoying stuff medical students do when rotating on CT surgery? That goes for anyone in this thread who has replied.

 

[YCAGA]

This paper surveyed applicants, not matriculants, at only 3 programs over 2 years prior to 2015. This is not what you should be basing your information off of.

I completely agree, this is why I said this in my initial post:

This is from 2015 and only 90 out of the 180 people sent a survey responded, so I am curious what you all think about the competitiveness of I6 programs these days since this paper isn't super reliable or up to date.

Thanks for your reply about your program. A cutoff of 230 on Step 1 makes sense given the limited number of spots.

Do people that match at your program normally do a sub-I/audition rotation at your program?

How would you rank the following in terms of importance? Step 1 (Step 2 going forward), class rank, clerkship grades, research publications/experience, performance on thoracic surgery sub-I, letters of recommendation, interview, anything else I forgot.

This again goes for anyone involved in CT surgery programs not just @SpliceOfLife

 

[SpliceOfLife]

I completely agree, this is why I said this in my initial post:


Thanks for your reply about your program. A cutoff of 230 on Step 1 makes sense given the limited number of spots.

Do people that match at your program normally do a sub-I/audition rotation at your program?

How would you rank the following in terms of importance? Step 1 (Step 2 going forward), class rank, clerkship grades, research publications/experience, performance on thoracic surgery sub-I, letters of recommendation, interview, anything else I forgot.

This again goes for anyone involved in CT surgery programs not just @SpliceOfLife

I cannot give you an estimate of which of these items is more important than the others, only to say that they are all important to some degree. The level of importance will vary on the application evaluator and the institution. Although it would be nice all around if the process were transparent and the criteria objective, they are not. Embarassingly, people at my institution make decisions on things that are quite subjective, even frivolous. Just try your best on all of these things, knowing that if you do reasonably well on many/most of these items, you will have a good chance of getting an interview at a good representative handful of institutions. I know that's not the answer you're looking for but life is not fair nor are people or the processes they create all that logical.

That being said, one important factor that you did NOT mention that you SHOULD be thinking about is your reason for going into cardiothoracic surgery. This is something that you need to have nailed down once you get an interview. Many people are eliminated because of a lack of concrete vision or drive for applying to this field which becomes apparent only when they interview. Don't be one of those people.

 

[YCAGA]

I cannot give you an estimate of which of these items is more important than the others, only to say that they are all important to some degree. The level of importance will vary on the application evaluator and the institution. Although it would be nice all around if the process were transparent and the criteria objective, they are not. Embarassingly, people at my institution make decisions on things that are quite subjective, even frivolous. Just try your best on all of these things, knowing that if you do reasonably well on many/most of these items, you will have a good chance of getting an interview at a good representative handful of institutions. I know that's not the answer you're looking for but life is not fair nor are people or the processes they create all that logical.

That being said, one important factor that you did NOT mention that you SHOULD be thinking about is your reason for going into cardiothoracic surgery. This is something that you need to have nailed down once you get an interview. Many people are eliminated because of a lack of concrete vision or drive for applying to this field which becomes apparent only when they interview. Don't be one of those people.

Thank for the answer! I much prefer you being honest as opposed to just making up an order when it can greatly vary from person to person.

I am just curious, what are some frivolous things that people have cared about before? If you feel comfortable sharing.

This might sound naive but the "why CT surgery?" or really just "Why my specialty?" sounds pretty similar to the "why medicine?" question that we have to answer when applying to medical school. Pretty much everyone has similar answers, so is it just how you articulate it? I can't imagine the reasons vary that much from surgeon to surgeon. Just to name two things, I think the thorax has the coolest anatomy and pathophysiology of any surgical specialty and on-pump heart surgery is the best display of teamwork and coordination in medicine. Like most medical students (I think), I am more drawn to the adult cardiac side of things as opposed to general thoracic, but I assume that is okay to be open about, since the I6 has two different tracks.

 

[deleted50541]

That being said, one important factor that you did NOT mention that you SHOULD be thinking about is your reason for going into cardiothoracic surgery. This is something that you need to have nailed down once you get an interview. Many people are eliminated because of a lack of concrete vision or drive for applying to this field which becomes apparent only when they interview. Don't be one of those people.

As an interviewer for an integrated program, this was definitely a red flag. Most applicants could provide a reasonable answer for why CT surgery interested them and what their educational and career goals were. The ones with clear, definable goals and obvious passion in their answers really stood out. Ultimately, these answers help us decide as program if we're a good fit for the applicant and vice versa.

On the other hand, those interviewees who's answers were lackluster and didn't give us a good reason why we should commit to educating them for 6-8 years were either ranked low or not at all.

This might sound naive but the "why CT surgery?" or really just "Why my specialty?" sounds pretty similar to the "why medicine?" question that we have to answer when applying to medical school. Pretty much everyone has similar answers, so is it just how you articulate it? I can't imagine the reasons vary that much from surgeon to surgeon. Just to name two things, I think the thorax has the coolest anatomy and pathophysiology of any surgical specialty and on-pump heart surgery is the best display of teamwork and coordination in medicine. Like most medical students (I think), I am more drawn to the adult cardiac side of things as opposed to general thoracic, but I assume that is okay to be open about, since the I6 has two different tracks.

I realize it's a general question, but yes, how you articulate the answer matters. We want to know what interests you about this field, what are your career aspirations, and how do you think our program will help you achieve your goals. If you can provide clear and concise answers to these questions in an interview, it goes a long way toward helping us rank you for our program.

As an aside, I still think I6 programs are better suited to folks interested in cardiac surgery rather than general thoracic. And newer programs are going to choose those applicants in turn. If general thoracic is your interest, I would choose the traditional route of gen surg + CT fellowship.

 

[YCAGA]

As an interviewer for an integrated program, this was definitely a red flag. Most applicants could provide a reasonable answer for why CT surgery interested them and what their educational and career goals were. The ones with clear, definable goals and obvious passion in their answers really stood out. Ultimately, these answers help us decide as program if we're a good fit for the applicant and vice versa.

On the other hand, those interviewees who's answers were lackluster and didn't give us a good reason why we should commit to educating them for 6-8 years were either ranked low or not at all.


I realize it's a general question, but yes, how you articulate the answer matters. We want to know what interests you about this field, what are your career aspirations, and how do you think our program will help you achieve your goals. If you can provide clear and concise answers to these questions in an interview, it goes a long way toward helping us rank you for our program.

As an aside, I still think I6 programs are better suited to folks interested in cardiac surgery rather than general thoracic. And newer programs are going to choose those applicants in turn. If general thoracic is your interest, I would choose the traditional route of gen surg + CT fellowship.

Thanks for your reply. That is great advice and makes a lot of sense.

I have heard that before about thoracic training probably being best if done through the general surgery route. What they said is that having general surgery training is useful when dealing with the foregut in the chest. Are there other reasons? I would imagine lung stuff is more common than esophageal stuff for general thoracic, but I am about as green as they come when it comes to all of this.

 

[deleted50541]

Thanks for your reply. That is great advice and makes a lot of sense.

I have heard that before about thoracic training probably being best if done through the general surgery route. What they said is that having general surgery training is useful when dealing with the foregut in the chest. Are there other reasons? I would imagine lung stuff is more common than esophageal stuff for general thoracic, but I am about as green as they come when it comes to all of this.

Yes, having training in GI surgery and being comfortable working on both sides of the diaphragm is important to being a good general thoracic surgeon. I don't do much foregut surgery myself (wasn't my main interest and I have two partners who do most of that work). But I still deal with foregut/GI emergencies like esophageal perforations, acute/traumatic diaphragm hernias with incarcerated viscera, and SBOs in our previously operated patients. I also double scrub esophagectomy cases when I can to keep my skills up.

I also think general surgery is important for the ICU training you should receive. Granted, ICU management is a critical part of cardiac surgery, but the lessons I learned taking care of non-cardiac surgical ICU patients were invaluable.

Lastly, general surgery gives you a strong foundation for taking care of any surgical patient. It's easy to get lost in the weeds when you're sub-specialized and only focusing on your area of expertise. But when you get experience with things like polytrauma patients and operate with surgeons in other sub-specialties, I feel you get a better sense of the patient as a whole and a more fundamental understanding of basic surgical practice.

 

[YCAGA]

Yes, having training in GI surgery and being comfortable working on both sides of the diaphragm is important to being a good general thoracic surgeon. I don't do much foregut surgery myself (wasn't my main interest and I have two partners who do most of that work). But I still deal with foregut/GI emergencies like esophageal perforations, acute/traumatic diaphragm hernias with incarcerated viscera, and SBOs in our previously operated patients. I also double scrub esophagectomy cases when I can to keep my skills up.

I also think general surgery is important for the ICU training you should receive. Granted, ICU management is a critical part of cardiac surgery, but the lessons I learned taking care of non-cardiac surgical ICU patients were invaluable.

Lastly, general surgery gives you a strong foundation for taking care of any surgical patient. It's easy to get lost in the weeds when you're sub-specialized and only focusing on your area of expertise. But when you get experience with things like polytrauma patients and operate with surgeons in other sub-specialties, I feel you get a better sense of the patient as a whole and a more fundamental understanding of basic surgical practice.

Wow this is awesome information. Thanks again. This type of reply is what I love about the internet. I have been to talks where similar questions are asked but for whatever reason the attendings haven't gone into much detail.

It’s also nice to know that my instincts as a medical students aren’t totally off. We don’t have an integrated CT surgery residency at my school, so I am not exactly sure how their rotations work, but I have assumed that it’s easy to get hyper-focused on the management of heart and lung pathologies and lose focus of GI, GU, etc management compared to a general surgery resident. From what I have gathered, the expectation for general surgery residents is that they can handle issues that other surgical specialities would refer straight to IM.
Not saying gen surgeons are gods that never ask for help, but I think you know what I mean.

 

[Medstart108]

Wow this is awesome information. Thanks again. This type of reply is what I love about the internet. I have been to talks where similar questions are asked but for whatever reason the attendings haven't gone into much detail.

It’s also nice to know that my instincts as a medical students aren’t totally off. We don’t have an integrated CT surgery residency at my school, so I am not exactly sure how their rotations work, but I have assumed that it’s easy to get hyper-focused on the management of heart and lung pathologies and lose focus of GI, GU, etc management compared to a general surgery resident. From what I have gathered, the expectation for general surgery residents is that they can handle issues that other surgical specialities would refer straight to IM.
Not saying gen surgeons are gods that never ask for help, but I think you know what I mean.

A lot of integrated CT surgery residencies still spend a significant amount of time in general surgery, with that being said, I have heard this advice that if you know you are interested in thoracic surgery, the 5+2 route is better. Most of the integrated residents are interested in cardiac.

 

[dienekes88]

Wow this is awesome information. Thanks again. This type of reply is what I love about the internet. I have been to talks where similar questions are asked but for whatever reason the attendings haven't gone into much detail.

It’s also nice to know that my instincts as a medical students aren’t totally off. We don’t have an integrated CT surgery residency at my school, so I am not exactly sure how their rotations work, but I have assumed that it’s easy to get hyper-focused on the management of heart and lung pathologies and lose focus of GI, GU, etc management compared to a general surgery resident. From what I have gathered, the expectation for general surgery residents is that they can handle issues that other surgical specialities would refer straight to IM.
Not saying gen surgeons are gods that never ask for help, but I think you know what I mean.

Every program is different. Cardiac surgery residents are often expected to manage all aspects of a patient's care.

 

[YCAGA]

Every program is different. Cardiac surgery residents are often expected to manage all aspects of a patient's care.

Gotcha, that makes sense. I did more research on the rotations of 6 year CT programs. It looks like the first 3 years are very similar to the first 3 years of general surgery (with basically all the electives focused on CT surgery) and then the last 3 years are the rotations of a 3 year CT fellowship.

 

[Dunkthetall]

Sorry to sort of derail this, but didn’t want to create a separate thread.

But do integrated CT residencies teach the interventional procedures used by interventional cardiologist? Or will that ever become a thing?
Just wondering because I hear the job market is good for cardiac surgeons right now, but also wondering if things will get bad again as medicine moves to become more minimally invasive.

 

[YCAGA]

Sorry to sort of derail this, but didn’t want to create a separate thread.

But do integrated CT residencies teach the interventional procedures used by interventional cardiologist? Or will that ever become a thing?
Just wondering because I hear the job market is good for cardiac surgeons right now, but also wondering if things will get bad again as medicine moves to become more minimally invasive.

From my research, some programs do teach these procedures but you have to realize that interventional cardiologists are already in the pipeline to receive patients needing endovascular treatment. Also, IC is a one year fellowship... and afaik, I don't think CT surgery can get 1 year worth of caths and cardiac interventions PLUS cardiac surgery PLUS thoracic surgery into 3 years of fellowship/last 3 years of I6 training. Maybe they can though.

 

[Dunkthetall]

From my research, some programs do teach these procedures but you have to realize that interventional cardiologists are already in the pipeline to receive patients needing endovascular treatment. Also, IC is a one year fellowship... and afaik, I don't think CT surgery can get 1 year worth of caths and cardiac interventions PLUS cardiac surgery PLUS thoracic surgery into 3 years of fellowship/last 3 years of I6 training. Maybe they can though.

Gotcha!

Is possible/feasible for a cardiac surgeon to do a one year IC fellowship after residency, then market themselves as someone that can do endo and open?

 

[YCAGA]

Gotcha!

Is possible/feasible for a cardiac surgeon to do a one year IC fellowship after residency, then market themselves as someone that can do endo and open?

Disclaimer: I have more or less no idea what I am talking about. I am just a med student.

I would say almost certainly not but I will defer to the actual surgeons who have been in this thread. If you’re really interested in endo stuff, I would look at CT + vascular surgery.

 

[LucidSplash]

Gotcha!

Is possible/feasible for a cardiac surgeon to do a one year IC fellowship after residency, then market themselves as someone that can do endo and open?

Currently no, there is no pathway for someone to do an interventional cardiology fellowship after a CT surgery residency/training.

Additionally the biggest problem you’re going to face is that the interventional cardiologist/medical cardiologists are the ones that see these patients first from primary care. They will then refer to CT surgery as needed. So there’s not going to be a whole lot of opportunity for you to do your own catheter based interventional cardiology procedures because the cardiologists capture them first.

 

[CTFellowMD]

This year there were over 120 applicants for the ~45 open integrated positions. We interviewed about 20 for our one spot. All interviewees were all-stars - numerous publications, high step 1 (>250), and glowing letters of rec from well known academic CT surgeons. It is currently VERY competitive.

 

[Billroth_III]

Don't forget you can do 5+2/3 OP. While it adds on a year or two, it will certainly not be as difficult as I6.

 

[YCAGA]

Don't forget you can do 5+2/3 OP. While it adds on a year or two, it will certainly not be as difficult as I6.

Currently I am a fairly average medical student and go to a fairly average MD school, so that sounds like the more realistic option.

I was under the impression that the “better” GS programs require at least a year of research if not two so it’s more like 6-7 plus 2-3 years. Of course people still match into CT fellowship from community programs with no research requirements or “recommendations.”

 

[YCAGA]

This year there were over 120 applicants for the ~45 open integrated positions. We interviewed about 20 for our one spot. All interviewees were all-stars - numerous publications, high step 1 (>250), and glowing letters of rec from well known academic CT surgeons. It is currently VERY competitive.

This is the kind of data point I was looking for. Thanks!

Well I don’t love to hear it is so competitive, but I am pretty sure that one of the goals of starting the I6 pathway was to make CT surgery more competitive again…sounds like it is working.

 

[dienekes88]

Gotcha!

Is possible/feasible for a cardiac surgeon to do a one year IC fellowship after residency, then market themselves as someone that can do endo and open?

I know of 2 people who have done something along these lines. They're one-off fellowships. There are also TAVR fellowships.

An integrated residency should be enough to get you comfortable doing: TAVR, TEVAR, single side arm device. In terms of doing coronary stents... you would have to do a lot of diagnostic caths to get a stent case. Most of the time the intervention happens at the time of diagnostic cath except in staged cases, structural cases, etc.

Finally, to be at the cutting edge of PCI, you have to be whole hog cath. Doing things that are probably better off as surgery early on, e.g. left main disease, and then allowing techniques to catch up. For bifurcation disease, you would have to be willing to do culotte technique, simultaneous kissing Y, provisional stenting when the evidence suggests that you should do surgery. I actually think you might limit your ability to he at the cutting edge by being a surgeon able to offer alternative therapies.

 

[dienekes88]

Currently I am a fairly average medical student and go to a fairly average MD school, so that sounds like the more realistic option.

I was under the impression that the “better” GS programs require at least a year of research if not two so it’s more like 6-7 plus 2-3 years. Of course people still match into CT fellowship from community programs with no research requirements or “recommendations.”

Research years were some of the best of my life: Personally and professionally. I wouldn't write off research time so easily.

 

[YCAGA]

Research years were some of the best of my life: Personally and professionally. I wouldn't write off research time so easily.

That is encouraging to hear. Do you take call/scrub in during research years, i.e. how do you stay fresh clinically/technically? This might be a non-issue after two full years of surgical residency...I don't know how quickly skills deteriorate.

 

[dienekes88]

That is encouraging to hear. Do you take call/scrub in during research years, i.e. how do you stay fresh clinically/technically? This might be a non-issue after two full years of surgical residency...I don't know how quickly skills deteriorate.

Every program is different. The important thing to note is that you won't be the first to go into the lab. You're not the last. Somehow, surgery residents make it work.

Separately, if you are in a basic science lab, your skills may actually progress in the setting of doing a bunch of small and large animal operations.

 

[HighPriest]

Depends upon whether or not you care about being board certified or working in a hospital as opposed to a warehouse by the bay.

 

[deleted50541]

Every program is different. The important thing to note is that you won't be the first to go into the lab. You're not the last. Somehow, surgery residents make it work.

Separately, if you are in a basic science lab, your skills may actually progress in the setting of doing a bunch of small and large animal operations.

I took a year off to do research with no clinical responsibilities. Was definitely a nice break both physically and mentally. I still took the ABSITE so I was studying and I did small animal procedures along with my bench work.

It was a little rough starting back, but the knowledge I learned, the papers I had published, and the meetings I went to because of my research were a definite boost to my application.