How competitive is....

[toxic-megacolon]

After doing a half-assed search of the forums, and not finding an answer I'm satisfied with, I was wondering how "competitive" many of the less discussed subspecialties are. If the following, "often discussed" specialties fall into the following categories:

Extremely Competitive
Pediatrics
Surgical Oncology
Plastics

More Competitive
Vascular
Straight Thoracic/Foregut
Minimally Invasive
Colorectal

Less Competitive
Cardiothoracic
Trauma/Critical Care
Transplant
Breast

In which categories would the following subspecialties fall into:
1. Endocrine
2. Hand
3. Hepatobilliary
4. Head and Neck

If you don't agree with where I put the other fields I thought I knew, please correct me.

I am especially curious about Endocrine.

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[Pilot Doc]

After doing a half-assed search of the forums, and not finding an answer I'm satisfied with, I was wondering how "competitive" many of the less discussed subspecialties are. If the following, "often discussed" specialties fall into the following categories:

Extremely Competitive
Pediatrics
Surgical Oncology
Plastics

More Competitive
Vascular
Straight Thoracic/Foregut
Minimally Invasive
Colorectal

Less Competitive
Cardiothoracic
Trauma/Critical Care
Transplant
Breast

In which categories would the following subspecialties fall into:
1. Endocrine
2. Hand
3. Hepatobilliary
4. Head and Neck

If you don't agree with where I put the other fields I thought I knew, please correct me.

I am especially curious about Endocrine.

Move Breast up to more competitive. Apparently applicants exceeded positions this year.

Of your question fellowships, none are accredited (nor numerous.) What that essentially means is that if you can convince anybody with a busy X practice to take you on, then ta-da, you have a fellowship.

 

[eilis721]

i was checking out the nrmp page the other day and was very surprised to find out that colorectal had a 39% unmatched rate this year. i believe peds surg is 38%. one of the chiefs at my program didn't match into colorectal this year. has anyone heard anything about it becoming so competitive?

 

[DO_Surgeon]

i was checking out the nrmp page the other day and was very surprised to find out that colorectal had a 39% unmatched rate this year. i believe peds surg is 38%. one of the chiefs at my program didn't match into colorectal this year. has anyone heard anything about it becoming so competitive?

Maybe I am misunderstanding but Peds Surg does not have a 38% unmatch rate. There are only 29 programs total and all matched. Peds Surg from what I understand is probably the most competitive due to the lack of positions.

 

[Pilot Doc]

Maybe I am misunderstanding

You are misunderstanding.

The prior poster was referring to the applicant unmatched rate.

 

[Misterioso]

Why is colorectal surgery so competetive?

Lack of positions or is there actually a high interest in becoming proctologists?

 

[avgjoe]

Why is colorectal surgery so competetive?

Lack of positions or is there actually a high interest in becoming proctologists?

The feeling I get is that both colorectal and breast are becoming more popular because of lifestyle issues - ie, few emergencies and planned surgeries in most cases.
I think surg onc is also similar, but it depends what you do - the whipples can certainly keep you going in at any time.

 

[geekgirl]

After doing a half-assed search of the forums, and not finding an answer I'm satisfied with, I was wondering how "competitive" many of the less discussed subspecialties are. If the following, "often discussed" specialties fall into the following categories:

Extremely Competitive
Pediatrics
Surgical Oncology
Plastics

More Competitive
Vascular
Straight Thoracic/Foregut
Minimally Invasive
Colorectal

Less Competitive
Cardiothoracic
Trauma/Critical Care
Transplant
Breast

In which categories would the following subspecialties fall into:
1. Endocrine
2. Hand
3. Hepatobilliary
4. Head and Neck

If you don't agree with where I put the other fields I thought I knew, please correct me.

I am especially curious about Endocrine.

i think several of your listed interests (i.e. endocrine and hepatobiliary) also fall under surgical oncology. if, in endocrine, you're interested in mostly necks with a few adrenals and stuff, i think you can get that training at any of the surg onc fellowships. if you want a bunch of endocrine zebras (like insulinomas, etc) the NCI fellowship at the NIH (particularly the metabolic group) deals with alot of those very special patients. that would be a good place to get experience.

same with hepatobiliary, many residencies have strong HPB experiences and with an additional surg onc fellowship focused on that system, you could go far.

re: hand and/or head and neck, those fall more under the umbrella of plastics (if you're coming from gen surg) - otherwise you could go through ortho or ENT. i know a chief who's doing plastics in order to do head and neck oncology. so basically, you can choose a fellowship to give you a specific skill set or exposure to patient population/surgeries that might have been lacking in your training. and there are many roads to the same destination.

regarding competitiveness, these fall in the first category with surg onc and plastics.

 

[Plastikos]

i think several of your listed interests (i.e. endocrine and hepatobiliary) also fall under surgical oncology. if, in endocrine, you're interested in mostly necks with a few adrenals and stuff, i think you can get that training at any of the surg onc fellowships. if you want a bunch of endocrine zebras (like insulinomas, etc) the NCI fellowship at the NIH (particularly the metabolic group) deals with alot of those very special patients. that would be a good place to get experience.

same with hepatobiliary, many residencies have strong HPB experiences and with an additional surg onc fellowship focused on that system, you could go far.

re: hand and/or head and neck, those fall more under the umbrella of plastics (if you're coming from gen surg) - otherwise you could go through ortho or ENT. i know a chief who's doing plastics in order to do head and neck oncology. so basically, you can choose a fellowship to give you a specific skill set or exposure to patient population/surgeries that might have been lacking in your training. and there are many roads to the same destination.

regarding competitiveness, these fall in the first category with surg onc and plastics.

I dont know about the others on that list but hand surgery isnt considered competitive, im told they dont even fill all their spots.

 

[geekgirl]

I dont know about the others on that list but hand surgery isnt considered competitive, im told they dont even fill all their spots.

yeah maybe, i sorta lumped hand in there, but regarding that one, i really don't have a clue!

 

[Winged Scapula]

Hand: not competitive; many positions do not fill. However, for a general surgery trained resident they are more competitive because 1) not all programs take Gen Surg residents (some are Ortho or Plastics only) and 2) you are not preferred over Ortho and PRS because they have more experience in the upper extremity than most GS residents do.

Breast: move to competitive; as noted above, applicants exceeded positions and all spots filled.

Endocrine: strict Endocrine is not competitive.

The reason Colorectal and Breast are touted to be more competitive is likely due to lifestyle considerations. Few emergencies, short(ish) procedures.

 

[Roux-en-Y]

Correct me if i'm wrong but aren't all of the hepatobiliary fellowships non-accredited?

 

[Winged Scapula]

Correct me if i'm wrong but aren't all of the hepatobiliary fellowships non-accredited?

True...but if there is no board for a certain specialty this shouldn't be construed as poor training. Some non accredited specialties offer a Certificate of Added Qualifications (CAQ) - Hand surgery, for example.

 

[guavero]

True...but if there is no board for a certain specialty this shouldn't be construed as poor training. Some non accredited specialties offer a Certificate of Added Qualifications (CAQ) - Hand surgery, for example.

I don't think Surg Onc is accredited either...

 

[Celiac Plexus]

I have to disagree with the poster that said "endocrine" is not competitive. There are only 13 fellowships listed on endocrinesurgery.org, and they are for the most part at prestigious institutions.

The lifestyle of the only endocrine surgeon that I know is pretty sweet, although this surgeon does not perform much adrenal work... mainly breast, thyroid, and parathyroid.

I'm guessing that as more general surgery residents become aware of this "lifestyle" subspecialty, interest will increase and these fellowships will become even more competitive.

 

[toxic-megacolon]

I'm guessing that as more general surgery residents become aware of this "lifestyle" subspecialty, interest will increase and these fellowships will become even more competitive.

That's what I'm afraid of