As you probably know, general surgery has gotten considerably less competitive over the last 5 years. You will certainly find a place to train, where that might be is a little up for grabs. With all passes (much more of a problem than your 208, which while not stellar wouldn't have been an issue at all if you could have gotten some higher grades), your letters are going to have to say something meaningful about you so choose your letter writers wisely. You are also going to be a little less picky than most.
If you are looking for _any_ program it really won't be a problem to find a mid level community program, or a less prestigious university program to take you. However, you are out of the running for the more elite 15-20 programs that are university based and 5-15 top community programs. Of course that still leaves something like 170 programs that you may have a shot!
What you need is some good counseling by someone who actually knows you and your personality. Seek out a mentor in your surgery department who would be willing to look over your materials and help you pick out programs that you would be well suited for. Also, often programs have "relationships" with certain pther programs (places with PDs with ties to the school, etc.) that may bump you up into a program that you otherwise might not be considering because of their selectivity.
In the meantime get signed up for some surgery sub-internshipships or electives and do really well!
while you might not be a candidate for the very top programs, you certainly have a shot at some of the better programs @ the next level especially at ones with large # of slots. With the fairly close applicantosition ratio, some of the larger programs (6 spots or more) go pretty far down their rank list sometimes to fill, if you get a foot in the door with an interview......who knows?
best of luck! Let me know if I can give you any advice (for what its worth)as you get closer
thanks for your responses. I am currently doing a sub i in surgery right now. i finished my vascular sub i with the chair of my department last rotation. I got a letter from him, a letter from a pretty famous laparoscopic surgeon, and a letter from a doc that seems to know the northern california programs very well, which is where I am applying. My question is which programs are considered to be in the top 20. I'm looking to go somewhere in Sacramento. THere are two programs there, UC davis and Kaiser. SHould I do an away rotation there to improve my chances? THere are also alot of UCSF satellite hospitals with surgery programs. Are any of these programs possible for me? WIth all these programs listed, it would number to about 5 - 7 at the top of my list.
I also will be applying for GS this year. I'm looking at programs in the Mid-Atlantic/South areas. I also feel totally in the dark as to which ones are ultra-competitive. I've heard that U. of Virginia is, but what about ones like UNC, UF, U. of Maryland, MCV, and the Kentucky and Tennessee programs? Just curious... thanks!
In the end though, I want to say once again:
Virtually any accredited program can provide you with adequate training. The ultra-competitive ones are nice for the prestige and for staying in academics, but otherwise don't always provide yo0 with the most operative experience.
Specific comments for the questions posted: In the years when general surgery was very popular (>4 years ago), the California schools were inundated with applications, and at that time I was under the impression that they preferred that you had rotated out there if you weren't from California or didn't have California ties at least as a mark of your level of interest. I doubt they've been able to keep that up in this decline except possibly UCLA and UCSF. Even then, I know of people who were ranked highly there without ever setting foot on campus before their interview.