Matching General Surgery in Chicago

[DM2016]

Hello guys,

I am applying to general surgery, and trying to maximize my chances of getting accepted at any of the Chicago programs. I wasn't planning on staying in Chicago, but due to family issues/sickness recently, I must be here!

I was looking at NW, UofC, UIC, Rush and Loyola

Anyone can comment on my chances or give any insight?

I have some research and 250+ on step 1 with A in general surgery

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[FIREitUP]

Hello guys,

I am applying to general surgery, and trying to maximize my chances of getting accepted at any of the Chicago programs. I wasn't planning on staying in Chicago, but due to family issues/sickness recently, I must be here!

I was looking at NW, UofC, UIC, Rush and Loyola

Anyone can comment on my chances or give any insight?

I have some research and 250+ on step 1 with A in general surgery

Very high with those scores.

 

[DM2016]

Very high with those scores.

Thank you for the feedback🙂

 

[Cytarabine]

Very high with those scores.

Yep, not much else to add other than that. And a compelling reason to want to stay in the area. Have a friend at UIC who has been happy with their experience fwiw

 

[FIREitUP]

Thank you for the feedback🙂

I would add that it might be a good plan to set up an away rotation in the area if you're 100% on chicago. though sometimes these can hurt you just as much as they can help you.

 

[Dr.TonySoprano]

I would add that it might be a good plan to set up an away rotation in the area if you're 100% on chicago. though sometimes these can hurt you just as much as they can help you.

why would do they hurt you? just if you were to make a bad impression?

 

[Dr.TonySoprano]

It is a month long job interview, and the general concept is that the potential to help is outweighed by the potential to harm, as all it takes is one slip up or bad impression on someone to torpedo your chances.

Medical students always seem to advice doing an away and "knocking it out of the park" to impress a program, without seeming to realize how hard "knocking it out of the park is".

thanks Surg.

 

[DM2016]

Yep, not much else to add other than that. And a compelling reason to want to stay in the area. Have a friend at UIC who has been happy with their experience fwiw

Is there a way I can get in touch with the friend and ask him few questions?

Thank you

 

[DM2016]

Your score certainly helps, but when you're talking about limiting your application to only 5ish programs there is no such thing as a guarantee, particularly at NW And Chicago (where students with >250 get rejected pre-interview every year).

You need to reconsider what "must" means. Certainly rank the chicago places first, but broaden your search. Lot of good programs in easy driving distance from Chicago.

I totally agree and I know that its a long shot. What programs that you know of are within a driving distance to Chicago?

 

[CopaceticOne]

I totally agree and I know that its a long shot. What programs that you know of are within a driving distance to Chicago?

Milwaukee, Madison, etc.

Consider a 2-3 hour radius and you can actually get good coverage. Heck, even UIowa can be driving distance from the north/west Chicago area.

 

[doc05]

I totally agree and I know that its a long shot. What programs that you know of are within a driving distance to Chicago?

Chicago is a major hub for all airlines... a 1-hour flight is easier than a 4-hour drive. You should look at every program between Pittsburgh and Minneapolis.

 

[mimelim]

I totally agree and I know that its a long shot. What programs that you know of are within a driving distance to Chicago?

I don't think anyone is saying that it is a long shot. You are in a good position with solid scores. But, the reality is that nothing can be taken for granted and hoping for the best, but preparing for the worst is the best way to approach these things, so you should be not only realistic, but also precautionary. That having been said, remember that there are 8 general surgery programs in Chicago and an additional 3 in Illinois.

My advice is to start with this list here:
https://services.aamc.org/eras/erasstats/par/display8.cfm?NAV_ROW=PAR&SPEC_CD=440

Think long and hard about what "must" means. The kind and quality of surgeon you will become depends on what program you end up at. There are some lower quality programs in Chicago that may be more attractive from a location perspective, but will not do you favors in your career over going to somewhere an hour and a half away. But, this is a ranking process that only you can do. I would map out 3 groups of programs. Those within 30 minutes of where you need to be, those within 2 hours of where you need to be and then all the programs that are within an hour plane flight/4 hour drive. You will be surprised how many fall into each of those categories.

I would also recommend considering doing 1-2 aways in Chicago. Always recognize that you can harm your chances of getting into a program by doing one, but also know that impressing the right 1-2 people at a program can really elevate your application.

 

[DM2016]

I don't think anyone is saying that it is a long shot. You are in a good position with solid scores. But, the reality is that nothing can be taken for granted and hoping for the best, but preparing for the worst is the best way to approach these things, so you should be not only realistic, but also precautionary. That having been said, remember that there are 8 general surgery programs in Chicago and an additional 3 in Illinois.

My advice is to start with this list here:
https://services.aamc.org/eras/erasstats/par/display8.cfm?NAV_ROW=PAR&SPEC_CD=440

Think long and hard about what "must" means. The kind and quality of surgeon you will become depends on what program you end up at. There are some lower quality programs in Chicago that may be more attractive from a location perspective, but will not do you favors in your career over going to somewhere an hour and a half away. But, this is a ranking process that only you can do. I would map out 3 groups of programs. Those within 30 minutes of where you need to be, those within 2 hours of where you need to be and then all the programs that are within an hour plane flight/4 hour drive. You will be surprised how many fall into each of those categories.

I would also recommend considering doing 1-2 aways in Chicago. Always recognize that you can harm your chances of getting into a program by doing one, but also know that impressing the right 1-2 people at a program can really elevate your application.

I cant thank you enough for this insightful information. Prior to the current events, I didn't have any location restrictions and wanted to go to a program where I can get the best education, but things changed.
But I really like the idea of having 3 groups of programs and developing the rank list based on the distance.

Do you think it would be unreasonable/harm my chances if I apply to few internal medicine programs in Chicago as well, and rank them lower on the list?
I know this comes down to how passionate/driven I am towards surgery, but family comes first and I can't be selfish I guess.

Again thank you!

 

[DM2016]

While it sounds like a big deal to be in a totally different city, the realities of a surgery residency mean that regardless of physical location you aren't going to have a lot of spare time or emotional energy to attend to family matters outside of work. You may not believe it, but you'll end up with close to the same amount of free time for them by living somewhere else and traveling to visit whenever possible. And if you end up at a program where you are unhappy with the work or it is malignant, then your amount of available emotional energy for others will be lessened dramatically.
QUOTE]


Wow, that is an eye opener I haven't even thought about it! Are you a surgical resident? Is it really that of a big commitment to the point that I wont have time or energy to spare?

 

[DM2016]

I would agree with the great advice above. Your list realistically should include programs within a 4 hr drive or 1-2 hr flying distance, which opens up basically all of the midwest +/- most of the NE and south.

Easy drives from Chicago include Milwaukee and Madison (1-2 hrs), Indianapolis - three hours, St. Louis - 4-5 hours. Ann Arbor or Detroit 4-5 hours. Cincinnati - 4-5 hrs. Iowa City - 3 hrs.

Those are just a few off of looking at Google. And would potentially open up another 10 or so good academic surgery residencies. Not to mention the places that are an easy flight.

While it sounds like a big deal to be in a totally different city, the realities of a surgery residency mean that regardless of physical location you aren't going to have a lot of spare time or emotional energy to attend to family matters outside of work. You may not believe it, but you'll end up with close to the same amount of free time for them by living somewhere else and traveling to visit whenever possible. And if you end up at a program where you are unhappy with the work or it is malignant, then your amount of available emotional energy for others will be lessened dramatically.

I wouldn't consider applying to a second field. It weakens your application for both (less time for sub-I's, letters, building connections, etc).

But this all depends on you, and what the particular personal situation is. Personally, the only situations that would lead me to consider something like this would be unexpected parenthood or divorce w/ a kid and custody issues. But that's just me.

Wow, that is an eye opener. I haven't even thought about surgery being such a big commitment that I wont have time to spare for family. Are you a surgical resident?

 

[mimelim]

I cant thank you enough for this insightful information. Prior to the current events, I didn't have any location restrictions and wanted to go to a program where I can get the best education, but things changed.
But I really like the idea of having 3 groups of programs and developing the rank list based on the distance.

Do you think it would be unreasonable/harm my chances if I apply to few internal medicine programs in Chicago as well, and rank them lower on the list?
I know this comes down to how passionate/driven I am towards surgery, but family comes first and I can't be selfish I guess.

Again thank you!

Wow, that is an eye opener. I haven't even thought about surgery being such a big commitment that I wont have time to spare for family. Are you a surgical resident?

I agree with the above. For you, I would not apply to another specialty based on competitiveness for residency. With solid scores and a reasonably well rounded application, you stand a good chance of matching in Chicago and a very strong chance (as good as anyone at least on paper) of matching in the immediate vicinity (based on the areas that we mentioned earlier. Everything is double edged. You can dilute your application potential by simply needing to focus on doing Sub-Is and getting LOR in two fields.

I made a mistake earlier. The first thing you need to do is sit down and have a no BS conversation with your family/friends/mentors about what you are getting into. Then you need to look internally and come to the conclusion that surgical residency is the right path for you. Both @SouthernSurgeon and I are surgical residents and as far as I can tell both are very happy with where we are. But, having been in surgery for some time now (he is almost done, I am finishing my 4th of 7 years), we recognize that surgery is not for everyone. It is demanding and for good reason. There is a ton to learn and experience. You can take care of family, you can start a family, you can do any number of things, but you can't do everything. And yes, surgical residency will be harder to deal with most of those things simply from a time and energy perspective. I don't want to discourage you from pursuing surgery because I am 4 years in and still show up at 5am smiling.

But, everyone is different. I don't think it is a good idea for you to apply to both. The 'correct' answer may be for you to only apply IM, but it would take pretty extreme circumstances for that to be true, especially since you will have a wide variety of programs that will work for you. If you NEEDED to be in Lubbock, Texas, this would a different story, but Chicago? Should be just fine.

 

[SouthernSurgeon]

My post will echo a lot of @mimelim 's. I'm very happy with both my career in surgery and my personal life outside of it. But I think it is important for everyone entering this field to do so with an appropriate understanding of what it entails. Surgery does entail a degree of sacrifice and effort that is rare even in other fields of medicine.

For your residency, you can expect your days to start early and end late. Think in the neighborhood of 4:30 nearly every morning, with a 5:30 or 6:00 alarm clock being considered a rare day of sleeping in. The bigger issue to me always than just the hours themselves though is the sheer unpredictability of them. I can't really estimate when I'm going to get to leave, particularly on a busy service. It's hard to commit to dinners or firm appointments. Regardless of what your family situation is, this will probably be the biggest practical barrier - you can't promise to pick someone up at 5:00 or cook them dinner at 7:00.

Fortunately for me, most of my friends are either in medicine or very understanding. So we end up with a lot of last minute cancelled plans, or a lot of last minute made ones. Days when we get done earlier than anticipated, it's very common for us co-residents to look at each other and go..."beer?"

Intern year will mean lots of call too. Don't forget that for right or wrong, surgeons are the ones basically asking the ACGME for permission to have 24 hr call back.

A key difference between surgery and other fields though is that it doesn't get easier after intern year and in fact in a great many ways it gets harder. For Internal Medicine, I think their intern year is nearly as hard and in some ways more painful than ours, but then after that you have an acute drop in hours and in inpatient months, and an acute rise in ability to delegate. Not the case in surgery - you pretty much go at the same pace/intensity for all five years, and as a chief you end up with a unique level of personal responsibility for your patients/service.

Now this leads me up to something I alluded to before...it's not just the hours, it's the emotional investment and toll. I have a lot of days where when I get home, I have no energy left. None. I sit on my couch, maybe watch 20 minutes of some dumb TV show, and fall asleep. I can have bills to pay, papers to write, a house to clean...doesn't matter. No energy left. The work isn't just about the hours, it's about the level of mental energy you have to expend.

Here's a great thread that has been getting some posts lately in the surgery forum, started by someone considering quitting after less than a year of this. It's just not for everyone:

http://forums.studentdoctor.net/threads/leaving-surgery.1193989/

 

[DM2016]

Thank you guys!! I am so glad I posted this question here. I wasn't expecting such great answers.
This means a lot, I underestimated the commitment, and hearing what its like from surgeons in training will give me a better chance of coming up with a decision that will balance family responsibilities vs work, and if considering other specialties at this point is the answer, then I have to suck it up and deal with it.

I wish you all the best!!

 

[ACSurgeon]

Thank you guys!! I am so glad I posted this question here. I wasn't expecting such great answers.
This means a lot, I underestimated the commitment, and hearing what its like from surgeons in training will give me a better chance of coming up with a decision that will balance family responsibilities vs work, and if considering other specialties at this point is the answer, then I have to suck it up and deal with it.

I wish you all the best!!

Have you done a general surgery rotation yet?

Also, are you at a US MD program? If so, matching in Chicago should be as close to guaranteed as possible. Sinai and UIC didn't strike me as competitive at all, but that was 5 years ago that I interviewed. UofC and NW are harder to get, with rush and Loyola seeming like average academic programs. Agree with the above about needing to play the numbers game to be sure, which means interviewing at 10-12 places.

Finally: yes surgery is very taxing. You won't want to spend any of your (very limited) free time taking care of family/friends on a regular basis. It's definitely easier to be in the same city as family/friends, as it allows for last minute plans on your part. This is still a far cry from having to routinely do something for anyone aside from yourself and your patients.

 

[doc05]

Wow, that is an eye opener. I haven't even thought about surgery being such a big commitment that I wont have time to spare for family. Are you a surgical resident?

I hope you are not serious in this question. Don't expect any free time. Sounds like you should pick another specialty. Best of luck.

 

[DM2016]

I hope you are not serious in this question. Don't expect any free time. Sounds like you should pick another specialty. Best of luck.

I know how extensive the training is but I didn't know it's to the point where you have to give up on your personal life completely...

 

[DM2016]

Have you done a general surgery rotation yet?

Also, are you at a US MD program? If so, matching in Chicago should be as close to guaranteed as possible. Sinai and UIC didn't strike me as competitive at all, but that was 5 years ago that I interviewed. UofC and NW are harder to get, with rush and Loyola seeming like average academic programs. Agree with the above about needing to play the numbers game to be sure, which means interviewing at 10-12 places.

Finally: yes surgery is very taxing. You won't want to spend any of your (very limited) free time taking care of family/friends on a regular basis. It's definitely easier to be in the same city as family/friends, as it allows for last minute plans on your part. This is still a far cry from having to routinely do something for anyone aside from yourself and your patients.

I am a US MD. When you say Sinai and UIC aren't competitive, how much of a qualified surgeon can someone become if he attends these places?

 

[ACSurgeon]

I am a US MD. When you say Sinai and UIC aren't competitive, how much of a qualified surgeon can someone become if he attends these places?

Both seemed very busy, and the residents supposedly had more autonomy then many other programs. You should emerge a competent surgeon but your academic career goals may be limited if you go to Sinai.

Contrast that to UofC where an attending told me his Chiefs can't operate and all need to do fellowships. I'm sure graduates of UofC have no problem achieving any academic goal, but Operative skills may or may not be great.

 

[Psai]

Both seemed very busy, and the residents supposedly had more autonomy then many other programs. You should emerge a competent surgeon but your academic career goals may be limited if you go to Sinai.

Contrast that to UofC where an attending told me his Chiefs can't operate and all need to do fellowships. I'm sure graduates of UofC have no problem achieving any academic goal, but Operative skills may or may not be great.

That's shameful. I'm noticing a decrease in autonomy for residents in general and it seems like newer attendings are a lot less willing to step back and allow their residents to go ahead. Then they comment about how residents are not as well trained as they were (it's not due to the duty hours)

 

[ACSurgeon]

That's shameful. I'm noticing a decrease in autonomy for residents in general and it seems like newer attendings are a lot less willing to step back and allow their residents to go ahead. Then they comment about how residents are not as well trained as they were (it's not due to the duty hours)

Well, to be fair, newer attendings weren't allowed to operate as residents/fellows so it take them 5-10 year as staff to really get good. Older attendings usually are just impatient and wanna finish quickly to move on the next thing.

I'm glad we have a robust trauma/ACS/VA experience as well as many community rotations that I believe prepare us for independent practice without mandatory fellowship time. Even then, I bet it'll take me a few years as an attending to become efficient and have "my way" of doing things.

 

[Hangry]

I know how extensive the training is but I didn't know it's to the point where you have to give up on your personal life completely...

Did you even read @mimelim and @SouthernSurgeon posts? You don't give it up completely..

And I second the poster above who asked if you've really done a general surgery rotation yet. Many of your questions and surprise at the answers you've received would indicate that you don't really "know how extensive the training is". You should absolutely know what you are getting into before you apply to this field.

 

[doc05]

Contrast that to UofC where an attending told me his Chiefs can't operate and all need to do fellowships. I'm sure graduates of UofC have no problem achieving any academic goal, but Operative skills may or may not be great.

That is typical of many (but not all) academic/university programs.

 

[starstarie]

Not to derail the thread, but could anyone comment on how the surgical subspecialties' residency compares to general?

 

[DM2016]

In terms of what? The commitment/work/hours? Or the difficulty matching in a specific locale. I'll assume the former.

Residency-wise they are basically just as hard. Still 5 years at 80 hours/wk. I've said several times I think the PGY2 and PGY3 years in ortho, urology, and ENT at my hospital are INTENSE. They have inpatients to cover, ED consults, cases, procedures they are expected to do solo at night (splinting fractures, NP scoping, foleys and cystos, etc). Urology in particular had a reputation for having a "home call" system which was like a bad joke - no one ever actually left the hospital, they were just strongly encouraged to log the overnight hours as home call so they could stay the next day and operate. They finally hired some NPs and got things better after an ACGME scare. But the challenge for all the subspecialties is that they are invariably smaller so it is a pool of less people to cover all the calls.

I think perhaps that the subspecialties may have a little less emotional blunting related to bad patient outcomes (excepting neurosurg) compared to general surgery, as their patient populations are (sometimes) less sick. Though maybe that's just me projecting - I'm not as innately familiar with that side of things and don't tend to ask my urology friends how many patients they've had die...

They still suffer a lot of emotional exhaustion and stress related to the hours, intensity of the work, and expectations though.

Probably the major difference for the subspecialties is the relative light at the end of the tunnel - once they get through residency they have more options to control their lifestyle and a better mix of outpatient procedures and generally a higher salary.

Why do they have more control over their lifestyle compared to general surgeons?

Can't general surgeons do the same in terms of being part of a large group and take calls less often?

 

[bob123451]

In terms of what? The commitment/work/hours? Or the difficulty matching in a specific locale. I'll assume the former.

Residency-wise they are basically just as hard. Still 5 years at 80 hours/wk. I've said several times I think the PGY2 and PGY3 years in ortho, urology, and ENT at my hospital are INTENSE. They have inpatients to cover, ED consults, cases, procedures they are expected to do solo at night (splinting fractures, NP scoping, foleys and cystos, etc). Urology in particular had a reputation for having a "home call" system which was like a bad joke - no one ever actually left the hospital, they were just strongly encouraged to log the overnight hours as home call so they could stay the next day and operate. They finally hired some NPs and got things better after an ACGME scare. But the challenge for all the subspecialties is that they are invariably smaller so it is a pool of less people to cover all the calls.

I think perhaps that the subspecialties may have a little less emotional blunting related to bad patient outcomes (excepting neurosurg) compared to general surgery, as their patient populations are (sometimes) less sick. Though maybe that's just me projecting - I'm not as innately familiar with that side of things and don't tend to ask my urology friends how many patients they've had die...

They still suffer a lot of emotional exhaustion and stress related to the hours, intensity of the work, and expectations though.

Probably the major difference for the subspecialties is the relative light at the end of the tunnel - once they get through residency they have more options to control their lifestyle and a better mix of outpatient procedures and generally a higher salary.

What fellowships after General Surgery would you say are more lifestyle friendly and have a "better mix of outpatient procedures and generally a higher salary."

 

[DM2016]

It's not just the frequency of call, it's the nature of what comes in on call and what takes up your time.

For ENT or urology you have a number of high volume low acuity procedures (eg tubes, cystos). Or stuff you can do in the office like NP scopes. It's not uncommon for a ENT or urology practice to have significantly more clinic time - but with office based procedures that reimburse well.

These are less common in general surgery.

The call also tends to have a higher volume of acute cases followed by a longer inpatient stay (which means subsequent rounding and postop care).

I really have to echo one of the above posters - have you actually done general surgery rotations???

Yes I have done the rotation, but maybe the site I was didn't give me a good idea of what to expect.

I am doing multiple surgical rotations starting June of this summer, and hoping to get a closer prespective before I start applying!

 

[Cytarabine]

In terms of what? The commitment/work/hours? Or the difficulty matching in a specific locale. I'll assume the former.

Residency-wise they are basically just as hard. Still 5 years at 80 hours/wk. I've said several times I think the PGY2 and PGY3 years in ortho, urology, and ENT at my hospital are INTENSE. They have inpatients to cover, ED consults, cases, procedures they are expected to do solo at night (splinting fractures, NP scoping, foleys and cystos, etc). Urology in particular had a reputation for having a "home call" system which was like a bad joke - no one ever actually left the hospital, they were just strongly encouraged to log the overnight hours as home call so they could stay the next day and operate. They finally hired some NPs and got things better after an ACGME scare. But the challenge for all the subspecialties is that they are invariably smaller so it is a pool of less people to cover all the calls.

I think perhaps that the subspecialties may have a little less emotional blunting related to bad patient outcomes (excepting neurosurg) compared to general surgery, as their patient populations are (sometimes) less sick. Though maybe that's just me projecting - I'm not as innately familiar with that side of things and don't tend to ask my urology friends how many patients they've had die...

They still suffer a lot of emotional exhaustion and stress related to the hours, intensity of the work, and expectations though.

Probably the major difference for the subspecialties is the relative light at the end of the tunnel - once they get through residency they have more options to control their lifestyle and a better mix of outpatient procedures and generally a higher salary.

"Home call" got exposed to me as a 3rd year when one of the 2nd year resident broke 120 hrs while on "home call" without ever being home. Seems like a dirty program trick to make work hours murky. If i had gone into surg, I'd have looked for a program that didn't do home call

 

[WingedOx]

I am a US MD. When you say Sinai and UIC aren't competitive, how much of a qualified surgeon can someone become if he attends these places?

😕

 

[Slack3r]

"Home call" got exposed to me as a 3rd year when one of the 2nd year resident broke 120 hrs while on "home call" without ever being home. Seems like a dirty program trick to make work hours murky. If i had gone into surg, I'd have looked for a program that didn't do home call

Most of the surgical subspecialties seem to use home call.

 

[Cytarabine]

Most of the surgical subspecialties seem to use home call.

Yea that makes sense, something I didn't think about. My experience was with gen surg

 

[Wordead]

If you only have 1-3 residents/year you cant actually do anything but home call and still have cases covered during the day. And you'd operate so much less.