Most Competitive Surgery Fellowships

[Good Mountain]

I heard that Paediatric surgery is one of the toughest together with cardiac surgery and that Trauma is at the other end of the list. Is that true? What about, vascular and transplant?
Just wondering.

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[Pilot Doc]

Peds is among the most competitive.

Cardiac was similar historically, but is now among the least competitive.

There are a couple of good threads on this that you should be able to find with a search.

 

[droliver]

The dwindling number of tradtional Plastic Surgery residency/fellowship positions has the most frightening applicant to position math these days.

Pediatrics and Oncology are competative (especially at places like MSK & MD-Anderson) but the applicant pool is small and often has been close to 1:1 for applicantosition ratio. PRS is creeping towards greater the 4:1

 

[driedcaribou]

The dwindling number of tradtional Plastic Surgery residency/fellowship positions has the most frightening applicant to position math these days.

Do you mean the surgical residency and then plastics residency route? Or?

Apologies, I am only aware of the integrated plastics and independent routes.

 

[droliver]

Yes, "traditional" would be after a surgery residency or one of the other complete pathways.

 

[NDESTRUKT]

how about colorectal or MIS?

 

[Blade28]

From what I've seen and heard (anecdotally), there seem to be 3 tiers (just like many things in life). Roughly speaking:

(1) Peds Surg, Plastics, Surg Onc
(2) Colorectal, Vascular, Hepatobiliary
(3) CT, Lap, Transplant, Trauma/CC, Breast

 

[Dr JPH]

From what I've seen and heard (anecdotally), there seem to be 3 tiers (just like many things in life). Roughly speaking:

(1) Peds Surg, Plastics, Surg Onc
(2) Colorectal, Vascular, Hepatobiliary
(3) CT, Lap, Transplant, Trauma/CC, Breast

I was under the impression that breast was more competitive.

Dont know if this was mentioned above but the competitiveness of the different subspecialties is cyclical...wait a few years and it might be completely different than it is now.

 

[Blade28]

Yeah, I was torn between Breast being in tier 2 vs. 3.

 

[Pilot Doc]

Yeah, I was torn between Breast being in tier 2 vs. 3.

The breast match this year had applicants>spots for the first time, which is certainly a significant change for those seeking breast training. No idea how the overall mix of applicant numbers and qualifications compares to other fellowships.

 

[Amgen1]

Pediatrics and Oncology are competative (especially at places like MSK & MD-Anderson) but the applicant pool is small and often has been close to 1:1 for applicantosition ratio. PRS is creeping towards greater the 4:1

Peds and oncology are closer to 2 applicants per one spot or even 3 applicants per one spot (I think surg onc had about 110 applicants for 45 spots and pedi had less that a 50% match rate)

 

[driedcaribou]

Yes, "traditional" would be after a surgery residency or one of the other complete pathways.

Thanks!

Is there a 'time limit' after one completes a surgical residency when he becomes 'uncompetitive' to apply for a plastics fellowship?

 

[Pilot Doc]

Thanks!

Is there a 'time limit' after one completes a surgical residency when he becomes 'uncompetitive' to apply for a plastics fellowship?

My guess would be about 24 hours, but Dr. Oliver could speak better to it.

The transition from a well-paid, well-respected, independent general surgeon ot a poorly-paid, badly-treated trainee with little medical autonomy is a tough one. People who have seen the other side and have the opportunity to go back essentially at will are more likely to do so. Program directors don't like to lose fellows halfway through the year.

"After" residency in this case almost always means immediately after.

 

[gerickson03m]

From what I've seen and heard (anecdotally), there seem to be 3 tiers (just like many things in life). Roughly speaking:

(1) Peds Surg, Plastics, Surg Onc
(2) Colorectal, Vascular, Hepatobiliary
(3) CT, Lap, Transplant, Trauma/CC, Breast

Considering that 20% of vascular applicants did not match this year, 33% of foreign grads did not match, that should place vascular between teir 1 and 2.

 

[tri]

My guess would be about 24 hours, but Dr. Oliver could speak better to it.

The transition from a well-paid, well-respected, independent general surgeon ot a poorly-paid, badly-treated trainee with little medical autonomy is a tough one. People who have seen the other side and have the opportunity to go back essentially at will are more likely to do so. Program directors don't like to lose fellows halfway through the year.

"After" residency in this case almost always means immediately after.

Actually, having gone through the plastics match this year, I encountered many plastics fellows and applicants who had completed gen surg and had been in private practice. I met fellows at highly competitive plastics programs who were priv practice gen surgeons for 4 years before they decided to do plastics. I even met a CT surgeon on the applicant trail who was probably in his late 40s applying for plastics. Basically, it can be done and I don't think it's looked down on at most places. In fact, it gives you more disposable income to buy book sets like Mathes ($1300) that us fresh gen surg residents can't afford =(

poor me
"will suck fat for spare change"

 

[Pilot Doc]

Actually, having gone through the plastics match...

I stand corrected by someone with more experience than I have.

 

[driedcaribou]

I stand corrected by someone with more experience than I have.

They are both interesting perspectives and I thank you both for them.

I am always amazed at how much time it spends to train to be a surgeon.... I really want to be one but man... it's such a big chunk of your life... I want some time to enjoy the outdoors and go camping again!

 

[maxheadroom]

Why does is matter which is more competitive? The bigger question is "What field do I want?" Are you going to make a choice based on the competitiveness of the field? Will you feel more validated because you matched Plastics or Peds? Will you feel like a loser for doing Vasc, CT, Critical Care, or Burns? You'll be a whole lot happier figuring out what you really like doing than what everybody else likes doing.

 

[Amgen1]

Why does is matter which is more competitive? The bigger question is "What field do I want?" Are you going to make a choice based on the competitiveness of the field? Will you feel more validated because you matched Plastics or Peds? Will you feel like a loser for doing Vasc, CT, Critical Care, or Burns? You'll be a whole lot happier figuring out what you really like doing than what everybody else likes doing.

I think it is a valid question for people to ask which fellowships are the most competitive. It does not mean they are going to make their choices based on others opinions. It might however mean that they understand that they need to focus themselves earlier for one fellowship as opposed to another.

If a resident know they want to do peds, the should probably start from day one of residency bulking up their CV with papers, making connections, etc.

Someone who is doing minimally invasive will have less hoops to jump through and probably does not have to start planning until later in residency.

 

[Good Mountain]

From what I've seen and heard (anecdotally), there seem to be 3 tiers (just like many things in life). Roughly speaking:

(1) Peds Surg, Plastics, Surg Onc
(2) Colorectal, Vascular, Hepatobiliary
(3) CT, Lap, Transplant, Trauma/CC, Breast

Thanx.

amsa.org uses the term "incredibly competitive" to describe peds!

I thought Cardiac was in the top tier (considering the average salary they make in that field).

What about those 5 spots of integrated vascular surgery that dont need to complete a general surgery residency first?

 

[I am Hans]

Thanx.

amsa.org uses the term "incredibly competitive" to describe peds!

That would be about right (assuming you mean Peds surgery).

I thought Cardiac was in the top tier (considering the average salary they make in that field).

The amount of money you can make in these fields has relatively nothing to do with the competitiveness, although some I'm sure would say that the popularity of plastics has to do with the income potential.

CT Surgery has decreased significantly in competitiveness to a low of 40 something people matching for around 150 positions (or 3 positions for every applicant) a couple of years ago. Not so bad these days, but still lowest tier in terms of competitiveness.

And the average salary is not a good indicator of competitiveness - when you consider that most Ped surgeons are in academics, so most likely make less than your average private practice surgeon, and many CT trained surgeons are unable to find a job (hence make significantly less than the money made in the "old days") once they finish training.

What about those 5 spots of integrated vascular surgery that dont need to complete a general surgery residency first?

Haven't seen any data on how many applicants there were, but would imagine it to be fairly competitive. They are new programs, many looking at general surgery have yet to decided on Vascular or perhaps had not even heard of the programs at the time of the match. But I'm sure they will attract a large number of candidates in the years to come...however, Vascular in and of itself, tends not to be very popular (it certainly isn't a "lifestyle" specialty), so we'll see.