Move over Derm??? (And Rads, Rad Onc, Uro, etc, etc)

[toxic-megacolon]

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So General Surgery was really the second most competitive specialty this year, after Plastics. More competitive than Radiology, Rad Onc, Derm, ENT, Urology, Ophtho, and Neurosurg??? 😱
What is GOING ON???

Do we have the 80 hour rule to thank/blame??

 

[Hobbs]

How are you judging competive? I don't disagree just want to know based on what.

Hobbs

Ps I think the 80 hour work week is exactly the reason.

 

[toxic-megacolon]

How are you judging competive? I don't disagree just want to know based on what.

Hobbs

Ps I think the 80 hour work week is exactly the reason.

It was actually a question to other members of the forum, not a judgment. Surgery just had less open categorical spots than any specialty except for plastics, despite having so many spots offered.

 

[geekgirl]

yeah, rad onc and derm all filled.

but for having 1000-ish spots and only 1 vacancy in surgery, that is really impressive.

 

[toxic-megacolon]

yeah, rad onc and derm all filled.

I don't think so.
There were 2 open spots in Rad Onc. There were 6 open in derm. More if you count Med-Derm, etc. Scroll down.

 

[Pilot Doc]

I don't think so.
There were 2 open spots in Rad Onc. There were 6 open in derm. More if you count Med-Derm, etc. Scroll down.

Can you post the file? It's not up on the public site yet.

 

[toxic-megacolon]

Can you post the file? It's not up on the public site yet.

Let me try...

 

[avgjoe]

There were 2 open spots in Rad Onc. There were 6 open in derm. More if you count Med-Derm, etc. Scroll down.

Seriously - this is amazing! Looks like not just all of us but tons of others have also realized that GSurg is the happening career choice 🙂 👍
That one program is going to really get its choice of applicants - I bet the one person who scrambles in is probably going to be their most qualified resident next year!
So .. shall we start the Matched list thread already?

 

[toxic-megacolon]

Let me try...

I can't get the stupid thing posted. I have it in WORD format. If you were in the match this year, its under "My Reports." Pilot, PM me if you want me to email it to you.

 

[Smoke This]

What is taken as "the" measure of competitiveness? Is it the unmatched %, number of unfilled spots, etc.?

 

[jdubya]

Fear not, those who didn't match. The influx of surgery residents is deceptive and the "80" hour work week on paper is very different than the "80" hour work week in practice. If most programs are at all like the couple of programs I am familiar with, there will be openings aplenty in upper level positions in the future.

 

[toxic-megacolon]

What is taken as "the" measure of competitiveness? Is it the unmatched %, number of unfilled spots, etc.?

There are so many. Agreed, unfilled spots are just one measurment. %age of IMGs, average USMLE score, %age of applicants that are AOA also factor in. In the latter 3 measures, derm/radonc/urology/etc probably have us beat.

 

[Smoke This]

toxic: I don't disagree with you. Surgery is obviously quite competitive and those who matched deserve multiple pats on the back. I'm the kind of guy who likes objectivity which is why I asked.

 

[Plastikos]

I think about numbers of applicants to positions, gross number of spots, etc...unfortunately the NRMP doesnt give out detailed specifics like the SF match does with #, AOA, board scores of matched vs. unmatched, IMG, etc....

Its likely the derm, etc...spots didnt match b/c their rank lists were too short or they thought they had some shoe ins, etc...they had more than enough apps im sure, just goes to show if your willing to go anywhere...you can probably match.

It has to be the 80 hour work week, G-surg went from a ton of open spots the year before to becoming instantly competitive.

 

[Misterioso]

Ps I think the 80 hour work week is exactly the reason.

Yep. Peeps know with the 80 hour week they'll work roughly as many hours as a surgery resident as they would in most other residencies, and once they finish residency they can tailor their practice to accomodate how many hours they want to work. Win-Win situation.

You take away the 80 hour week and its popularity will immediately decrease to how it was before. Not as many people would be willing to put in 120-130 hour weeks for 5 years.

 

[Gfunk6]

I'll have to admit, this is pretty damn impressive. Though I have to attribute a lot of it to the foresight of PDs who probably (and wisely) had pretty long rank lists. Still . . . 1 freaking unfilled spot? Incredible.

 

[avgjoe]

I'll have to admit, this is pretty damn impressive. Though I have to attribute a lot of it to the foresight of PDs who probably (and wisely) had pretty long rank lists. Still . . . 1 freaking unfilled spot? Incredible.

I agree.
In terms of overall competitiveness though, is there anywhere where the total number of applicants is posted? Because the ratio of total to spots is also part of the deal.. I hope for fellow surgeon wanna-be's sakes that there weren't too many who applied in surgery and didnt match, but with only one spot open, I'm guessing there were quite a few in that boat. Good luck tomorrow guys!

 

[guavero]

Congrats to those who matched!

Anyone know (w/o guesstimation) how many total applicants were there for this year? The word on the street is 1600-1800.

Lo que sera, sera 🙂

 

[highlandguy]

So General Surgery was really the second most competitive specialty this year, after Plastics. More competitive than Radiology, Rad Onc, Derm, ENT, Urology, Ophtho, and Neurosurg??? 😱
What is GOING ON???

Do we have the 80 hour rule to thank/blame??

Although I do agree that general surgery may be seeing a rise in competitiveness, I would say these numbers reflect more interest than competitiveness at this point. These figures are based on the open institutional positions available, not the applicant pool. My summarized idea would be something like this:

Interest = % of positions filled
Competitiveness = % of applicants matching

It looks like gen surg has shown stability in interest over the last few years with a definite increase in interest since 2002. Here are figures from the NRMP:

Year Offered Filled Unfilled
2006 1048 1047 1
2005 1051 1044 7
2004 1044 1042 2
2003 1049 1038 11
2002 1039 981 58
2001 1041 973 68

Just wanted to put things into perspective. I'm glad to see the renewed interest. It's likely to be followed by increased competitiveness. I'm not sure you can compare its competitiveness as a whole to the fields mentioned above just yet though.

 

[geekgirl]

I think about numbers of applicants to positions, gross number of spots, etc...unfortunately the NRMP doesnt give out detailed specifics like the SF match does with #, AOA, board scores of matched vs. unmatched, IMG, etc....

here's a little bit of info re: previous applicants (this link is for categorical gen surg only)....
http://www.aamc.org/programs/eras/programs/statistics/residency/surg-c.htm

 

[avgjoe]

here's a little bit of info re: previous applicants (this link is for categorical gen surg only)....
http://www.aamc.org/programs/eras/programs/statistics/residency/surg-c.htm

So using the % philosophy, it looks like there are approximately 4000 Gsurg applicants, for 1000 spots. In plastic surgery, there are about 400 applicants, for 90 spots. Keeping in mind that many (if not all of them) also apply for gsurg as a backup, it looks like yes, plastics is a little more competitive, but not really by that much - numbers-wise. Radonc however, had almost 400 applicants themselves for much fewer slots, and derm had 945 applicants for what - 30 slots? - so there we go..

But all this being said, I think it says a lot that Gsurg is the only one of the bigger specialties (medicine, ob, peds, etc) that had such numbers. And for a few years now too - I guess it's more proof that all of this is cyclical!

 

[Misterioso]

Although I do agree that general surgery may be seeing a rise in competitiveness, I would say these numbers reflect more interest than competitiveness at this point.

The source of that interest being the 80 hour work week.

I doubt that medical students have changed so much in the past five or so years that more are having an interest in general surgery for general surgery itself. If anything med students are becoming more life style oriented and if the 80 hour week wasn't in place for residency then there wouldn't be as much interest in GS.

 

[SLUser11]

The source of that interest being the 80 hour work week.

I doubt that medical students have changed so much in the past five or so years that more are having an interest in general surgery for general surgery itself. If anything med students are becoming more life style oriented and if the 80 hour week wasn't in place for residency then there wouldn't be as much interest in GS.

Uuuuhhh.....no sh#t.

 

[Plastikos]

So using the % philosophy, it looks like there are approximately 4000 Gsurg applicants, for 1000 spots. In plastic surgery, there are about 400 applicants, for 90 spots. Keeping in mind that many (if not all of them) also apply for gsurg as a backup, it looks like yes, plastics is a little more competitive, but not really by that much - numbers-wise. Radonc however, had almost 400 applicants themselves for much fewer slots, and derm had 945 applicants for what - 30 slots? - so there we go..

But all this being said, I think it says a lot that Gsurg is the only one of the bigger specialties (medicine, ob, peds, etc) that had such numbers. And for a few years now too - I guess it's more proof that all of this is cyclical!

I would go by US applicants to spots. Radonc may have had 400 apps but there are well over 100 positions, same for derm there are about 295-310 spots. Since those are PGY-2 spots you have to look at that bottom chart on the my reports link.

 

[pruritis_ani]

Judging competitiveness by the amount of spots unfilled has serious flaws.

First of all, is it that surgery is more competitive, or that PD's simply ranked more people per position in order to fill? Or is the applicant pool being filled in by more applicants with lower scores? Or is it some combination of the above?

While I know that a lot of GS applicants are very strong, the average applicant is certainly not on the level of the average ENT, Uro, Derm, Plastics applicant...

I think that interest in surgery has certainly increased, which will make it a bit more competitive. But, I also think that GS is still a far, far easier match than some of the traditionally competitive programs.

I mean, look at my field, Ob/Gyn. It certainly went up in competitiveness based on percentage unfilled. In fact, by this criteria ob is more competitive than Gas, Rads, and EM this year, to name a few. But, do you really think the average ob applicant is a more competitive applicant than the average rads applicant?

There are simply too many factors to make a claim like this. And, given the realtively HUGE amount of positions in GS, there is certainly still room for the average applicant somewhere.

 

[Plastikos]

Im on a derm rotation right now and they were talking about how the programs that went unfilled are notorius for only ranking a very small number of students. Same thing with UCLA plastics last year, they only ranked two exceedingly competitive applicants, thats just plain stupid.

 

[DrDawg]

I think about numbers of applicants to positions, gross number of spots, etc...unfortunately the NRMP doesnt give out detailed specifics like the SF match does with #, AOA, board scores of matched vs. unmatched, IMG, etc....

Its likely the derm, etc...spots didnt match b/c their rank lists were too short or they thought they had some shoe ins, etc...they had more than enough apps im sure, just goes to show if your willing to go anywhere...you can probably match.

It has to be the 80 hour work week, G-surg went from a ton of open spots the year before to becoming instantly competitive.

If you review the data, since 2003 gen surg has had a 99% fill with 11, 2, 7, and 1 open spot after the match. And prior to that it was 93 and 94% in 2001 and 2002. Not sure when there was a ton of open spots. A more interesting thing to review would be gen surgery drop out vs. other specialties

 

[DrDawg]

So using the % philosophy, it looks like there are approximately 4000 Gsurg applicants, for 1000 spots. In plastic surgery, there are about 400 applicants, for 90 spots. Keeping in mind that many (if not all of them) also apply for gsurg as a backup, it looks like yes, plastics is a little more competitive, but not really by that much - numbers-wise. Radonc however, had almost 400 applicants themselves for much fewer slots, and derm had 945 applicants for what - 30 slots? - so there we go..

But all this being said, I think it says a lot that Gsurg is the only one of the bigger specialties (medicine, ob, peds, etc) that had such numbers. And for a few years now too - I guess it's more proof that all of this is cyclical!

Just an aside:
Derm is PGY2 subspecialty and there was nearly 200 spots for PGY2 plus the 30 pgy1 spots.

 

[Plastikos]

If you review the data, since 2003 gen surg has had a 99% fill with 11, 2, 7, and 1 open spot after the match. And prior to that it was 93 and 94% in 2001 and 2002. Not sure when there was a ton of open spots. A more interesting thing to review would be gen surgery drop out vs. other specialties

I would call 68 and 58 a lot of open spots, then you get 80 h workweek--->11, 7, 2, 1. Especially considering the amount of applications they get.

 

[Misterioso]

A more interesting thing to review would be gen surgery drop out vs. other specialties

GS has one of the highest rates of residents not completing residency. Somewhere around 20% wash out voluntarily or involuntarily during the 5 yrs. As one surgeon said "Just because you want to be a surgeon and get in to a residency doesn't mean you'll become a surgeon". But that dude did residency back when they had the pyramid system where they competed with their fellow residents to advance to the next year. He told me stories about residents who made it all the way to PGY4 only not to be chosen to advance to the final year. That was the old school era where the legends were made.

 

[DrDawg]

GS has one of the highest rates of residents not completing residency. Somewhere around 20% wash out voluntarily or involuntarily during the 5 yrs. As one surgeon said "Just because you want to be a surgeon and get in to a residency doesn't mean you'll become a surgeon". But that dude did residency back when they had the pyramid system where they competed with their fellow residents to advance to the next year. He told me stories about residents who made it all the way to PGY4 only not to be chosen to advance to the final year. That was the old school era where the legends were made.

I've heard the 20% number thrown around alot. My intern class started with 4 and dropped to 3. The two years above me same story. We easily filled by getting residents for other schools. So i guess its pretty good approximation. But I wonder what the voluntary drop out rate was before the 80 or 88 hours "limitation" compared to now. I speculate that many people thought that it would be easier, because, well its only 80 hours. And that more people washout now, voluntarily than are forced out.

 

[Plastikos]

I've heard the 20% number thrown around alot. My intern class started with 4 and dropped to 3. The two years above me same story. We easily filled by getting residents for other schools. So i guess its pretty good approximation. But I wonder what the voluntary drop out rate was before the 80 or 88 hours "limitation" compared to now. I speculate that many people thought that it would be easier, because, well its only 80 hours. And that more people washout now, voluntarily than are forced out.

I think thats the case, ppl somehow assume b/c your "closer" to 80 hours now it will be simple. Its still tough.

 

[exlap]

I think thats the case, ppl somehow assume b/c your "closer" to 80 hours now it will be simple. Its still tough.

What 80hrs translates into is the same amount of work having to be done, but being done by fewer people. Hence, tougher/busier calls.

Another drawback is less operating time. As the outdated surgical saying goes... "The problem with q2 call is that you miss half the cases."

 

[DrDawg]

What 80hrs translates into is the same amount of work having to be done, but being done by fewer people. Hence, tougher/busier calls.

Another drawback is less operating time. As the outdated surgical saying goes... "The problem with q2 call is that you miss half the cases."

I think the only part of the 88hour restriction that was worth anything to us was the one day off a week. Im tired of attending thinking that we are slackers and have so much time cause we only work 88hours. I still find it hard to read at night without falling asleep, and rarely can read more than a half chapter of the absite review while in the hospital. Case loads up, and turnover is faster. We are still working pretty darn hard. Still love my job though

 

[Irish Eyes]

Has the 80-Hour Work Week Had an Impact on Voluntary Attrition in General
Surgery Residency Programs?
Thomas J Leibrandt, MA, et al.

J Am Coll Surg 2006;202:340–344.

Basically states that while the 80 hour ww has made general surgery a more attractive choice, the attrition rate remains the same.

And I agree with exlap---there is no disadvantage to training more when it's acceptable to be a trainee.

 

[Von Hohenheim]

Has the 80-Hour Work Week Had an Impact on Voluntary Attrition in General
Surgery Residency Programs?
Thomas J Leibrandt, MA, et al.

J Am Coll Surg 2006;202:340–344.

Basically states that while the 80 hour ww has made general surgery a more attractive choice, the attrition rate remains the same.

Ah, but remember that the ACS was and is opposed to the 80 hour week. It's not all that surprizing that they'd publish a paper that happens to support their position.

A more interesting study would be an investigation of the relationship between actual 80 hour compliance and attrition. 😉

 

[Roux-en-Y]

Judging competitiveness by the amount of spots unfilled has serious flaws.

First of all, is it that surgery is more competitive, or that PD's simply ranked more people per position in order to fill? Or is the applicant pool being filled in by more applicants with lower scores? Or is it some combination of the above?

While I know that a lot of GS applicants are very strong, the average applicant is certainly not on the level of the average ENT, Uro, Derm, Plastics applicant...

I think that interest in surgery has certainly increased, which will make it a bit more competitive. But, I also think that GS is still a far, far easier match than some of the traditionally competitive programs.

I mean, look at my field, Ob/Gyn. It certainly went up in competitiveness based on percentage unfilled. In fact, by this criteria ob is more competitive than Gas, Rads, and EM this year, to name a few. But, do you really think the average ob applicant is a more competitive applicant than the average rads applicant?

There are simply too many factors to make a claim like this. And, given the realtively HUGE amount of positions in GS, there is certainly still room for the average applicant somewhere.

All very valid points; but it still amazes me how freakin' competitive GS has become; of course, the 80 hour work week has a HUGE role in this. Undeniably, the credentials of the average student matching into a categorical spot have risen (I just don't have the reference on hand). The real question is how will all of this affect the quality of surgical care and the face of surgery and everything GREAT about surgery, over the next several decades...

 

[Plastikos]

All very valid points; but it still amazes me how freakin' competitive GS has become; of course, the 80 hour work week has a HUGE role in this. Undeniably, the credentials of the average student matching into a categorical spot have risen (I just don't have the reference on hand). The real question is how will all of this affect the quality of surgical care and the face of surgery and everything GREAT about surgery, over the next several decades...

The average in general is going up, and by general i mean all specialties. Schools are putting more emphasis on the USMLE, the books are excellent, and the gunners admitted get worse every year. Hopefully this will mean great things for the field.
Not that long ago it wasnt nearly as hard to get into medicine as it is today.

 

[miler]

The average in general is going up, and by general i mean all specialties. Schools are putting more emphasis on the USMLE, the books are excellent, and the gunners admitted get worse every year. Hopefully this will mean great things for the field.
Not that long ago it wasnt nearly as hard to get into medicine as it is today.

I've seen the stats in past years, does anyone know what the average USMLE score was for this years categorical and prelim spots?
Thanks