MS3 need advice on matching in Plastic Surgery

[DrDrToBe]

So I am almost done with my surgery rotation, and unexpectedly realized that I love Plastic Surgery (probably reconstructive head & neck). I realize this is a super competitive field, and I am planning to meet with my advisor as well as the plastics residency PD at my school in a few weeks to discuss what I need to do to match. Also, I may need to restructure my clerkship schedule to accommodate sub-i's etc, which I would also need to take care of in the next few weeks. I have done some research and am interested in an Integrated program.
In the mean time, I would appreciate your suggestions on a few things:
1) When would I need to do sub-i's?
2) When do I apply for sub-i's, and where are some good places to do those?
3) When do I take Step 2, and should I take it before my application goes in (lots of people at my school wait until after to take it).
4) Any suggestions for other thing to discuss with the PD, or how to plan for my meeting with him?

Thanks a lot!

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[DrDrToBe]

Hmm, no responses... Maybe wrong forum. Just saw that there's a plastic surgery forum, mods can you please move thread to that forum? Thanks!

 

[officedepot]

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[DrDrToBe]

What was your step 1 score? You will need research to make yourself more competitive. And be prepared to not match and go to general surgery and a plastic fellowship later. As to more specifics I think you can figure out the answers. Do sub-is early 4th year after you have taken all your core rotations and study extremely hard and do your best to look good. Go to aways at places you would like to match. Taking step 2 depends on your step 1 score but in general more and more places are looking for that score now so a great one will be nice.

Step 1 okay but not that competitive unfortunately (240's), I probably will have to do Step 2 early (scared that I may do worse). Also, I like general surgery but definitely wouldn't want to be stuck doing that if later I can't match into a fellowship. None of my research is plastics, and since I'm on clerkships I don't have time to do research. Do many people take a year off to do research in this scenario? Also, I was thinking I might try to do a case report instead of trying to get research done with the little time I have. Totally sucks that I didn't figure this out earlier.

 

[VisionaryTics]

ENT? 240s is plenty competitive, and it's a straight shot to facial plastics and reconstructive surgery.

 

[Slack3r]

Step 1 okay but not that competitive unfortunately (240's), I probably will have to do Step 2 early (scared that I may do worse). Also, I like general surgery but definitely wouldn't want to be stuck doing that if later I can't match into a fellowship. None of my research is plastics, and since I'm on clerkships I don't have time to do research. Do many people take a year off to do research in this scenario? Also, I was thinking I might try to do a case report instead of trying to get research done with the little time I have. Totally sucks that I didn't figure this out earlier.

Isn't the average Step 1 for integrated plastics like a 243?

 

[officedepot]

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[xanthomondo]

Isn't the average Step 1 for integrated plastics like a 243?

A few years ago it was. For the last match data it was a 249

http://www.nrmp.org/data/chartingoutcomes2011.pdf

 

[Sheldor]

Step 1 okay but not that competitive unfortunately (240's), I probably will have to do Step 2 early (scared that I may do worse). Also, I like general surgery but definitely wouldn't want to be stuck doing that if later I can't match into a fellowship. None of my research is plastics, and since I'm on clerkships I don't have time to do research. Do many people take a year off to do research in this scenario? Also, I was thinking I might try to do a case report instead of trying to get research done with the little time I have. Totally sucks that I didn't figure this out earlier.

No one, even those with >260 with AOA and research, can count on matching to integrated plastics. Sad, but true. So your best best in terms of applications is to apply to all the integrated and a healthy number of back ups. Now, if you are absolutely sure that you wouldn't be happy doing GS if you can't match a fellowship later, I'd suggest ENT as a "back up." From ENT you can do general ENT, a facial plastics fellowship OR a normal full on plastics fellowship. That last option would obviously be your best bet, unless you decide you only want to do head and neck reconstruction. Most people don't know that you can apply to plastics fellowships from ENT, but you can. From what I hear you aren't as competitive as they prefer those from GS, but hey, its still an option.

In terms of fourth year I'd just echo the above advice. Research now during third year (I know its hard, but even case reports or a retrospective would show initiative and be helpful), then as many and as early Sub-i's as you can, followed by a lot of prayer

 

[Butler]

No one, even those with >260 with AOA and research, can count on matching to integrated plastics. Sad, but true. So your best best in terms of applications is to apply to all the integrated and a healthy number of back ups. Now, if you are absolutely sure that you wouldn't be happy doing GS if you can't match a fellowship later, I'd suggest ENT as a "back up." From ENT you can do general ENT, a facial plastics fellowship OR a normal full on plastics fellowship. That last option would obviously be your best bet, unless you decide you only want to do head and neck reconstruction. Most people don't know that you can apply to plastics fellowships from ENT, but you can. From what I hear you aren't as competitive as they prefer those from GS, but hey, its still an option.

In terms of fourth year I'd just echo the above advice. Research now during third year (I know its hard, but even case reports or a retrospective would show initiative and be helpful), then as many and as early Sub-i's as you can, followed by a lot of prayer

Anyone who is has a >260 Step 1, AOA and research that doesn't match is most likely a huge weirdo that interviews extremely poorly. That or a complete dummy that applied to <5 programs. Just my opinion, so no one go ragefest on me because you have a 261.

 

[Sheldor]

14/21 people with over a 260 matched to integrated plastics. I think that a match rate of 66% confirms my original statement.

 

[Butler]

14/21 people with over a 260 matched to integrated plastics. I think that a match rate of 66% confirms my original statement.

I am sure they were all well-rounded applicants with AOA and research that interviewed well. Pray tell since you seem to know all 21 personally .

 

[Sheldor]

I am sure they were all well-rounded applicants with AOA and research that interviewed well. Pray tell since you seem to know all 21 personally .

Nobody ever knows all of the applicants. However, if you look at other specilaties widely considered to be competitive, those with over a 260 fair much better. For example, I believe dermatology is regarded as the most competitive other than plastics. For Derm, 73/76 with >260 matched. Thats a 96% match rate. Unless you are assuming that "weird" personalities are only attracted to Plastic Surgery, it is a fair assessment to say that compared to other specialties having >260 doesn't come close to assuring you a match.

 

[Butler]

Nobody ever knows all of the applicants. However, if you look at other specilaties widely considered to be competitive, those with over a 260 fair much better. For example, I believe dermatology is regarded as the most competitive other than plastics. For Derm, 73/76 with >260 matched. Thats a 96% match rate. Unless you are assuming that "weird" personalities are only attracted to Plastic Surgery, it is a fair assessment to say that compared to other specialties having >260 doesn't come close to assuring you a match.

That is like comparing apples to oranges. What a PD looks for in a Derm applicant is not the same thing another would look for in a Plastics app. Hell, look at Rad Onc. Out of 89 applicants that had >240 Step 1, only two of them didn't match. No other single factor had such a strong correlation to matching. Different specialties put emphasis on varying aspects of the app. Obviously plastics is competitive, I don't pretend to disagree with you on that. My main point is that far too much emphasis is placed on people's Step 1 scores simply because its easiest to crunch those numbers and then seem like an expert guru on applicant's chances than to look at the intangibles like fit, number of programs applied to and/or personality. 1 person that was 201-211 even matched after all . Anyways, I have already hijacked this thread too much. This is the last I will say on the issue.

 

[DrDrToBe]

A few years ago it was. For the last match data it was a 249

http://www.nrmp.org/data/chartingoutcomes2011.pdf

I saw this, which actually puts me below average Definitely burst my bubble, I will have to work extra hard on Step 2 to try to get >260. It does seem like Step 1 score makes up the bulk of your application. One attending told me that LORs don't mean much unless they come from someone well known in plastics, as all the letters usually say how great students are. Also, he said that applicants usually have 5-10 publications. Seriously, who are these people ????

 

[Fah-Q]

If you want to do head and neck reconstructive work then you would be much better off going through ENT. Most head and neck recon is done by ENT's these days. You can do general plastics after ENT if you still want to do hands, butts, and boobs. You can also go into facial plastics or head and neck cancer surgery fellowships after ENT residency. ENT is not easy but it is slightly less competitive than plastics.

 

[xanthomondo]

Related question:

When choosing a med school, would it be more beneficial to choose a school with a plastics residency/department at the affiliated hospital for someone interested in pursuing a PRS-Integrated residency?

I'm not going into plastics, but I'd imagine life would be a lot easier if your school had a plastics department. Probably not necessary, it would just be easier to get involved during your preclinical years with research and such.

 

[DrDrToBe]

Related question:

When choosing a med school, would it be more beneficial to choose a school with a plastics residency/department at the affiliated hospital for someone interested in pursuing a PRS-Integrated residency?

I'd say definitely yes, my school has a great department with very supportive attendings. All the people I know who are interested in PRS have a mentor here and have publications in Plastics.