Need some perspective

[rsmitty233]

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[edited]

 

[VisionaryTics]

No one can give you advice on what you should go into. That's a decision you should make.

Charting shows 85/119 US seniors applying to ortho with scores between 221-230 matched. That's 71%. Not too bad. You have a realistic shot, all things being equal.

Just an observation/question: I've noticed a lot of med students who are interested in surgical specialties but who don't have the scores decide on internal medicine/rads/etc. I can't imagine myself doing anything else other than operating...is general surgery so distasteful that you'd rather give up the OR permanently?

 

[rsmitty233]

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[IJL]

Just an observation/question: I've noticed a lot of med students who are interested in surgical specialties but who don't have the scores decide on rads.

?

If you don't "have the scores" for a surgical specialty, you won't have the scores for rads.

 

[rsmitty233]

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[survivordo]

I wouldn't mind general surgery but the length of training puts me off a bit (7 years general + 3 years fellowship). I know with something like interventional cards I'm looking at 7 years minimum but a decade of further training post medical school is a little worrisome. Of course maybe I'll find something I love in general surgery that another 10 years wouldn't matter.
QUOTE]

Just a note for readers - there are plenty of 5 year GS programs out there (some programs require 2 years of research which is where the OP is getting 7 from) and there is plenty of opportunity to practice after the 5 years as a GS. While it's true there are many 3 year fellowships, there are also plenty of 1 and 2 year fellowships available as well... so length of training for GSurg can be 5,6,7,8 etc. years, not necessarily 10!

Survivor DO

 

[KinasePro]

If you absolutely must operate on bones and orthopedic injuries, you could always shoot for a decent gen surg program and specialize in hand. Learn more about that here. Not all gen surg programs are 7 yrs. You could do 5 yr g surg + 1 yr hand = 6 yrs total.

IV cards is great and all, but if you're willing to put up with that lifestyle why not go into vascular surgery? Pay is similar, you won't have to be a flea for 3 yrs, and would have a wider array of interesting procedures you could perform.

 

[Guillemot]

You can apply to two specialties. Eg ortho and gs, ortho and IM. May as well give ortho a shot if thats what you really want.

 

[tiedyeddog]

I wouldn't mind general surgery but the length of training puts me off a bit (7 years general + 3 years fellowship). I know with something like interventional cards I'm looking at 7 years minimum but a decade of further training post medical school is a little worrisome. Of course maybe I'll find something I love in general surgery that another 10 years wouldn't matter.

Just a note for readers - there are plenty of 5 year GS programs out there (some programs require 2 years of research which is where the OP is getting 7 from) and there is plenty of opportunity to practice after the 5 years as a GS. While it's true there are many 3 year fellowships, there are also plenty of 1 and 2 year fellowships available as well... so length of training for GSurg can be 5,6,7,8 etc. years, not necessarily 10!

Survivor DO

I agree, not sure what OP is talking about. General surgeons are lacking in many areas, you won't have any trouble finding a job as a GS.

 

[VisionaryTics]

?

If you don't "have the scores" for a surgical specialty, you won't have the scores for rads.

In 2011, 115/122 matched with a score between 221-230 in rads. And for those with scores between 211-220 56/61 matched. Granted I bet these are probably community programs?

I agree, not sure what OP is talking about. General surgeons are lacking in many areas, you won't have any trouble finding a job as a GS.

Plus, in those areas, you have a shot at being a true general surgeon. Breast, vascular, trauma, etc. in addition to guts and butts.

 

[rsmitty233]

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[tiedyeddog]

I apologize if I'm misinformed but after doing some research I thought a lot of decent general surgery programs now require 7 years total (w/ 2 years of research)? And to get into competitive fellowships I thought almost all would require residents coming from 7 year programs?

Also with the hand fellowship wouldn't it be harder for someone coming from a general surgery residency compared to plastics or ortho?

Sorry for being blunt here, but you got a 228 on step 1. What academic, research-focused 7-year GS programs are you going to get into?

No, there are plenty of fellowships you can get that do not require going to harvard for GS.
Here is the data for vascular http://www.nrmp.org/fellow/match_name/vascular/stats.html
There are over 90 programs and only 90 something percent were filled last year.

 

[rsmitty233]

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[J ROD]

I would apply ortho and gs backup. If you want to be a surgeon.

Cards is different. Not a surgeon.

Decide that first.

 

[tiedyeddog]

Oh I'm not expecting to although I do know a few people in past years from my institution who matched into top tier general surgery programs with low step scores.

Would I even have a shot for any university program? I have no idea.

It's not impossible but my point was you don't have to do a 7-year GS program to get a fellowship and you're probably not competitive for those anyway I am sure you're still competitive for some university programs,

 

[rsmitty233]

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[KinasePro]

Also with the hand fellowship wouldn't it be harder for someone coming from a general surgery residency compared to plastics or ortho?

Job prospects arent as great for g surg as for ortho trained hand surgeons, but theres a shortage so the jobs will always be there regardless. The g surg specialties that require 2 research years are only surg onc, peds, and possibly colorectal. Plastics, vascular, etc are most often acquired without dedicated research time.

EDIT: I take it back, g surg hand fellowships are actually competitive. However, they're less so if you do plastics first.

 

[rsmitty233]

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[alpinism]

Apply ortho and GS as a back up.

Make sure you continue to do research and try to pump out a few more pubs before submitting ERAS.
Don't be afraid to use your connections to call in a few favors. Meet w/ your university's ortho PD and get more specific advice on where to apply. For ortho, many top programs and some mid tier programs use step 1 screening cut-offs in the 230s for granting interviews.

If you apply broadly with great LORs and solid clinical grades you'll have a very good shot of matching somewhere (prob your home program or a good community program).

 

[Winged Scapula]

Apply Ortho with GS as a backup.

Honestly doing procedures is not the same as operating. I cannot see someone who wants to be a surgeon being happy doing Interventional Cards or IR.

And while a 228 may screen you out of the top GS and Ortho programs, there are plenty of middle tier GS programs with a good track record of matching into Surg Onc, Peds, PRS fellowships.

There are plenty of surgical specialties in which you spend a good time in clinic (if you don't match into Ortho). Breast certainly, but Vascular as well, Colorectal (lots of in office procedures as well as OR) and any oncologic based practice (long term followup).

A Hand fellowship after GS is a more difficult match (only because there are fewer programs which accept GS trained residents) but I have a couple of friends who did it and are happily working with Ortho groups after not matching into Ortho.

 

[rsmitty233]

Thank you all for your advice. I did not expect to get this many responses and I really am thankful.

 

[kedrin]

After reading this thread it really pisses me off we will NOT get a charting outcomes anytime soon. For all we know orthopaedics and GS are getting less competitive or even more uber competitive.

 

[KinasePro]

After reading this thread it really pisses me off we will NOT get a charting outcomes anytime soon. For all we know orthopaedics and GS are getting less competitive or even more uber competitive.

According to NRMP, the competitiveness doesn't change much from year to year and 2011 is a good proxy for the 2013 match. Here are the numbers from 2009 compared to 2011:

Ortho
2009 Step 1: 238
2009 Match rate: 79%
2011 Step 1: 240
2011 Match rate: 77%

GS
2009 Step 1: 224
2009 Match rate: 85%
2011 Step 1: 227
2011 Match rate: 80%

I'd agree with their assessment. Not a huge difference in either case, apart from GS attracting more applicants these days.