New M1 wanting to pursue surgery

[chronicangina]

Hi, I just started M1 year and pretty sure know I want to go into surgery, specifically pediatric surgery. We can talk about the difficulty of a pediatric surgery fellowship match later but I wanted to know how difficult it would be to match at top institutions for general surgery. I know specialties like ortho and optho are very difficult, but I wanted to know how gensurg compares, especially at top intitutions like for example: MGH, Brigham, UPENN etc. Also specifically if anyone can answer what class rank I should be aiming for, ie. top 25%, upper middle 25% or if that has little bearing if any. Also I know its early on in my med school career but I want to try and get ahead of things and make sure I have the appropriate resources and such. Thank you!

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[mikeGR]

If you're aiming at the most prestigious academic institutions, gen surg is probably as competitive as ortho and ophtho. Look at it this way: the most competitive gen surg applicants have similar qualifications with the most competitive applicants of any surgical subspecialty. The difference is usually in mid and lower tiers of "competitiveness". The same principle applies more or less for surgical fellowships too.

 

[deleted50541]

Congrats on starting med school. It's never too early to start planning your medical career if you've got a specific goal in mind. It should be a given that your main focus needs to be on doing well in med school, crushing the STEP exams, and making a good impression on the folks you work with and are trained by.

With surgery in mind, start by looking at the grads from your school and where they've gone for residency. If they're at top institutions you're interested in, you may be able to network with them and learn more about their journey. Joining a surgery interest group at your school can connect you with fellow classmates in various stages of seeking a surgery residency.

Lastly, connect with the pediatric surgery department at your institution if possible. Ask about shadowing a surgeon or finding out about research you could get involved in. It shouldn't be something that dominates your time away from med school, but it can give you a foot in the door to start building your CV and network in the small world of peds surgery.

Obviously, these steps are no guarantee of success. But it's a reasonable outline that I've seen many others use to be successful in their burgeoning careers.

 

[chronicangina]

Hmmm yeah okay that's basically what I though also, I needed to confirm! Thank you both! I just joined the surgical interest group but with corona the activities are limited for now *sigh*. As a follow up, is it necessary to be at an top institution to match into a good peds sure fellowship? Or is it just best if the residency program has a peds surg fellowship at the same institution? So basically, I don't necessarily need to go to MGH to match at Boston children's, I can maybe go to Ucincy and still have an excellent chance at matching at a top peds sure fellowship

 

[ThoracicGuy]

Hmmm yeah okay that's basically what I though also, I needed to confirm! Thank you both! I just joined the surgical interest group but with corona the activities are limited for now *sigh*. As a follow up, is it necessary to be at an top institution to match into a good peds sure fellowship? Or is it just best if the residency program has a peds surg fellowship at the same institution? So basically, I don't necessarily need to go to MGH to match at Boston children's, I can maybe go to Ucincy and still have an excellent chance at matching at a top peds sure fellowship

If you are looking for pediatric surgery, I would focus for matching at places that:

1. Pediatric surgery fellowships in house
2. Have extensive history of matching residents into ped surg fellowships
3. Have placed a resident into a ped surg fellowship
4. Other academic training programs, preferably with a research year built in.

You can set yourself towards those goals as you go through school. Basically try to get as good of grades as possible and as high of Step scores as possible (when they are scored).

 

[ACSurgeon]

Hi, I just started M1 year and pretty sure know I want to go into surgery, specifically pediatric surgery. We can talk about the difficulty of a pediatric surgery fellowship match later but I wanted to know how difficult it would be to match at top institutions for general surgery. I know specialties like ortho and optho are very difficult, but I wanted to know how gensurg compares, especially at top intitutions like for example: MGH, Brigham, UPENN etc. Also specifically if anyone can answer what class rank I should be aiming for, ie. top 25%, upper middle 25% or if that has little bearing if any. Also I know its early on in my med school career but I want to try and get ahead of things and make sure I have the appropriate resources and such. Thank you!

If the motivation of going to a top general surgery program is for the purpose of fellowship match, keep in mind that some “less fancy” programs can get you into very prestigious fellowships also. Once you’ve done a fancy fellowship the world is your oyster.

Re: peds- if you go to a residency with a strong children’s hospital and peds fellowship that can go a long way, even if it’s not MGH or Hopkins.

Obviously you should work hard at every step, and always try to get the best thing possible, but if step 1 doesn’t go as well as you’d like or you end up an average med student you still have a way to accomplish your goals.

 

[chronicangina]

If the motivation of going to a top general surgery program is for the purpose of fellowship match, keep in mind that some “less fancy” programs can get you into very prestigious fellowships also. Once you’ve done a fancy fellowship the world is your oyster.

Re: peds- if you go to a residency with a strong children’s hospital and peds fellowship that can go a long way, even if it’s not MGH or Hopkins.

Obviously you should work hard at every step, and always try to get the best thing possible, but if step 1 doesn’t go as well as you’d like or you end up an average med student you still have a way to accomplish your goals.

Yeah I was thinking that what really matters in the end is fellowship, for peds sure I mean. So a program with a strong peds surg department would be awesome. Also, step 1 is P/F for me so that is where part of my question comes hahaha in terms of not having that standardization anymore

 

[Smurfette]

Yeah I was thinking that what really matters in the end is fellowship, for peds sure I mean. So a program with a strong peds surg department would be awesome. Also, step 1 is P/F for me so that is where part of my question comes hahaha in terms of not having that standardization anymore

What happened before residency matters little for surgery fellowship matching. Get into a program that has been able to get residents to place into peds surg fellowships. If a "big name", great, it can open doors for you, but you can get there from a non-big name too. You just need to know the program has made the right connections and conditions happen in the past for others with the same interest.

No one cares about your step scores once you are beyond residency matching, only that you passed. Remember that peds surgery is going to be at least 9 years of training (5 yrs GS + 2 yrs research + 2 yr fellowship. Some people take extra years beyond that to further bolster their app).

 

[dienekes88]

Hi, I just started M1 year and pretty sure know I want to go into surgery, specifically pediatric surgery. We can talk about the difficulty of a pediatric surgery fellowship match later but I wanted to know how difficult it would be to match at top institutions for general surgery. I know specialties like ortho and optho are very difficult, but I wanted to know how gensurg compares, especially at top intitutions like for example: MGH, Brigham, UPENN etc. Also specifically if anyone can answer what class rank I should be aiming for, ie. top 25%, upper middle 25% or if that has little bearing if any. Also I know its early on in my med school career but I want to try and get ahead of things and make sure I have the appropriate resources and such. Thank you!

I would encourage you to look at this stepwise: your first job is to become a broadly educated doctor. Your second job is to be the best applicant possible. I would discourage you from worrying about top 25% or top 50%. You should do the absolutely best you can independent of that. If we told you that a 240 on step 1 and 2 abstracts were enough, then would you just stop at that once you achieved it? In order to maximize your probability of getting into a strong residency program and a strong fellowship, you have to be thinking about doing your absolute best in every facet.

Pediatric surgery is interesting stuff. Best of luck.

 

[Rainbow Zebra]

Hi, I just started M1 year and pretty sure know I want to go into surgery, specifically pediatric surgery. We can talk about the difficulty of a pediatric surgery fellowship match later but I wanted to know how difficult it would be to match at top institutions for general surgery. I know specialties like ortho and optho are very difficult, but I wanted to know how gensurg compares, especially at top intitutions like for example: MGH, Brigham, UPENN etc. Also specifically if anyone can answer what class rank I should be aiming for, ie. top 25%, upper middle 25% or if that has little bearing if any. Also I know its early on in my med school career but I want to try and get ahead of things and make sure I have the appropriate resources and such. Thank you!

My brother, now a 3rd year GS resident, had a 260 step 1, research (pubs and patents) in non Surgical field, came from a top Medical School and didn't get interviews at the big places (did at Harvard's 2nd tier Beth Israel Deaconess, but turned it down). He was in 2nd quartile of his class, non-AOA, but got 15 interviews, went on 13 of them.

Those top places are stat wh0re$, need good step 1 + AOA, plus Pubs in Surgery, plus letters that say you walk on water. These top 10 schools tend to be very incestuous with other top 10 med schools for residency and it helps to have important people working it behind the scenes. Look at their match lists, and you will see. One of my classmates is in Plastics now at Man's best hospital, and he walked on water according to the people who vouched for him. At this level, it is who you know + merit, need both. The rest of us mere mortals have to settle for second tier residencies, and work to get the fellowship we want.

 

[Rainbow Zebra]

Not sure why you’re telling people general surgery is some death sentence or how it’s impossible to match well unless you’re some once in a lifetime person. Those same match lists have people coming from “regular” medical schools and I can name just as many people who did less than perfect on boards (240-250), had maybe a pub or two, and weren’t AOA either (some were foreign graduates too), but matched at places like Columbia, Cornell, Hopkins, etc. They just did a rotation, had reasonably above average scores, and probably good letters.

GS is tough, and people with kids need to understand the sacrifices it will take. Folks talking about UPenn/MGH or bust need a bit of a reality check. No, there are not a lot of "regular" hard working people on those match lists. Anyone without stellar stats had something else going on, probably in the who you know category (or in my experience, who you are related to). Lots of academic faculty have kids in medical school, as I am just one of many at my school.

I do agree, there are lots of good programs out there that are not top 10 or 20. Define matching well. I think interviewing at least 10 programs, then matching in one of your top 10 rankings is matching well. Apply broadly, as the goal is to match, not match at the top 10 program or bust.

So Bladerunner, you are suggesting run of the mill med students at second tier schools can dream of the big leagues with just above average scores? Not in the experiences I have seen. When that happens, I suspect it is family connections that play a role. Just like folks wanting to work finance dream of Goldman Sachs or JPMorganChase. Or law students wanting to clerk for the Supremes. Look at who works where, and that is how the world works, not any different in the medical profession.

 

[Shufflin]

Just $0.02 here, but the big name med school where I attended revealed that their gensurg applicant pool decreased to the point of lowering incoming stats. They mentioned how the pendulum was swinging away from gensurg because applicants were much more interested in balanced lifestyles and such and they had to reach much lower on the match list than years prior.

 

[Rainbow Zebra]

Just $0.02 here, but the big name med school where I attended revealed that their gensurg applicant pool decreased to the point of lowering incoming stats. They mentioned how the pendulum was swinging away from gensurg because applicants were much more interested in balanced lifestyles and such and they had to reach much lower on the match list than years prior.

That is interesting. Thank you for the feedback. Makes sense that the brutal hours are taking a toll. Glad to see they may need to change their ways, like, hmmm, maybe adhere to work rule hours? Maybe more women in medical school is now having an impact in the macho culture of GS. Whatever is driving it is a good trend to see. Big schools love nothing better than to brag about their stats, how low they had to go in their rankings, and complain about USNWR ranking methodology that doesn't rank them number 1 or in the top 10.