Official FAQ planning thread

[surg]

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As we get ready to welcome new MS1 and MS3s to our surgery board, I propose that we start work on a FAQ that will aid those interested in surgery to quickly get up to speed. It is my belief that this FAQ should answer newbie questions, not to quash discussion, but to decrease the number of pure fact-finding questions, allowing us to spend our time on more nuanced questions.

This thread is for people to do 1 of 2 things:
1) propose a FAQ that should be written up
2) volunteer to draft an answer for the FAQ

Topics I can already think of:
1) What subspecialties of general surgery are available and how long does it take to get into each one?
- a short list should suffice here
2) What's the difference between a categorical and prelim spot?
3) I heard that there would 5 billion spots available in the scramble!
4) What are the advantages/disadvantages of choosing a community program? a university program?
5) How high a score do I need on step I to get into surgery?
6) Can a DO get into surgery?
7) I heard that there will be a short route to CT surgery. How do I get into it?


Anyone can sign up if they feel they can create a good answer, multiple answers for the same question are ok, and encouraged, especially for the opinion type questions. Post signup for each question in this thread. When done, create a new thread that starts with FAQ:
I am willing to collate them if no moderator will, and hopefully a moderator will be kind enough to sticky it to the top of the board.

 

[surg]

Oh, here's another one that comes up a lot:

8) What are good medical student level books? intern level books?

 

[doc05]

(9) advice about surgery clerkship:

- for students who want to go into surgery

- for students who just want to get through the clerkship


(10) info. on the various subspecialties (ENT, uro, ortho, neuro)

 

[daveyboy]

This is a really great idea. Thanks for starting it off!

 

[Skylizard]

10) When should I take Step II
--Should I try to hide my step II scores
11) Not getting in (unmatched)-what options remain
12) How does the scramble work
13) Is there a benefit or disadvantage to ranking preliminary spots over categorical spots
14) FMG/IMG in surgery
15) Can medical students ?scrub in?
16) ATLS do I need it before residency? Who pays for it
17) ACLS do I need it before residency? Who pays for it
18) BCLS do I need it before residency? Who pays for it
19) PALS do I need it before residency? Who pays for it
20) Will I get in? what do programs look for in an application
--Is my undergraduate record important in applying for residency
--How important is research in obtaining a gsurgery or surgical subspecialty spot
--What kind of letters do I need?
--What kind of scores do I need for Gsurgery or subspecialty surgery
21) Canadian residency
22) UK residency
23) Foreign residency
24) What is the difference between community and academic residency
25) Pocket reference books
26) What are chief residents?
27) What is the ABSITE and when do you take it& how do you prepare
28) What is the American Board of Surgery Exam and when do you take it & how do you prepare
29) What are the fellowship options after Gsurgery and how do I get in
--What is SICU
--What is Colorectal
--What is hepatobiliary
--What is thoracic
--What is cardiac
--What is pediatric surgery
30) Are there and is there a difference between fellowships and ?additional training?
31) Are you covered by insurance against malpractice while a resident
--Who pays for your malpractice insurance
32) How do you and how difficult is it to obtain a PGY2 or higher categorical spot
33) what is an "unrestricted license"
--does it work anywhere
--how do I get one
--who pays for it
--how many can I have
34) what is "moonlighting"
--who can moonlight
--who pays you
--is it taxable
--am I insured when I moonlight
--does moonlighting count towards the 80hrs rule
36) when do I take step III
--where do I take it
--who pays for it
37) who pays for my trainee license
38) what should I look for or ask about at residency
39) what should I consider in ranking programs for the match
--benefits package (health insurance, retirement/401K etc...)
--do they pay for my license
--do they pay for my loupes
--travel expense
--do they pay for a board review course at the end of residency
40) what are surgical loupes
41) After match
--what is my legal/contractual/moral/ethical obligation to the program
--how long do I have to stay
--can I change residency? If so, when & how
--can I reapply for the next ERAS match
42) What happens if I fail BCLS/PALS/ACLS/ATLS
43) Good books for MS4s
44) how long is residency training for specialty XX
45) interview and spouses

 

[Castro Viejo]

A monumental effort. This reminds me of the FAQ we developed for the old misc.education.medical that you may still be able to find on the internet somewhere.

Wow.

 

[surg]

The funny thing is, I was a participant on that usenet group as well. That's where I came up with the idea

Alright guys, let's deal with the big ones first. Who's willing to start writing? Not expecting a tome, even a quick compilation of a thread that was already done on a topic is good.

 

[surg]

Here's my plan,
sign up on here as to what question numbers you want to do by posting a reply on this forum. That way we won't get as many duplicates

You can then post the text of your answer either on this thread or in a new thread (which I think is probably smart from a search function perspective). If you use a new thread, start the subject line with FAQ: <text of question> You can also pm me the info.

I'll do all the formatting and do any grammar editing I think needs doing. Then I will compile them into one big word doc, and post it as a fresh thread for the moderators to sticky to the top of our board.

 

[Skylizard]

Question 10: When should I take Step II
--Should I try to hide my step II scores

Originally posted by Skylizard

First, if you did stellar or above average on step I nobody is going to ask too much about when you will take step II. Also remember, Step I is often a good indicator as to how you will perform on step II.

Second, if you are concerned about having a poor showing on step II then do not take it in enough time such that you have the scores before interviews.

Third, if you take it early you should plan on sharing that information with the programs... Either take it early and plan on sharing the information or don't take it early. Do not start with the mentality of "can I hide this until after" I match, get the contract, get the job, get the promotion, etc... There is nothing wrong with taking a test in a way that optimizes your options. There is arguably something wrong with choosing to take a test at a time that might be less then helpful and then trying to withhold the information. Do not try and have it both ways. Be honest with yourself and the programs.

Finally, your program will ultimately know when you took step II if you match. If your scores were lousy, your PD will not miss the fact that you failed to fully disclose prior to the match. That is not a way to build trust, to start a training program or to start a career.

 

[Skylizard]

Question 11: Not getting in (unmatched)-what options remain

Originally posted by droliver
take a deep breath & relax....

First off, you really need to work your ass off this year (in prelim spot) to make a good impression on your fellow residents & staff. They will be your most valuable asset in finding another position. Starting in the early spring, a # of positions begin to be solicited for those residents who have decided to quit surgery or transfer into another specialty. Many programs with openings send out mass mailings to other PD's advertising these spots. Stay in touch with your PD & chairman in the spring and they can help you look for other programs & oppurtunities. Many times, they will find a position for you @ their own program if you knock their socks off with your work ethic. You will be under a microscope because of your prelim status, but if you do good work the word gets out quickly among your fellow residents & eventually your staff.

Sometimes positions are advertised in some of the journals in the back (usually pgy2 &3 positions)

Prelims spot is an option as are a paid research fellowship. Research may give you an opportunity to obtain publications while allowing you more freedom in interviewing. In general, if you signed a contract for a preliminary spot you should honor that contract. keep your head up and good luck, it will work out.

 

[Skylizard]

Question 13: Is there a benefit or disadvantage to ranking preliminary spots over categorical spots

Originally posted by droliver
There are a signifigant amount of spots that open in the PGY-2 & 3 years just thru attrition & the like. Doing a prelim year at a large & reputable program has been a very effective way to parlay yourself into categorical programs for many years. If you go somewhere & do a good job people notice even if you're a prelim & they are more then willing to go out of their way to help you find a job @ their program or elsewhere thru networking.

Originally posted by SurgResident
It definitely is a risky move, but I think it's a reasonable risk if you are absolutely committed to an academic program/career. My program brings in more than a handful of prelims each year. Each year, at least one prelim stands out. Because of the usual turnover rate in GS residency and also because of requests for extra lab-time by some residents, we take prelims into the categorical program every once in a while (sometimes several in a year). I must tell you that these prelims are on par with the categorical interns and by the time they finish residency, you would never guess that some chiefs came in as prelim interns. If you go this route, you need to be confident in your skills/knowledge/dedication.

Originally posted by Geek Medic
You will only be able to transition from preliminary to categorical if the institution has open positions (either someone quit, was let go, or the institution just created a position for you). You'd have to be very good for them just to create a position for you.

If you want to be a general surgeon, then you should really apply to a categorical program.

A MEDICAL STUDENT

Originally posted by womansurg
If you are unable to match into a highly competitive program to start with, then probably it is because your clinical performance, grades, so forth have not been of sufficient caliber. As a prelim you will be heavily scrutinized, and often treated a bit like a bastard stepchild, especially if you are there without holding a permanent position upon graduation. You will also find yourself compared with the categorical interns who - since they did secur a spot in the first place - are probably exceptionally bright and capable.

I suppose you need to examine why it is that you weren't able to perform at an expected level for such programs, and decide how likely you think it is that those factors are alterable over the nex year.

You definitely would have no trouble getting into academic surgery coming from a mid tier program if your performance was solid, and I suspect the risk of you experiencing failure and frustration would be much less.

Good luck with your decision.

Originally posted by duramaterdoc
I think that ranking ANY preliminary spot over a categorical spot is very risky and NOT WORTH IT.

To do academic surgery, you don't necessarily have to come from a top level program. YOU DO have to survive and do well. If you want to do academics I think you should TRY to match into an academic (rather than community program) but ultimately you should match categorical. EACH year you attempt to match when you're not a 4th year student SIGNIFICANTLY LOWERS your chances of ever matching.

Yes, spots do open...but they are NEVER guaranteed....Also, they are most likely to be filled by people WITHIN the institution...you may never even know about them let alone have the program give you a greater chance than a resident already familiar with the system, etc.


If you match into a categorical, you can always transfer if a spot opens.

ANYONE who is a prelim. in general surg. is thought of as an "extra"--no real talent but provides a good strong back. You would look better if you matched into some OTHER residency and switched. Prelims are generally thought of as "people who couldn't match at all"--meaning they will always suspect there is "something wrong with you" whether or not that is a valid thing to do.

If you match at a mid-tier program, so what, do an AWESOME job there, shine and get a KICK-BUTT fellowship!

 

[Skylizard]

Question 15: Can first & second year medical students ?scrub in?

Originally posted by Skylizard
ASK YOUR ATTENDING

Originally posted by surg
I'm not aware of any laws that would prohibit this. The real question is who assumes the liability? If you are at your University hospital or an affiliated one and this is part of your education, the school covers you with their malpractice insurance.

Bottom line: it's legal in virtually any context. If this is at your school's affiliated hospitals it is probably no problem. If it isn't a teaching hospital or the surgeon doesn't regularly participate in teaching, it may be against hospital rules or the surgeon's malpractice carriers rules to use an unlicensed assistant but that is their call. It is unlikely but possible that you could get in trouble for it personally.

Originally posted by Kimberli Cox
Depends on the attending and the policies of the of the hospital/OR.

Generally, medical students are covered for liability and are allowed to scrub as long as the attending surgeon is ok with it. Others are often prohibited (ie, one of the surgeons here wanted his son, a medical student elsewhere, to scrub in and was told he wasn't allowed because the hospital's medical defense insurance wouldn't cover him, nor would his school's since he was just here on vacation).

Check with the attending concerned for direction.

 

[Skylizard]

Originally posted by Skylizard
ATLS, Advanced Trauma Life Support is a 2 day course that involves a live animal lab (generally pigs or large dogs)
General surgical residents are required to take this, it is generally paid for by the residency program, consequences for failing are program dependent. Lacking certification can have an impact on your role on the trauma team and in the trauma bay.


* Emergency medicine residents and anesthesia residents are required to take this course at some residency programs.

 

[Skylizard]

Originally posted by Skylizard
17) ACLS, Advanced Cardiac Life Support
I believe ALL residents are required to take and pass this 2 day course. I was told at my program that it is a safety requirement of Joint Commission. Generally paid for by your residency program/institution. The course was revamped in the last few years and generally nobody fails. If you fail there may be some problems (program dependent).

 

[Skylizard]

Originally posted by Skylizard
18) BLS, Basic Life Support (AKA: CPR and then some)
Every respectable physician should be sufficiently knowledgeable and skilled to be certified in this as grade school kids are being certified. Yes, you should have this in residency. It is likely paid for by your residency. You shouldn't fail.

 

[Skylizard]

Originally posted by Skylizard
19) PALS, Pediatric Advanced Life Support
Some general surgery programs are now requiring this given the amount of pediatric trauma. Check with your surgery program as to if you need this. If your program requires it they will probably pay for it. This is a very student friendly 2 day course. In general nobody fails. If your surgery program requires it then you need to find out what the penalties are from them if you some how fail the course.

*Pediatrics residents, ER residents, FP residents, & anesthesia residents usually need to take this one.

 

[neutropeniaboy]

Anyone care if I insert an ENT mini-FAQ?

 

[njbmd]

Originally posted by ******
A monumental effort. This reminds me of the FAQ we developed for the old misc.education.medical that you may still be able to find on the internet somewhere.

Wow.

Hi there,

As one of the authors of the FAQs for misc.education.medical, I am touched that you remembered.
njbmd😀

 

[synapse_rules]

It would be great if the forum moderators could also start separate forums and a specific list of FAQs for ENT and Neurosurgery too.

Cheers !

 

[Weeble]

Originally posted by neutropeniaboy
Anyone care if I insert an ENT mini-FAQ?

That would be awesome!