Prelim Surg at University Hospital

[filipina]

Hello everyone. I am a US IMG. My step scores are as follows, Step 1 low 220s, Step 2 CK low 220s, Step 2 CS Pass. All first attempt. I have lots of experience with surgical missions both local and international (US based mission groups). I really want to practice surgery in the US and I have applied to both categorical and preliminary surgical residency programs. So far I have interviewed only for preliminary programs. There is one program however which I am very interested in. It is a BIG IVY LEAGUE UNIVERSITY program.

Will it be easier to convert into a categorical general surgery position at another institution if I complete the prelim general surgery residency from a University program?

Thanks

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[RabidSurgeon]

If that big Ivy League program is UPenn, you might want to stay away from there.
If you search this forum, you'll find a lot of advice about prelim years in general surgery.
Based on what I've heard/read, prelims have around a 25% chance of matching. It's mostly based on scores, connections, publications, being at the right place at the right time, and the attrition rate of other programs. Apparently fewer and fewer people are dropping out of general surgery programs, and more and more people are applying. This is making it harder and harder for prelims to get any categorical spots.
If you are a US Citizen, I think you can repeat prelim years as much as you like, or go into research and wait for a categorical position to open up.
My advice (whatever it's worth) is that is doesn't matter where you go for the prelim, only if the place you go to is supportive of prelims or not. There are small, non-Ivy League programs that match all of their prelims and go above and beyond to help them out in every way possible, and there are large Ivy League programs that couldn't care less about where you end up. Find the supportive program and take your chances there.

 

[filipina]

If that big Ivy League program is UPenn, you might want to stay away from there.
If you search this forum, you'll find a lot of advice about prelim years in general surgery.
Based on what I've heard/read, prelims have around a 25% chance of matching. It's mostly based on scores, connections, publications, being at the right place at the right time, and the attrition rate of other programs. Apparently fewer and fewer people are dropping out of general surgery programs, and more and more people are applying. This is making it harder and harder for prelims to get any categorical spots.
If you are a US Citizen, I think you can repeat prelim years as much as you like, or go into research and wait for a categorical position to open up.
My advice (whatever it's worth) is that is doesn't matter where you go for the prelim, only if the place you go to is supportive of prelims or not. There are small, non-Ivy League programs that match all of their prelims and go above and beyond to help them out in every way possible, and there are large Ivy League programs that couldn't care less about where you end up. Find the supportive program and take your chances there.

Thank you very much for replying RabidSurgeon. The program is not UPenn. I am sorry I cant specify which program it is. Anyway, I really appreciate your response. I have done a lot of research as well on the topic of prelim surgery and like you I have come across information that is not very encouraging. However, I did not find much info regarding placement after graduating from a university program. Also, the program that I interviewed with seems very friendly and willing to find placement for their prelims. I would assume that having an established name behind me would help to get me into programs elsewhere.

My decision would be straightforward if it were not for the other offers I received. I also applied for internal medicine just to be safe in case I did not match in general surgery. All IM programs that I interviewed with are categorical. I guess i just feel that prelim surgery is such a risk compared to categorical IM programs.

 

[RabidSurgeon]

Thank you very much for replying RabidSurgeon. The program is not UPenn. I am sorry I cant specify which program it is. Anyway, I really appreciate your response. I have done a lot of research as well on the topic of prelim surgery and like you I have come across information that is not very encouraging. However, I did not find much info regarding placement after graduating from a university program. Also, the program that I interviewed with seems very friendly and willing to find placement for their prelims. I would assume that having an established name behind me would help to get me into programs elsewhere.

My decision would be straightforward if it were not for the other offers I received. I also applied for internal medicine just to be safe in case I did not match in general surgery. All IM programs that I interviewed with are categorical. I guess i just feel that prelim surgery is such a risk compared to categorical IM programs.

No need to specify the program (nor did I ask ). There are many who would say that having a big name behind you as a prelim would help you match next year. I, however, do not think it is the name of the institution that matters as much as the people who are pushing for you and trying to help you secure a categorical spot. Many places also make lots of promises to prelims: they will help you match bla bla bla, but when push comes to shove they leave you out to dry.

I view prelim surgery as a terrible gamble; it's up to you decide if it is worth it. Also keep in mind that next years match is the "watershed year" where IMGs may find it virtually impossible to match in the US - in any specialty. So if you did a prelim year in surgery and then tried to switch to another specialty, you may not be able to match due to the increased number of AMGs and the relatively stagnant number of residency positions. Also keep in mind that Step 1 scores are steadily increasing, so the places that called you this year may not call you next year because your Step 1 score may be too low.

I think the best thing to do would be to find out where the prelims at that program have ended up in the past few years. Did they match at the same program, match at different ones, stay in surgery, change specialties, get stuck in research, or end up leaving the country? For the prelims who succeeded, what were their step and ABSITE scores, and how much research did they have on their CV? These things would help you determine if there is where you would like to take the risk of doing a prelim year.

Good luck Whatever happens, I hope it works out for the best.

 

[ThoracicGuy]

If that big Ivy League program is UPenn, you might want to stay away from there.
If you search this forum, you'll find a lot of advice about prelim years in general surgery.
Based on what I've heard/read, prelims have around a 25% chance of matching. It's mostly based on scores, connections, publications, being at the right place at the right time, and the attrition rate of other programs. Apparently fewer and fewer people are dropping out of general surgery programs, and more and more people are applying. This is making it harder and harder for prelims to get any categorical spots.
If you are a US Citizen, I think you can repeat prelim years as much as you like, or go into research and wait for a categorical position to open up.
My advice (whatever it's worth) is that is doesn't matter where you go for the prelim, only if the place you go to is supportive of prelims or not. There are small, non-Ivy League programs that match all of their prelims and go above and beyond to help them out in every way possible, and there are large Ivy League programs that couldn't care less about where you end up. Find the supportive program and take your chances there.

Regarding the bolded part above, in order to become board certified, you can only complete training at a total of 3 different institutions. You'd be allowed to stay as a prelim for 1-2 years, usually only 1, at an institution. Prelim surgery years are often paths to nowhere. Many that want to be surgeons and can't find a categorical spot end up changing to other fields for training...

 

[ThoracicGuy]

Prelim years only count towards the three institution limit if you're advancing. If you repeat a PGY1 prelim at another institution that doesn't count toward your limit. (Not that repeating PGY1 is desirable, nor that it will help your odds of finding a categorical slot)

Ahh, that is a distinction that I didn't catch... I can only imagine that there aren't too many people repeating a PGY 1 prelim year very often, though.

 

[filipina]

Thank you everyone for replying to my querry. I have done a lot of research and I have given myself some time to think about this. I have come to the decision to rank the prelim program last on my list. As much as I want to be a surgeon I believe the risks far outweigh the benefits. Thank you again for all your help guys!