Preliminary Surgery!!!

[Doctorss]

I have graduated from medical school 4 years ago, and I have been working as a general surgeon at my home country since.
I have completed my USMLEs 3 years back...scored 93 step 1 & 86 step 2. My bro who is a year younger completed his exams 2 years ago and scored over 95 in both exams. We both applied for general surgery catagorical and preliminary, we both got interviewed....he matched into a preliminary position..I didn't match. Last year I applied again, got interviewed and did not match!!! i was shocked. My bro tried to impress his program director in every way...he made excellent connections with everyone he talked to and applied to 2nd year catagorical in his program and about 60 other programs...and he applied to 2 prelim positions as a safty move. He was not matched for any catagorical spot....fortunatly he was matched again for a 2nd preliminay position and is stuck with that until proven otherwise.
89% of residents who get into preliminary position fail to switch to catagorical position....only 11% who have amazing contacts can do it and I'll post the statistics I got in a new thread (pdf file). I honestly believe that getting into a preliminary surgical position is a complete waste of time, energy and money!!!!
if you apply to medicine or another non-surgical field after completing prelim in surgery...the first thing that will come on the program directors mind would be..why did he/she go for surgery if they are interested in medicine!!!! or any other field. it becomes a negative point rather than a positive one! people who really understand how the system works, never go for prelim surgery....but we had to learn the hard way.
I really need advice from the wise and experienced members of these forums. shall I apply to general surgery catagorical again....or shall I choose something else...and don't forget, I have 4 years of experience as a general surgeon, so if I decide to switch to another field, then those 4 years would be wasted.

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[NotAProgDirector]

I'm an IM program Director, so I may not be 100% versed in the "surgery game", but I'll add my 2 cents

....fortunatly he was matched again for a 2nd preliminay position and is stuck with that until proven otherwise.

I'm not so sure he's lucky. He might be able to get a categorical surgery spot, but also might not. If no, then he has 2 years of training that are completely meaningless. I hope he succeeds, but as you mention it is difficult.

89% of residents who get into preliminary position fail to switch to catagorical position....only 11% who have amazing contacts can do it and I'll post the statistics I got in a new thread (pdf file).

I would love to see this data. Not sure where it comes from. The ACGME and the ABS might collect such data, as might the APDS. Please share!

I honestly believe that getting into a preliminary surgical position is a complete waste of time, energy and money!!!!

This is a mostly true statement. Prelim surgery spots are by no means a guarantee of future training -- in fact, as you stated above, most people in perlim surgery spots seem not to get categorical slots. Completing a prelim year might get you a cat year if someone from your program drops out AND you're the best of the prelims in your group. This competition between prelims tends to make these programs painful. In addition, many programs give prelim surgery residents little OR time, and some Cat programs require that you start the PGY-1 year all over if you transfer from a prelim program.

Are they a COMPLETE waste of time? Not for the 11% that you state convert them to a categorical program.

if you apply to medicine or another non-surgical field after completing prelim in surgery...the first thing that will come on the program directors mind would be..why did he/she go for surgery if they are interested in medicine!!!! or any other field. it becomes a negative point rather than a positive one!

Well, not exactly. I have had residents who failed to match in Rads, Derm, G Surg, etc who ended up in IM instead. I know they would have chosen a different field, but they come to medicine and find a niche. The key is this: Could you be happy in a different field or are you only happy doing surgery? Cardiology might be an option, but remember that requires getting into a good quality IM program, doing well, and then another competitive match in the future.

shall I apply to general surgery catagorical again....or shall I choose something else...and don't forget, I have 4 years of experience as a general surgeon, so if I decide to switch to another field, then those 4 years would be wasted.

What have you done since applying the last two times to make yourself more competitive? If nothing, then it's unlikely you will match. You are having trouble matching a prelim spot (which as mentioned above may be worthless), matching a Cat spot will be that much more difficult. Each year farther away from your med school graduation makes it more difficult.

Sadly, your 4 years of previous training will be largely ignored no matter where you might train. Another way of looking at it: those four years will make you a much more well-rounded internist/FP/path, etc.

Good luck

 

[anestheticman]

This made me think about something I didn't consider.

I'm 100% set on anesthesia right now so if I end up doing a prelim surgery spot and for some crazy reason decided to go into medicine instead later... would I be screwed? I know people end up changing residencies all the time, and I hope I don't change my mind but just curious.

 

[Winged Scapula]

This made me think about something I didn't consider.

I'm 100% set on anesthesia right now so if I end up doing a prelim surgery spot and for some crazy reason decided to go into medicine instead later... would I be screwed? I know people end up changing residencies all the time, and I hope I don't change my mind but just curious.

Well, depends on what you mean by "screwed". If you mean having to start internship all over again, then most likely yes...although you *may* get some credit for any SICU months you served during your Prelim year.

If you are talking about CMS/HCFA funding, since funding "term limits" don't start until you enter the categorical training track, Anesthesia is longer than Medicine, so its not a problem.