Question about competitiveness of general surgery

[MadScientist95]

Hey guys, just wanted to ask a few questions regarding general surgery. I am about to complete my first year at a state DO school and am currently interested in both general surgery and internal medicine. While I am not 100% sure about surgery, I still would like to keep my options open if possible. While my school does not rank students, based on my test scores when compared to the class average I would say I probably fall within the top 60-70 percentish. I have a research project scheduled for this summer, which I have been told will be published next year by the pHD I will be working with. I plan to start studying for boards this summer to get a head start. Is there anything else I should be doing? How competitive is general surgery for a DO if they are not picky about the location? What score should I be aiming for on step 1 to simply get in somewhere? I dont want to sell myself short, I guess I simply want to get an understanding of how hard it would be to match general surgery if I end up deciding to pursue this specialty. Thanks!

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[AnatomyGrey12]

It's competitive, but not overtly so like the surgical subs. 230/550 is kind of the magic line to be at score wise where your chances of matching increase significantly, although people match with scores below that every year. The general rule of thumb is 230+ is good, 240+ is better, and 250+ is icing on the cake and will open some doors. Obviously not a hard and fast rule. I personally know people in the 220's who matched solid programs this year. You absolutely want to take Step, not having it will limit you severely in where you can apply (I.e. only former DO programs pretty much). There are even former DO programs now that are requiring Step of all applicants, ex. Swedish in Denver.

Research is always a plus. If you are targeting MD programs then it's a must. Actual peer reviewed publications are best but most DO students have case reports, posters, etc and that is ok too.

Class rank is always nice to have but won't be what ruins any applicant.

Here are some things that I've seen help DO students and will help set you apart from other DO applicants. 1. LOR's. Most MD GS applicants have 3 letters of req from general surgeons. A lot of DO applicants will only have 1-2 and then have non-surgeon letters. Having 3 surgeon letters, with one being from a PD or Chair will go a long way. 2. Aways. Obviously for DO programs the audition is still a big deal, but even for MD programs an away can be what gets you in the door to a place that might not have given you a chance without being able to see you I person. They also serve as a great way to get letters of req from academic surgeons (a lot of DO surgeon letters are from community PP guys that precept students).

Since you go to a state school you will likely be at a clinical site with a residency. Make connections, see if the residents need any help with research projects, if it's the culture of the program to let students show up to didactics then pop in from time to time as your schedule allows. Get to know the interns as they are the closest to where you currently are and in my experience are generally willing to give advice and help you. Be around but don't be annoying.

tldr. 230/550 is the threshold where matching chances go up quite a bit, have some research, get 3 LOR's from surgeons, be a cool person that isn't annoying. Good luck, General Surgery is an awesome field.

 

[MadScientist95]

Thank you so much! I found this very helpful. How hard would you say it is to get a 230 on step 1? I find it a bit confusing when I hear people say this is a good score as it correlates to the 50th percentile. On the MCAT, the 50th percentile was 500, which may or may not be good enough to get into MD or DO schools. Does this mean that if I were to average scores as a DO student, I would likely get somewhere?

 

[AnatomyGrey12]

How hard would you say it is to get a 230 on step 1?

Depends completely on the student. Some people will study for months and get a 230 and others will start out at 230 as their baseline before any board specific prep.

I find it a bit confusing when I hear people say this is a good score as it correlates to the 50th percentile. On the MCAT, the 50th percentile was 500, which may or may not be good enough to get into MD or DO schools.

Different testing pools. There are only so many people interested in any given specialty per year. Competitiveness waxes and wanes depending on how many apply that year and what their applications look like. The matched average for MD's was 236 and 238 for DO's (2018 data, we'll have 2020 data later this summer.

Does this mean that if I were to average scores as a DO student, I would likely get somewhere?

You would have a solid chance, yes. I would say that's the floor though, obviously people do match lower than that but it is more difficult. Obviously the higher the better.

 

[Angus Avagadro]

Dont underestimate the value programs put on reliable, hard working applicants. I'm probably stating the obvious, but when on rotations, make sure you show up early, volunteer to help in any capacity, and stay late. When told to go home, ask if there is anything else you can do. Surgery is not for the meek or people who would rather be somewhere else. LORs can be very helpful, especially from a PD or from someone known to the program you are applying to. Gray knows the ropes as well or better than anyone interested in surgery. Listen to him. Good luck and best wishes!

 

[CITIZENSURGEON]

Certainly agree with Angus, as a reviewer of applicants for general surgery residency and previously for gen surg and pediatric surgery fellowship I can say that evidence of hard work on rotations and support of hard work in your letters of recommendation carry an enormous amount of weight. For me, I feel that the step score can be an attention getter (high or low) but it is only a single piece of data; competition for the top spots goes deep on the application so make sure you make your step score is authentic by doing the work.

 

[Billroth_III]

Hey guys, just wanted to ask a few questions regarding general surgery. I am about to complete my first year at a state DO school and am currently interested in both general surgery and internal medicine. While I am not 100% sure about surgery, I still would like to keep my options open if possible. While my school does not rank students, based on my test scores when compared to the class average I would say I probably fall within the top 60-70 percentish. I have a research project scheduled for this summer, which I have been told will be published next year by the pHD I will be working with. I plan to start studying for boards this summer to get a head start. Is there anything else I should be doing? How competitive is general surgery for a DO if they are not picky about the location? What score should I be aiming for on step 1 to simply get in somewhere? I dont want to sell myself short, I guess I simply want to get an understanding of how hard it would be to match general surgery if I end up deciding to pursue this specialty. Thanks!

I'm in the same position as you, listen to the advice that you are getting on here right now. It will definitely serve you better than whatever your school tells you or what some of your clueless classmates may be doing

 

[DameJulie]

1) will research outside the GS specialty (eg. Basic science research in anatomy) help much, if that’s the only research opportunities one has?

2) does volunteer/ec/club leadership value much?

 

[AnatomyGrey12]

1) will research outside the GS specialty (eg. Basic science research in anatomy) help much, if that’s the only research opportunities one has?

2) does volunteer/ec/club leadership value much?

Yes

No

 

[giguerex35]

Yes

No

what is the view of having LOR from surgeons that are not GS. I know alot of those applying to NSurg for example will likely apply to GS as a backup and obviously a LOR from a NSurgeon is needed in this case. Do you think GS PDs would view a NSurg letter the same as any other letter written by someone outside the field, like a PhD LOR for example or youd just need a GS & NSurgeon to write letters in this case

 

[AnatomyGrey12]

what is the view of having LOR from surgeons that are not GS. I know alot of those applying to NSurg for example will likely apply to GS as a backup and obviously a LOR from a NSurgeon is needed in this case. Do you think GS PDs would view a NSurg letter the same as any other letter written by someone outside the field, like a PhD LOR for example or youd just need a GS & NSurgeon to write letters in this case

GS programs really want to see GS letters. They don't like being a back up. If it's a GS subspecialty like trauma, colorectal, peds, surg onc, then they are fine, but I would avoid stuff like NS, ortho, or any field that has integrated programs like vascular, plastics, CT, etc.

 

[3member]

Class rank is always nice to have but won't be what ruins any applicant.

Would you say this is the case for MD applicants as well?

 

[AnatomyGrey12]

Would you say this is the case for MD applicants as well?

Yes. Rank isn’t really very important u less you’re at the top or bottom.

 

[3member]

Yes. Rank isn’t really very important u less you’re at the top or bottom.

Thanks! Top as in top 10%? Bottom as in bottom 10%?

 

[AnatomyGrey12]

Thanks! Top as in top 10%? Bottom as in bottom 10%?

Ya. Even if you're at the bottom if the rest of your app is good even then it probably won't matter too terribly much.

 

[Angus Avagadro]

I think class rank can mostly help you.
Programs want you to be able to pass boards.

 

[Kr#36]

I think class rank can mostly help you.
Programs want you to be able to pass boards.

Wouldn't step 1 and 2 tell them a lot more than class rank? Those exams are standardized and mostly everyone does as well as they can. Course grades can vary by school quite a bit and a decent chunk of students just do enough to pass classes.

 

[Angus Avagadro]

No one said class rank was more important than boards, letters, auditioning, research, etc. Having said that, matching into your first choice for any competetive residency requires a solid application, with multiple boxes being checked.A survey of residency program directors revealed that about 70% of PDs looked at class rank and weighted it 3.9 out of 5 with respect to importance in their decision on acceptance. Step 1 and several other factors ranked higher on their list of importance. Check it out, its an interesting survey. As Grey said earlier, class rank won't be much of a factor unless your are on the extremes of upper or lower rank. I think class rank pretty much can help you more than it hurts you. Interestingly, the survey reported that class rank was weighed about the same as being AOA.
With respect to those students doing just enough to pass, PDs are looking for hard workers more than the bare minimum types. Thats why I have always believed auditioning is very important in selecting residents. You have this person for several years and being a hard worker is a desired trait, especially in surgical specialties.