Rol 2012

[Dan Plainview]

I guess I'll start. These were super helpful for me, so I'll post my profile and my rank list.

Applied: 33
Offers: 25
Rejections: Washington, Stanford, UCSD, Penn, Hopkins, Brigham, Vanderbilt, Case Western
Interviews: 15
Ranking: 15

School: Deep South, not top 40 NIH
Class Rank: top 25%
AOA: Yes
Step 1: 260's
Step 2: 260's
Clerkships: honors in all third year rotations
LOR's: one from a division chief at MGH, 2 from decently well known surgeons
Research: 2 projects, 1 publication, 1 poster at a national meeting
Extracurriculars: Gold Humanism Honors Society, community health project, officer positions in several clubs

Disclaimer: I realize my rank list may not make a lot of sense to the outsider, but gestalt and fit played a big role in the creation of my rank list.

ROL:
1. Mass Gen– I realize this one isn't quite like the others on the rest of my top 5. Given how competitive it is to match at MGH, I won't be surprised at all if I don't end up here (but would be stoked if I did!). I ranked it first because my time here was outstanding. I liked the residents, the PD, and chair. My s/o and I like Boston a lot as well. I also like that while research is required, you can do things like surgical education, international surgery, etc.
2. UAB – solid program that affords a lot of flexibility in terms of research/no research, sends people into private practice (which to me means they feel prepared coming out of residency). Also liked the residents here a lot when interacting with them.
3. Mayo (MN) –Obviously the apprenticeship model is a double-edged sword, but I just liked it here. I thought that Dr. Heller would be an excellent advocate and I liked her vision for the department. My s/o was able to travel with me to this one and liked Rochester.
4. Home Program (trying to maintain some anonymity) - I love the program and the people here. It's an academic affiliated program and has the most friendly, non-malignant staff I've encountered. Would be thrilled to match here.
5. UNC – I liked this program and liked Chapel Hill a lot, I just picked up a little bit of a weird vibe from a few of the chiefs, but then again they could have just been quiet and introverted. Again, they offer flexibility and have a good mix of sending people to fellowship and private practice.
6. Kentucky
7. University of Michigan
8. Utah
9. OHSU
10. Wash U
11. BIDMC
12. Northwestern
13. Carolinas
14. Cornell

I was a little disappointed not to get an interview from Washington or Vanderbilt, as I was highly interested in both. I was even rejected for an away rotation at one of them.
Overall I feel very fortunate and blessed to have some of these programs on my rank list. I would be ecstatic with my top 5. My partner and I had originally wanted out of the south, but I think we realized that quality of life and training mattered more than a "big name" and living somewhere expensive and cold.



Best of luck to everyone else in the match!

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[SLUser11]

For what it's worth, we matched a couple of UAB grads into our fellowship this year, and they are very solid residents. My n=2 is that UAB provides an excellent surgical education.

Another one was from BIDMC and also seemed well-trained, but I didn't spend as much time with him.

I have a co-fellow who did general surgery at OHSU and she received excellent training with good balance.

I think your list looks pretty good, and my guess is that you'll be happy on match day.

 

[SocialistMD]

2. UAB – solid program that affords a lot of flexibility in terms of research/no research, sends people into private practice (which to me means they feel prepared coming out of residency). Also liked the residents here a lot when interacting with them.

For what it is worth, the assumption that I bolded above is an unfair one to make. 95% of the graduates from my residency go into fellowship, but it is because 75% go into academics (where they have to have a specialty niche) and the other 20% go into private practice as specialists (vascular, colorectal). I would say most of us feel confident as general surgeons coming out. I know I will. I'm sure the same can be said for most other academic programs in the country. Don't think everyone sees fellowship as finishing school; many of us see it as a means to an end in the current market and nothing more.

Best of luck in the match.

 

[DoctwoB]

I guess I'll start. These were super helpful for me, so I'll post my profile and my rank list.

Applied: 33
Offers: 25
Rejections: Washington, Stanford, UCSD, Penn, Hopkins, Brigham, Vanderbilt, Case Western
Interviews: 15
Ranking: 15

School: Deep South, not top 40 NIH
Class Rank: top 25%
AOA: Yes
Step 1: 260’s
Step 2: 260’s
Clerkships: honors in all third year rotations
LOR's: one from a division chief at MGH, 2 from decently well known surgeons
Research: 2 projects, 1 publication, 1 poster at a national meeting
Extracurriculars: Gold Humanism Honors Society, community health project, officer positions in several clubs

Thanks for posting! I know gensurg is getting more competitive, but It still surprised me to see someone with crazy high steps, all honors on rotations and AOA getting several interview rejections and even one from an away rotation. Do you think anything in particular was holding you back or is that just par for the course even for the top applicants?

Either way it sounds like you interviewed at some great programs and should be happy come match day. Good luck!

 

[Dan Plainview]

Thanks for posting! I know gensurg is getting more competitive, but It still surprised me to see someone with crazy high steps, all honors on rotations and AOA getting several interview rejections and even one from an away rotation. Do you think anything in particular was holding you back or is that just par for the course even for the top applicants?

Either way it sounds like you interviewed at some great programs and should be happy come match day. Good luck!

I'm not sure what happened there. I thought it could be my LOR's, though I received very good comments about them at many interviews ("it's obvious your home program wants to keep you" or "Dr. Soandso thinks the world of you" or "we granted you an interview because of this letter"). My medical school is not very well-known, but we are affiliated with a general surgery residency. I know that they get people with similar stats from institutions like Columbia, Hopkins, Penn, etc so I'm certainly outmatched there. I think it's just how it goes for those programs.
One program director left a hand-written note on the rejection letter "You deserve better than this as AOA and GHHS. Best of luck."

For what it is worth, the assumption that I bolded above is an unfair one to make. 95% of the graduates from my residency go into fellowship, but it is because 75% go into academics (where they have to have a specialty niche) and the other 20% go into private practice as specialists (vascular, colorectal). I would say most of us feel confident as general surgeons coming out. I know I will. I'm sure the same can be said for most other academic programs in the country. Don't think everyone sees fellowship as finishing school; many of us see it as a means to an end in the current market and nothing more.

Best of luck in the match.

Good points. Thanks!

 

[Green Grass]

I'm not sure what happened there. I thought it could be my LOR's, though I received very good comments about them at many interviews ("it's obvious your home program wants to keep you" or "Dr. Soandso thinks the world of you" or "we granted you an interview because of this letter"). My medical school is not very well-known, but we are affiliated with a general surgery residency. I know that they get people with similar stats from institutions like Columbia, Hopkins, Penn, etc so I'm certainly outmatched there. I think it's just how it goes for those programs.
One program director left a hand-written note on the rejection letter "You deserve better than this as AOA and GHHS. Best of luck."

Really makes you wonder what goes on behind closed doors at committee meetings. Such a shady process with so many unknowns. Apparently, not even the PD at this particular program could get you an interview - awesome. thumbdown

 

[doc05]

ghhs?

 

[filter07]

ghhs?

http://humanism-in-medicine.org/index.php/ghhs

meh

 

[Green Grass]

http://humanism-in-medicine.org/index.php/ghhs

meh

lol, nice "meh". It at least means the OP is a nice guy, which goes a long way when you have to work with that person for 5+ years.

 

[Svidrillion]

May I opine for a moment on this topic. The difficult thing I found with ranking programs is the uncertainty. How much can you really know about a program after spending 5-6 hours there? As they put on their best behavior? You don't know what it's really like to work with those attendings, with those residents. You don't actually know what your operative experience will be like. And you don't know whether those things you really think you like about a program will change or not in the next one, two, or four years. If you knew every program as well as you know your home program, then you'd have a better shot at informed ranking. As is, it's actually a shot in the dark.

 

[SLUser11]

May I opine for a moment on this topic. The difficult thing I found with ranking programs is the uncertainty. How much can you really know about a program after spending 5-6 hours there? As they put on their best behavior? You don't know what it's really like to work with those attendings, with those residents. You don't actually know what your operative experience will be like. And you don't know whether those things you really think you like about a program will change or not in the next one, two, or four years. If you knew every program as well as you know your home program, then you'd have a better shot at informed ranking. As is, it's actually a shot in the dark.

You are absolutely right. All you see on interview day is the polished version of the program with everyone on their best behavior....and all they see is the polished version of you without knowing where you'll be weak. This is why you should see any bad behavior on interview day as a big red flag (if they can't stop complaining about their program even for that short segment of time, it must suck there)...just like programs see any bad behavior from you as a red flag for the same reason.

All you can do is crunch the objective data, which is board pass rates/ABSITE/fellowships/research/didactics/case logs, and combine it with the subjective gut feeling you get about the place, then make a decision. As many have said before (I think Pilot Doc said it a lot), you really don't know if you've made the right decision until it's too late.

Still, it's important to gather information and cast an intelligent application net, then go on interviews, and formulate an educated guess about the right places to train.

 

[Green Grass]

Well said! Hear, hear!!

 

[Phoenixrising24]

As many have said before (I think Pilot Doc said it a lot), you really don't know if you've made the right decision until it's too late.

Indeed. This is what's keeping me up at night. (Btw, hello everyone. Looongtime lurker in the Surg forum, more or less a first-time poster. )

I've searched every thread here about my top choices, and really want to bump them...then realized that all I *really* want is someone to validate my choices and satisfy me that I'm not making a colossal error. Which seems like a poor reason to bump a thread, especially since there are likely some people who would disagree with my choices, and so the whole exercise might well serve to increase my cognitive dissonance rather than lowering it. I feel a lot of pressure to "get this one right" since I feel like I ended up choosing my med school without considering a number of relevant issues. Don't get me wrong, it's overall been a good experience and education...I just don't "fit" particularly well. And now I'm worried that I'll pick a program based on gut feeling/gestalt/fit more than anything else and wake up as a PGY-4 and do a big face-palm and wonder why I didn't pick [insert bigger more prestigious academic program here] as my first choice. [/endpublicfreakout]

I take comfort in the fact that life has an uncanny way of working itself out, and I probably have substantially less control than I think. Now if I could just stop having anxiety dreams about running into PDs/Chairs on vacation, ending up at undesirable program xyz, and so on then we'd be in good shape.

T-1 month. Stay strong friends!

 

[Svidrillion]

All you can do is crunch the objective data, which is board pass rates/ABSITE/fellowships/research/didactics/case logs, and combine it with the subjective gut feeling you get about the place, then make a decision.

And when you get there, you find the warts. (I'm sure every place has them).

The thing about the 'objective data' that always bothered me was that I can look at case logs, but I do not know what the resident's experience for those cases were. Some folks do a case skin to skin and others do 50.000000000001% of a case and they both are going to log it the same. There's a big difference there. And everyone says the operative experience is, "phenomenal".

 

[SLUser11]

And when you get there, you find the warts. (I'm sure every place has them).

The thing about the 'objective data' that always bothered me was that I can look at case logs, but I do not know what the resident's experience for those cases were. Some folks do a case skin to skin and others do 50.000000000001% of a case and they both are going to log it the same. There's a big difference there. And everyone says the operative experience is, "phenomenal".

I believe it's nearly impossible to decipher what percent of the cases are actually being performed by the residents. One step beyond that is deciding how much of the resident's operating is done with independent thought....I can walk med students through many cases saying "cut here" and "bovie there," but if I left them alone, they would surely be lost...the same goes for some residents when the cord is finally cut.

One trick I used was to ask the students from that program for insider information. However, I think senior medical students still don't fully understand operative autonomy, and possibly would not be able to tell this from scrubbing on cases.

This is a controversial topic, but I believe that there's no substitute for volume. It's just common sense that your comfort level with a case, and an attending's willingness to let you perform a case, is based primarily on your previous operative experience, and what you've shown that you can do (e.g. if I've done 5 colectomies with a resident, I'm going to let him do a lot more in the case than if it's our first one together).

That doesn't mean you need 1400 major cases, but I would be very careful about ranking places where residents average less than 1000....and I would run the other way from places that average 800. The less cases you have to choose from, the more likely you are to "round up" to 51% when calculating your participation.

 

[Dirt]

And now I'm worried that I'll pick a program based on gut feeling/gestalt/fit more than anything else and wake up as a PGY-4 and do a big face-palm and wonder why I didn't pick [insert bigger more prestigious academic program here] as my first choice. [/endpublicfreakout]

Similarly, I ranked programs based mostly on location and environment where my wife and I would be happiest. While I think it will work out for the best in the long run, I would be lying if I said I didn't get periodic anxiety attacks because I am essentially forgoing some prestigious places in favor of "lesser" programs based on location.

In the end I think about what I really want in my life, namely happiness for my family and I, and realize that the prestige of my residency is not integral to achieving that goal. So if it means I don't do that surg onc fellowship at MSK or peds wherever than so be it. And personally, I believe that the training you receive is only part of becoming a good surgeon, and that a lot of it depends on one's inherent abilities and traits.

 

[45408]

Similarly, I ranked programs based mostly on location and environment where my wife and I would be happiest. ....So if it means I don't do that surg onc fellowship at MSK or peds wherever than so be it.

Your account at SDN will be suspended for this heresy.

Thanks,

The Management

 

[SLUser11]

I would be lying if I said I didn't get periodic anxiety attacks because I am essentially forgoing some prestigious places in favor of "lesser" programs based on location......... And personally, I believe that the training you receive is only part of becoming a good surgeon, and that a lot of it depends on one's inherent abilities and traits.

I think if ROLs were always organized based on perceived prestige, there would be a lot of unhappy residents out there. It's the immature, egocentric student who believes certain training programs are beneath him/her. It's the reasonable, level-headed student who realizes that prestige is sort of bulls#@t.

I disagree with the bolded above statement. I think the training you receive is integral to becoming a good surgeon. However, I think it's foolish to believe that the prestige of a program is directly correlated with the quality of training.

Make your ROL based on where you can be happy and functional, and where you can receive a solid surgical education. If you ruminate over passing up an opportunity to train at one of the 20 or 30 "Top Ten" programs, you'll be a roadblock to your growth as a surgeon, and you'll ultimately make yourself unnecessarily unhappy.

 

[Svidrillion]

It's the reasonable, level-headed student who realizes that prestige is sort of bulls#@t.

If you ruminate over passing up an opportunity to train at one of the 20 or 30 "Top Ten" programs, you'll be a roadblock to your growth as a surgeon, and you'll ultimately make yourself unnecessarily unhappy.

Perhaps, then, you can speak to one of my main concerns. The conventional wisdom that I keep getting is that it's "better to train up than train down" and that going to a program without name cachet makes fellowship more difficult (besides making peds and surg onc at MSK impossible) and that it also limits your practice options. Will training in the middle of nowhere in the midwest, even at a quality training program, prevent you from getting a job at a large city on either coast?

 

[SLUser11]

Perhaps, then, you can speak to one of my main concerns. The conventional wisdom that I keep getting is that it's "better to train up than train down" and that going to a program without name cachet makes fellowship more difficult (besides making peds and surg onc at MSK impossible) and that it also limits your practice options. Will training in the middle of nowhere in the midwest, even at a quality training program, prevent you from getting a job at a large city on either coast?

I think students hear this from their surgical residents and attendings, and they take it at face value, but the truth is that most academic residents and attendings know very little of life outside their prestigious institution. This sort of stereotyping is extremely dangerous and also extremely common.

"Training up or down" is sort of a misnomer, as is training "in the middle of nowhere." What I will say is that the people most concerned with prestige and name-dropping are usually the ones who are at those prestigious institutions. People outside of that little bubble care very little about it.

I think if your interest is to ultimately end up as an attending at a "Top 10" academic institution, then you are best served by doing your residency and fellowship at similar institutions. That's just common sense. However, very few of us have aspirations to be the Chairman at MGH. Most of us want good training, the opportunity to do the surgery we like, and a fulfilling job after residency....you don't need a prestigious pedigree to get those things.

From personal experience, if you are a strong resident, and you do well for yourself in residency, then you can get exactly what you want coming a community program in the "middle of nowhere." It will surprise people with less experience (see post #21 in this thread), but it happens all the time.

 

[dynx]

I think students hear this from their surgical residents and attendings, and they take it at face value, but the truth is that most academic residents and attendings know very little of life outside their prestigious institution. This sort of stereotyping is extremely dangerous and also extremely common.

"Training up or down" is sort of a misnomer, as is training "in the middle of nowhere." What I will say is that the people most concerned with prestige and name-dropping are usually the ones who are at those prestigious institutions. People outside of that little bubble care very little about it.

I think if your interest is to ultimately end up as an attending at a "Top 10" academic institution, then you are best served by doing your residency and fellowship at similar institutions. That's just common sense. However, very few of us have aspirations to be the Chairman at MGH. Most of us want good training, the opportunity to do the surgery we like, and a fulfilling job after residency....you don't need a prestigious pedigree to get those things.

From personal experience, if you are a strong resident, and you do well for yourself in residency, then you can get exactly what you want coming a community program in the "middle of nowhere."

I agree. The one qualifier I will put on that is the Surg Onc/Peds fellowships. The don't require a prestigious university but they basically require research. Thats more easily done at a 7 year program of course. Short of this, every fellowship is open to you from any reasonable residency program. I would say THE MOST important factor and the one thing a program can't fake is the match list. If residents from that place suck, fellowships are going to know and not take them. (this won't assure that you get the best program but it will keep you from a bad program) Go to a program where:
1. You're going to get good training.
2. You're not going to be miserable because of the location/weather/People.

Every program is going to be a pain in the ass in terms of hours/work. Why add miserable people and digging your car out of snow into the mix?

In terms of prestige. If thats what you're going for then go for it, MGH is your program. If you're going for being the best surgeon I can't tell you what the best program is, but its not MGH. Clearly there's a spectrum there but the point is that prestige does not equal good training no matter what anyone tells you.

It will surprise people with less experience (see post #21 in this thread), but it happens all the time.

Is this a self referring post?

 

[SLUser11]

Is this a self referring post?

Sort of. I was referring to Guile's question about the CRS application process. I think I got a little over-snippy/defensive in that thread in response to a pretty innocent question, but it illustrates my point about people being surprised there are not more roadblocks to success when you come from a "hybrid" program.

When it comes to KU Wichita, I think it's obvious that I have pride in my former program. However, I don't think Wichita is super-special or an anomaly. I think there are several hybrid programs that offer solid training with a balanced pain:benefit ratio, and they routinely get overlooked due to location and the "community" label.

What probably came off as bragging or biased ranting by me in the past was really my attempt to get students to become more open-minded. I don't want everyone to rank KU #1. Instead I want students to explore these "hybrid" programs, go to 1 or 2 on the interview trail and see for themselves, then make a balanced, educated decision.

 

[Buzz Me]

One trick I used was to ask the students from that program for insider information. However, I think senior medical students still don't fully understand operative autonomy, and possibly would not be able to tell this from scrubbing on cases.

I would argue that many junior residents still won't know the true meaning of "operative autonomy"...certainly interns are happy when they're wielding the Bovie for most of the case. But setting up the room, getting adequate exposure, dissection with the right angle/Adson/hemostat...those are much more difficult when the attending/chief/senior resident isn't in the room.

 

[surgapp]

25 posts, 1 ROL.

 

[Green Grass]

25 posts, 1 ROL.

I think we can all agree it's way more useful/fun to discuss why "hybrid programs" offer better training than the "prestigious university programs".

Here's an idea, why don't we just let this year's applicants post their ROL so we can see what everyone was impressed/disappointed by this year?

 

[SLUser11]

25 posts, 1 ROL.

Here's an idea, why don't we just let this year's applicants post their ROL so we can see what everyone was impressed/disappointed by this year?

I don't see ROLs from either one of you, and I know you are both in the match this year. I would opine that you are both directly responsible for the lack of ROLs in this thread.

Now, since the deadline is February 22nd, my guess is that this thread was started prematurely, and won't see any significant action for another week. In the meantime, I think it's reasonable for the more experienced SDNers to give insight on what factors should help you finalize a list.

Of course, we know that most of you will not take our advice....nobody is looking for advice at this stage...just someone to reassure them that they're making the correct choice even if it's blind and foolish. As Simon and Garfunkel sang, "Still a man hears what he wants to hear, and disregards the rest. mmmmmmmm."

I'll leave you with some actually useful information:

Here's a thread I started in 2010 for the ROLs, and it has links to the 2005-2009 ROLs as well. It was a simpler time, those many many many years ago, and SDNers weren't so afraid to share.

 

[Green Grass]

I don't see ROLs from either one of you, and I know you are both in the match this year. I would opine that you are both directly responsible for the lack of ROLs in this thread.

Ouch. The truth hurts I guess.

Now, since the deadline is February 22nd, my guess is that this thread was started prematurely, and won't see any significant action for another week. In the meantime, I think it's reasonable for the more experienced SDNers to give insight on what factors should help you finalize a list.

I would agree.

Of course, we know that most of you will not take our advice....nobody is looking for advice at this stage...just someone to reassure them that they're making the correct choice even if it's blind and foolish. As Simon and Garfunkel sang, "Still a man hears what he wants to hear, and disregards the rest. mmmmmmmm."

I'll leave you with some actually useful information:

Here's a thread I started in 2010 for the ROLs, and it has links to the 2005-2009 ROLs as well. It was a simpler time, those many many many years ago, and SDNers weren't so afraid to share.

 

[gadad]

Applied: 45
Offers: 27
Rejections: Tulane, Emory, LSU, Wash U, Louisville
Interviews: 16
Ranked: 16

School: Deep South, not top 40 NIH
Class Rank: Middle half
AOA: No
Step 1: 223
Step 2: 245 (had it back in between applications and interviews)
Clerkships: A's and B's (A in surgery)
LOR's: Standard
Research: 4 basic science projects, 1 publication,
Extracurriculars: Married w/ kids, 2 year mission to Brazil, worked with local boys and girls clubs

Progam interest: Two programs called/emailed me several times last week; Spartanburg and my home program.

My overall goal is to be a general surgeon in some medium town in the south. I may do a one year fellowship to have some sort of niche, but I want >50% of my practice to be general.

I was looking for three things: Excellent clinical training, atmosphere, and schools for my kids. I liked the community/hybrid programs (hybrid= time with academic faculty + significant time with private faculty ) the most. Location played a huge role both in proximity to family and having a safe environment with good schools.

Also, I did not want any mandatory years off for research, so I ranked those lower. I also did not want to be at a place with only two residents a year.

The rest is gestalt.

1. Spartanburg Regional- I've been hearing good things about them for years. Seemed like a great group of people to work with. Also seemed like I would fit in well.
2. ETSU
3. UT-Knoxville- Was going to rank them 1st until I did a second look; I can't place it, but I got some weird vibes. Still an excellent program though.
4. Mercer-Macon
5. Carolinas
6. UT-Chattanooga
7. ECU
8. New Hanover
9. Florida Hospital-Orlando
10. AMC
11. Vanderbilt- Great place but >90% do two years in the lab. I did not feel that I would fit in very well.
12. UF-Jacksonville
13. GHSU (formerly MCG)
14. South Alabama
15. Palmetto Health Richland
16. USF

 

[Apollyon]

Did you apply for the Greenville Health System GSx program? If you did "Sparkleburg", and liked it, GHS might have been even better. And the residents were sharp and normal. And G-vegas is well over Sparkleburg.

 

[Svidrillion]

Applied: 45

1. Spartanburg Regional- I've been hearing good things about them for years. Seemed like a great group of people to work with. Also seemed like I would fit in well.
2. ETSU
3. UT-Knoxville- Was going to rank them 1st until I did a second look; I can't place it, but I got some weird vibes. Still an excellent program though.
4. Mercer-Macon
5. Carolinas
6. UT-Chattanooga

Why'd you put Chattanooga where you did?

 

[LucidSplash]

Why'd you put Chattanooga where you did?

Probably because of the research time; he stated that he ranked those programs lower.

 

[gadad]

Did you apply for the Greenville Health System GSx program? If you did "Sparkleburg", and liked it, GHS might have been even better. And the residents were sharp and normal. And G-vegas is well over Sparkleburg.

I did apply to Greenville, but did not get an invite. I'm not sure why; a few of my classmates with similar stats interviewed there.

If we end up in Spartanburg, we will most likely live closer to Greenville; about 15-20 minutes away.

I actually checked my post a couple of times to make sure that I did not misspell Spartanburg!

Probably because of the research time; he stated that he ranked those programs lower.

That's correct. I thought it was a great program. They do let you do a CC fellowship in lieu of the research (1 per year), but I don't think I want to do that.

 

[Apollyon]

I did apply to Greenville, but did not get an invite. I'm not sure why; a few of my classmates with similar stats interviewed there.

If we end up in Spartanburg, we will most likely live closer to Greenville; about 15-20 minutes away.

I actually checked my post a couple of times to make sure that I did not misspell Spartanburg!

Dude, bummer! But the Sparkleburg GSx residents come to G'ville for peds and something else, so you'll see the "Uni"!

 

[Mr Cookie Pants]

Me:

Applied 42, 10 no response, 7 reject, 5 full (soft reject), 5 turn down interviews, went on 13-or so. Basically a 50% interview offer rate

Middle of class at middle medschool.
Step 1: 215 (pre-screened me from quite a few places that friends with 221's got invites to)
Step 2: 251 (places liked this)
Surgery resarch and 2nd author in Surgery Journal.
Boring 26 year old white guy who runs marathons and applied to med school to do surgery-IE stable choice but not exciting. Married no kids.

Goals: CT or Gen Surg + Surgical Critical care. Maybe vascular


1. Riverside Methodist (Columbus)- tons of operating, put 4 chiefs in 3 years into CT, 3 months a year of CT/Vasc. Plus theyre doing a perc valve study that I'd get to do. I thought I'd be happy there and they seemed to want me.
2. South Florida- PD seemed awesome, Tampa looked like fun, Moffitt
3. U Kentucky- for the basketball tickets
4. U Louisville- got moved down because of 6 year, uncertainty of future. 2 weeks ago it was #1
5. East Carolina- Seemed awesome but in the middle of nowhere, worried about wife finding job. Otherwise would've been #1. Also 6 years
6. Missouri (Columbia)- seemed great, wife didn't want to move there. I loved it
7. Knoxville- seemed nice, great residents, just wasnt the place for me.
8. Penn State- solid program but didn't really gel
9. SLU- interesting but a few red flags. Faculty seemed awesome. Nice City
10. Chattanooga- awesome residents, strange vibes from PD. Also I had to drive 12 hours from the interview to another one that night, so that could have clouded my perception. The residents I met (who are on here) were awesome.
11. Good Samaritan (OH)- would be great if I wanted to do straight PP GSurg. Level III, lack of ICU care bumped it down.
12. Wright State- Bad vibes, but would rather have a job than no job
13. Prelim at home

Did not rank- Savannah. Many red flags.


So yes, I'm a SDN'er who actually wants to go to a non-university program. The biggest drag on community programs is fellowship, well if your program has a track record of putting people in, then it all becomes moot. And I think I'll be a better technician. 75% of everyone (99% of community and 50% of academic) goes into Private practice anyways.

Good luck everyone.

 

[cpants]

Similarly, I ranked programs based mostly on location and environment where my wife and I would be happiest. While I think it will work out for the best in the long run, I would be lying if I said I didn't get periodic anxiety attacks because I am essentially forgoing some prestigious places in favor of "lesser" programs based on location.

In the end I think about what I really want in my life, namely happiness for my family and I, and realize that the prestige of my residency is not integral to achieving that goal. So if it means I don't do that surg onc fellowship at MSK or peds wherever than so be it. And personally, I believe that the training you receive is only part of becoming a good surgeon, and that a lot of it depends on one's inherent abilities and traits.

You've discovered the secret to a successful match...making sure your wife is happy. My advice to anyone attached would be to make sure your significant other has a TON of input into your rank order list (at least if you want to stay attached). Sure your dream of residency at Man's Best Hospital is important, but the husband/wife has dreams too. Can they get a job there? Is there family within reach? What will their support system be like? What kind of home will you be able to live in? Guess it's too late for this year. Good luck everyone.

 

[inc]

...

 

[SLUser11]

So yes, I'm a SDN'er who actually wants to go to a non-university program. The biggest drag on community programs is fellowship, well if your program has a track record of putting people in, then it all becomes moot. And I think I'll be a better technician. 75% of everyone (99% of community and 50% of academic) goes into Private practice anyways.

Good luck everyone.

I would opine that far less than 99% of community grads go into private practice, and far more than 50% of academic grads do the same. However, I have no source to back that up.

Placing residents into CT is not super-hard to do. However, plenty of more competitive fellowships are also available to community grads...depending on the quality of the program as well as the applicant. I'm not familiar with your #1, but even if your career goals change, you'll probably still have many fellowship options.

 

[Mr Cookie Pants]

I would opine that far less than 99% of community grads go into private practice, and far more than 50% of academic grads do the same. However, I have no source to back that up.

Placing residents into CT is not super-hard to do. However, plenty of more competitive fellowships are also available to community grads...depending on the quality of the program as well as the applicant. I'm not familiar with your #1, but even if your career goals change, you'll probably still have many fellowship options.

Right, I know you need a pulse to get into the majority of any General Surgery fellowships. But the fact that a program pumps them out generally means that theres exposure to it. Since there's no ACGME required Cardiac cases and most people can get their chest numbers on trauma or peds, the CT rotations are going away (as well as CT surgeons not liking the young whippersnappers around). So that was a factor as well. I made sure I asked about what rotations there were now and what seemed to change.

I also wasn't ready/competitive enough to apply to integrated CT, and I like thought of doing general surgery and the experience that comes with being a chief (more decision making, etc). The program I put #1 has a chief run service for 6 months where you do all aspects-run the clinic, do the operations, see the patients (usually uninsured) and the residents spoke highly of it.

 

[SLUser11]

I also wasn't ready/competitive enough to apply to integrated CT, and I like thought of doing general surgery and the experience that comes with being a chief (more decision making, etc). The program I put #1 has a chief run service for 6 months where you do all aspects-run the clinic, do the operations, see the patients (usually uninsured) and the residents spoke highly of it.

Those chief rotations are excellent. I don't want to call them essential since not everybody gets to have one....but they are nearly essential.

As for doing general surgery vs. an integrated pathway, my bias is still toward 5 years of general surgery first, which is mostly because your opinions change as you get more exposure to a specialty.

 

[thedrjojo]

I don't see ROLs from either one of you, and I know you are both in the match this year. I would opine that you are both directly responsible for the lack of ROLs in this thread.

Now, since the deadline is February 22nd, my guess is that this thread was started prematurely, and won't see any significant action for another week. In the meantime, I think it's reasonable for the more experienced SDNers to give insight on what factors should help you finalize a list.

Of course, we know that most of you will not take our advice....nobody is looking for advice at this stage...just someone to reassure them that they're making the correct choice even if it's blind and foolish. As Simon and Garfunkel sang, "Still a man hears what he wants to hear, and disregards the rest. mmmmmmmm."

I'll leave you with some actually useful information:

Here's a thread I started in 2010 for the ROLs, and it has links to the 2005-2009 ROLs as well. It was a simpler time, those many many many years ago, and SDNers weren't so afraid to share.

oh the memories...

Really, 2 years ago already? Even though my program has had some major changes, still no regrets. Actually, less regrets about going to my #1 (home) vs #2 (NYU) since my interest has shifted from Surg Onc to Transplant... Kinda sad I haven't seen anyone have NJMS on the rank list yet... lol, oh well, a small sample size.

 

[LucidSplash]

oh the memories...

Really, 2 years ago already? Even though my program has had some major changes, still no regrets.

+1. 2 years seems like a long time and not a long time all at once. Now here I am waiting on the schedule for next year to be done so I know if I'm going to our 3rd year rural rotation first or not...

 

[45408]

Yeah, kind of crazy to think I'll be a PGY-3 in four months.

 

[thedrjojo]

Yeah, I am going into the lab, so now I just have to make it the 4 months (1 of icu, 1.5 surg Onc which currently owns 4 of 10 icu pts), and 1.5 of vascular (a painful way to end year, essentially will be alone on the team)...

Sent from my DROID RAZR using Tapatalk

 

[45408]

4. Wisc VS - Diamond in the rough. Large aneurysm #s. With addition of Matsumura endo expected to ramp up (possible friction with open guys?). Entirely faculty voices support for 0+5, including Chair of Gen Surg (Kent) who is a vascular surgeon.

Matsumura's been there several years though already, right?

I thought it was amusing/odd that UW put his picture in an ad in Architectural Digest a year or so ago, just to put the hospital's name out there.

 

[inc]

Matsumura's been there several years though already, right?

I thought it was amusing/odd that UW put his picture in an ad in Architectural Digest a year or so ago, just to put the hospital's name out there.

He's been there since late 2009. I probably should have phrased it a little better, in that he's only recently started pushing the more advanced endovascular techniques.

Wisc is in an interesting situation: it's a superb training program with very strong faculty and a relatively insane large #s of TAAA given the population base. The entire faculty seems really committed to building up the academic name via research and conference presentations. It's definitely on the up and up.

 

[SLUser11]

I'm getting nostalgic for my time as a nervous MS4. It was only 6 years ago, but it feels like much longer. I'll try to offer some comforting words, but I'm sure they'll produce bittersweet feelings.

To those SDNers anxiously awaiting match day: At this point, there's nothing you can do to change what's going to happen. It is my professional medical opinion that you should just drink a lot.

I also have many friends who have gone through general surgery residency, and several of them did not end up exactly where they wanted, but most of them are personally and professionally happy. We're all super-competitive in nature, and our egos demand that we match at our #1, but I think sometimes dropping a little down your ROL is the best thing that can happen to you.

 

[mwsurg]

I'm getting nostalgic for my time as a nervous MS4. It was only 6 years ago, but it feels like much longer. I'll try to offer some comforting words, but I'm sure they'll produce bittersweet feelings.

To those SDNers anxiously awaiting match day: At this point, there's nothing you can do to change what's going to happen. It is my professional medical opinion that you should just drink a lot.

I also have many friends who have gone through general surgery residency, and several of them did not end up exactly where they wanted, but most of them are personally and professionally happy. We're all super-competitive in nature, and our egos demand that we match at our #1, but I think sometimes dropping a little down your ROL is the best thing that can happen to you.

Sure, why not.

Step 1&2: both 220s. Non-AOA.

1. Mayo, Rochester
2. Ohio State
3. Riverside Methodist, Columbus
4. St. Joseph Exampla, Denver
5. Hennepin County Medical Center
6. Gundersen Lutheran
7. Lahey Clinic
8. St. Joseph Mercy, Ann Arbor
9. University of Wisconsin
10. Good Samaritan, Cincinnati
11. Inova Fairfax
12. Medical College of Wisconsin
13. University of Rochester

I'm couples matching, so it made things a bit more complicated. My personal top 3 would've been St. Joseph in Denver, Hennepin County, and then Mayo, in no particular order. I picked our number 1, she picked 2 and 3, I picked 4 and 5, and so forth. Overall I will be very happy to end up at any of the programs above. Didn't rank 3 other programs that I couldn't see myself in.

 

[Smurfette]

On behalf of an anonymous user:

Applied: 32
Offers: 27
Rejections: MGH, Brigham, Yale, Berkshire (?), Lankenau (?)
Interviews: 17
Ranking: 17

School: not top 40 NIH
Class Rank: top 15%
AOA: Yes
Step 1: 260's
Step 2: 270's
Clerkships: honors in all third year rotations except Family
LOR's: No one well known
Research: None in med school, couple things as pre-med
Extracurriculars: Admissions committee, student gov't stuff, clubs, clinics, etc.

ROL: Married with a new kid, so pretty much based everything on location. Was not really interested in 7 years but would do 6.

1. Baystate - best fit location wise (read family support), residents get along very well with each other and with attendings, very collegial environment, great leadership
2. UConn - Also great location wise, great fellowship match, lots of affiliates, just didn't have the same feel as baystate, went with my gut
3. Dartmouth - 6 years, hands down my favorite place, amazing hospital, very strong clincally, amazing opportunities in research year, everyone gets along very well, location just not the best for me
4. Brown - great program, excellent clinically, well balanced, great faculty, residents work hard, excellent fellowship placement, again location not the most ideal
5. Albany - Another good location for me, good clinical experience, highest caseload of anywhere I interviewed, not a ton of research going on
6. UMass - Nice program, often overlooked, strong clinically, fair amount of fellows
7. BI Deaconess - 7 years, great program, boston is expensive
8. BU - good program, Doherty seems like he will be great, on the up and up
9. Lahey - Unlike anywhere else, tiny hospital with some of the strongest colorectal/hpb around, fellow heavy
10. Tufts - Another good boston program
11. Jefferson - 6 years, Amazing place, very strong clincally, Yeo is the key, would love it here if not for location and lack of family support
12. Drexel - Underrated program, new leadership, on the up and up
13. Cooper - 6 years, great hospital, good faculty, new med school coming, a couple years from being great
14. Temple - strong trauma, leadership/faculty in flux, otherwise would be higher
15. Abington - good community program
16. Danbury - Brand new program full of transplants from other places, nice hospital, will be a good community place once it gets through the pains of being brand new
17. Hosp of St. Raph - being bought by Yale, some confusion as to what will happen to the residents

 

[AEG406]

Applied: 40
Offers: 24
Rejections: U-Wisc, U-Chicago, Northwestern, Louisville, Swedish (?)
Interviews: 15
Ranking: 14

School: Top 40 NIH
Class Rank: top 25%?
AOA: No
Step 1: 230's
Step 2: 250's
Clerkships: honors in all third year rotations except peds
LOR's: Dept chair, division chief x 2
Research: One publication, year of reserach before med school
Extracurriculars: Lots of volunteering in underserved clinics

ROL: Single, outdoorsy, from the intermountain west, OK with midwest, east coast but didn't want to live in the south. Want excellent gen surg training (thoracic, gyn, etc) in case I end up in small town PP, but don't want to r/u fellowship completely (no peds, no surg onc = OK). Applied to a good mix of community and university figuring I would get a sense on the trail of where I "fit". Ended up liking several of each, but leaning toward communiveristy with decent trauma.

1. Santa Barbara Cottage: Excellent training for future rural PP, could snag a CC/vascular/breast fellowship if I change my mind. Great ancillary staff. Residents were tight-knit, smart and work hard/play hard. Great location (both hospital and city), obviously. Cost of living = $$$!
2. Maine Medical Center: Again, great training for small town PP with fellowship options/academic-ish feel, and no fellows. They cover most of Maine for trauma, which is a plus. All new sim center. I loved loved loved the PD's philosophy, the faculty and residents, but figured that the winters and the distance from family was enough to bump it from #1.
3. OHSU - Excited about their rural 4th year option, but it's not a guarantee. Having a Univ. hosp, VA, Children's, plus many many community sites is a plus, but it may detract from attendings getting to know you well. Also, it's HUGE (12 chiefs) which may not be the best fit for me. Lots of options for research/MPH/internation work after R3. Overall a solid program where I'd be happy to end up.
4. VM - Strong, academic-y, community program. Access to Harborview is an asset. Mentor model is nice and the chiefs I met were whom I want to be in 5 years, but the days of clinic could be tedious. Seattle is pretty rainy, but I'd survive.
5. BMC/BU: Some unknowns given new chair/PD, but Doherty seems like he will move things in a good direction. Great trauma, county hospital/safety net concept, and rotations on the Cape are praised. But Boston is expensive.
6. UVM: the only 5+1 I ranked highly; I'm not psyched about research, but I'd live with it (MPH or something). Early operative experience, for an academic program. Weird that the chair is ENT, not gen surg but I'm biased obviously. Burlington is a fun city.
7. St. Joe's (Ann Arbor) -- Small community program with faculty full of former academics who escaped Michigan. High volume, good teaching. Great trauma since they're closer to the rougher areas than UM. Opportunity for international rotations.
8. Utah: Nice combo with UofU/VA/Children's/PP sites. Residents seemed a little more competitive and driven than I am, but were still down to earth. They also have a rural option. Also, skiing.
9. Dartmouth: I LOVED the program itself, although I didn't click too well with the residents (they were too nice? sounds crazy!). Love their public health bent, but didn't love the remote location.
10. San Diego: Liked PD and his philosophy. Strong MIS research, residents seem happy and treated well. Not sure I would want to live in SD.
11. MCW: Again, they have the trifecta of hospital sites and decent research (which I don't really want to do...), but nothing stood out, had an odd resident interview and I didn't love MKE.
12. Good Sam/PISR: Strong community program, Alaska oppportunity is fun, and great transplant rotations. Older facilities. Liked the new PD, who will probably shake things up. Residents seemed uninspired, didn't mingle at the dinner, didn't sell the program at much (IMHO). New sim center (if I'm thinking of the right program...) is pretty sweet. Intern who gave us a tour didn't know where things were, which was strange. Also, Phoenix is HOT and sprawly.
12. Exempla St. Joe's (Denver) -- Strong community program, great underserved clinic opportunity. Residents were well-trained for PP. Majority were married with kids. I didn't get the excited/loving residency vibe. Denver is great with family nearby.
13. Ohio State: Also 5 + 1, which doesn't rock my world. Interesting masters program, lots of research available. Columbus is sorta bland. It was my first interview, so I don't remember much else. The cheese pizza of programs, for me. Wouldn't say no, but I'd probably pick something else, given the chance.
14. Cleveland Clinic: Way too specialized for me, wanting to head to PP as I do, but a very exciting place to train. Gorgeous hospital. Residents were dynamic and interesting.

Reading back, my reasons seem flimsy and not particularly related to the training opportunities themselves. In the end, figuring that I will get good training no matter where, I think it all came down to gestalt, looking at their chiefs as who I would become, and picturing where I might be happiest living.

Ok, now that I've done this to pass another 30 minutes of the tedious wait until match day -- now what?