drranjit

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Oct 5, 2014
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Dear SDNers,

I am a US MS3 in Chicago. I'm interested in Gen Surg, and if possible doing a fellowship afterwards (in CT or vascular maybe). I am a below average applicant (bottom 1/3 of the class, step 1 of 212, high pass in Peds, Surg and Med, no honors so far, 2 1/2 years of surg research, 1 podium presentation, 1 abstract). I understand I need to score well above average on Step 2 (~250), get great LORs etc.

-First of all, is Gen Surg in an academic program (categorical, anywhere in the US) still an option for me? Anyone with similar step 1 matched in academic gen surg categorical before? The reason I'm asking academic is because I'm interested in pursuing a fellowship afterwards

-Ideally, I'd like to join my husband who lives in NYC so I was wondering if any of you guys are familiar with programs in NYC? With my stats, is it still possible to match in an academic NYC program (categorical)? How about Boston? I know I am not competitive enough to be picky but NYC would still be ideal for family reasons...
And anything I can do to boost my chances (maybe aways in NYC?)

-Finally, I understand that academic programs are more competitive than community programs. Any good community programs in NYC/Boston where I could still hope to match (categorical)?

Thanks a bunch and good luck to you all.
 
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drranjit

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Oct 5, 2014
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Btw, FWIW, I don't have any huge red flags (never failed/remediate a course, no time off during med school, good/excellent reviews on MSPE so far, decent amount of volunteering/EC/leadership)
 

SouthernSurgeon

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You can match in surgery but it is going to be an uphill climb. You will need to apply broadly and go on as many interviews as you can.

Unfortunately the "academic" desire makes NYC or Boston in particular a slog. You'd be better off looking at academic programs in traditionally less desirable areas of the country - where there are some very solid programs that may be a little more "under the radar"

I'm not particularly familiar with the community programs in the NY or Boston area. But again - they are artificially competitive due to the desire of applicants to live in these two areas.
 
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drranjit

5+ Year Member
Oct 5, 2014
27
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You can match in surgery but it is going to be an uphill climb. You will need to apply broadly and go on as many interviews as you can.

Unfortunately the "academic" desire makes NYC or Boston in particular a slog. You'd be better off looking at academic programs in traditionally less desirable areas of the country - where there are some very solid programs that may be a little more "under the radar"

I'm not particularly familiar with the community programs in the NY or Boston area. But again - they are artificially competitive due to the desire of applicants to live in these two areas.
Thanks, SouthernIM! That makes sense, I will definitely apply broadly. Do you have any example of "very solid programs" (academic) in less desirable areas by any chance?
 

BlondeDocteur

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There are many programs in the greater NYC area which would be interested in you (assuming you go to an allopathic school in Chicago). Do away rotations at them, at places like SUNY Downstate, Brooklyn Hospital, or NY Methodist. Unless you are planning an academic career which is research-heavy you do not need to go to a name-brand residency program.

NYC is less competitive that you might think-- many hospitals are IMG-heavy and the workload is much, much higher than in the rest of the country due to the fierce health care workers' union and the resultant lack of ancillary services.
 

Winged Scapula

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You should also know that currently CT and Vascular fellowships are not competitive and are obtainable for the average resident, even one from a community hospital program. As @BlondeDocteur notes, a big name academic program is not necessary for your career goals and may be out of reach for you.
 
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drranjit

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Oct 5, 2014
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There are many programs in the greater NYC area which would be interested in you (assuming you go to an allopathic school in Chicago). Do away rotations at them, at places like SUNY Downstate, Brooklyn Hospital, or NY Methodist. Unless you are planning an academic career which is research-heavy you do not need to go to a name-brand residency program.

NYC is less competitive that you might think-- many hospitals are IMG-heavy and the workload is much, much higher than in the rest of the country due to the fierce health care workers' union and the resultant lack of ancillary services.
Thank you very much for the detailed answer. I will do an away in one of those institutions then. In addition to the 3 programs in Brooklyn that you listed, do you by any chance know other programs that I should target in the NYC area (or Boston)? I also found those programs: Maimonides, Albert Einstein, NYMC Metropolitan. Are those programs I should target (and do i stand a chance there)? Any other NYC programs that you may know about and might fit my profile?

Thanks again so much, much appreciated!

PS: yes, I go to an allopathic school!
 
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drranjit

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You should also know that currently CT and Vascular fellowships are not competitive and are obtainable for the average resident, even one from a community hospital program. As @BlondeDocteur notes, a big name academic program is not necessary for your career goals and may be out of reach for you.
Thanks for the response Winged Scapula. I had no idea CT and Vasc were not competitive. So even with my low step 1 and going to a community program I can still make it? That'd be wonderful!
 

Winged Scapula

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Thanks for the response Winged Scapula. I had no idea CT and Vasc were not competitive. So even with my low step 1 and going to a community program I can still make it? That'd be wonderful!
Well there are no guarantees but currently CT Surgery fellowships have more positions than applicants; I haven't checked on Vascular in awhile but I haven't heard any changes. Please note that I am speaking of the Independent programs, not the Integrated ones which are quite competitive.

But yes, these are notoriously some of the less competitive fellowships following general surgery.

Right now work on getting into the best program for your general surgery training; there are many fine community programs out there which, all else being equal, will allow you to do a fellowship. Your Step 1 score is the barrier to getting into GS; once you start residency, your fellowship match will be based, amongst other things (but not your Step 1), on your in-training exam scores.
 
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drranjit

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Well there are no guarantees but currently CT Surgery fellowships have more positions than applicants; I haven't checked on Vascular in awhile but I haven't heard any changes. Please note that I am speaking of the Independent programs, not the Integrated ones which are quite competitive.

But yes, these are notoriously some of the less competitive fellowships following general surgery.

Right now work on getting into the best program for your general surgery training; there are many fine community programs out there which, all else being equal, will allow you to do a fellowship. Your Step 1 score is the barrier to getting into GS; once you start residency, your fellowship match will be based, amongst other things (but not your Step 1), on your in-training exam scores.
Thank you so much, super helpful.
That makes a lot of sense. I will definitely do my best in 3rd/4th year, do aways in NYC and try to score high on step 2.
Just one more question. How do you find the "fine community programs" out there? In other words, how can you differentiate a good community program (that would allow subsequent fellowship opportunities) vs. a "poor program"?

I'm starting to look at and target those programs so I can try to do an away at those programs.

Thanks a bunch!
 

BlondeDocteur

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Vascular is much more competitive than CT, and there is talk (perpetual talk) of CT eventually converting to an all-integrated match. As more programs convert there will be fewer traditional CT slots for which to compete.

Albert Einstein will likely be out of reach. Metropolitan is a god-awful program which may be shut down. Maimonides is a good bet.
 
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drranjit

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Oct 5, 2014
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Vascular is much more competitive than CT, and there is talk (perpetual talk) of CT eventually converting to an all-integrated match. As more programs convert there will be fewer traditional CT slots for which to compete.

Albert Einstein will likely be out of reach. Metropolitan is a god-awful program which may be shut down. Maimonides is a good bet.
You know so much about those programs, thanks BlondeDocteur, you're the best! How can I find out which programs are good (such as Maimonides) or bad (so I can avoid programs like Metropolitan which may be shut down!)? I couldn't find that type of info anywhere.

I just discovered Freida and did a search of Gen Surg programs in NYC. If we exclude all the big ones (Columbia, Cornell, Albert E, NYU), where I shoudn't apply b/c I suppose will be completely out of reach and exclude the ones you already commented on, I found the following programs:

1) Lenox Hill
2) Icahn Mt Sinai (Beth Israel), Icahn at Mt Sinai, Icahn at Mt Sinai/St Luke (by the way are these 3 separate programs?)
3) Brookdale Univ Hosp and Med Center
4) NY Hospital Medical Center of Queens/Cornell
5) Staten Island Univ Hospital
6) Lincoln Medical and Mental
7) Harlem Hosp Center

If you don't mind, could you by any chance comment on those programs (i.e. should I apply/avoid/too competitive for me, if there are solid community programs with possible fellowships afterwards etc)? I spent all afternoon searching but couldn't find a place that recommends/critics those programs and you seem to know so much so I thought maybe I'd ask you for your help.

Thanks a lot once again! I really appreciate it.
 

TraumaLlamaMD

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Your PD and multiple other faculty members are very knowledgeable about different programs - they hear back from their students who have gone elsewhere to train, and they know the quality of their own staff who have trained at other institutions. They also have a sense of which - if any - programs have a good history of matching graduates from your school and thus might be more likely to offer an interview. I'd recommend finding out if your PD holds a session at any point to discuss these issues, and if not, consider asking for some time to sit down with him/her or another faculty member with whom you have good rapport to see if they have any advice for you on where to apply.
 

BlondeDocteur

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No problem.

1) Lenox Hill - ritzy hospital on the upper east side, treating a lot of PITA VIPs. Less scut work than other community NYC hospitals

2) Icahn Mt Sinai (Beth Israel), Icahn at Mt Sinai, Icahn at Mt Sinai/St Luke (by the way are these 3 separate programs?)- Three separate hospitals. Beth Israel is a see-everything do-everything place with minimal ancillary support. Mt Sinai is Mt Sinai and is probably out of reach. St Luke is the former St Lukes-Roosevelt combined program; treats a combination of wealthy upper east siders and Spanish Harlem patients. A good bet for you. Also apply to Roosevelt.

3) Brookdale Univ Hosp and Med Center-- a good bet, sees a lot, minimal ancillary support
4) NY Hospital Medical Center of Queens/Cornell-- teaching affiliate of Cornell (Cornell residents do trauma and a few community rotations there)-- all FMG, minimal ancillary support, but you see a lot and do a lot
5) Staten Island Univ Hospital- great bet for you
6) Lincoln Medical and Mental - All FMG mill in the south Bronx-- dangerous area, dangerous patients, totally resident-run, horrendous scut, etc
7) Harlem Hosp Center - Columbia teaching affiliate (though not for surgery). Level 1 trauma center, sees a lot, treat the entire Harlem area. All FMG staff and minimal ancillary support.

Also look at northern New Jersey-- Morristown is a nice program.
 
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drranjit

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Oct 5, 2014
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No problem.

1) Lenox Hill - ritzy hospital on the upper east side, treating a lot of PITA VIPs. Less scut work than other community NYC hospitals

2) Icahn Mt Sinai (Beth Israel), Icahn at Mt Sinai, Icahn at Mt Sinai/St Luke (by the way are these 3 separate programs?)- Three separate hospitals. Beth Israel is a see-everything do-everything place with minimal ancillary support. Mt Sinai is Mt Sinai and is probably out of reach. St Luke is the former St Lukes-Roosevelt combined program; treats a combination of wealthy upper east siders and Spanish Harlem patients. A good bet for you. Also apply to Roosevelt.

3) Brookdale Univ Hosp and Med Center-- a good bet, sees a lot, minimal ancillary support
4) NY Hospital Medical Center of Queens/Cornell-- teaching affiliate of Cornell (Cornell residents do trauma and a few community rotations there)-- all FMG, minimal ancillary support, but you see a lot and do a lot
5) Staten Island Univ Hospital- great bet for you
6) Lincoln Medical and Mental - All FMG mill in the south Bronx-- dangerous area, dangerous patients, totally resident-run, horrendous scut, etc
7) Harlem Hosp Center - Columbia teaching affiliate (though not for surgery). Level 1 trauma center, sees a lot, treat the entire Harlem area. All FMG staff and minimal ancillary support.

Also look at northern New Jersey-- Morristown is a nice program.
Thanks a ton for all your help, BlondeDocteur, you were incredibly helpful. Best of luck to you!
 

Maruko

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NYC is less competitive that you might think-- many hospitals are IMG-heavy and the workload is much, much higher than in the rest of the country due to the fierce health care workers' union and the resultant lack of ancillary services.
Why does the workload increase due to healthcare workers' UNION?
 

Raryn

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Why does the workload increase due to healthcare workers' UNION?
The nurses (who are unionized) experience a decreased workload. The residents (who are generally not) experience an increased one... Someone has to do it.
 

Maruko

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The nurses (who are unionized) experience a decreased workload. The residents (who are generally not) experience an increased one... Someone has to do it.
... makes sense.