Subspecialty fellowships after community-based residencies?

[SLUser11]

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I'm currently considering either academic institutions or university-affiliated community-based residency programs for general surgery, and some of the community programs look pretty competitive (25-50% AOA/top 10%), but according to www.facs.org, it can be difficult to get fellowships following a community-based residency.
My question for current gen surg residents/subspecialty fellows: IN GENERAL, as a rule of thumb, is it significantly more difficult to get fellowships following a community residency vs. a university residency? I understand that this is a hard thing to answer yes or no to, based on the esteem of the private program and the difficulty level of the fellowship (e.g. peds).......Colorectal/oncology/CTS/plastics? I'm specifically looking and university-affiliated community-based programs in the midwest. Thank you.

 

[Leukocyte]

I'm currently considering either academic institutions or university-affiliated community-based residency programs for general surgery, and some of the community programs look pretty competitive (25-50% AOA/top 10%), but according to www.facs.org, it can be difficult to get fellowships following a community-based residency.
My question for current gen surg residents/subspecialty fellows: IN GENERAL, as a rule of thumb, is it significantly more difficult to get fellowships following a community residency vs. a university residency? I understand that this is a hard thing to answer yes or no to, based on the esteem of the private program and the difficulty level of the fellowship (e.g. peds).......Colorectal/oncology/CTS/plastics? I'm specifically looking and university-affiliated community-based programs in the midwest. Thank you.

I can only tell you what I personally experienced. I did a rotation at a community hospital in Conn. There were 2 chief residents. One was accepted to a Vascular program. The other was accepted into a CT program. They were both FMGs (True FMGs, from Poland and China). Both very smart. The GS community program was a 6 year program. I year is devoted entirely to RESEARCH (the residents must publish) at Yale-New Haven and Memorial Sloan-Kettering.

Good Luck

 

[Winged Scapula]

Conventional wisdom is that, yes, it is more difficult to obtain fellowships from community programs. That said, it depends on the program, the individual and the fellowship applying for. Having a PD with connections don't hurt either.

Our local community program, not considered a prestigious one, has been able to place people into Surg Onc, Plastics (a few years back), CT, etc. So while it might make it somewhat easier at an academic program, especially the availability of lab time for those fellowships which seem to require it, it isn't a given.

 

[JudoKing01]

I think it also depends on where you want to do your fellowship. Some community hospitals also have fellowships, like the hospital near my house has a 6 year general surgery program and they offer a 2 year vascular surgery fellowship. I'm not sure if there are a ton of fellowships offered at community hospitals, or if you're even willing to do one there, but you could check it out.

 

[njbmd]

Hi there,
Some post surgery fellowships are very competitive such as Pediatric Surgery and you are likely to face a huge uphill battle in trying to get into a Peds surgery fellowship coming out of a community program unless you are have very strong connections or credentials. Plastics and Transplant could also be listed in the most competitive category meaning that you should probably do your training at a university-based residency where you can have some solid research. Minimally Invasive fellowships are pretty competitive too.

On the other hand, Trauma Surgery, Burn Surgery Vascular Surgery, Colo-Rectal Surgery and lately, CT Surgery are less competitive. Does this mean that you are going to be a "walk-in" for these fellowships? No,you still need to have the ABSITE scores and you need to do very well in your residency program but many of these programs have graduates from strong community programs. If you know that you want to do a fellowship in one of the less competitive fellowships, you should look for a very strong community program where you can have access to good experiences and research opportunities.

Good luck!
njbmd 🙂

 

[SLUser11]

Thanks for the input. I'll keep all of this in mind, and I'll be sure to ask alot of related questions during the interview process.

 

[avgjoe]

I'm getting more interested in colorectal surgery .. you say it's not as competitive as the others? Why not? It seems like it has a good mix of different types of surgeries, you get to work with the abdomen, not too many emergencies come in so lifestyle wise it's pretty good, etc. I don't know about the financial stuff and whether that's low and therefore people don't want to do it.. of crs many are put off by the 'rectal' part. What are other reasons why it's not so popular now?

 

[Celiac Plexus]

unless the academic surgical program is a "name" program, the value of academic training vis a vis fellowship procurement is debatable. the university of south florida is a university/academic program, but there's not much prestige factor to the name usf. nothing against usf it just doesn't have the same gravitas as harvard, hopkins, wash u, ucsf etc.... don't go to an academic program just because you think having the word "college" or "university" on your cv is essential...

imho the benefits of an academic program are the research opportunities, and the chance to develop important connections in your field of interest. for example, let's say you train at a community program... you get good operative training, learn to be a good teacher, get good absite scores, and good letters of recommendation. you will be a decent candidate for many fellowships. if you train at an academic center that has many productive researchers, you will get the same as above, plus many publications, attend many meetings, make many connections, and eventually be an excellent candidate for all fellowships. there are residents who finish residency with 10, 20, 30, or even in 100+ publications in high impact journals. often this requires time in the lab, but with that many publications, meetings, possibly some awards, and connections, that resident will be a top candidate for fellowship application.

 

[geekgirl]

"if you train at an academic center that has many productive researchers, you will get the same as above, plus many publications, attend many meetings, make many connections, and eventually be an excellent candidate for all fellowships. there are residents who finish residency with 10, 20, 30, or even in 100+ publications in high impact journals. often this requires time in the lab, but with that many publications, meetings, possibly some awards, and connections, that resident will be a top candidate for fellowship application."

while i admit i agree with the above comments, 100+ pubs in high impact journals is sort of ridiculous. i know what you're saying, celiac, but if those numbers were the reality i'd have to cry my little heart out. 'cause there aren't enough hours in the day. 🙄

but otherwise, as always, you're right on.

 

[Celiac Plexus]

"if you train at an academic center that has many productive researchers, you will get the same as above, plus many publications, attend many meetings, make many connections, and eventually be an excellent candidate for all fellowships. there are residents who finish residency with 10, 20, 30, or even in 100+ publications in high impact journals. often this requires time in the lab, but with that many publications, meetings, possibly some awards, and connections, that resident will be a top candidate for fellowship application."

while i admit i agree with the above comments, 100+ pubs in high impact journals is sort of ridiculous. i know what you're saying, celiac, but if those numbers were the reality i'd have to cry my little heart out. 'cause there aren't enough hours in the day. 🙄

but otherwise, as always, you're right on.

well, i'll pass you some kleenex because michael longaker did it.

http://med.stanford.edu/profiles/michael_longaker/

he has published over 750 papers according to his profile. and i have been told (i have not actually looked up his full bibliography) that he had greater than 100 publications when he finished residency.

he is atypical to be sure, but there are many residents who finish residency with 10-30 publications. to do this, you have to be involved in a big lab that has a lot of stuff going on. everyone just puts everyone else's name on every paper that gets written. it's not what i consider "doing research" per se, and it's not something that i endorse, but that's how it's done at some big labs. for the hard-core academic types... well, that's how they roll... and that ain't gonna happen at a community program.

 

[NRAI2001]

Hi there,
Some post surgery fellowships are very competitive such as Pediatric Surgery and you are likely to face a huge uphill battle in trying to get into a Peds surgery fellowship coming out of a community program unless you are have very strong connections or credentials. Plastics and Transplant could also be listed in the most competitive category meaning that you should probably do your training at a university-based residency where you can have some solid research. Minimally Invasive fellowships are pretty competitive too.

Is there really a fellowship specifically teaching minimally invasive procedures?

 

[Pikevillemedstudent]

Is there really a fellowship specifically teaching minimally invasive procedures?

yes there is

 

[Dire Straits]

publications...yawn

such an unoriginal way to pad your resume

 

[NRAI2001]

Is there really a fellowship specifically teaching minimally invasive procedures?

What type of procedures would someone trained in this perform (obviously MIS)?

 

[blue2000]

MIS fellowship trained surgeons typically do a mixture of lap colons, bariatrics, adrenals, spleens, etc. etc. etc. Think of the most challenging lap cases available, and these surgeons are the ones who get them in major markets.