The hardest surgical field to match into...

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overthebridge

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UROLOGY. Don't consider applying unless you are God's gift to Earth. Very low match results again!
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I was interested in urology for a while, but it lost its luster after a while. The hours aren't as good as rumors would have you believe. Also uro-oncology, which interested me most, seems to spend a lot of research dollars defending its treatments which, to me at least, points to troubled waters down the line. Peds, endouro, and fertility are still fantastic fields though, if you like the patient populations and can handle the amount of clinic needed to find candidates.

GL to those who didn't match.
 
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Generally, Plastic Surgery is the hardest surgical field into which you can match.
 
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Sorry about the match. At least there's time to enter into the regular match.
 
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Sorry, just a little overdramatic. Thought last year was going to be the lowest match rate, but this year was worse. Does anybody see this trend continuing in the future?

I am considering going into prelim general surgery and sticking with it because I don't think I can match Uro as a reapplicant.
 
overthebridge said:
Sorry, just a little overdramatic. Thought last year was going to be the lowest match rate, but this year was worse. Does anybody see this trend continuing in the future?

I am considering going into prelim general surgery and sticking with it because I don't think I can match Uro as a reapplicant.
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What's your basic stats? Then perhaps others can give you better info.
 
Etorphine said:
What's your basic stats? Then perhaps others can give you better info.
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Step 1/2: 250s/250s
Class Rank: Top 25%, not AOA
Clerkship Grades: Mostly honors including surgery
Research: 2 basic science publications (2nd,3rd authors), 1 clinical publication (2nd) - all uro
Attend a highly regarded school in the East
45 applications (broad: tier and region) - 11 invites

I am more upset that it is so competitive rather than me getting passed over by someone else since everyone is amazing on the interview trail.
 
uro has been the only surgical subspecialty to not interest me the past two years. what is so appealing about it?
 
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I'd venture a guess that Cardiothoracs is much more difficult. Considering the very little availability of this integrated program and only 1-2 spots per program.
 
Kaustikos said:
I'd venture a guess that Cardiothoracs is much more difficult. Considering the very little availability of this integrated program and only 1-2 spots per program.
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I've seen the applicant #s for our integrated cardiac program.

Nowhere close to urology/plastics land.

I'd say that the integrated cardiac pool closely resembles the pool competing for the top general surgery slots, but perhaps with slightly stronger/more focused research.
 
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Is 68% a low match rate? That seems pretty good but I am not familiar with match rate statistics. At least it is much better than the odds of securing an NIH R01 (<10%).
 
Cyal said:
Is 68% a low match rate? That seems pretty good but I am not familiar with match rate statistics. At least it is much better than the odds of securing an NIH R01 (<10%).
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It is when everyone applying has first author papers, 240/250, strong letters of recommendation and honors everywhere.
 
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Cyal said:
Is 68% a low match rate? That seems pretty good but I am not familiar with match rate statistics. At least it is much better than the odds of securing an NIH R01 (<10%).
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I would hardly equate applying for a grant to applying for residency. If you don't match...you don't have a job on July 1. That's pretty dire. There are VERY few fields with a high number of applicants (esp US MDs) who don't match.
 
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Cyal said:
Is 68% a low match rate? That seems pretty good but I am not familiar with match rate statistics. At least it is much better than the odds of securing an NIH R01 (<10%).
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Yes, 68% is very low. For comparison, ortho and radonc, which are also considered very competitive, have match rates of around 80%.
 
No doubt the lack of a job is severe. I was more so approaching this from a "rate" perspective rather than delays in training progress. But I would have sworn someone with the OP's stats would match urology. Isn't it possible to apply to two independent fields?

I'm also surprised the rate for Rad Onc is that high.

southernIM said:
I would hardly equate applying for a grant to applying for residency. If you don't match...you don't have a job on July 1. That's pretty dire. There are VERY few fields with a high number of applicants (esp US MDs) who don't match.
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SurgeDO said:
uro has been the only surgical subspecialty to not interest me the past two years. what is so appealing about it?
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It's a field that has a very broad range of procedures and operations. In a single day a urologist can perform a cystectomy and reroute the ureters through an ileal conduit that exits the abdomen like a colostomy followed by a transurethral resection of the prostate or transurethral resection of a bladder tumor (both of the latter performed using a scope inserted through the urethra). You can also do cryotherapy for prostate cancer, artificial urethral sphincters, and even inflatable penile prostheses! I won't even go into the various scrotal operations. There is a huge variety of things you can do, and you can focus your practice based on your interest. Want to focus on relatively quick endourologic cases? Great! You can do that. You can also remove kidneys, perform retroperitoneal lymph node dissections, adrenalectomies, and inguinal node dissections.

Just like with any surgical field (aside from trauma, I suppose) you have to wade through clinic to find surgical candidates. But even in clinic you can perform cystoscopy, stent removals, etc in the office, so it can still be heavily procedure based.

As you age and your dexterity fades you can transition your practice to be more clinic based referring to other urologists when a significant operation is needed. I know of a few older urologists who do primarily clinic and ESWL (patient is sedated and shock waves break up the stones) with the occasional "simple" (hydrocelectomy, etc) operation who have a great income along with family time. Longevity can definitely be had in urology.

As was mentioned above the hours are not as great as they are made to seem, but they are not bad for a surgical residency. You will work hard during residency, but it won't be nearly as bad as general surgery. When I start taking call as a urology resident it will be roughly one weekend every 5 weeks and one weeknight every week- not that bad.

Also mentioned above is the fact that a lot of research funding is going towards defending treatments for uro-onc. This is somewhat true, but it is not necessarily a bad thing. Any academic urologist will tell you that the literature out there sucks compared to other fields. Most studies, while providing some valuable input, are just not well designed to determine efficacy, etc. That's the nature of the uro-onc disease prevalence/incidence in most cases, but it also provides great opportunities for upcoming urologists to shape the field if you have any inclination in academics.

Also, the "difficult" patients in urology are incontinence and ball pain. I will take those two patient types over your typical IM or EM "difficult" patients any day.

To overthebridge, I'm sorry about the match. I was in the military match so it was different, but I know from my classmates that this year was tough. If you love urology hang in there. A guy in the class ahead of me did not match last year, did a TY, and subsequently matched this cycle. All is not lost.
 
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I saw multiple statuses on facebook from med school people saying they had matched in urology (like 5 or 6?). However, I obviously have no idea about those who applied to urology and didn't match. I will say that all those who matched are either very personable, or are very good at acting like they're personable (may just be because I don't like 2 of them).

OP - your stats seem very good. I'm surprised that you didn't match, especially with 11 invites. Best of luck in the future.
 
overthebridge said:
Step 1/2: 250s/250s
Class Rank: Top 25%, not AOA
Clerkship Grades: Mostly honors including surgery
Research: 2 basic science publications (2nd,3rd authors), 1 clinical publication (2nd) - all uro
Attend a highly regarded school in the East
45 applications (broad: tier and region) - 11 invites

I am more upset that it is so competitive rather than me getting passed over by someone else since everyone is amazing on the interview trail.
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Geeze did you molest the secretary everywhere you interviewed or something?? Your application looks exceptional. Very surprising you didn't match. Do you think your letters were luke warm?
 
Man that is rough. Really sorry to hear OTB...
 
sobored said:
Geeze did you molest the secretary everywhere you interviewed or something?? Your application looks exceptional. Very surprising you didn't match. Do you think your letters were luke warm?
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Everything looks good but it just did not turn out that way. There aren't many urology posts but I can tell you that people with better credentials also did not match or barely matched (ie. 15th/20 on their rank list). Some questions and thoughts in my mind now about the urology match process:

1. The most important thing in matching is who your letter writers know (ie. back room deals). Politics 101 my friends.
2. Majority of applicants should apply to a backup specialty simultaneously.
3. Something needs to be done regarding how many schools you can apply to. People with excellent numbers still applied to 75+ schools got 20+ invites and went on all of them. I'm not blasting them for doing so as it is their right and currently fair, but this problem really shows up when many people don't match or match really really low on their lists.
 
overthebridge said:
Everything looks good but it just did not turn out that way. There aren't many urology posts but I can tell you that people with better credentials also did not match or barely matched (ie. 15th/20 on their rank list). Some questions and thoughts in my mind now about the urology match process:

1. The most important thing in matching is who your letter writers know (ie. back room deals). Politics 101 my friends.
2. Majority of applicants should apply to a backup specialty simultaneously.
3. Something needs to be done regarding how many schools you can apply to. People with excellent numbers still applied to 75+ schools got 20+ invites and went on all of them. I'm not blasting them for doing so as it is their right and currently fair, but this problem really shows up when many people don't match or match really really low on their lists.
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The bolded shouldn't have stopped you from matching, unless there were multiple urology programs that did not fill their spots this year (which to me seems pretty unlikely).

Is there a SOAP for urology?
 
evilbooyaa said:
The bolded shouldn't have stopped you from matching, unless there were multiple urology programs that did not fill their spots this year (which to me seems pretty unlikely).
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Theoretically, it could have. If these people went on fewer interviews, he may have gotten more himself and potentially could have matched at one of them. Of course, if all programs filled, that would just mean he pushed out some other unlucky sap ;)
 
what happens if you don't match? can you apply concurrently with the ACGME match, scramble, go for a TRI/intern year or do you sit out a year?
 
It's difficult to know, because the interview itself could change the outcome.

But presumably...if you consider that:
1) the strongest candidates get the most interviews
2) the programs all fill

Then the people who were " pushed out " of interview slots by stronger candidates would not somehow push their way back in if the interviews were more evenly distributed
 
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