Thinking about specializing

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Hello! I'm a relatively "new grad" having graduated from Edinburgh University and started working in GP in the US right after graduating. I ve been in practice for a year and three months now.

I enjoy surgery and dermatology. When in my final year rotations I loved dermatology, anesthesiology and scrubbing into surgery! I get a bit of all of these things in GP but think about specializing and being a master rather than a jack of all trades. I won't lie, financial stability is also a factor in me considering specializing. I also worry that I don't have a definite favorite between my interests...

Here's the question is working in GP detrimental to a future application to VIRMP? I have heard it's considered less competitive but is it that bad? Would pursing an internship be advised? Any specialists here have input from their experience? Thank you in advanced!

 

[JaynaAli]

Tagging @SocialStigma and @supershorty for surgery-specific insight.

I think the “impact” of time in GP is going to vary between specialties and even between programs. I am not a surgeon, but I have heard people say that surgery tends to prefer new grads so they don’t have to un-teach techniques to someone who has already spent time doing surgeries independently. Is that actually true? No idea…hopefully some of our surgery focused people can chime in. And again, I’m not a dermatologist, but I feel like GP experience would potentially be very valuable for derm, since you’d likely have handled so many of those cases? It gives an important frame of reference. Even if time in GP did make someone less competitive, it doesn’t mean you have no chance.

I am in clin path, which is actually a specialty that, as a whole, really likes to see some clinical experience though it isn’t necessary. I will say that when I was part of the selection committee choosing path residents, the ‘non-traditional’ applicants who had been out in GP tended to have app packets which were just not as competitive as the fresh students. Experience with the field and strong letters of rec from specialists in that field are going to be really, really important for any app, and those who have been out of school often don’t have as easy of access to specialists to write the letters. I remember one applicant who had an amazing letter of rec from her GP boss, but she didn’t have a letter from a pathologist and hadn’t spent much time shadowing pathology since school, and the faculty on the committee basically passed her over because of that. That wasn’t the only factor but it was a major one. I bring this up to say that, if you haven’t been shadowing or maintaining relationships with surgery or derm specialists, it may be wise to consider doing an internship to thrust you back into the academia/specialty world and help facilitate those connections and optimize your chances at getting a residency. But definitely talk to some actual surgeons and dermatologists and see what they recommend for those fields specifically. So many surgery residents had to do multiple internships including both rotating and surgery specific internships, I’d expect you to probably have to do some interning if you pursue surgery. Not as confident about derm and I don’t know that we have any derm regulars here on SDN.

 

[gartersotter]

There are a few programs that prefer people with "real world" experience for their residencies. Generally, it's because these programs want their residents to be cutting right away and need minimal guidance on routine emergency cases. Understandably, most of these are private practice programs.

Generally speaking, most residency programs I've worked with prefer candidates that haven't left the bubble of post-graduate training (rotating internship, surgery internship), but we wouldn't necessarily use it as a strict exclusion criteria without reviewing an application and I've certainly interviewed many people in that camp. That being said, many programs require a rotating internship as a prerequisite so there are candidates who have to kind of go backwards and get that completed first.

To be frank, yes, your time in GP would be considered less competitive than a well-known rotating internship if your application landed on my desk. There are other things you can do to make up for it (great class rank, a number of publications, great letters), so don't fret too much but just be aware that you'll have to work harder in other areas as a result.