Transitional vs. General Surgery Year

[AbbaZabba85]

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As I get ready to submit my rank order list for internship I find myself constantly going back and forth between choosing a transitional year and a general surgery internship as my top choice. I plan on doing my intern year, doing my time as a flight surgeon, and getting out to pursue civilian training. I'm interested primarily in anesthesiology but haven't completely discounted general surgery or possibly urology. This is the way I see it:

Transitional Year Pros:
-Better quality of life during internship
-Fulfills requirement for anesthesiology
-Better preparation for GMO/flight surgery (?)

TY Cons:
-"Spinning my wheels" according to some residents
-Doesn't fulfill requirements for general surgery or urology base year

Gen Surg Pros:
-Can pursue anesthesia, gen surg, or urology afterwords; more options
-More rigorous training (?)

Gen Surg Cons:
-Crappy quality of life
-Scut heavy according to some former GS interns

I was planning on ranking either San Diego or Portsmouth number one on my list. Any insights or guidance you guys and gals may have would be GREATLY appreciated since I've been racking my brain and losing sleep over this!

 

[DrMetal]

As I get ready to submit my rank order list for internship I find myself constantly going back and forth between choosing a transitional year and a general surgery internship as my top choice. I plan on doing my intern year, doing my time as a flight surgeon, and getting out to pursue civilian training. I'm interested primarily in anesthesiology but haven't completely discounted general surgery or possibly urology.

Then do a General Surgery internship. That way you can do any of the above, without having to repeat a pgy1 year.

Transitional Year Pros:
-Better quality of life during internship
-Fulfills requirement for anesthesiology
-Better preparation for GMO/flight surgery (?)

Not necessarily true (you're right about it fulfilling requirement for anes). Your 'quality of life' isn't going to be that much better if you do a TY year. It could be better, if you purposely choose easy electives. But you'd probably wanna choose some surgical electives if that's the way you're thinking of going. The difference could be 80 vs. 90 hours/week . . .again, not that much of an improvement in terms of quality of life. As far a prep for a GMO . . .I wouldn't sweat that too much. From what I've heard, all internships do something to prep you for GMO, and all of them do nothing in other regards. And so I wouldn't weigh GMO-preparation too much into your decision.

The other problem with a TY year is that you have to do Peds/Ob/Psych . . that's nearly 3 months of training. That's a colossal waste of time if you have no intention of doing any of those specialties.

Gen Surg Cons:
-Crappy quality of life
-Scut heavy according to some former GS interns

Theres plenty of "scut" work in any kind of internship . . . and I really wouldn't call it scut work, if in fact you're doing something for your education and/or for patient care. Yes you have to put in orders, write notes, run around on a floor . . but these are all things that have to be done. If you weren't doing it, an R2 or R3 would be doing it . . .at non-teaching hospitals the attending does it, and so it's not just BS scut work. (You're not mopping the floor or painting the walls).

I was planning on ranking either San Diego or Portsmouth number one on my list.

either would work, they're both great programs for TY or GS. If you truly intend to go flight surgery, its doesn't matter a whole lot where you do your pgy1 year . . you'll be moving soon thereafter to flight school then again to your next duty station. Visit the programs, see what you like, go with your gut and your geographic preference.

 

[garyplayer]

I'm interested primarily in anesthesiology but haven't completely discounted general surgery or possibly urology.

If the OP were to complete a PGY-1 surgery then fulfill their time as a flight doc and decided to pursue general surgery, could they apply for the civilian match 2 years before they get out to coast right into a program as a PGY-2? Has that happened? Or would they have to apply for vacant PGY-2 spots or enter the civilian match the year before (restarting as a PGY-1)? Or some combination? Would the plan be much different if they decided on urology?

 

[Gastrapathy]

Not a lot of experience for the group since the match went "all-in." If you think you might want to be a surgeon, do a surgery internship. It might dissuade you but its better to figure it out early.

 

[denali]

If you think you might want to be a surgeon, do a surgery internship. It might dissuade you but its better to figure it out early.

This. You should decide on surgery or not before the end of PGY1. Then you'll know which side of the curtain to be on when you try to work in some OR time while you're a GMO.

 

[HomeSkool]

I'm interested primarily in anesthesiology but haven't completely discounted general surgery or possibly urology.

Then do yourself a favor and do a gen surg internship. It'll work for any of those specialties. Don't doom yourself to an extra year of GME by going TY if you think you may go into a specialty that won't accept it.

Transitional Year Pros:
-Better quality of life during internship
-Fulfills requirement for anesthesiology
-Better preparation for GMO/flight surgery (?)

The first point is iffy. I generally worked a lot of hours as a TY. Sure, my FP clinic-only month was nice, but I spent a lot more of the year getting my butt kicked around the hospital on IM and gen surg.

The second point is true.

The third point may or may not be true; I have no experience as a GMO or flight surgeon so I really can't comment.

TY Cons:
-"Spinning my wheels" according to some residents
-Doesn't fulfill requirements for general surgery or urology base year

It's only "spinning your wheels" if it becomes a wasted year. Don't do that to yourself. Only go TY if you're positive you'll be doing a residency that accepts it.

I would add the extra con of not belonging to any of the services you rotate with (IM, surgery, ortho, ED, peds, etc.). That can burn you because you're basically invisible to many of the staff. A lot of staff won't bother trying to educate you because you're not "theirs;" you're just a visitor on their service for four weeks. There are a lot of TY interns who get abandoned to work in clinic while the categorical residents go off to didactics, even though the rules are that TY interns are supposed to be treated like categorical ones.

Gen Surg Pros:
-Can pursue anesthesia, gen surg, or urology afterwords; more options
-More rigorous training (?)

A TY internship can range anywhere from a cushy waste of time to a full-on beatdown punctuated by months of respite. A gen surg internship is basically a full-on beatdown without any respite. But you're right, it doesn't limit you with regards to OR-based residencies.

Gen Surg Cons:
-Crappy quality of life
-Scut heavy according to some former GS interns

Regardless of which internship you complete, you will be a scut monkey. Deal with it, and remember that it will end.