Unopposed Gen Surg Residency (Best way to learn how to do basic ortho/neuro surg on G Surg)

[globalsurgeon]

Hello!

I am an MS3, and my long-term goals include doing global/rural surgery. I want to start looking for programs that train me to do a wide range of surgeries including some ortho/neuro surg procedures. Any recs about programs that might be able to teach this would be super helpful.

Additionally, if anyone knows about programs that allow/encourage/require residents to spend large chunks of time doing surgery abroad would be appreciated.

Thank you!

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[deleted480308]

Hello!

I am an MS3, and my long-term goals include doing global/rural surgery. I want to start looking for programs that train me to do a wide range of surgeries including some ortho/neuro surg procedures. Any recs about programs that might be able to teach this would be super helpful.

Additionally, if anyone knows about programs that allow/encourage/require residents to spend large chunks of time doing surgery abroad would be appreciated.

Thank you!

You should not be doing ortho and neuro surgery as a general surgery trained doc regardless of where you want to do it, just because the patients are poor doesn’t mean you should give them bad care

 

[TraumaLlamaMD]

The ABS has pretty specific requirements for graduating residents in terms of how many cases they need to have done in certain categories to graduate (i.e. X number of biliary procedures, Y number of thoracotomies). I think it would be difficult, if not impossible, to both meet your case numbers for general surgery and also become proficient enough in neuro or ortho procedures that you’d be safe practicing them unsupervised.

I also don’t think there are many, if any, programs that will allow “large chunks” of time away from the home institution outside of a research year or other planned experience. I do have many co-residents who have chosen to spend vacation time working abroad, and the procedures they most commonly do are General Surgery bread and butter - hernias and gallbladders, sometimes thyroid or an extremity sarcoma. Nobody is asking them to do complex neuro or ortho procedures and they are plenty busy with the procedures they are well trained to do.

In terms of working in the rural US, again, there’s enough of a General Surgery deficit in many areas that you can make a busy living with procedures within our wheelhouse. I would encourage you to get even more practice than required with colonoscopy and endoscopy, as those services are valued in rural areas as well.

 

[Jolie South]

I was in unopposed program and did basic orthopedic reductions but would not feel comfortable doing anything beyond that. I don’t think anyone should do more than that in the orthopedic/neurosurg realm unless specifically trained in one of those residencies.

 

[anatomist_surgeon]

Current gen surg resident here with an interest in rural/community surgery. Several programs I interviewed at offered electives in OB/GYN, Ortho, Uro, etc or overseas elective. How comfortable the residents felt doing those procedures in practice I can't say. Off the top of my head, Gundersen Lutheran in LaCrosse WI is a well respected rural surgery residency with rotations in ortho, urology, OB/GYN and electives overseas. Bassett Medical Center in New York is another rural focused program with broad training. St Joseph Mercy in Ann Arbor, MI offered a two month overseas elective in Africa with a former graduate who did general surgery but also a large number of orthopedic cases. UC Davis is another program that had a rural/global track although I don't remember much about it. The University of Wisconsin and the University of Minnesota offered rural tracks but I don't know if they're as broad as you are looking for.

 

[Dares Dareson]

I feel like the only ortho/neuro procedures you could possibly be doing as a general surgeon in a super rural setting would be closed reductions and burr holes? Everything else is just too highly specialized and you wouldn't have the equipment/staff where you would be anyway. Maybe I'm wrong, I'd love to know if I am.

I do think C sections and gyn procedures might be more useful to learn.

 

[anatomist_surgeon]

I know general surgeons in rural areas who do basic hand surgery (carpal tunnels, trigger fingers, etc) but nothing complex like joints. Some are trained to do emergency decompressive burr holes but that is about the extent of the neuro procedures that I know of GS people doing. I know some general surgeons that also do some gyn, uro, and some ENT cases (tubals, abdominal hysterectomy, cystoscopy, tonsils and adenoids, ear tubes.) Most trauma is going to get shipped so even things like reductions don't seem to be commonly done by GS.

 

[wanderingraven]

I have done a considerable amount of international work and have seen multiple general surgeons do ambitious neuro/ortho cases. Anyone who tells you that this is not possible has never been in the trenches of the developing world. Additionally, I am currently in a gen surge residency that provides the flexibility in rotations to allow me to train in related fields in order to prepare me for my international work as I see fit. PM me if you would like more information.

 

[DoctwoB]

Current gen surg resident here with an interest in rural/community surgery. Several programs I interviewed at offered electives in OB/GYN, Ortho, Uro, etc or overseas elective. How comfortable the residents felt doing those procedures in practice I can't say. Off the top of my head, Gundersen Lutheran in LaCrosse WI is a well respected rural surgery residency with rotations in ortho, urology, OB/GYN and electives overseas. Bassett Medical Center in New York is another rural focused program with broad training. St Joseph Mercy in Ann Arbor, MI offered a two month overseas elective in Africa with a former graduate who did general surgery but also a large number of orthopedic cases. UC Davis is another program that had a rural/global track although I don't remember much about it. The University of Wisconsin and the University of Minnesota offered rural tracks but I don't know if they're as broad as you are looking for.

No offense intended but other then getting better at placing foleys or maybe scoping in a catheter how would doing rotations in Urology expand your scope of practice? I could certainly see general surgeons doing lap nephrectomies for cancer (after all they already do them in transplant) in areas without urologists, but beyond that I can't see someone without GU training doing significant endoscopic procedures (TURPs, bladder tumors, Stones), prostates, partial nephrectomies, cystectomies, etc.

 

[anatomist_surgeon]

No offense intended but other then getting better at placing foleys or maybe scoping in a catheter how would doing rotations in Urology expand your scope of practice? I could certainly see general surgeons doing lap nephrectomies for cancer (after all they already do them in transplant) in areas without urologists, but beyond that I can't see someone without GU training doing significant endoscopic procedures (TURPs, bladder tumors, Stones), prostates, partial nephrectomies, cystectomies, etc.

No offense taken. I can't say for sure as I'm not at a program with a built in urology curriculum and have little interest in learning those procedures myself beyond perhaps ureteral stenting which we do on colorectal. I don't know of any rural surgeons (or non-transplant trained in general) surgeons doing nephrectomies outside of a trauma setting but that isn't to say it doesn't happen. I remember from interviews though that PGY2's at Gundersen do a urology elective and residents at Bassett take care of urology patients but I'm not sure how relevant those skills/rotations are to practice.