WAMC: Integrated Thoracic Surgery Residency

[DrDummyAccount]

Hello SDN.

I am about to start my third year at a US MD program (mid tier), and am wondering what I would have to do to make my application competitive for I6 thoracic residencies, if I'm even still in the running.

Step 1: 234
Preclinical GPA: 3.54
Volunteer experience: a ton
Work experience: a TON
Research: 1 poster and 1 abstract in emergency medicine

Not sure if this matters, but there is an I6 program in my home-state, one city over from where I currently go to med school. I have some personal fringe-connections there, and my school has actual connections.

I've been pretty set on thoracic surgery due to OR experience in the field during my gap years, but it was all shadowing, nothing that will boost my app. I would love the chance to get right to my passion without going through general surg/fellowship, I'm not getting any younger. Is this a decent reason to go I6?

I'm thinking beefing up my research and killing the surgery shelf/Step 2 CK are my highest-yield targets. Do you guys have different/additional advice? Thanks!

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[peachrings]

Not extremely well versed in CT surgery, but I would apply to I6, gen surg, and 4+3 programs if your goal is truly to be a cardiothoracic surgeon. A year or two more of training will not negative affect you in the long run. Even super star candidates apply to gen surg as back up.

 

[slowthai]

Not extremely well versed in CT surgery, but I would apply to I6, gen surg, and 4+3 programs if your goal is truly to be a cardiothoracic surgeon. A year or two more of training will not negative affect you in the long run. Even super star candidates apply to gen surg as back up.

Yeah, there are just too few programs to not apply with a backup, especially when the GS to CT route is a lot closer to a sure thing.

 

[DrDummyAccount]

Yeah I do intend on applying to general surgery as well, but I’m interested in what I can do to increase my chances with the integrated application specifically. I’m wondering if I should even bother with my step 1 score being so low.

 

[slowthai]

I read somewhere that gen surg sees the I6 application and gets upset that gen surg is the back up. Is that true? Do you know anything about that? It was some study surveying students applying to I6, and some 50%+ of applicants said they felt their I6 app negatively impacted their chances in gen surg

Is this it?

The Bias Against Integrated Thoracic Surgery Residency Applicants During General Surgery Interviews

 

[stickgirl390]

Is this it?

The Bias Against Integrated Thoracic Surgery Residency Applicants During General Surgery Interviews

Lol yes, you beat me to it. I deleted my original comment and was just writing a new one with this link

 

[slowthai]

Yeah I do intend on applying to general surgery as well, but I’m interested in what I can do to increase my chances with the integrated application specifically. I’m wondering if I should even bother with my step 1 score being so low.

Based on this thread, a research year could be a viable in-road.

 

[slowthai]

Lol yes, you beat me to it. I deleted my original comment and was just writing a new one with this link

I find this phenomenon very interesting, honestly. GS is a backup for so many people pursuing the surgical subs (minus ortho, lol). Looks like creating two different apps and basically manufacturing an interest in GS is necessary to avoid the bias, according to the paper.

 

[frenchyn]

Step 1 is definitely below average. Research is non existent...definitely one research year if not two...depending on how many pubs you can get out in one year.

 

[WinslowPringle]

Based on this thread, a research year could be a viable in-road.

Step 1 is definitely below average. Research is non existent...definitely one research year if not two...depending on how many pubs you can get out in one year.

I personally wouldn't do research year now before applying I6 and Gen Surg if your main focus is time and you're at all ok doing GS first. If you get I6 anyways, you didn't need it; if you don't and match GS you can still match TS as a 2 year fellowship. Doing a research year now makes total time 7 years, same as GS +2 year TS fellowship. Plus, you might decide to do a research year or two during residency (when you can moonlight...). On the other hand, if you really want to avoid GS at all costs doing a research fellowship might help - just make sure you go to a strong program and get good CT mentors and get good pubs and good contacts. I'd be leery of doing a research year at your school if not a strong CT department.

As you know, your Step I is low for I6 matched. You also need research, good letters and connections. Killing Step 2 and getting some CV pubs out would improve your chances. Regardless the I6 match rate is low; no reason for you not to apply (besides time and money....) and give it your best shot.

Just curious - if TS is your passion, why didn't you start with research in TS at the beginning of med school? Any of those people you shadowed able to pull strings and write good letters?

Also if you do apply I6, keep in mind you may have to explain your 2x career change. One of the issues I've heard discussed is the challenge of making sure the applicants know that TS is what they want and that they'll stick to it and graduate on the other end a cardiac surgeon. It's different when interviewing people who have (almost) made it through GS residency because you know they can make it through OR/residency working conditions and know a little of what they're getting into. Hopefully you got to scrub and assist a ton of pump cases - talking cardiac-specific experience can be a selling point in interview!

 

[DrDummyAccount]

I personally wouldn't do research year now before applying I6 and Gen Surg if your main focus is time and you're at all ok doing GS first. If you get I6 anyways, you didn't need it; if you don't and match GS you can still match TS as a 2 year fellowship. Doing a research year now makes total time 7 years, same as GS +2 year TS fellowship. Plus, you might decide to do a research year or two during residency (when you can moonlight...). On the other hand, if you really want to avoid GS at all costs doing a research fellowship might help - just make sure you go to a strong program and get good CT mentors and get good pubs and good contacts. I'd be leery of doing a research year at your school if not a strong CT department.

As you know, your Step I is low for I6 matched. You also need research, good letters and connections. Killing Step 2 and getting some CV pubs out would improve your chances. Regardless the I6 match rate is low; no reason for you not to apply (besides time and money....) and give it your best shot.

Just curious - if TS is your passion, why didn't you start with research in TS at the beginning of med school? Any of those people you shadowed able to pull strings and write good letters?

Also if you do apply I6, keep in mind you may have to explain your 2x career change. One of the issues I've heard discussed is the challenge of making sure the applicants know that TS is what they want and that they'll stick to it and graduate on the other end a cardiac surgeon. It's different when interviewing people who have (almost) made it through GS residency because you know they can make it through OR/residency working conditions and know a little of what they're getting into. Hopefully you got to scrub and assist a ton of pump cases - talking cardiac-specific experience can be a selling point in interview!

Thank you so much for your input. I am 100% fine with going GS+fellowship, really my only reason for pursuing I6 is to save time, since I’m already set on CT. My research decision was a monetary one at the time: the emergency med research paid me, and the CT options did not. That was during M1, and I figured I still have three years to do CT research. Our fourth year has 5 months of research time “built in” should you choose to use the time that way, so I’ve always been slotting that time in my head for CT.

Totally agree with what you said tho. No point in taking research years as that defeats the purpose of saving time. At that point I’d rather go GS and get my residency underway.

Excellent advice on the career change explanations. I’m not worried about that though. My two previous careers feed into medicine and supplement it very nicely. (Not saying what they were to maintain anonymity.)

 

[Frogger27]

Yeah I don't think you have much of a chance at an I6 program... A lot of the people I know who were successful in the I6, a) knew day 1 they wanted CT surgery and started making connections/doing research, b) had strong grades, and c) had a home department.

You don't have much of any of the above and the lack of a home department will make this an extremely challenging match. It is such a small field and having a home program is crucial. I think you are correct in trying to do everything you can (eg, crush third year, do CT research, Step 2, etc), but I would 100% be mentally prepared to do a GS program. I'd start looking at GS programs that have affiliated CT fellowships, 4+3 programs, etc).

 

[FindersFee5]

Thank you so much for your input. I am 100% fine with going GS+fellowship, really my only reason for pursuing I6 is to save time, since I’m already set on CT. My research decision was a monetary one at the time: the emergency med research paid me, and the CT options did not. That was during M1, and I figured I still have three years to do CT research. Our fourth year has 5 months of research time “built in” should you choose to use the time that way, so I’ve always been slotting that time in my head for CT.

Totally agree with what you said tho. No point in taking research years as that defeats the purpose of saving time. At that point I’d rather go GS and get my residency underway.

Excellent advice on the career change explanations. I’m not worried about that though. My two previous careers feed into medicine and supplement it very nicely. (Not saying what they were to maintain anonymity.)

4th year is not a good time to count on for research because any pubs that come from it will be after the ERAS deadline and interviews have gone out.

 

[DrDummyAccount]

4th year is not a good time to count on for research because any pubs that come from it will be after the ERAS deadline and interviews have gone out.

Two things:

1) Can you include prospective pubs in ERAS if the research is already completed?
2) My school is weird and our 4th year starts in April, does that change your statement at all?

 

[AnatomyGrey12]

Two things:

1) Can you include prospective pubs in ERAS if the research is already completed?
2) My school is weird and our 4th year starts in April, does that change your statement at all?

You can call them "projects submitted for publication" but they won't mean anything because I can draw up a manuscript about sea horses in 10 minutes and send it into a predatory journal and call it the same thing.

Outcomes from research typically takes 9-12 months to appear in my experience, with potential for a lot longer depending on what kind of research it is.

 

[peachrings]

Two things:

1) Can you include prospective pubs in ERAS if the research is already completed?
2) My school is weird and our 4th year starts in April, does that change your statement at all?

1. Prospective pubs in submission can be included but are not seen as the same level as accepted/in-press/published. This can be an issue when competing against candidates with 5+ accepted/in-press/published, which is not uncommon in surgical sub-specialties. If you can swing it, start research during M3.

2. If ERAS submission is in September again in 2021, that leaves 5 months for research. This seems like a good time frame to get several projects wrapped up and submitted, but most likely will not have review decisions on submissions by then.

At this point, it seems like the best/likeliest option is to enter a residency in a good General Surgery program that will set you up nicely for fellowship.

 

[ed*26]

Most I6 programs have 1-2 slots with close to 100 applications. What you need is for the program to know you. If you bust a** you could have a decent shot. But make sure it's what you actually want. And some I6 programs have 1-2 required research years, plus many do fellowships so any way you slice it it's going to be a long path.

- The fact that you've been interested in CT for so long will work in your favor. Reach out to whatever contacts you had before school and let them know you're a rising M3 and still highly interested in a CT career. If you don't have elective time this year, figure out a way to get into a CT OR. Prepare to explain why you knew you wanted CT but did nothing with it for your first two years.
- Try to get in with some current residents/fellows, they will have research projects that you can get started on now. Starting research 4th year is too late, even for good GS programs.
- Ideally, you will attend one of the major conferences (STS/AATS) before applying -- kind of a bust with covid but try anyways. Basically, you need name and facial recognition.
- Also build a good application for general surgery programs with 4+3 tracks or in house CTS fellowships