I have always wanted to become a surgeon. However, I had a conversation with my uncle who is in internal medicine, and he said that the surgical residency is a pyrimid (spelling?) system, meaning that every year one person is cut from the program. Granted, his experience is based on the medical education system of 2 decades ago, so i am hoping it is different. Are there really cuts in who makes the surgical residency? It seems kind of harsh to make it to the third year with the potential to be cut. And what happens to those who don't make it? I am hoping my current beliefs regarding the surgical residency system is flawed. Any responses on how the system works would be greatly appreciated.
What is the path to becoming a surgeon?
- Thread starter Biryani
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This does not happen anymore.. I am currently interviewing for general surgery, a program director recently told me that he thinks there are 2 programs in the country that continue to use this old system. I don't know which they are.
Brutal though, eh?
Good luck!!
Brutal though, eh?
Good luck!!
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This is very rare.
However, realize there are different kinds of surgery residents. Those who are "categorical" are essentially guarenteed a spot for the full 5 years it takes to complete a general surgery residency (technically you get a contract for a year at a time, and some residents have been fired, but generally you have to be really bad for that to happen. The vast majority of categorical residents finish the full 5 years)
Then there are preliminary surgery residents. Of these, there are two types. The first is designated preliminary. These are people who have matched into a surgical subspecialty that requires a year or two of general surgery first (examples are ENT, otho, neurosurgery). The second kind is non-designated preliminary. Not all programs have these spots. This is an intern year slot only, with no possibilty of moving on (unless a categorical resident quits and the program wants the non designated person to stay and fill that spot)
The vast majority of US medical school grads with decent grades/board scores don't have much difficulty getting a categorical surgery spot these days.
However, realize there are different kinds of surgery residents. Those who are "categorical" are essentially guarenteed a spot for the full 5 years it takes to complete a general surgery residency (technically you get a contract for a year at a time, and some residents have been fired, but generally you have to be really bad for that to happen. The vast majority of categorical residents finish the full 5 years)
Then there are preliminary surgery residents. Of these, there are two types. The first is designated preliminary. These are people who have matched into a surgical subspecialty that requires a year or two of general surgery first (examples are ENT, otho, neurosurgery). The second kind is non-designated preliminary. Not all programs have these spots. This is an intern year slot only, with no possibilty of moving on (unless a categorical resident quits and the program wants the non designated person to stay and fill that spot)
The vast majority of US medical school grads with decent grades/board scores don't have much difficulty getting a categorical surgery spot these days.
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It is now illegal to have a pyrimid system in any residency, although it did happen in the past (your uncle is telling the truth from when he trained). These days, if you match into a categorical spot, you really are supposed to be guaranteed the opportunity to finish all 5 years. Programs are not allowed to set up pyrimid systems anymore.
Of course, you can be fired, just like you can from any job, but in my experience so far, the few people I've known or heard about who got "cut" from a surgery program recently were given plenty of chances to improve their performance or behavior and did not, and were appropriately fired for either repeatedly doing things that put patients in danger or for just blatently not following the orders of their staff surgeons repeatedly.
There are preliminary postitions, in which you know up front you are only signed up for a year or two and you know going into it that you are not guaranteed anything beyond that, just as the above poster said.
As long as you apply to enough realistic programs you should match into a categorical spot and have no worries about not being able to finish the residency program.
Of course, you can be fired, just like you can from any job, but in my experience so far, the few people I've known or heard about who got "cut" from a surgery program recently were given plenty of chances to improve their performance or behavior and did not, and were appropriately fired for either repeatedly doing things that put patients in danger or for just blatently not following the orders of their staff surgeons repeatedly.
There are preliminary postitions, in which you know up front you are only signed up for a year or two and you know going into it that you are not guaranteed anything beyond that, just as the above poster said.
As long as you apply to enough realistic programs you should match into a categorical spot and have no worries about not being able to finish the residency program.
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As others have noted, with the exception of military programs (which are not governed by the RRC0, it is frowned against to have a pyramidal program in any residency.
Do not confuse prelim spots with categoricals finishing the program.
Do not confuse prelim spots with categoricals finishing the program.
