Hi mcg,
I didn't even decide to apply for General Surgery until the summer after third year, and as such I have only learned about pediatric surgery from my advisor (who's a peds surgeon) over the past few months, so please take this with a grain of salt.
Peds surgery is quite competitive. The demand for pediatric surgeons is lower than for adult, simply b/c the patient population is smaller (numbers-wise, not height-wise
). As a result, there are few pediatric surgery fellowships (30 in the US), and each program takes one resident yearly, on average. Despite the low number of programs, peds surgery is attractive to many surgeons in training b/c it encompasses all body systems, involves unique pathology, and has the added perk of working with kids and guiding families through difficult perioperative challenges.
The number of interested applicants coupled with the paucity of fellowships results in a competitive field, and according to my advisor there are a few things to keep in mind:
(a) Although there are certainly exceptions, on the whole a university-based gen surg residency program - particularly one with a strong history of placing residents in peds fellowships, and with good pediatric surgeons on the faculty - will better your chances of acceptance to a peds fellowship than will a small community program.
(b) Although not a designated requirement, it's very difficult to match in peds surg without taking time from residency to conduct research, usually two years.
(c) My advisor actually recommends deciding about peds surgery EARLY, and seeking out peds surgery mentors among the faculty. The rationale is that you can always change your mind later, but it's hard to decide late during residency to apply for peds, then scramble to make the connections and do the research.
(d) Most residents apply to all 30 fellowship programs in the US to ensure that they match. This is potentially a big negative, for myself included - I'm not sure I want to uproot my husband (and possibly kids) to travel halfway across the country for two years.
As the field is so small, all of the pediatric surgeons from the different programs know each other. As a med student, if you're really interested, try doing a sub-I or elective in pediatric surgery, and get to know the surgeons. They can help you down the road when applying for residency, and connect you with the people to whom you should talk when assessing programs.
Otherwise, the only thing to focus on in med school is really to just work to the best of your ability, to give yourself the most options when applying for residency. Take it in steps, and spend time thinking about what you'd really love to do!
Good luck to you!
