Competitiveness for Academic General Surgery Heavy Hitters

[BlazerMS]

This is my first time posting in SDN, so please let me know if I'm breaking any rules.

Question for all of the gen surg applicants here. Obviously as a third year medical student, it is too early for me to have be assessed accurately as an applicant. But I wanted to see what you guys thought my chances would be to match into a very strong (training and prestige) gen surg academic program.

Story: Wanted to do ortho surgery all of 2nd and 3rd year. Still very much on the table but starting to realize how important academic medicine is for me and also that gen surg has a lot of cool subspecialties. Talked with the chief of surgery very recently and am starting to shift over to prepare myself for possibility of matching into gen surg over ortho.

School: Top 35~50 (whatever it may mean in different rankings)
Pre-clinical: Pass/fail (but was P1 for what it's worth)
Clinical: first 3 rotations (1 honor, 2 high pass) <- none of those surgery
Step 1: 239
Step 2: taking it early and hoping for a jump

AOA: too early to know but as far as I know I do qualify to apply.

Research: A LOT of ortho research. 3 first author papers submitted. 4 more submitted where I'm 2~4th author. At least a couple more planned to be submitted where I'm 2~4th author. On 2 more projects about to be started. 13 abstracts accepted to national conference (this is anywhere from 1st to whatever n-th author. Was told by PI it doesn't matter. But maybe it does). 15 abstracts accepted to regional conference (some overlap, maybe like 5, with the national conference. Also anywhere from 1st to n-th author). 1 local abstract accepted.
In touch with trauma surgery research group at our main hospital to get some gen surg related research. Setting up meeting date as we speak.

EC: Decent leadership. Lab leader, founded and am president of a journal club, a student rep. Meh community service. Random events here and there. Technically am a translator for a not common language at our free clinic but have never been used. Looking to join some on-going service group soon.

Looking to see if I can still make it to the big names in surgery or if my average step 1 score excludes me. I went and talked to my school advisor yesterday and it looks like people at my school with scores between 230~246 (obviously 230 and 246 is very different but that was the 1 SD above) were able to match into the likes of MGH, Brown, Beth Israel, etc. I want to know if I can make it to programs like NYU, MGH, JH, etc.

Thank you for reading this!

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[BlazerMS]

Odds not spectacular and you will need VERY convincing letters to remove the stink of “marginal ortho candidate backup” from your application

You are 100% right about the ortho back up thing. Talked to my advisor as well about it. I️ will be taking up some heavy gen surg research for the rest of this year and next year and am trying to get mentored by our chief of surgery, who is endocrine surgeon. If I️ do apply gen surg, I will only be applying gen surg (not dual applying to ortho and gen). With a story of change of heart and 100% dedication to gen surg, would I️ still be completely out of the game for Northeastern academic programs?

 

[BlazerMS]

I mean I think you can apply to them but you need to cast a wide net with a lot of “B/B+” level programs.

At risk of sounding harsh, you have a step score at least a SD below those programs average, and nothing else to distinguish yourself as a top general surgery candidate.

Not harsh. Thank you for the response! Will be applying broadly whichever way I️ go.

 

[BlazerMS]

I mean I think you can apply to them but you need to cast a wide net with a lot of “B/B+” level programs.

At risk of sounding harsh, you have a step score at least a SD below those programs average, and nothing else to distinguish yourself as a top general surgery candidate.

One more thing, I️ know things are pretty vague and subjective, but what programs in your mind falls into B/B+?

 

[Dwan]

This is my first time posting in SDN, so please let me know if I'm breaking any rules.

Question for all of the gen surg applicants here. Obviously as a third year medical student, it is too early for me to have be assessed accurately as an applicant. But I wanted to see what you guys thought my chances would be to match into a very strong (training and prestige) gen surg academic program.

Story: Wanted to do ortho surgery all of 2nd and 3rd year. Still very much on the table but starting to realize how important academic medicine is for me and also that gen surg has a lot of cool subspecialties. Talked with the chief of surgery very recently and am starting to shift over to prepare myself for possibility of matching into gen surg over ortho.

School: Top 35~50 (whatever it may mean in different rankings)
Pre-clinical: Pass/fail (but was P1 for what it's worth)
Clinical: first 3 rotations (1 honor, 2 high pass) <- none of those surgery
Step 1: 239
Step 2: taking it early and hoping for a jump

AOA: too early to know but as far as I know I do qualify to apply.

Research: A LOT of ortho research. 3 first author papers submitted. 4 more submitted where I'm 2~4th author. At least a couple more planned to be submitted where I'm 2~4th author. On 2 more projects about to be started. 13 abstracts accepted to national conference (this is anywhere from 1st to whatever n-th author. Was told by PI it doesn't matter. But maybe it does). 15 abstracts accepted to regional conference (some overlap, maybe like 5, with the national conference. Also anywhere from 1st to n-th author). 1 local abstract accepted.
In touch with trauma surgery research group at our main hospital to get some gen surg related research. Setting up meeting date as we speak.

EC: Decent leadership. Lab leader, founded and am president of a journal club, a student rep. Meh community service. Random events here and there. Technically am a translator for a not common language at our free clinic but have never been used. Looking to join some on-going service group soon.

Looking to see if I can still make it to the big names in surgery or if my average step 1 score excludes me. I went and talked to my school advisor yesterday and it looks like people at my school with scores between 230~246 (obviously 230 and 246 is very different but that was the 1 SD above) were able to match into the likes of MGH, Brown, Beth Israel, etc. I want to know if I can make it to programs like NYU, MGH, JH, etc.

Thank you for reading this!

Seems a bit odd that you have 29 abstracts yet no published papers (I don't know the story, but may appear like you're gaming the pub count). The avg accepted applicant to gen surg has a 235 and you're within that range, so I don't see any compelling reasons why you would be a candidate to the most elite programs.

 

[masaraksh]

From what I've heard (I'm not applying gs but friends are), just because its not a "competitive" specialty, its pretty darn tough at the top. You're more likely to not even get an interview at MGH.

 

[BlazerMS]

Seems a bit odd that you have 29 abstracts yet no published papers (I don't know the story, but may appear like you're gaming the pub count). The avg accepted applicant to gen surg has a 235 and you're within that range, so I don't see any compelling reasons why you would be a candidate to the most elite programs.

I️ can definitely see that. Thank you for pointing it out. I️ became the lab leader for my ortho lab and pretty much took part in every data collection (retrospective and procedures in cadaver studies) and abstract editing for all projects getting off of the ground. Then I️ assigned different med students and research fellows to those studies for analysis and manuscript writing. I️ had the first choosings for studies but was not named on all of the studies since our lab is pretty big and we like to keep the author list to 6 (for manuscripts but not abstracts/posters). With 2 PIs and a statistician on every paper, I️ was not able to be listed as one of the manuscript authors as often as an abstract author.

As for publications, I️ should jump in that category in the next couple months. About 5 manuscripts (me listed as 1st-3rd author) are in the final stages to be published in journals.

But I️ do agree that my numbers will probably keep me out of the top top. Was just trying to gauge about where I️ would be in terms of competitiveness with this post.

 

[BlazerMS]

My other concern upon reflection. And maybe it is unfair, but I thought it so chances are other application reviewers would too:

Are you truly interested in general surgery or do you simply perceive that you’re going to get more “bang for your buck” at prestigious programs in general Surgery than you would have in ortho?

That is a fair assumption. I would be lying if I️ said that the thought of becoming from a marginal applicant for ortho to above (?) average applicant for gen surg didn’t across my mind and made me feel a little bit easier about the potential transition.

But I️ can honestly say, no it’s not about the prestige factor. I️ am honestly fully interested in a couple of subspecialties of gen surg and the more I️ learn, the more I️ get interested in other gen surg subspecialties that I️ didn’t think of before, for example endocrine surgery. If anything, I️ am looking into prestigious programs BECAUSE I️ am interested in gen surg subspecialies. Not the other way around. For whatever it is worth, the current plan for me if I️ go to gen surg is to do a fellowship after. No real interest in staying a pure gen surgeon. Of course, that would also be depending on how competitive I️ am once I️ am a resident. But that is for future me to work on and inquire about.

I️ really appreciate your critiques and views of my application. It’s bringing different perspectives that I otherwise would have thought were negligible. If you think of any more, please continue to comment!

 

[BlazerMS]

From what I've heard (I'm not applying gs but friends are), just because its not a "competitive" specialty, its pretty darn tough at the top. You're more likely to not even get an interview at MGH.

That’s what I️ figured would be the general consensus. Even in less competitive specialties like psych or peds, the top top programs are full of people easily getting 250+. Just for my curiosity, do you have any friends with my similar step score and know about what range of programs they are applying to?

 

[LucidSplash]

Just FYI, about 80% of GS residents do a fellowship, so not just those at “prestige” programs. So wanting to do a fellowship is not a good enough explanation for wanting an ivory tower in GS.

 

[BlazerMS]

Just FYI, about 80% of GS residents do a fellowship, so not just those at “prestige” programs. So wanting to do a fellowship is not a good enough explanation for wanting an ivory tower in GS.

Yes of course. I’m aware. That’s not the reason I️ want get into the ivory tower. I️ want to get into a great program (if I️ can) and so I️ can pursue and further my career in academic medicine.

 

[Redpancreas]

I know nothing about Surgery residency admissions, but I can say as an IM applicant that top tier IM is also brutally competitive at the top. After I got my Step score back, I was thinking top 20 because after all, everyone said IM wasn't that competitive, but boy was I wrong...

 

[pathslides]

Why is a top level academic gen surg program so important ? Your scores are good but below avg for the top level programs. You have a bunch of research but anything past 2nd author in my opinion is not much of value (I have seen peeps who have done 30 min of data inputting and get 3rd author). Top level academics is highly over rated. But it's your career so go for it but your best bet is to aim for good mid to upper mid program, kick butt, and land a fellowship at a top level place if a strong academic place is your thing.

 

[HighwayVagabond]

@SouthernSurgeon has given you solid feedback, and is probably being very realistic with your chances. That being said, I am a senior GS resident at one of the programs you mentioned being interested in above and I had a lower step 1 score than you. I also had zero publications at the time of application submission (though I did have some research experience). However, I had a very high step 2, honors in everything, AOA, many leadership positions, and some other unique pieces of my application that made me an interesting applicant. There are tons of people with great step scores, research, etc, and yes, these factors are generally used as a filtering tool, but the institutions you are interested in want to find people who are going to be leaders in academic medicine, and who will fit in well in their program, neither of which are generally related to scores and numbers.

Some things you can focus on going forward to give yourself the best chance possible include obtaining honors on your surgery clerkship (a must), scoring very well on step 2, getting solid recommendation letters (also a must), and writing a strong personal statement that addresses some of the ortho-related red flags. I also think you may be someone who would benefit from doing a visiting sub-I at institutions you are most interested in (if your advisors agree), as this would clearly demonstrate you are committed to general surgery, and not ortho.

Good luck!

 

[guytakingboards]

Do you not have a home ortho program? I'd be pretty shocked if you had one and your program didn't take you given your amount of research in their department.

If you're well-liked, your home program should overlook the more 'meh' aspects of your application and be happy to get someone willing to do so much research.

Ivory tower programs are what they are, but plenty of people going into academics having not trained at a top 10 program (in any specialty).

 

[BlazerMS]

@SouthernSurgeon has given you solid feedback, and is probably being very realistic with your chances. That being said, I am a senior GS resident at one of the programs you mentioned being interested in above and I had a lower step 1 score than you. I also had zero publications at the time of application submission (though I did have some research experience). However, I had a very high step 2, honors in everything, AOA, many leadership positions, and some other unique pieces of my application that made me an interesting applicant. There are tons of people with great step scores, research, etc, and yes, these factors are generally used as a filtering tool, but the institutions you are interested in want to find people who are going to be leaders in academic medicine, and who will fit in well in their program, neither of which are generally related to scores and numbers.

Some things you can focus on going forward to give yourself the best chance possible include obtaining honors on your surgery clerkship (a must), scoring very well on step 2, getting solid recommendation letters (also a must), and writing a strong personal statement that addresses some of the ortho-related red flags. I also think you may be someone who would benefit from doing a visiting sub-I at institutions you are most interested in (if your advisors agree), as this would clearly demonstrate you are committed to general surgery, and not ortho.

Good luck!

Thank you very much for your advices! I️ really appreciate your and others feedback in this thread. Have a great day!

 

[BlazerMS]

Do you not have a home ortho program? I'd be pretty shocked if you had one and your program didn't take you given your amount of research in their department.

If you're well-liked, your home program should overlook the more 'meh' aspects of your application and be happy to get someone willing to do so much research.

Ivory tower programs are what they are, but plenty of people going into academics having not trained at a top 10 program (in any specialty).

We do have an ortho program. And I️ am not considering gen surg because I️ think I️ won’t match into ortho. I️ am not as strong of an applicant for ortho as gen surg, but I️ am confident that I can match into ortho somewhere if I️ decide to go in that direction. I️ am genuinely interested in the fields in gen surg.

And that sounds great about the academic medicine! The possibility of ivory tower programs are very exciting, but I️ am very glad that I️ will be able to do what I want to regardless of whether I️ match top 10 or not.