Dual apply Ortho and gen surg?

[deborahs]

Hi all, MS3 currently in Texas.

I was wondering if anyone has applied/knows someone who has applied to both ortho and gen surg? Would love to do ortho, but my stats are too low to be confident that I would match if applying to ortho only. I also really like gen surg and would be happy having a career as a gen surg as well, but at this point, if I could choose, I would still have a preference for ortho. Hence my desire to dual apply. I heard some said it's good to dual apply, some said it's a red flag for the gen surg programs who sees the applicant as someone who is using gen surg as a mere back up plan. Was wondering what you guys think?

I also heard about Gen Surg prelim year before going into ortho, but know nothing about it. Any opinion?

Thanks y'all!

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[premedk]

Not sure why no one's replied. I was wondering the same thing. I really like ortho, but my step score is almost 20pts lower than the average for matched candidates...I've been trying to kill it this year...but I'm getting killed on shelfs(all Bs). I just suck at tests...but I really like ortho.

I do know of one current PGY1 ortho resident at my school that applied ortho, didn't match, ended up starting gen surgery, 3 months in an ortho spot opened up and he was able to grab it. He was a strong candidate with multiple interviews, but just slipped through the cracks.

Is applying to two residencies a good idea for an average candidates trying to match ortho or should I just learn to love another specialty? I felt so bad for those premeds with 22 MCAT and 3.0 desperately trying to get into med school...I don't want to be the 4th year med school version of them.

 

[Kbkilla]

OMS IV going for gen surg. I've definitely met people along the interview trail who are going for more competitive surgical specialties and using gen surg as a backup. I think its a wise decision if you are unsure how competitive you are.

I would just make sure you sell the gen surg program on the fact that you want gen surg and not bring up the fact you are applying another specialty. Make sure you write two different personal statements (assuming your ortho one talks about ortho), and try and get some gen surg LORs.

If you do all of that, I'm not sure how it could hurt applying to both. Don't give up on ortho, but be realistic and have these backups in place.

 

[SallySparrow]

If you go for a prelim year as opposed to a categorical spot as a backup, be aware that this means you will have to reapply the next year, while being a PGY-1 surgery resident. I don't have personal experience, but from what I've heard from people who I've talked to on the trail, this is difficult. You are put in a different category because you have already graduated (so financially this means different things for the residency program that takes you; if they take you as a PGY-1, they have to pay for an additional year of residency for you outside of whatever the government allots). Sometimes if you work hard and have the support of your prelim program, this can show that you are an excellent potential resident. But not all programs treat their prelims well, so ask the prelims about this at each program if that is the way you go. You would have to ask about how they would handle you taking time off from your clinical duties for interviews. I don't know the requirements for Ortho and a PGY-2 spot, but some other residencies like Anesthesia, etc. that often take PGY-2s want certain electives so that might be something you'd have to ask about at each prelim interview as well if relevant
.
But if you are definitely sure you would want to do Ortho over Gen Surg, (e.g. you might be unhappy in Gen Surg), the prelim year or a research year (either now! between 3rd and 4th year to beef up your application, or possibly after you don't match) or potential options. As you say, you would still be interested in general surgery, so a dual application sounds like it might be a reasonable backup. As was mentioned previously, have independent applications as much as you can in terms of letters and personal statements, know that most of the rest of the ERAS application will be common, try and have non-overlapping lists of programs, and when you go on interviews, make sure you have your separate sets of answers ready for your Ortho interviews and your General Surgery interviews.

 

[Bonebro]

I'm a current marginal 4th year ortho applicant and have to disagree that prelims are a last resort. I think SOAPing into one should be but applying and interviewing at them is a legitimate option. I've went on a few prelim interviews sprinkled between my ortho ones and there is a night and day difference between them.

One program told me if an ortho spot opens up during my prelim year at some program and I am selected to fill it, they would not let me out of my contract and force me to stick out the prelim year and they will only allow you to go about 6 interviews the next season forcing you to apply to one specialty at that point. This program will not make the rank list. On the flip side, another program has the mentality you aren't doing a prelim year as your career. They set up a meeting with their ortho chair/pd at their institution who told me I would be able to get at least 2 mo on ortho not only to try out for their program but to impress their other famous ortho faculty that are known to make phone calls to help people match. The gen surg faculty told me that they would support me dual applying the next year around and often times offer their prelims a spot in their own program to stay on if they do well if a spot opens. I was able to speak candidly to a current prelim and he confirmed all of this.

To me the advantages of apply to ortho plus surg prelim vs. categorical are:
1. You don't have to work on a separate app. Meaning you don't have to waste a valuable sub-I month getting excellent gen surg recs, you can do all ortho, which if you're not competitive the more ortho rotations the better.
2. You don't have to fake the gen surg route yet, you can go to prelim interviews and ask "if I come here what can you do for me to match me into ortho nex year" and get an honest answer which as mentioned above is crazy variable.
3. You don't match into a categorical and be sketch about trying to find open ortho spots, it's expected and if one opens up you can ask the program to go to bat for you.
4 If you truly don't want to do gen surg as your 2nd choice you're not committed to it.

 

[metopic]

Just an FYI your prelim program couldn't keep you... once you've served your 45 days or w/e as long as you are going to a different specialty (that is to say you couldn't leave after 80 days to go to another prelim surg, but you could to go to ortho) it's not a match violation.

 

[Bonebro]

I agree if you're happy doing gen surg dual apply. I don't think getting an ortho spot out of a categorical gen surg spot is anymore likely than a prelim spot as the second poster was bringing up that situation. So if you want to give it another shot I feel like prelim is better than categorical.

 

[WinslowPringle]

I've been on the interview trail for GS and met several (now) GS applicants who are applying after failing to first match in ortho. They're applying while doing a prelim. What I've heard from them is:

1. Prelim year and re-applying is *not fun.* It's another application cycle, which means more time and lots more money. Plus the opportunity cost of a year's worth of attending salary. Plus not getting enough time off from their internship to go to all the interviews they need. Plus interviewing post-call isn't fun.

2. They have to answer more questions about "Why GS?" when it's pretty evident they didn't want to apply GS in the first place. You don't want to have to say that you're applying because you weren't competitive enough for your 'top choice' specialty.

3. They have to send out a lot more applications and be happier with places that would have otherwise been lower on their list. (And then get questions like "Oh, you're top 25% of your class, AOA, with a 240 Step 1 - why are you applying here?")

4. You don't really want to repeat intern year if you don't have to. I've heard it's certainly better some places than others, but there are some places in which the prelims do all the scut and never see the OR (even more so than the categorical interns, I mean).

Personally, if I were applying to ortho (I'm not) and were a marginal candidate, I would apply to GS as well, but make sure I had separate application materials and not dual apply to both programs at the same place.

 

[sandros1]

I find this thread particularly interesting. Be very sure you like gen surg if you apply to dual specialties. I applied and didn't match ortho. Scrambled (before the computer based scramble) into a gen surg prelim and found a categorical PGY2 - definitely lucky. I must say, gen surg is not what I initially wanted, and I felt I would be ok if I ended up doing general surgery as I loved "operating". Not the case. I'm plugging through it as I don't have a choice this far into it, but I would very closely look at your choice as the two fields, although surgical, are NOTHING alike.

Gen Surg is required to basically be the garbage can of the hospital. If medicine has no idea what to do with a patient? Call a surgery consult. Patient with pulmonary effusion - call surgery for a chest tube (only at night bc IR can put a pig tail in during the day, but by the time medicine is done rounding and figuring this out its past 5 and the IR team is long gone). Can't find a pulse even though it is there - call vascular (or general) surgery. Ugly foot wound?? - vascular/general. ED docs at my institution dump loads of crap in our laps. Don't get me started on trauma - you'll get a call for a trauma consult on a single broken rib without PTx if the patient tripped into a table....Oh, and the ABSITE this year was more medicine/urology/OB/ortho/ENT than actual bread and butter surgery.

Now, evaluate your local Ortho resident - asked to set fractures, and suture lacs. Asked to cover traumas - if there's no fracture they walk away. They have perhaps some neuro call when on spine, but they are far from the garbage can of the hospital. If you like ortho, as I did, you may find you hate gen surg. The OITE - classification of fractures and fracture management, along with some embryological, vascular and neurological aspects.

If the OR is where you want to be, you can do that with urology, ENT, or plastics, in addition to ortho and gen surg. If you're the type that wants to be the go-to guy for all sh1tty (pun intended) problems, gen surg may be your ticket to happiness.

 

[premedk]

Sandros1 has a good point. I think OP likes Gen surg, but personally, after 6 weeks, I want nothing to do with it. They say orthopods are the carpenters of medicine, if that's true, that would make gen surgeons the sewage cleaners. I hate dealing with crap, in every sense of the word. I will have to think hard about my career choice because all of the surg subspecialty are very competitive, and I'm not. I love the OR and would love to operate for a living, but I'm not doing gen surg. Is there another option?

 

[hyperresonant]

Could anyone comment on whether gen surg programs (or any program, for that matter) look at your transcript from 4th year (July, Aug and Sept)? Will PCs/PDs know that you did three aways in ortho? If an applicant has 2 separate sets of letters, for ortho and gen surg, I wonder whether gen surg will know that you did aways in another specialty if they're seeing letters only from general surgeons. Especially since the conventional wisdom is not to do gen surg away's, as opposed to it being mandatory for other surgical subspecialties (ortho, plastics, ENT etc)

The reason I ask is because I genuinely am split between ENT vs. gen surg, and I was planning on doing 2 aways in ENT and 1 in gen surg. I will only apply to 1 specialty though (financial reasons), but even if I only apply to gen surg, I figure I'd be snubbed for a lot of interviews just on account of having dipped my toes in ENT waters, or if I made it to interviews, it would be hard to convince general surgery programs that I'm not using them as a backup.

Any comments/insights would be appreciated (I'm especially curious what SouthernSurgeon's thoughts are). Thanks!

 

[hyperresonant]

Thank you for your reply, Southern Surgeon. Since I'm undecided, I was going to do 2 ENT aways and 1 surg sub-i away rotation. I don't think I can financially afford to do more than 3 aways. Is 1 gen surg sub-i away enough to at least be considered by programs to give me an interview? I can try to convince them during the interview that I was genuinely torn about it, especially since I only intend to apply to either ENT or gen surg anyways. Any insight would be appreciated. Thanks!