How hard is landing a surgery residency?

[dmprice2]

How hard is it really? Give me an idea what kind of grades/step exam scores/etc you have to land a surgery residency. I am about to start med school this year and want to make sure I know what I am getting into.

Thanks

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[Green Chimneys]

For g-surg, there are a bajillion positions out there so much like IM, if you just want a position you'll probably get it (a little harder than IM, but not absurdly). If you want that position at a top academic medical center so you can get that coveted fellowship and be a big whig professor someday, yeah you better be towards the top of your class and crush the boards.

It's Friday of your senior year though, stop worrying about the future and go drink (or at least socialize while abstaining if that's your thing).

 

[typeB-md]

How hard is it really? Give me an idea what kind of grades/step exam scores/etc you have to land a surgery residency. I am about to start med school this year and want to make sure I know what I am getting into.

Thanks

I assume you're referring to gen surg; this is currently a solid mid-tier competitive residency.

Grades-wise you'll want to be in middle third of your class for the good programs and probably top third for the stellar/best reputation programs. You can probably still match even if you're lower third of the class, but you it will obviously be more difficult and limited.

Step scores are similar to grades. >240 should leave you very competitive for all but the most stellar residencies. Solid 230's make you competitive but somewhat limited. Solid 220's you'll likely match but you'll need to be realistic.

The best advice I can give is also the biggest cliche advice: Do your best and don't worry about residency.

Chances are that right now you have no idea what medical school will do to your personality or how it will change your outlook on things. What seems like great ideas know will quickly fade as you progress through your training. General surgery is a very intense training program -- even with the "80" hour work limitation. It has also become more competitive because of this limitation. You should do your best because it'll keep doors open and allow you to choose your destination as opposed to having to settle for a less than desirable position somewhere. Also keep in mind that residency competitiveness cycles and currently the trend in general surgery is that of becoming more, not less, competitive.

 

[smq123]

How hard is it really? Give me an idea what kind of grades/step exam scores/etc you have to land a surgery residency. I am about to start med school this year and want to make sure I know what I am getting into.

Thanks

If you're about to start med school, it's very difficult to say.

The competitiveness of gen surg has changed dramatically in the past 5 years or so. There's no telling how competitive it will be by the time you graduate from med school.

Last year, you needed to have an above-average Step 1 score (~220 or so) to have a good chance of matching in a strong university program. That's probably true this year as well.

You will almost certainly need a very good grade on your surgery clerkship by the time you become a third year.

It's too early to say - you will almost certainly change your mind. During MS2, I SWORE, up and down, that I'd HATE surgery and would NEVER enjoy being in an OR - and then I ended up loving my surgery rotation. I know many of my classmates who were the opposite - were in love with surgery, until they actually had to do the rotation, and couldn't stand the 15 hour days, starting each day at 4:30, coming in to the hospital to see patients at 5 AM on Saturday mornings, etc.

 

[SLUser11]

For g-surg, there are a bajillion positions out there so much like IM, if you just want a position you'll probably get it (a little harder than IM, but not absurdly).

Funny.

 

[TxMed]

harder than im, family, peds, etc. but, easier than scoring a three-way. there have been studies; three-way is definitely more competitive, and the evaluations are brutal.

 

[MrBigLips]

harder than im, family, peds, etc. but, easier than scoring a three-way. there have been studies; three-way is definitely more competitive, and the evaluations are brutal.

bahhahahahaahhaa.


alright so i'm about to take my step 1, and im shooting for 240+, and i think thats realistic for me. do u guys think thats good enough for a categorical position at an above average place for a US IMG like myself? or should i not even get my hopes up and be happy if i match a preliminary?

i know i know, there are a million other factors that come into play. USCE, step II scores, LORs, MSPEs, clerkship grades, etc.... but... assuming that one is in the in the top 10% of their class, is it possible?

and how much does research take part in all of this. i read the statistics which stated that GS PD's marked research pretty low in factors taking part in matching, but does the same hold true for IMG applicants?

 

[kirurg]

You will have a hard time matching categorical because programs want to look good on paper. They will rank medical students with the best grades/publications from schools with the best reputation highest. I believe the match rate for US grads is ~85%, so it is tough for anyone else. I have seen many prelims go on to get a categorical position at nice programs. If you have good research and great numbers I'm sure you'll eventually get a spot (about 30% of interns wind up leaving surgery).

bahhahahahaahhaa.


alright so i'm about to take my step 1, and im shooting for 240+, and i think thats realistic for me. do u guys think thats good enough for a categorical position at an above average place for a US IMG like myself? or should i not even get my hopes up and be happy if i match a preliminary?

i know i know, there are a million other factors that come into play. USCE, step II scores, LORs, MSPEs, clerkship grades, etc.... but... assuming that one is in the in the top 10% of their class, is it possible?

and how much does research take part in all of this. i read the statistics which stated that GS PD's marked research pretty low in factors taking part in matching, but does the same hold true for IMG applicants?

 

[MrBigLips]

so 70% of prelims eventually find a spot down the road if they work hard enough?? thats not bad at all. i was under the impression that only about 25% would be able to make it.

thanks a lot for ur help. im going to have to mentally prepare myself for what im getting myself into. my worst nightmare is to match a GS prelim spot, love the place, and then end up being that 30% who end up leaving.

 

[Pir8DeacDoc]

I'm not sure how you came up with those numbers. 70% of prelims don't end up in surgery, at least not from my experience. A lot will end up in other fields. Maybe you mis-read/misinterpreted what the above poster wrote??

 

[MrBigLips]

this is what i think it is.....

IMG's wanting a spot in GS are pretty much limited to only preliminary positions with some exceptions who get categoricals. of the ones who are prelims in GS, 70% eventually end up making it to categorical positions either at the initial institution they matched prelim at, or at another program. the remaining 30% of prelims dont end up securing a spot anywhere, and eventually leave surgery altogether.

or at least... thats the take home msg i got from kirug's post.

 

[kirurg]

What I meant to say was that about 30% of categorical residents leave general surgery. That is the number people always throw around, but that seems high from my experience. From what I have seen, it would be closer to 15%. Many good prelims wind up landing a categorical spot in the end though.

 

[Winged Scapula]

The attrition rate in GS has always been around 22%. I have to wonder if it's less now with better training hours.

At any rate, kirurg did not state or mean to imply that 70% of Prelims get Categorical positions or that 70% of IMGs match into GS. That data can be ectracted from NRMP Data Tables. What we don't know is what percentage of IMG Prelims get Categorical positions in GS. There is single institution data but nothing widespread. I can tell you anecdotally that the percentage is nowhere near 70%. Many end up in other specialties or doing several Prelim years and then quitting medicine.

 

[cpants]

As an IMG trying to get into surgery, you shouldn't be worried about getting into a good program. You should be trying to get ANY categorical spot. It is possible to match into a categorical spot, especially if you have excellent board scores, and that should be your goal. As you get closer to application time after you've recorded your Step I scores, you should be reaching out to PD's at community programs who have taken IMG's in the past. It is sometimes possible to arrange a position outside of the match. The prelim route leaves things very up in the air, and adds internship years to your training.

 

[MrBigLips]

I can tell you anecdotally that the percentage is nowhere near 70%. Many end up in other specialties or doing several Prelim years and then quitting medicine.

The prelim route leaves things very up in the air, and adds internship years to your training.

Man, u guys are breaking my heart. But i very much appreciate everyones help, especially those who are experienced in the field. i would be lost without the effort and help of everyone here on SDN.

as sad as i am right now, im gunna kick some ass on those boards.

 

[Buzz Me]

this is what i think it is.....

IMG's wanting a spot in GS are pretty much limited to only preliminary positions with some exceptions who get categoricals. of the ones who are prelims in GS, 70% eventually end up making it to categorical positions either at the initial institution they matched prelim at, or at another program. the remaining 30% of prelims dont end up securing a spot anywhere, and eventually leave surgery altogether.

or at least... thats the take home msg i got from kirug's post.

Nope, that's not what kirug said. The attrition rate among categoricals is around 20-25% each year. But of the many nondesignated prelims, many do not go onto to gain a categorical General Surgery spot.

 

[MrBigLips]

Nope, that's not what kirug said. The attrition rate among categoricals is around 20-25% each year. But of the many nondesignated prelims, many do not go onto to gain a categorical General Surgery spot.

Yea I got that the second time around. Thanks!

 

[SurgeonMonkey]

Hi all,

I'm a 3rd yr M.D. student in Southern California. My Step 1 score was...well let's say not ideal (between 200-210). I think it's a fluke cuz I was scoring way higher on practice exams at the time and I was feeling sick that day, but whatever, excuses won't help.

I'm studying for step 2 CK, and I'm definitely aiming toward getting above at least 240, hopefully even >250. So here's the deal, is it realistic for me to go for general surgery residency with these stats (assuming I do >240 on step 2)? Is it even more of a fantasy to match into a program (either community or university) in California? (I'm willing to move anywhere in the U.S., but since I've been living in southern california my whole life, I want to stay west coast). Of course I'm mainly talking about categorical spots, but any comments about prelim spots would be helpful too.

P.S. I have 2 original papers published as well as 2 abstracts and 4 research oral presentations all in the field of surgery that I did during 1st and 2nd year. Don't know how much this would help though.

Thanks for any responses!

 

[Guile]

Hi all,

I'm a 3rd yr M.D. student in Southern California. My Step 1 score was...well let's say not ideal (between 200-210). I think it's a fluke cuz I was scoring way higher on practice exams at the time and I was feeling sick that day, but whatever, excuses won't help.

I'm studying for step 2 CK, and I'm definitely aiming toward getting above at least 240, hopefully even >250. So here's the deal, is it realistic for me to go for general surgery residency with these stats (assuming I do >240 on step 2)? Is it even more of a fantasy to match into a program (either community or university) in California? (I'm willing to move anywhere in the U.S., but since I've been living in southern california my whole life, I want to stay west coast). Of course I'm mainly talking about categorical spots, but any comments about prelim spots would be helpful too.

P.S. I have 2 original papers published as well as 2 abstracts and 4 research oral presentations all in the field of surgery that I did during 1st and 2nd year. Don't know how much this would help though.

Thanks for any responses!

You should be able to get a spot, especially if you do well on Step 2. Get as many honors/A's in your rotations as possible, especially in surgery. Be an awesome student on your AIs as a fourth year. Get to know people in the department. When it comes time for applications having people who will go to bat for you makes a world of difference.

 

[Buzz Me]

This topic concerns med students looking to get into a surgical residency and therefore belongs in the Clinical Rotations forum. Interested residents/fellows/attendings can respond there.

Moving.

 

[drmedstudent]

bahhahahahaahhaa.


alright so i'm about to take my step 1, and im shooting for 240+, and i think thats realistic for me. do u guys think thats good enough for a categorical position at an above average place for a US IMG like myself? or should i not even get my hopes up and be happy if i match a preliminary?

i know i know, there are a million other factors that come into play. USCE, step II scores, LORs, MSPEs, clerkship grades, etc.... but... assuming that one is in the in the top 10% of their class, is it possible?

and how much does research take part in all of this. i read the statistics which stated that GS PD's marked research pretty low in factors taking part in matching, but does the same hold true for IMG applicants?

240+:
top 10%:
research:
IMG:

say u get 240 on step 1 & 2, do 1 research project = probabilty of matching into categorical gen surg residency program according to 2009 NRMP ~ 30-40% for you........ (difficult but not impossible)...apply to A LOT programs. u should get in somewhere!!

 

[cabinbuilder]

How hard is it really? Give me an idea what kind of grades/step exam scores/etc you have to land a surgery residency. I am about to start med school this year and want to make sure I know what I am getting into.

Thanks

Get into medical school first. Then suffer through the first two years of class. Then go out on rotations and see if you even like the surgery lifestyle and 18 hrs days. I went into medical school thinking I wanted to do surgery. That didn't happen and now I do family practice with lots of procedures and go home at 6pm each day. Wait until you are in the thick of it before thinking of applying to residency.

 

[Analytic]

Here is some additional information from "So, You Want to Be a Surgeon":

With my academic track record, where should I apply?

All programs try to take the best applicants they can, and your academic credentials dictate your chances. Some institutions require that you have an advanced degree, several publications, and be elected to Alpha Omega Alpha, while other institutions may be willing to review your record more broadly and value your other accomplishments as well, such as the fact that you worked your way through school and are involved in community activities. Evaluations from your clerkships and letters may also give the programs a feel for whether you are the sort of person who treats everyone well and will remain calm and effective in the face of all the challenges a general surgery resident may face during a hectic clinic or in the middle of the night.

If your record places you in the lower half of your class or if you scored below the mean on the United States Medical Licensing Examination™ (USMLE), you may not get many invitations to interview relative to the number of places you apply. Placement in the second quartile of your class or scoring at least a mean score on USMLE tests will make you competitive for many good independent medical center-based programs and some university-based programs. If you are in the top quartile of your class, have scores well above the mean on the USMLE examinations, and have some honors on your clinical clerkships, there are quite a few university-based programs you can consider. If you have been elected to Alpha Omega Alpha and have many major clinical honors, you should be competitive for any program in the country. We discuss this scenario further in Section III.

 

[KeyzerSoze]

Here is some additional information from "So, You Want to Be a Surgeon":

Meh. At my low-ranked private medical school, the average GPA and USMLE scores of people who match into general surgery are virtually identical to those who match into EM, IM, FM, and peds.

 

[skylina]

s

 

[uchicago]

Since most of the grads here are AMGs, I am not sure how is it helpful to give an opnion for IMGs. But let's see:

IMG: 2007 (-)
Step 1: 250s (+)
Step 2: 260s (2nd attempt) (+/-)
Research: 1 paper: presented in national meeting (+)
1 paper published. (+)
USCE: 8 mo with LoR (one from Vascular Chief, and another from GS attending) (+)
Don't need visa (green card)


I know I don't have big chance and I am realistic not applying for categorical. Only prelim then do my best and hope for good good ABSITE score.

Do you guys think I can actually get a spot prelim? I have 3 iv so far one in university based. So what do you think guys my chances are and in case, God forbid, I didn't get matched, what should I do; research or what?

Thanks and I appreciate any constructive input.

 

[abmd]

I go to a lower tier academic school, good (not amazing but above gen surg avg) step 1, research but no publications, good extra-curriculars, top 1/3 of med school class, lots of ECs. hoping to do amazing on step 2. Do I have a chance to match to the top programs, or just middle tier. Also does anyone have a listing of the top programs?

 

[Skinceutical]

For g-surg, there are a bajillion positions out there so much like IM, if you just want a position you'll probably get it (a little harder than IM, but not absurdly).

Funny.

What's so funny about it? According to the 2011 match data for successful American MD applicants:

GS:
Avg. Step I: 227
Avg. Step II: 238
Avg. # of Pubs: 3.3
% AOA: 13.1%

IM:
Avg. Step I: 226
Avg. Step II: 237
Avg. # of Pubs: 3.2
% AOA: 15.5%

Looks like they're essentially neck and neck in terms of applicant qualifications. The only major difference is that IM has about 5x as many positions as GS, so the number of unmatched applicants is significantly lower, and there's more room for DOs/IMGs.

 

[Dirt]

Gen Surg

1,108 positions offered
830 US seniors matched
205 US seniors did not match

IM
5,407 positions offered
2,947 US seniors matched
171 US seniors did not match

So 20% of US allopathic seniors who tried to match into gen surg did not compared to 5% in IM.

 

[SLUser11]

What's so funny about it? According to the 2011 match data for successful American MD applicants:
.............. The only major difference is that IM has about 5x as many positions as GS, so the number of unmatched applicants is significantly lower, and there's more room for DOs/IMGs.

It looks like you sort of answered your own question. Roughly 55% of IM spots are filled by US allopathic seniors every year, compared to 80+% for surgery.

Competition is based on number of spots versus number and quality of applicants. If everyone is super smart in IM, but they all match where they want, and there's no competing for spots....then it's not that competitive. It doesn't mean everyone in IM is dumb and everyone in surgery is smart. It just means it is easier to land an IM spot than General Surgery. 2000 IM spots were filled by "independent applicants" in the NRMP report.

You also quoted a 4-year old post by me, so I'm surprised I picked it up. Since we're talking stats and old threads, here's an old thread I started to discuss this report from the NRMP, where my mission statement was that surgery is not as competitive as it's made out to be.

 

[Skinceutical]

You also quoted a 4-year old post by me, so I'm surprised I picked it up.

Sorry about that, I didn't realize how old your post was. After the thread had been resurrected by the poster above me, I didn't check to see when individual posts had been written.

Competition is based on number of spots versus number and quality of applicants. If everyone is super smart in IM, but they all match where they want, and there's no competing for spots....then it's not that competitive.

I don't entirely agree.

Lets take your logic a little further. ENT, neurosurgery, rad onc, and radiology all have higher match rates for US seniors than general surgery. Yet, given the average applicant qualifications in those fields, few would dispute the fact that they are all more competitive than GS. Even though more applicants end up getting spots, I would argue that's a function of having a more self-selecting applicant pool than there being a relative "lack of competition" for spots.

 

[SLUser11]

Sorry about that, I didn't realize how old your post was. After the thread had been resurrected by the poster above me, I didn't check to see when individual posts had been written.


I don't entirely agree.

Lets take your logic a little further. ENT, neurosurgery, rad onc, and radiology all have higher match rates for US seniors than general surgery. Yet, given the average applicant qualifications in those fields, few would dispute the fact that they are all more competitive than GS. Even though more applicants end up getting spots, I would argue that's a function of having a more self-selecting applicant pool than there being a relative "lack of competition" for spots.

I don't want to have a big drawn-out discussion on this topic. General surgery is more competitive than it was 10 years ago, thanks in part to the ACGME work hour rules, but it is still not as competitive as things like Derm, Plastics, Ortho, ENT. Radiology is debatable. I think solid applicants who work hard can routinely match into general surgery without stellar numbers...however I think people have to work hard to not match into IM. The two just aren't comparable.

I think the best way to measure competition is to look at the ratio of # of US seniors applying to # of available spots. An even better way is to look at % of spots filled by US seniors.

But, I also think big discussions about competition are more ego-driven than anything else...people want to feel like they're special....that's why every year, there are threads in most specialties (ER, OBGYN, IM, Psych) that discuss how the given specialty is getting more competitive.

 

[Butler]

But, I also think big discussions about competition are more ego-driven than anything else...people want to feel like they're special....that's why every year, there are threads in most specialties (ER, OBGYN, IM, Psych) that discuss how the given specialty is getting more competitive.

QFT. People that choose a specialty based on perceived "competitiveness" are in for a rude awakening if they aren't passionate about it.

 

[Jack is Back]

I don't want to have a big drawn-out discussion on this topic. General surgery is more competitive than it was 10 years ago, thanks in part to the ACGME work hour rules, but it is still not as competitive as things like Derm, Plastics, Ortho, ENT. Radiology is debatable. I think solid applicants who work hard can routinely match into general surgery without stellar numbers...however I think people have to work hard to not match into IM. The two just aren't comparable.

I think the best way to measure competition is to look at the ratio of # of US seniors applying to # of available spots. An even better way is to look at % of spots filled by US seniors.

But, I also think big discussions about competition are more ego-driven than anything else...people want to feel like they're special....that's why every year, there are threads in most specialties (ER, OBGYN, IM, Psych) that discuss how the given specialty is getting more competitive.

QFT. People that choose a specialty based on perceived "competitiveness" are in for a rude awakening if they aren't passionate about it.

This is actually a struggle of mine. Sometimes I find myself leaning to a more competitive specialty because it's harder to get into. Like some club, that if you gain entrance, you can feel like you've achieved something. I guess the good part is recognizing that desire and silencing it.