Last minute switch to plastics from neurosurgery

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cristiano

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I'm in need of some advice here. I'm in the middle of my 4th yr and have into neurosurgery since I got to med school. I had a tremendous interest in research, and have been very productive. I am on my home sub-I right now and have realized that I really don't like the field at all. Outcomes are awful, surgeries are not super elegant, lifestyle, etc.

How reasonable is it to pursue plastics at this point? A complete last minute switch , I know, but any advice would be appreciated. Thanks in advance!

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I think your numbers are fine. The limiting factor at this point will be getting enough PRS LORs and setting up at least 2-3 sub-Is to maximize your chances of matching. If you can hop on a couple PRS research projects that'll help as well.

Things you need to ask yourself:
-What is your driving force for pursuing plastics versus, say, ENT or ophtho? I think it's great that you enjoyed what you saw in the OR, but make sure you've adequately sampled the scope of PRS and enjoy stuff outside of the head and neck region (sounds like the case you saw was H&N-related). Scrub into a hand case, lower extremity recon, breast recon, etc to make sure you could see yourself doing this stuff for 6-7 years in training. You can always exclusively focus on craniofacial later, but there's no way around the endless tissue expanders for breast recon, hand washouts, and sacral decubs of PRS residency
-Would you be willing to take an extra year off to do PRS research if necessary? While your stats are adequate, it may not be feasible to set up enough sub-Is and get LORs at this point (particularly if your program doesn't have an integrated PRS residency).

Just some points to consider. I'm obviously biased and love PRS (rising PGY-3 integrated resident), but definitely try to scrub into more PRS cases and meet the faculty/residents to pick their brains. If your school has one and you haven't already, go introduce yourself to the PRS chair/program director and hear their thoughts.
 
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Thanks for the awesome response. Thankfully, though, my home institution does have an integrated program so I will try to get some face time in. I have yet to introduce myself to the PRS chair/PD yet because I am still in the middle of my neurosurgery sub-I and I am afraid it may burn a lot of bridges, and possibly hurt me in the long run since all the chairs/PDs are friends here at my program.

Taking an extra year (on top of the one I've already taken) would suck but I would rather eat the year on the front end than hate what I'm doing for the rest of my life. I really need to assess this a bit more. Research productivity is not huge here but I am capable of being productive so it could play in my favor.

In terms of other cases for exposure, hand is incredibly fascinating and the flaps/recon work blows my mind. Craniofacial stuff is of course awesome, I think microsurgery in general is what I find most appealing (and in fact is a major part of what I enjoy about neurosurgery).

Thanks again for the advice. Navigating this in a short time frame will be tough...
 
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Taking an extra year (on top of the one I've already taken) would suck but I would rather eat the year on the front end than hate what I'm doing for the rest of my life. I really need to assess this a bit more. Research productivity is not huge here but I am capable of being productive so it could play in my favor.

One of the more mature statements ever made by a medical student on this forum.

Anecdotally, I had a buddy in med school that also went in to plastics but chose to do a year of research to strengthen his chances of matching instead of just rolling the dice. I, instead, decided not to "waste a year."

Bottom line, he matched into one of the top integrated programs in the country and is now a PGY5 while I'm barely starting this July as a PGY4. While nothing is ever guaranteed, a well spent year establishing contacts and being productive can be incredibly beneficial.

Hindsight being 20/20 I would much rather have spent an extra year up front paying dues than having to drudge through 5 years of something I never wanted to do in the first place... and still taking a year off to do research...
 
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Your stats are fine for any specialty. You just need to figure out what you want at this point - one case/subI shouldn't completely change your mind. There are always certain cases people love/hate doing - you just need to love the cases more often than not.

I suggest you find ways to efficiently explore other specialties before making a decision to see what you'll enjoy most. Good luck and remember that it is better you figure this out now rather than after starting residency.
 
One of the more mature statements ever made by a medical student on this forum.

Anecdotally, I had a buddy in med school that also went in to plastics but chose to do a year of research to strengthen his chances of matching instead of just rolling the dice. I, instead, decided not to "waste a year."

Bottom line, he matched into one of the top integrated programs in the country and is now a PGY5 while I'm barely starting this July as a PGY4. While nothing is ever guaranteed, a well spent year establishing contacts and being productive can be incredibly beneficial.

Hindsight being 20/20 I would much rather have spent an extra year up front paying dues than having to drudge through 5 years of something I never wanted to do in the first place... and still taking a year off to do research...

Can you explain? If I am understanding correctly - you did something for two years after medica school (research year? Didn't match?) and are now going the general surgery route? What were your stats in comparison to his?

Feel free to share as much or as little as you want. Just curious to see how the research year had such a significant impact as you claim.
 
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Can you explain? If I am understanding correctly - you did something for two years after medica school (research year? Didn't match?) and are now going the general surgery route? What were your stats in comparison to his?

Feel free to share as much or as little as you want. Just curious to see how the research year had such a significant impact as you claim.

I wasn't commenting on stats. They are good. I was commenting on the fact he/she is taking a mature approach to the situation.
 
I wasn't commenting on stats. They are good. I was commenting on the fact he/she is taking a mature approach to the situation.

Right, I understand. I was just curious about your personal journey since it seems as though you were able to match after a few years and will presumably still get to do plastic surgery. We typically hear that if you don't match the first time around, it's extremely difficult thereafter.
 
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I agree that I am confused that ram006 took one less research year, and still is one year behind. that means a two year differential.

Regardless, I agree with the advice given and the difficulties you will face with matching this year. However, your stats are very very good, and if anyone was to have a chance it would be you. I would cancel your remaining neurosurg sub is, and see if you can do any prs sub is.

And beofre you speak to prs chair might want to speak with neurosurg chair about your change of heart and ask for his "advice".
 
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I agree that I am confused that ram006 took one less research year, and still is one year behind. that means a two year differential.

Regardless, I agree with the advice given and the difficulties you will face with matching this year. However, your stats are very very good, and if anyone was to have a chance it would be you. I would cancel your remaining neurosurg sub is, and see if you can do any prs sub is.

And beofre you speak to prs chair might want to speak with neurosurg chair about your change of heart and ask for his "advice".


5 years of GS, 1 year of research, starting independent residency as a PGY6 (equivalent to an integrated PGY4) next month. Common pathway.
 
I agree that I am confused that ram006 took one less research year, and still is one year behind. that means a two year differential.

The fact that it is a two year differential bc I didn't make an upfront investment in my future was sort of my point...
 
Plastics fellowship is 3 years.

If you had matched the first time you would have been a year ahead.

I think these losses are miniscule in the grand scheme of things.
 
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Plastics fellowship is 3 years.

If you had matched the first time you would have been a year ahead.

I think these losses are miniscule in the grand scheme of things.

Yes, the independent plastic surgery RESIDENCIES are 3 years.

So, some basic math for you since this is just becoming annoying.

Since graduating from medical school in 2011, I've done 5 years of gen surgery and 1 year of research for a total of 6 years. My classmate did 1 year of research before matching into an integrated residency. He has thus completed a year of research and 5 years of an integrated residency.

So, after 6 years I am starting as a PGY4 independent resident while he will be in his PGY6 year as an integrated resident.

Minuscule losses? Not at all. Aside from the 500k-750k it's also two years my life. I think the sacrifice is worth it, but it's not nothing.
 
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Yes, the independent plastic surgery RESIDENCIES are 3 years.

So, some basic math for you since this is just becoming annoying.

Since graduating from medical school in 2011, I've done 5 years of gen surgery and 1 year of research for a total of 6 years. My classmate did 1 year of research before matching into an integrated residency. He has thus completed a year of research and 5 years of an integrated residency.

So, after 6 years I am starting as a PGY4 independent resident while he will be in his PGY6 year as an integrated resident.

Minuscule losses? Not at all. Aside from the 500k-750k it's also two years my life. I think the sacrifice is worth it, but it's not nothing.

Why cant you count? Calm down. I already did the math for you in the previous post.
You dont have to repeat me.

It is very naive to write off the two years because there are many things you would have seen in general surgery that would benefit you as a plastic surgeon too like separation of parts etc, breast surgery and reconstruction etc.

And like I said, if you had matched PRS the first time you would have been a year ahead. Could have gone one way or the other. Hindsight 20/20
 
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Checking back in here...

Ended up spending more time with PRS and figured out it really isn't for me. I'm glad you all gave me such great advice to pursue this further before committing because it helped me see how much I love neurosurgery and that it really is the right choice for me. Turns out, the malignancy of my home program was so off-putting that it made me reconsider my whole life. I spent a month at a different institution for an away and it was the greatest thing I have ever done.

Thanks again to everyone!
 
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