MD Need advice/thoughts for PS Vascular Surgery, chronic pain, and Low STEPS

[Surgicalart]

I am a rising MS4 who wants to pursue vascular surgery integrated.

STEP1: 213
STEP2: 229
1 vascular case report under review
Surgery: HP

I had a leg calve perthes as a chid that took me out of school for periods of time and put me in a wheelchair fo3 years. After 4 surgeries I was able to regain some ROM and walk with a severe limp, but had chronic severe hip pain from limited ROM and osteonecrosis throughout the rest of my adolescence and college, and developed progressively worsening scoliosis partially from the leg length discrepancy but more likely d/t genetics ( mom and grandmother have it).

I Had a hip replacement before medical school as I knew the pain would severely impat me, which significantly improved my life and pain but i still have scoliosis which continues to worsen. As i lived with chronic severe pain for many years, I didnt really acknowledge that I was having intermittent mild back pain until a few months ago when i realized I had been constantly reajusting in chairs and cracking my back for almost 3 years now at a slowly inreasing frequency. Since my realization, I now notice it more, thus it bothers me more, and it has continued to worsen and is now occuring daily. I am constantly reajusting my position, tryin to crack my back, and moving around to resolve it (to no avail), especially while sitting or doing anything passive.

I strongly believe this pain has negatively affected my exam performance on shelfs/nbmes and especially STEP (longer length) as I am constantly reajusting and focusing on the pain instead of the test so I am unable to maintain solid focus.

Despite this, I have excelled in my rotations and am very good clinically. This is not to say I am notconstantly reajusting and trying to crack my back from pain but it appears the pain affects me/i notice and thus focus on the pain less when im actively doing things versus sitting and thinking.

I am trying to find a good way to include in my personal statement that this chronic pain has affected my focus and memory (there is a lot of literature supporting this) thus affecting my STEP scores, without having whoever reads it ask themseves “if this is affecting her memory/focus on tests then how wont it affect her focus/memory in surgeries?” I feel this is impt to include, because of how uncompetitive I am for vasular programs, and beause it is a personal challenge I have faced.

I’m looking for ANY thoughts/advice/suggestions/ideas that anyone has in my predicament and thank you in advance!!

---

Members don't see this ad.

 

[ndafife]

Do you have a way to address how your pain wont affect you during surgeries?

Because right now your explanation for 1 red flag (low Step scores) brings up another (can you physically handle vascular surgery residency).

 

[mimelim]

I would not bring this up. Personal statements for residency are not about challenges you faced or explaining deficiencies in your application. They are about, why vascular surgery. Beyond this, personal statements are not a major part of your application and the general maxim is that few personal statements help applications while many more hurt their applications. This is why. You are seeking to explain away something that can't really be explained away by opening a potential can of worms.

This in no way does not mean that I am not sympathetic to your situation or your physical issues. Chronic pain can drag down the strongest of people. It absolutely can tank someone's scores. But, this is just a practical reality of applying to one of the most competitive specialties out there. While in general the numbers game is a little silly, I would have significant reservations about your application. It is not atypical to be standing in the same position for 4+ hours. It is not atypical to be wearing heavy lead for 8+ hours in a day. You don't have to be super fit, but on going musculoskeletal issues are going to be severe limitations to your ability to function at a high level as a resident.

 

[doc05]

Why on earth would you consider vascular? Your chronic pain will become much worse with the long surgeries and wearing lead pretty much all the time.

 

[OrthoTraumaMD]

Why on earth would you consider vascular? Your chronic pain will become much worse with the long surgeries and wearing lead pretty much all the time.

Agree.


Sent from my iPhone using SDN mobile

 

[hopeful123456789]

I understand the concern for OP especially if he pursues a surgical specialty, but do all of you think that those with musculoskeletal problems should stay away from surgical/procedural specialties?

To the OP: I hope you find a good way to cope with the challenges you face right now and that they won't keep you out of your specialty of choice. Generally I would agree with the previous posts, as you would probably have a harder time to convince people to rank you. When you make people aware, they will likely have more difficulty seeing you as a successful resident. It may be unjustified, but keep in mind that these doubts are much harder to dispel than those caused by a low Step score.

 

[OrthoTraumaMD]

I understand the concern for OP especially if he pursues a surgical specialty, but do all of you think that those with musculoskeletal problems should stay away from surgical/procedural specialties?

I do not think that musculoskeletal issues by themselves should rule out a surgical specialty. I have met plenty of surgeons with problems ranging from hip dysplasia to amputations (legs). There is even an achondroplastic dwarf surgeon. But for someone with chronic pain, especially if they are on pain medication, it may behoove them to shadow the specialties and see if they are capable of prolonged activity in that specialty. All the people I mentioned found workarounds in terms of their problems. The person with hip dysplasia got absolutely jacked in their upper body, and was able to do all the necessary procedures in our field. Not that this is a problem, but significant physical weakness is also an issue when it comes to my job in particular, I was not very strong when I started and had to work out significantly in order to be able to do basic things. But the point is, you have to be able to DO the actual job.


Sent from my iPhone using SDN mobile

 

[hopeful123456789]

I do not think that musculoskeletal issues by themselves should rule out a surgical specialty. I have met plenty of surgeons with problems ranging from hip dysplasia to amputations (legs). There is even an achondroplastic dwarf surgeon. But for someone with chronic pain, especially if they are on pain medication, it may behoove them to shadow the specialties and see if they are capable of prolonged activity in that specialty. All the people I mentioned found workarounds in terms of their problems. The person with hip dysplasia got absolutely jacked in their upper body, and was able to do all the necessary procedures in our field. Not that this is a problem, but significant physical weakness is also an issue when it comes to my job in particular, I was not very strong when I started and had to work out significantly in order to be able to do basic things. But the point is, you have to be able to DO the actual job.


Sent from my iPhone using

Thank you for elaborating. Obviously you should be able to actually practice the specialty you are hoping to train in. So far all my classmates (with comparatively mild illnesses or ANY disability) who voiced an interest in surgery were openly discouraged. Unfortunately their interest was not only met with concern (as above) but they were often ridiculed if not humiliated for their "audacity" to see surgery as a career choice. Hopefully the OP won't face quite this much (hurtful) commentary. Also, would you mind giving a few examples of the "workarounds" the surgeons came up with?

 

[OrthoTraumaMD]

Thank you for elaborating. Obviously you should be able to actually practice the specialty you are hoping to train in. So far all my classmates (with comparatively mild illnesses or ANY disability) who voiced an interest in surgery were openly discouraged. Unfortunately their interest was not only met with concern (as above) but they were often ridiculed if not humiliated for their "audacity" to see surgery as a career choice. Hopefully the OP won't face quite this much (hurtful) commentary. Also, would you mind giving a few examples of the "workarounds" the surgeons came up with?

Well as I said, the person with hip dysplasia became an upper body bodybuilder in order to be able to handle the physical tasks. The dwarf surgeon I’m pretty sure uses a stepstool. Etc.


Sent from my iPhone using SDN mobile