Preliminary Surgical Programs start?

[raidenxp2005]

hi

when do preliminary surgical programs usually start???

thanks

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[Winged Scapula]

There are no hard and fast rules about this by specialty. It is dependent on the specific program you are interested in.

It may be as early as the first week of June (I've heard as early as June 5) and as late as just a couple of days before July 1. Most have at least a week of orientation.

Best to contact programs you are interested in and ask them (although many may not yet have specific dates nailed down yet either).

 

[raidenxp2005]

thanks !!!

are they any special requirements i might need for preliminary surgery, in general?

 

[Blade28]

Are you thinking about applying for them during the Match? Outside the Match?

Are you using ERAS?

 

[raidenxp2005]

i want to use the match/ERAS.....but if i have to go outside of the match i would

so what do i need to secure a preliminary spot, in terms of them noticing/wanting me?

i know my score is low but i still want to do surgery!!!

i'm weighing the pro's and cons of preliminary and waiting or searching for a categorical spot

my stats are below

190/77 on step 1, IMG, graduated last month, A's in general surgery, Internal Med, Family Med rotations, have written a thesis on CABG and angioplasty?? plus i;m working on step 2 cs and ck

 

[Blade28]

By "thesis," do you mean you've submitted a journal article for publication? Or is this a paper for a Masters-type degree?

Have you begun to apply for a residency position yet?

How's the rest of your app? When are you taking Step 2/3? Letters of recommendation?

 

[raidenxp2005]

thesis meaning a master's type degree

i'm taking step 2CS/CK in april/may and step 3 in september

my letters of recommendation (3-4 in number) are great....from doctors who i have trained with....the general surgeon, i worked with trained at Cornell and i got A's from him.......i'm still putting my personal statement together

i haven't started to sign up for the match or eras because cash issues plus I want to apply to programs/residencies that would atleast consider me

 

[Winged Scapula]

The awful truth is as follows:

for FMGs, it (ie, being able to match) almost ALL comes down to your USMLE scores.

Your grades from a foreign school will be disregarded. Surgeons are not concerned about your grades in Family Medicine and most other rotations outside of surgery. Nonetheless, even "A" grades from a foreign school, especially one which is not well known, will not be included as a factor in the evaluation of your application.

Your letters from foreign physicians, even those who have done training in the US, will largely be disregarded unless they are widely recognized as an international expert.

Your graduate degree and thesis will be disregarded.

The best things you can do for yourself now:

pass and get a great score on USMLE Step 2; get ECFMG certified.

take USMLE Step 3 if you can

get a US visa (you will need one to come here and take Step 2 CS)

get US clinical experience (if you have none and are able to)

There are no specific requirements for Preliminary Surgery other than you be eligible for a US medical license and be ECFMG certified.

I'll be honest, with the information you have provided us, it will be a hard road to getting a categorical position. The longer you are out of medicine the harder it will be to find a position.

I used to recommend that people take Preliminary positions in an attempt to get a "foot in the door" to a Categorical track...the trouble is now there is a limit to residents of training in no more than 3 programs. If you cannot get a categorical spot in 3 years of different Prelim programs, then you are out of luck as far as finding a categorical position because most places will not take the chance on training someone who cannot be Board Certified. So I am at a loss as to what is the best road to try at this point in time.

 

[raidenxp2005]

thanks everyone

now i'll go kill myself

if i do go into a preliminary program and shoot for categorical PGY1 the following year ... will it make me more attractive for programs even with Step 3 added ??????

and does preliminary pay well..atleast well enough?

and what kind of visa do i need??

I don't mind going over PGY1 .... i will ask for a PGY2 but i'll accept PGY 1 as long as i'm on track with a categorical program

now i'm killing myself for sucking up to these loosers and their LOR's don't mean a $@#$%

 

[Blade28]

if i do go into a preliminary program and shoot for categorical PGY1 the following year ... will it make me more attractive for programs even with Step 3 added ??????

and does preliminary pay well..atleast well enough?

(1) Well what other options do you have?

(2) All PGY-1s at any given institution make the same salary. Usually it's around $37-43k.

 

[raidenxp2005]

okay

i've been getting advice from two forums, this one and usmleforum.com

one of the members from the matching and residency section said this,

quote

docsdoc - 01/28/08 12:12 Preliminary surgery is definitely easier to get into. But if you want to do Categorical surgery you are going to need to find a PGY-2 spot to transfer into the following year. This is extremely difficutl. It is almost impossible to start at PGY1 all over again as your funding will be limited to 5 years and no program is going to spend their own money to train you for one year. However if you want to start Cat. IM the next year, you can start PGY1 as IM is 3 years. It could be benificial as it is 1 year USCE. Good luck.


Even if i do a preliminary, dooing/finding a PGY-1 or PGY-2 will be difficult???

Surgery seems to be a stale mate no matter where i turn..... please any comments on the above statement?

 

[raidenxp2005]

(1) Well what other options do you have?

(2) All PGY-1s at any given institution make the same salary. Usually it's around $37-43k.

other options would be Family Medicine and Internal Medicine....i hate those but i was good enough for the doctors to take advice from...i read ACP Medicine religiously

i want surgery..... can't do another year without putting on my scrubs and getting all squeaky clean for OR......i love being in the hospital...to hell with 80hr a week !!....lets do 180hr. ..... living on red bull and starbucks...aahh, thats living the life for me

 

[Winged Scapula]

okay

i've been getting advice from two forums, this one and usmleforum.com

one of the members from the matching and residency section said this,

quote

docsdoc - 01/28/08 12:12 Preliminary surgery is definitely easier to get into.

That is definitely true. Preliminary surgery is a much easier match than Categorical General Surgery.

But if you want to do Categorical surgery you are going to need to find a PGY-2 spot to transfer into the following year. This is extremely difficutl.

Again, true. Your best bet in transferring into a Categorical Surgery position is at the program where you did your Prelim position. Open positions are few and far between and are often given to in-house candidates, so others never hear about them.

It is almost impossible to start at PGY1 all over again as your funding will be limited to 5 years and no program is going to spend their own money to train you for one year.

Perhaps. For candidates that a program is VERY interested in, they will not be as concerned about the decrease in funding. General Surgery positions are fully funded at 5 years in the US. Anyone who takes longer than that to train (ie, doing multiple Prelim or intern years, spending time in a research lab) will result in their program only getting 50% of the government funding for their position. This *may* be a drawback as programs would, in most cases, prefer a candidate who has the full 5 years of funding.

That said, a program that knows you...ie, you've spent your intern year there and they know how you work and what your skills are, *might* take a chance on you if they have a categorical position to give you.

These are a LOT of *mights*.

However if you want to start Cat. IM the next year, you can start PGY1 as IM is 3 years. It could be benificial as it is 1 year USCE. Good luck.

True. IM is not an easy match, but it is easier than general surgery at most programs. Whether or not it is beneficial as USCE for someone who wants to be a surgeon is debatable, but at least if you do an IM year, you can stay in IM training and complete that.

Even if i do a preliminary, dooing/finding a PGY-1 or PGY-2 will be difficult???

Yes. There are many more people who want to do surgery than positions open. A PGY-2 position depends on someone dropping out, being fired or dying...rare occurences, although the general surgery attrition rate is approximately 20%. There are no guarantees that you will be able to get a categorical position having completed a Prelim spot...BUT its your only chance. You need to weigh how much work and money you want to put into this effort...you at least owe yourself one chance to try and get into a program.

 

[raidenxp2005]

The awful truth is as follows:

I used to recommend that people take Preliminary positions in an attempt to get a "foot in the door" to a Categorical track...the trouble is now there is a limit to residents of training in no more than 3 programs. If you cannot get a categorical spot in 3 years of different Prelim programs, then you are out of luck as far as finding a categorical position because most places will not take the chance on training someone who cannot be Board Certified. So I am at a loss as to what is the best road to try at this point in time.

okay i've only graduated in 2007 December...i'm off now from any other medical work to study for step 2 cs/CK and 3.......wouldn't a year of preliminary be good enough?.....i'm not looking to go thru 2-3years of preliminary programs...i just want to improve my application appearance to programs so i can be accepted...i just can't stand Internal Medicine or Family Med.........plus i'm not looking for a top brass university-hospital...i'm pretty much lowering my standards here....so i'm take a community program at this point

 

[Pir8DeacDoc]

Getting a prelim really isn't the issue. The issue is what are you going to do with yourself after that? Why didn't you apply for the match this time?

 

[Winged Scapula]

okay i've only graduated in 2007 December...i'm off now from any other medical work to study for step 2 cs/CK and 3.......wouldn't a year of preliminary be good enough?.

Maybe, maybe not. General surgery is more competitive than it used to be and after completing a year of Prelim Gen Surg you are competing against hundreds of others who are also looking for a categorical spot. Doing a year of Prelim Surgery is a good way for programs to see that you can handle the work but the fact is that there are more applicants, with better scores, US citizenship, etc. than there are positions.

....i'm not looking to go thru 2-3years of preliminary programs...i just want to improve my application appearance to programs so i can be accepted..

I know you're not...the point I was making is that you MIGHT have to, that there is no guarantee that you will get into a categorical surgery position after just 1 Prelim surgery year. And if it takes 2 or 3 years, are you willing to do that (bearing in mind that you cannot be at more than 3 programs total to be Board Eligible). If you do well during your Prelim year, you may get lucky and get a categorical position, maybe even as a PGY-2, but you need to be ready for the possibility that you won't. There are a LOT of FMGs languishing in Prelim spots all across the country, many of them with no hope of ever getting into a Categorical position. Some of them have been treated poorly by programs, and never had a hope of doing so, but were led to believe that they would...others simply do not have the qualities that programs are looking for to push them ahead of everyone else applying.

.

i just can't stand Internal Medicine or Family Med..

This was suggested by usmle.org as you quoted. I know what its like not to enjoy other fields, but you have to be realistic with a USMLE Step 1 of 77, no US letters, no USCE and non-US citizen, you are behind the 8 ball when it comes to desirable attributes that US program directors are looking for. So considering other options at this point is prudent.

......plus i'm not looking for a top brass university-hospital...i'm pretty much lowering my standards here....so i'm take a community program at this point

To be honest, that is most likely the only chance you will get. When I say that general surgery is a more competitive match and that it will be difficult for you, I don't mean just at top brass university hospitals but ANYWHERE.

Obviously if you do MUCH better on USMLE Step 2, that can alter your chances but there isn't anything you've told us that would make a US program director, even at a community hospital, consider you a competitive candidate. You probably CAN get a Prelim Surgery position, but as asked above: what THEN will you do if you can't get a categorical position?

 

[chrisisinnocent]

I hate to rain on your parade but with a 190 on your Step I you will be much better off shooting for surgical training in your own country. It would be difficult even for a US grad to get a spot with that score.

 

[raidenxp2005]

to previous persons.....

i don't want to do a surgical residency in my country because most of the ppl there think their God even the residents....plus the program doesn't teach squat other than be on time and do some minor appendectomies...the whole point is, the guys are a-holes, no professionalism AT ALL!!! .... if u're a cute resident and u can't make the grade...35mins. on the beach with the program director would make u a possible candidate for chief resident.... and i'm not kidding!!!

okay, back to the point.....how well do i have to do on step 2 or even step 3 to be considered for a spot even with one year preliminary???

 

[Blade28]

It doesn't matter what score we say, right? Because you're going to study hard and try to do as well as you can anyway, right?

I mean, always shoot for the top score possible! In this case, shoot for a 99!

Why shoot for anything less?

 

[gutonc]

I think we need to back up here. Am I correct in assuming that the OP, an FMG, is talking about applying for surgery this cycle? And that his Step 1 score blows goats, even for an AMG? And that he hasn't taking Step 2 yet? And that he hasn't even completed ERAS yet or actually submitted any applications? If I'm off on any of this, that's cool (and I apologize). If the OP is trying to get in on the current cycle...you're kind of hosed.

 

[raidenxp2005]

THANKS GUYS.....

IT SEEMS LIKE FAMILY MED MIGHT BE AN OPTION.....

BUT MY GRADE IS GOOD ENOUGH FOR A RESIDENCY IN FAMILY MEDICINE IN NY RIGHT?? I MEAN THAT KIND OF SPECIALTY SHOULDN'T BE TOO HARD TO GET WITH MY CREDENTIALS, RIGHT?

IF IT'S NOT, MY LAST AND FINAL OPTION WOULD BE TO DO PEOPLE'S TAXES...BUT I FIND THAT TOO BORING...

 

[raidenxp2005]

I think we need to back up here. Am I correct in assuming that the OP, an FMG, is talking about applying for surgery this cycle? And that his Step 1 score blows goats, even for an AMG? And that he hasn't taking Step 2 yet? And that he hasn't even completed ERAS yet or actually submitted any applications? If I'm off on any of this, that's cool (and I apologize). If the OP is trying to get in on the current cycle...you're kind of hosed.

I'm applying for the 2009 match...not now because I have some stuff to deal with before I head for North....

 

[Blade28]

THANKS GUYS.....

IT SEEMS LIKE FAMILY MED MIGHT BE AN OPTION.....

BUT MY GRADE IS GOOD ENOUGH FOR A RESIDENCY IN FAMILY MEDICINE IN NY RIGHT?? I MEAN THAT KIND OF SPECIALTY SHOULDN'T BE TOO HARD TO GET WITH MY CREDENTIALS, RIGHT?

Argh! No "all caps lock" please!

Do you have to be in New York?

For most fields, doing well on Step 1 and 2 CK will help a lot - as well US clinical experience and letters of recommendation from US physicians. This is important whether you're applying to General Surgery or Family Medicine.

 

[raidenxp2005]

u have a OCD thing going, blade28???

anyways, sorry for the all caps thing

 

[raidenxp2005]

Yes i have to be in New York

But scoring higher on my step 2 and step 3 wouldn't be enough??

I'd rather do a preliminary for Surgery than Internal Medicine....

I'd rather start getting my feet wet b4 taking a quick wipe on something i'd just have second preference for

 

[Blade28]

u have a OCD thing going, blade28???

You'll find it's a common complaint among all Internet users. Using all capital letters signifies you're "yelling," plus it's just difficult to read!

Of course a great Step 2 CK and Step 3 score will help you. But nothing is ever guaranteed - no one here will be able to predict what your chances are.

Edit: Hey I just remembered your name (and avatar - though isn't that Sub-Zero?) from a previous thread (from back in September):

http://forums.studentdoctor.net/showthread.php?t=448638

I just wanted to reiterate that with a Step 1 score of 190 on your second attempt, you gotta really do well on Step 2! Have you been studying since September?

 

[raidenxp2005]

yeah that is sub-zero.....i like how he looks but raiden can kickass

anyways, i would rather get a Family Medicine residency straight up....

maybe i can shoot for general surgery after Family Medicine....

and the reason why i want it to be in New York is because of my family and my wife to be and because I'm getting a place to live in for free ...all i have to do is pay for cable and internet

but i will still apply for Family Medicine and a preliminary of Internal Medicine just in case I don't get a spot for FM

but i'd still love to do surgery.....