Why is PRS so competitive?

[asmallchild]

Habeed, you are going to be mowed down in medicine if you dared to display in person even a fraction of the stubbornness you display online.

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[Habeed]

Habeed, you are going to be mowed down in medicine if you dared to display in person even a fraction of the stubbornness you display online.

That's right. Whenever someone else is clearly wrong, I should just roll over and acknowledge that because they have more knowledge than me on paper they must be right.

You know, no need for me to check for proof or anything...

Since "Blond Docteur" allegedly has more education than me, according to his anonymous online profile, when he says that a USMLE score has a standard deviation of 15, and a 260 is three standard deviations from the mean he must be right.

Not like it says "standard deviation of 24" on a USMLE score report, making a 260 less than 2 standard deviations from the mean.... No sir, it's not there in black and white.

 

[DHT]

This probably doesn't matter seeing as you have just gotten yourself banned, but I suspect by your subborn nature you will be back under a different name anyway.

I just wanted to clarify a few things:

BlondeDocteur is female.

USMLE scores are not a perfect bell curve. The curve is negatively skewed which means the SD below the mean is greater than the SD above. Even by that score report you posted, it says that "Most scores fall between 140 and 260." I'm not positive on how they determine this but it seems like there is a wider range below the mean than above it.

If you don't believe me you can go to that NRMP document you love so much and simply add up all the scores >260 and compare that to the total number of test takers. I believe BlondeDocteur already did that for you in a previous post.

The attendings and residents you work with WILL be wrong from time to time. It happens to everyone. Usually it is best to just let it go, but if you must confront the issue (which I suspect you will every time) the best thing to do is politely explain what you were thinking and then let it go immediately if they don't realize their error. Chances are they were right to begin with and you just got things jumbled in your head (you learn so much in the first 2 years its easy to do), but if they were wrong, you making a big deal and fighting them about it will get you poor evaluations and label you as someone they would never want to work with which will hurt you far worse than them thinking you were wrong about something.

I don't know what kept you out of Med School for 5 years, but I promise you that personality is VERY important in achieving your goals - especially during 3rd and 4th years.

 

[Domperidon]

Nobody cares if "x member" is male, female or something in between...

Why was he banned anyway? I suspect you guys are getting a little too touchy... just state your opposite opinion and move on, no need to shut down people.

 

[core0]

Nobody cares if "x member" is male, female or something in between...

Why was he banned anyway? I suspect you guys are getting a little too touchy... just state your opposite opinion and move on, no need to shut down people.

Probably this one
http://forums.studentdoctor.net/showthread.php?t=612549
Although other posts were also skirting the banhammer.

 

[SouthernSurgeon]

Nobody cares if "x member" is male, female or something in between...

Why was he banned anyway? I suspect you guys are getting a little too touchy... just state your opposite opinion and move on, no need to shut down people.

Probably the fact that last night he started a thread titled "how can I get banned?" then proceeded to start troll threads in the pre-allo, allo, military, and gen surgery forums.

 

[asmallchild]

Nobody cares if "x member" is male, female or something in between...

Why was he banned anyway? I suspect you guys are getting a little too touchy... just state your opposite opinion and move on, no need to shut down people.

Mocking blind people while simultaneously antagonizing all members of SDN as a lowly med student usually gets the mods to wield the mighty banhammer too.

 

[What the pho]

Question for you attendings: is this the medical equivalent of a Napoleon complex?

I think that you are one with the napoleon complex with your grad school and med school in your signature, so that everyone can see with every post of your's your greatness.

I don't need to put in my sig that I went to a top med school and I'm at a top derm program, because people already know derm is the tuffest to match. Just go to the nrmp it well tell you the same: http://www.aamc.org/newsroom/pressrel/2009/090319.htm

"Dermatology, neurological surgery, orthopaedic surgery, and otolaryngology were the most competitive specialties for medical school seniors."

Why would you let us know that exactly? Did you think "I'll prove how awesome and supergenius I am, then they'll realize how much cooler derm is!"? Statistics weren't working, but your board score was going to be the clincher?

I almost find your statements scary, because someone being devoid enough of self-awareness to think that anyone -- derm, plastics or garbage man -- was going to respond positively to them is amazing.

I let you know that because in your post you said that derm and plastics people have no overlap. I disagree and say that they do. I point to myself and to the usc (unmatched derm applicant but scrambled plastics) guy. I know a handful of others who have done the same because they can. You know the type, the ones that have to be the top of the heep, the most alpha in whatever they do, with blind ambition. Just go to the dropping out of intergrated thread and you'll see the types that I'm referring to. I'll quote GSresident those "pursuing plastics for the wrong reasons - glamor, status, money etc. Or perhaps they wanted to prove something to someone, that they were worthy of matching into a competitive specialty." I say that these types have alot of overlap in derm and plastics. Those that choose derm do so for the lifestyle, and in the end many call themselves cosmetic surgeons and do a number of cosmetic procedures (some doing breast aug face lifts, rhinoplasty etc.). Just google it you'll find dermatologist doing these procedures.

I'm not trying to say that I'm awesome and a supergenius, you sound like a five year old trying to put words in my mouth. I actually admit that I'm average (for derm that is). I don't really care if you respond postively to my statement, cause I'd expect your ego's are unable to take the blow that your are not the biggest studs. And you guys have proved me right by not attacking my arguments like most adults do but by attacking me. Go back to your psych books cause I guess you missed it in your step 2 and you'll see that this is an immature defense mechanism. I rest my case and well leave you guys to your ad hominem on this thread. Now if you guys want to do some name calling in another thread, trust me I'm really ghetto, and have some your mama jokes that well make you cry and tap out. Until then piece out.

 

[BlondeDocteur]

I think that you are one with the napoleon complex with your grad school and med school in your signature, so that everyone can see with every post of your's your greatness.

I don't need to put in my sig that I went to a top med school and I'm at a top derm program, because people already know derm is the tuffest to match. [ Just go to the nrmp it well tell you the same:] (run-on) http://www.aamc.org/newsroom/pressrel/2009/090319.htm

"Dermatology, neurological surgery, orthopaedic surgery, and otolaryngology were the most competitive specialties for medical school seniors."



I let you know that because in your post you said that derm and plastics people have no overlap. I disagree and say that they do. I point to myself and to the usc (unmatched derm applicant but scrambled plastics) guy. I know a handful of others who have done the same because they can. You know the type, the ones that have to be the top of the heep, the most alpha in whatever they do, with blind ambition. Just go to the dropping out of intergrated thread and you'll see the types that I'm referring to. I'll quote GSresident those "pursuing plastics for the wrong reasons - glamor, status, money etc. Or perhaps they wanted to prove something to someone, that they were worthy of matching into a competitive specialty." I say that these types have alot of overlap in derm and plastics. Those that choose derm do so for the lifestyle, and in the end many call themselves cosmetic surgeons and do a number of cosmetic procedures (some doing breast aug [,] face lifts, rhinoplasty etc.). [Just google it you'll find dermatologist doing these procedures.]

I'm not trying to say that I'm awesome and a supergenius, you sound like a five year old trying to put words in my mouth. I actually admit that I'm average (for derm that is). I don't really care if you respond postively to my statement, cause I'd expect your ego's are unable to take the blow that your are not the biggest studs. And you guys have proved me right by not attacking my arguments like most adults do but by attacking me. Go back to your psych books cause I guess you missed it in your step 2 and you'll see that this is an immature defense mechanism. I rest my case and well leave you guys to your ad hominem on this thread. Now if you guys want to do some name calling in another thread, trust me I'm really ghetto, and have some your mama jokes that well make you cry and tap out. Until then piece out.

two sixty whatsit?

 

[What the pho]

two sixty whatsit?

Wow big deal. Your grammar and spell check is better then mine. I bow down.

My arguments are still valid, didn't know I was writing an essay for english class, oh actually I wasn't. That's some pre-allo stuff they're always pulling correcting peoples grammar and spelling. Correct your senior's or attending's grammar in the O.R and see where that gets you. I speek 2 other languages and english isn't my primary. I've got a word for you english/grammar nazi from the mcat verbal section, can we say pedantic. Next time I post I'll get my med student to proof read it for me and correct it to please your great ivy leagueness, yeah right.

 

[asmallchild]

You seem unusually angry for a derm resident

 

[...to_the_OR!]

Those that choose derm do so for the lifestyle, and in the end many call themselves cosmetic surgeons and do a number of cosmetic procedures (some doing breast aug face lifts, rhinoplasty etc.). Just google it you'll find dermatologist doing these procedures.

So derm is so much hotter than plastics and one of the reasons is that they do plastic surgery?.... Good stuff. BTW derms, dentists, and OB-GYNs doing augs is friggin nuts. I just don't get it... If you want to do plastic surgery, then train in plastic surgery. I am not gonna try to deliver babies. Doing surgery outside of your specialty's scope of practice for the cash it brings is unethical... But maybe that cash could buy you a spiffy new suit for court. That'll impress all us plastic surgeons too, just like your board score.

 

[Domperidon]

You seem unusually angry for a derm resident

Maybe he is, but he's also right. What sense does it make to underline irrelevant spelling errors? What does it add to the argument?

 

[VincentAdultman]

Boy I'd be bitter too if I worked so hard in medical school only do something so mundane as to pop pimples as a living.

Hey let me prescribe some cortisone for that....

 

[BlondeDocteur]

Maybe he is, but he's also right. What sense does it make to underline irrelevant spelling errors? What does it add to the argument?

It's only relevant when you brag about having, as someone in the neurosurgery forum recently said, "genius-level smarts." Then it's amusing.

 

[asmallchild]

Boy I'd be bitter too if I worked so hard in medical school only do something so mundane as to pop pimples as a living.

Hey let me prescribe some cortisone for that....

Now now, some of us actually find that to be very rewarding work

 

[What the pho]

Um, no.

A max of 15 points = 1 standard deviation. (Many argue it's actually 10-12 pts).

215 is the 50th percentile.

Therefore, (260-215) = 45 = 3 SDs.

As Barbie says-- math is HARD.

It does appear hard for you so does reading comprehension. The premed was schooling you on what the SD of the usmle is, and even posted a score report to show you this. When I took my boards the sd wasn't 15 and hasn't been in a long time. Even when someone post evidence contrary to your beliefs you can't admit you're wrong. Great evidence medicine practionar you'll be. Is your ego so big already that you can't take the hit of being wrong, I'd hate to be around you if and when you do match. I don't think your ego could fit in the O.R.

So derm is so much hotter than plastics and one of the reasons is that they do plastic surgery?.... Good stuff. BTW derms, dentists, and OB-GYNs doing augs is friggin nuts. I just don't get it... If you want to do plastic surgery, then train in plastic surgery. I am not gonna try to deliver babies. Doing surgery outside of your specialty's scope of practice for the cash it brings is unethical... But maybe that cash could buy you a spiffy new suit for court. That'll impress all us plastic surgeons too, just like your board score.

Never said derm was hotter because of that. I did say derm is harder to match, and hotter because of the life style. I personally won't practice outside my scope. I well do lipo, hair transplants, lasers, fillers, and local flaps. And even if I did want to do breast and stuff I'd just get boarded in "cosmetic surgery" and get a boarded "cosmetic surgeon" to defend me in court if need to testify against a boarded PRS expert. Just look at one of your most famous guys on T.V. (Dr. 90210) he isn't even BC'd.

You seem unusually angry for a derm resident

Oh I'm not angry, I'm very happy with my work and free time. You soon well be too. I just can't stand these big ego types who can never admit they are wrong and think their specialty is the hardest to get into when it is not.

Boy I'd be bitter too if I worked so hard in medical school only do something so mundane as to pop pimples as a living.

Hey let me prescribe some cortisone for that....

I'm not bitter it's just a job I don't need excitement from it. I get enough excitement in my life outside of medicine, something you might not know about since you live in the hospital.

It's only relevant when you brag about having, as someone in the neurosurgery forum recently said, "genius-level smarts." Then it's amusing.

Again I see your reading comprehension isn't working for you. I already said I'm not a genius I'm actually average (for derm). Yes I do have hi board scores but last I checked no spelling or grammar was on step 1. You should've looked into that and maybe you would of scored higher on your boards. Hence wouldn't have to take a year off to beef up you application for plastics. Everyone knows that the strength of an application is inversely related to amount of time doing research or other activities beefing it up. If you were as great as you think you are, you would've matched only doing 4 years of med school.

Again I've never claimed to be a genius just because you feel inadequate about someone else's boards score being higher then yours maybe you should have spent less time studying spelling and grammar and more time on path. Getting hi boards is just memorization and some pattern recognition, it's not rocket science. It's not my fault you couldn't score above 240, and are not a strong plastics applicant, maybe you should try the g-surge route first.

Now as jackie chan would say "dooo yuooo undastan da wooords dat r comming ou of my mou?"

I told ya'll I had some jokes/insults that would make you want to tap out. Since you guys won't stick to the augments and only do personal attacks, seems you can't better me on that ether.

Oh one more thing is my grammar/spelling good enough for your greatness. To bad I don't really care, if this was an english lit forum for PhD's I would but it's not.

I'm out, now if anyone wants to go back to the arguments/debate I'm all for it. If you want to continue with the personal attacks I say lets go to the lounge and I'll be more then happy to exchange insults with you there.

 

[asmallchild]

Oh I'm not angry, I'm very happy with my work and free time. You soon well be too. I just can't stand these big ego types who can never admit they are wrong and think their specialty is the hardest to get into when it is not.

Off topic, but, I really really really cannot wait to start!

 

[BlondeDocteur]

Pho, I don't have a problem admitting I was wrong about the SD on the boards. I was going to tell Habeed that, but he got banned for being an ass.

I was quite correct about what kicked the whole argument off-- that "4%" of people score >260. Less than 300 people a year achieve scores in that range. Which simply confirms what everyone already knew-- you need a z-score to convert to percentile rank, since the scores are not normally distributed.

Which means your own high scores are a real accomplishment-- I'm sure you worked hard for them, and it's awesome that you did so well after immigrating from Vietnam, learning French as your second language, etc.

However, you kickstarted this whole train wreck by coming on and claiming that derm was superior to plastics and that you outscored most people matching into PRS, etc, so the sudden humble change of heart rings a little false.

And how dare you expose my 191! I worked hard for that!

 

[DHT]

A SD of 24 to my knowledge is the highest its been in recent years. Usually its closer to 20. As I said in my post, the bell curve is negatively skewed which means the SD above the mean is actually less than that which is noted, probably closer to 15-17. There is no way to get a percentile without a z-score as BD stated. The best thing you can do is add up all the scores on the NRMP match data and figure out that a 260 >99%tile.

Attacking someone's board score is pretty classless and adds nothing to your argument.

The plastics world is not especially proud of Dr. Rey. In fact, he is part of the reason I am not interested in plastics.

Anyway, this entire fight about plastics vs derm is ******ed. It doesn't matter at all, shouldn't you be picking your specialty based on what you like? That being said, I would be more nervous (I'm not saying it is more or less competitive) about applying to Derm because my step 1 also falls in the >260 range and statistically speaking a higher % did not match in my score range. However, there are more spots for people with lower scores to get spots in Derm. So they are both very competitive in their own ways. Why is this? Maybe there is more "who you know" in the Derm match, where plastics may focus more on numbers? Maybe its harder to come up with a convincing answer for "why do you love derm" - thus weeding out some of the 260s. I don't know and I don't care. The bottom line is it doesn't matter at all and this entire thread is stupid.

 

[What the pho]

Pho, I don't have a problem admitting I was wrong about the SD on the boards. I was going to tell Habeed that, but he got banned for being an ass.

I was quite correct about what kicked the whole argument off-- that "4%" of people score >260. Less than 300 people a year achieve scores in that range. Which simply confirms what everyone already knew-- you need a z-score to convert to percentile rank, since the scores are not normally distributed.

Which means your own high scores are a real accomplishment-- I'm sure you worked hard for them, and it's awesome that you did so well after immigrating from Vietnam, learning French as your second language, etc.

However, you kickstarted this whole train wreck by coming on and claiming that derm was superior to plastics and that you outscored most people matching into PRS, etc, so the sudden humble change of heart rings a little false.

And how dare you expose my 191! I worked hard for that!

Okay now we are making some progress and can have a discussion without name calling. It takes big ovaries to admit you're wrong and maybe at M&M you won't be pointing the finger at other people but learning from it.

1. I wasn't trying to kick off any train wreck but I was trying to correct him O.P. when he said this.

Why do you think PRS is THE most competitive residency right now?

My argument before being called troll or napoleon complex was that it is not. Granted if you look at the mean usmle step 1 for plastics being 240 something and derm being around 238, plastics does appear more competitive. But if you look at other measures like % AOA and the fact that getting over 260+ doesn't have a 100% match rate then I'd say derm is in that since. If you look at those with 260+ applying plastics the match rate is 100%. That's better then what my cure rate is when I cut out skin cancer X with X mm margins or mohs.

2. Then I was trying to correct some med student's (who probably doesn't know to much about derm) assertion when they said this

Plastics is a surgical residency. They get to operate and work in the OR a lot. For someone who enjoys operating, derm is never really an option, because it's so non-surgical in nature.

Furthermore, derm involves a LOT of clinic. LOTS of it. Considering how much surgeons tend to dislike clinic, I can't see them ever seriously entertaining the idea of doing a mostly clinic-based specialty such as derm.

And I was trying to tell them we do operate and do surgeries so their assertion that derm is "non-surgical" is false. I know plenty of people who go into derm with the specific goal of doing a mohs/procuderal fellowship. Lets define surgery "a branch of medicine concerned with diseases and conditions requiring or amenable to operative or manual procedures." I cut out skin cancer everyday so by definition I do surgery everyday. Does this not look like surgery?

3. Then I wanted let this guy below know just because he hadn't seen it in all his wisdom as a med student, doesn't mean it doesn't exist.

I can't say there's any overlap at all between the "plastics people" and the "derm people" in my class or older classes. The plastics people were considering other surgical specialties and the derm people.. well they figured out derm was a good gig in 2nd year and never looked back.

So I told him about the unmatched derm guy who scrambled into plastics and myself who applied both as evidence that some of those people do overlap. Also I do this

to repair this

about once a month. This doesn't look like derm plastic overlap to you?

4.Then I had to deal with statement

The MOHS fellow got to that position after completing a mostly non-surgical derm residency. That's like saying that radiology ought to be considered a surgical specialty because you can do an IR fellowship after it. Please. Let's not start clutching at straws here.

I do mohs about every week in my procedure clinic and again there are those who go into derm with the specific intent to do derm surgery. There are rads guys who don't do IR fellowships who do almost all IR. At the county hospital where I did my internship this was common due to lack of resources so it's not like clutching straws but more like this person putting words in my mouth. Rads get 16 weeks of IR in their res more if they have an interest and do their electives in it.

5. Then I had to counter your mods argument below.

You're confusing a term Klein coined ("tumescent technique") with what was actually being done years before - tumescent liposuction. Illouz (and Fournier to a lesser extent) were really the ones who pioneered and popularized tumescing tissue with fluid containing adrenaline and local anesthetic in the 1970's.

With my quote from the literature http://www.ncbi.nlm.nih.gov/pubmed/9...?dopt=Abstract

"In 1982, Illouz in France began injecting hypotonic saline into his operative sites on the premise that the saline solution would help rupture adipocytes. He called the solution the Wet Technique. Fournier, a colleague, later demonstrated that there was no more disruption with his dry technique(without saline injection) than with Illouz' wet technique.1,2 Their cases were performed under general anesthesia, and blood loss was a problem when aspirating 2000 cc or more of fatty tissue.

After my 1982 visit to Illouz, Dr. William Mathews and I began using a mixture of 0.3% lidocaine with 1:320,000 epinephrine, which was equivalent to 15 to 16 mg/kg of body weight .....

In 1993, Klein, a dermatologist, and an internist reported their results using a tumescent solution similar to Toledo's, which we adapted in 1989.7 Klein's safe lidocaine injection of 35 mg/kg of body weight was immediately popular, partly because of the eye-catching term"tumescent."

6. So you see Blondie I wasn't trying to say derm was superior to plastics, just that it is harder to match if you look at other measures. I also wasn't saying I outscored plastics people just that with my score I'd feel like this poster below

I would be more nervous (I'm not saying it is more or less competitive) about applying to Derm because my step 1 also falls in the >260 range and statistically speaking a higher % did not match in my score range.

I too was a cocky med student like other wannabe plasticos on here who thought I knew everything and had a humble change of heart ever since I matched derm and realized almost everyone is aoa and has stellar boards. This is maybe something you'll learn too when you do match plastics and find out how smart your coresidents are or everyone in your field is.

Attacking someone's board score is pretty classless and adds nothing to your argument.

Don't be so sensitive, I was just trash talking. I don't even know Blondies board scores. Relax we've got this love hate thing going on, she loves to hate me.

 

[VincentAdultman]

Someone is taking teh internets seriously.

Internet. Serious business.

 

[...to_the_OR!]

Pho:
1. The board of cosmetic surgery is garbage. Pretty sure it has nothing to do with the ABMS. I can type cosmetic surgeon on a piece of paper too.
2. Just cuz a prs surgeon is on tv doesn't mean anything - dr Rey is a punchline. I hate that people think he represents my specialty.
3. Derm's a rad specialty - super tough to get into, so I'd think people would want practice it since they worked so hard to get in. Tell your buddies to stick to skin and I'll stick to flaps, grafts, and implants. It'll work out great.
4. I get what you're saying, but in my mind the number of spots is a huge factor. It's like radonc or ped surg. Just the increased ratio of applicants to spots makes it tough. Also prs is a ridiculously small world, letters and who calls who is more important than a 260. Anything over 240 is really just splitting hairs.

 

[asmallchild]

Pho:
1. The board of cosmetic surgery is garbage. Pretty sure it has nothing to do with the ABMS. I can type cosmetic surgeon on a piece of paper too.
2. Just cuz a prs surgeon is on tv doesn't mean anything - dr Rey is a punchline. I hate that people think he represents my specialty.
3. Derm's a rad specialty - super tough to get into, so I'd think people would want practice it since they worked so hard to get in. Tell your buddies to stick to skin and I'll stick to flaps, grafts, and implants. It'll work out great.
4. I get what you're saying, but in my mind the number of spots is a huge factor. It's like radonc or ped surg. Just the increased ratio of applicants to spots makes it tough. Also prs is a ridiculously small world, letters and who calls who is more important than a 260. Anything over 240 is really just splitting hairs.

Regarding point #3, I've seen quite a few flaps and grafts done as part of MOHS surgery. (Obviously nothing huge like you would see in plastics). I'll agree with the implants. (Although I also interviewed at a program where the cosmetic dermatologist performed liposuction regularly)

 

[jaydoc07]

Why does the number of people over 260 not matching matter. That just means derm draws more people with great scores that happen to be tools or otherwise have a poor application. Not a strong argument. I really don't understand why the argument even persists. Who really cares which is "tougher to get into?"

Also, I can treat a rash. I treat at least one rash per month. A lot of my friends who are in peds treat rashes too. We don't call ourselves dermatologists. Just because you can rotate a PMFF doesn't make you a surgeon. BTW...I can change my oil. Does that make me a mechanic?

 

[asmallchild]

Who are you addressing? I never said dermatologists needed surgeon in their title. I was saying some of the procedures overlap between the two fields (albeit on a much smaller level in dermatology)

 

[DHT]

I'm glad we can all start getting along now.

Pho, I'm very happy that you do not actually know BD's step 1. I didn't know it either but it makes the trash talking a little more acceptable. I get real fired up when someone uses sensitive material which someone divulged in order to insult them.

Back to why I think plastics is so competitive:
1. Number of Spots
2. Number of Spots
3. Number of Spots. I honestly believe that if you took the top 100 applicants to Derm, Ortho, Neurosurg, RadOnc, and Rads (sorry if I left other competitive things out, but this is off the top of my head and I've been drinking), you would have very similar statistics. By virtue of having so few spots, the programs get to choose from the very best applicants.
4. Controllable lifestyle - Big draw for those coming from GS.
5. Option for cash procedures - just incase we go socialized (won't happen, but big draw for fresh applicants)
6. Operate on all age groups and relatively healthy patients (excluding wound care)
7. Variety of cases - many claim to be their #1 reason for choosing plastics (but I think their #1 is really 4 or 5 based on their background).

 

[Tristero]

You can have Dr. Klein, I'll stick with Harry Buncke, the inventor if microsurgery. Or better yet, Joseph Murray, plastic surgeon and Nobel prize winner for the first successful organ transplantation.

I am a PRS resident, early in my training. I will readily admit, there are many nights on hand call when I wish I was a derm resident. Everytime I get into the OR, though, its easy to remember why I made my choice. And I'd do it again a thousand times over.

Those are some nice excisions and flaps, but I'm sorry that doesn't make you a surgeon in the true sense.

That basal cell excision looks a bit icky. How about a paraspinal advancement flap over an inch of exposed dura, hardware, and kyphotic spine. Or a ventral hernia repair that the GENERAL surgeons need help closing. Or NOE/frontal sinus where we have to reconstruct the frontal bone and orbit. We did all these cases on the SAME day, with the SAME attending.

Pho, Habeed I hope y'all have a great time in dermatology--its a fun, intellectually rewarding, and lucrative career, Oh, and thank you for liposuction.

We (plastic surgeons) sacrifice our lifestyles to develop technical skills, problem solving abilities and creative judgment. Even if we're years out and wildly successful in private practice. Ask Sherrell Aston. I did- the dude works like 80 hours a week. That being said, I do feel like our specialty tends to attract a "work hard, play hard" personality.

 

[GSresident]

This is an entertaining read. I've gone through a couple bags of popcorn already. I can't say that I understand why it is important which specialty is more competitive, but watching the argument is entertaining. I think Andy Kaufman may have come back from the dead to post a couple times. There are a couple of Tony Clifton characters that I just love. Its too bad one of them got banned. I think that must be why I like watching UFC so much - I love a good fight. Verbal fights are far more entertaining than physical ones.

I got a chuckle that I was quoted out of context by someone. Seriously people, don't put too much weight to what I say. I'm just once voice with one perspective on things.

 

[MOHS_01]

Echo.... what GS said. This d*ick measuring contest has been amusing.

 

[Habe3d]

Indeed.

 

[VincentAdultman]

 

[asmallchild]

Derm: mostly clinic-based, 40-50 hrs per week, 4 yr residency with no in-house call, cool cases = local flaps for mohs recon, occasional blephs, and tumescent liposuction

PRS: mostly OR and hospital based, 60+ hrs per week, (80+ in residency), 6-7 yr residency with in-house call for at least the first 3 yrs, cool cases = 24hr chimeric free flaps, pan-facial fractures, cranial vault remodeling, extremity replantation, sexual reassigment, composite tissue allotransplantation

Disclaimer: I am a PRS resident. Every morning when I wake up at 4, and every night that I stay at the hospital seeing nec fasc consults I wish I was a derm resident. And every time I do a case I take it back.

I think this sums it up perfectly

 

[Mortal_Lessons]

We had a dermatologist lecture us the other day and he referred to himself as a cutaneous oncologist.

 

[235750]

Which simply confirms what everyone already knew-- you need a z-score to convert to percentile rank, since the scores are not normally distributed.

A z score = (x-μ)/σ, so basically its how many standard deviations you are from the mean...so it's only helpful to convert to percentiles when you look at normally distributed scores. With non gaussian data using standard dev is not that helpful

Maybe a third masters is in order?

 

[What the pho]

Someone is taking teh internets seriously.

Internet. Serious business.

Don't you got some carpentering to do or some bones to brake.

Pho:
1. The board of cosmetic surgery is garbage. Pretty sure it has nothing to do with the ABMS. I can type cosmetic surgeon on a piece of paper too.
2. Just cuz a prs surgeon is on tv doesn't mean anything - dr Rey is a punchline. I hate that people think he represents my specialty.
3. Derm's a rad specialty - super tough to get into, so I'd think people would want practice it since they worked so hard to get in. Tell your buddies to stick to skin and I'll stick to flaps, grafts, and implants. It'll work out great.
4. I get what you're saying, but in my mind the number of spots is a huge factor. It's like radonc or ped surg. Just the increased ratio of applicants to spots makes it tough. Also prs is a ridiculously small world, letters and who calls who is more important than a 260. Anything over 240 is really just splitting hairs.

1. Agreed. That's why I brought it up as joke. After doing a peds internship one could probably get boarded as a cosmetic surgeon, and the lay people who sit on the jury in court well suck it up like banks are sucking up ballout packages.

2. Agreed. A big joke. You guys need to do some serious PR work and get people to understand this.

3. Agreed, derm is rad, but I'll stick to skin and still do local flaps and smaller grafts. Implants you can have. Now if the I.D. guys can find a cure for HIV I'll let you guys put in a penis implant in me, I'll quit medicine and become a porn star.

4. Agreed too, only thing is I think after above 250 that is just a matter of luck on that day. So yeah if you look at mean usmle and # spots to those applying I give it to PRS. If you look at % AOA and that getting 260+ isn't a 100% match rate I give it to derm. Looks like we can agree on stuff. I just wanted others to consider other measures and that PRS wasn't the undisputed champ with no one worth going into the cage with.

Why does the number of people over 260 not matching matter. That just means derm draws more people with great scores that happen to be tools or otherwise have a poor application. Not a strong argument. I really don't understand why the argument even persists. Who really cares which is "tougher to get into?"

Like I said above, just wanted others to consider other measures and that PRS wasn't the undisputed champ with no one worth going into the cage with.
Also if you didn't care which is tougher then why are you posting on this thread responding to me. Walk away it will be okay or try the ignore this thread key/option.

As for drawing more tools I total disagree. I think PRS draws more tools with god complexes, that's why all those with 260+ matched. You know those tools I'm talking about. Think they know everything, and are big studs in the OR but take them to a bar and try to talk to some girls then they withdrawl to the dweebs they are and only able to talk work, have no game with the ladies. Derm can and rather fill their spots with social well adjusted glamazon model types with 240s then toolish 260s. Just go to any one of our meetings and you'll see the hottest female physicians of any specialty.

Also, I can treat a rash. I treat at least one rash per month. A lot of my friends who are in peds treat rashes too. We don't call ourselves dermatologists. Just because you can rotate a PMFF doesn't make you a surgeon. BTW...I can change my oil. Does that make me a mechanic?

If you treated a rash everyday for 3 years this still wouldn't make you a dermatologist, throw some skin cancer in, some dermpath and whatever else the acgme requires and I'll say maybe. I'll also wont have to wait long for one of you guys to treat a rash and then have it turn out to be a malignancy (eg extramammary pagets, superficial spreading BCC, langerhans histocytosis or cutaneous T cell lymphoma) to see you or your peds friends in court as the expert witness for the plaintiff. BTW if you can change your oil and change every make out there's oil for several years you still wouldn't be a mechanic. You'd be a one trick pony like jiffy lube.

You can have Dr. Klein, I'll stick with Harry Buncke, the inventor if microsurgery. Or better yet, Joseph Murray, plastic surgeon and Nobel prize winner for the first successful organ transplantation.

I am a PRS resident, early in my training. I will readily admit, there are many nights on hand call when I wish I was a derm resident. Everytime I get into the OR, though, its easy to remember why I made my choice. And I'd do it again a thousand times over.

Those are some nice excisions and flaps, but I'm sorry that doesn't make you a surgeon in the true sense.

That basal cell excision looks a bit icky. How about a paraspinal advancement flap over an inch of exposed dura, hardware, and kyphotic spine. Or a ventral hernia repair that the GENERAL surgeons need help closing. Or NOE/frontal sinus where we have to reconstruct the frontal bone and orbit. We did all these cases on the SAME day, with the SAME attending.

Pho, Habeed I hope y'all have a great time in dermatology--its a fun, intellectually rewarding, and lucrative career, Oh, and thank you for liposuction.

We (plastic surgeons) sacrifice our lifestyles to develop technical skills, problem solving abilities and creative judgment. Even if we're years out and wildly successful in private practice. Ask Sherrell Aston. I did- the dude works like 80 hours a week. That being said, I do feel like our specialty tends to attract a "work hard, play hard" personality.

Hey I give you PRS guys props too, you guys do some amazing stuff. I was just pointing out to those know it all med students that derm is not all clinic and rashes and that we do some cutting. And yes after res I wouldn't call myself a skin surgeon ether, but after fellowship of doing nothing but excisions and flaps I will call my self a skin surgeon. Okay you guys attract the "work hard, play hard" personality, derm attracts the "work hard, but play harder" personality and gives us the time to play harder.

Echo.... what GS said. This d*ick measuring contest has been amusing.

Glad I was able to get some good laughs on this forum. You know what they say the best jokes have a hint of truth to them and get you to say WTF that is kind of true.

 

[MegaProjectile]

Oh my. I stumbled on this thread and couldn't take my eyes off. Great read. Too bad Habeed got himself banned. The dude sure puts up a strong fight!

Ok, I'm going away now .....