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General Surgery

General Surgery Residency Questions

What advice would you give about getting letters of recommendation in your specialty?

Three letters minimum. It is okay to have four or more and utilize some more selectively. Chair letter is very useful for more “traditional” programs, so it is probably best to have one. This would require an appointment with the Chair, unless you have worked with him/her extensively already. As a PD, I realize most Chair letters are a bit generic and form-ish, usually based on an interview and not much direct knowledge. For letters to be completed by September 15, you should ask at least a month in advance if not 1.5 to 2 months in advance. At least 2 months from surgeons.  Make sure it’s somebody that can provide a quality letter with an accurate description of you and your better qualities.   More impressive names and titles make a difference at some programs, but the bigger issue is letter quality.   

What is the value of doing audition rotations in your specialty?

I think they are useful. If you put on an exceptional performance, an audition rotation may be of benefit.  Far more often, though, students just don’t put in the requisite effort to do so. It is a month long interview and a chance for you to shine and be remembered. Particularly useful if you are soft in some area or areas of your application and applying for a reach or high-end program. This may be your chance to get in one of these type of places. Ask your advisor for details and then ask your acquaintances what characteristics of you that are good and bad; try to drop the bad habits prior to leaving. There are times it is better to ride your online application over a personal application after an away rotation. I highly recommend at least one away from your home institution to make sure you still like the specialty somewhere else.  Audition rotations are far more useful for you than for the programs, allowing you to see different types of programs (i.e., academic, community, hybrid) and determining how well you fit into specific cultures.  

To what extent does research, publications, or presentations affect one’s ability to match in your specialty? 

Very useful; it can differentiate you from others. Particularly necessary in a research heavy institution that you may be applying to. See the mission statements and history of the programs that you are applying to. If they emphasize academia and research, you should be able to demonstrate that you can and likely have done some.  The importance very much depends on the programs to which you are applying.  Research and the results thereof are looked upon positively, but lack of research rarely causes a significant decrease in the program’s estimation of you.

Is a Step 2CK score needed before you will invite someone for an interview?

Not necessary if you have a well above average Step 1, but I prefer a Step 2 score in hand; I like to see it higher than Step 1, but not a deal breaker. 

What does the perfect applicant look like in your specialty?

Above average Step 1 and 2; some research activity with leadership roles in med school, a memorable CV, U.S. citizen with U.S. medical degree; no felonies/misdemeanors. Three LOR with surgery writers on two of them that talk about how they want to recruit you to their program.  The value of the interview is inestimable—they need people who fit with the people and the culture of the program, and you can only do that by meeting in person.

Does having a below average Step 1 score doom you in your specialty?

Likely yes; saving items would be marked jump on Step 2 to an above average score, some other superlatives, or a good reason for your low scores (i.e., illness, death in family).  A Step 1 score less than 210 can be a deal breaker. 

Would you ever take someone with a Step 2CS failure?

No.

Does a student need to Honor in your specialty in order to match?

No.  Honors criteria are too varied between institutions to make it an absolute criterion.

The students have significant elective time during their 2nd and 3rd year for career exploration.

What electives would you recommend to a student who knows they are interested in your specialty? 

Exploring the various subspecialties to which one might be exposed in general surgery residency is of value (so as to get a better sense of what the next five years will involve).  Any surgical elective; GI, Cardiology, Radiology/Interventional Radiology can be helpful.

What electives would you recommend to a student who is undecided but considering your specialty? 

Immerse yourself in a challenging rotation at your institution in surgery. General surgery/minimally invasive surgery, trauma, acute care surgery—the bread and butter of residency general surgery and community practices.  Take call frequently like the interns or upper level residents. Make sure you like it after that. 

Is there anything else I haven’t asked that you feel an applicant to your specialty ought to know?

Surgery is still a demanding residency. You will work 80 hours a week most of your weeks of residency. You will likely work harder than most of your friends in other specialty residencies. Your significant other needs to know this too.  Residency/training will end and life will be much more predictable, but still demanding at times. You will however be granted an amazing privilege to care for patients at critical times in their lives with an opportunity to make immediate and meaningful impact—this is what should get you up every day to go to work.