You should take advantage of every opportunity to expose yourself to that field. For surgery, you should take advantage of the Surgical Society's Preceptor for a Day and Night On-Call with a Resident Programs, monthly lectures, suture clinics, laparoscopic workshops, surgical instruments workshops, and faculty-student receptions (aka Grover dinners).
Research (either basic science or clinical) is another way to explore the academic side of surgery. A research project can be conducted in the surgical sciences or in another area. Regardless of your focus, research also looks very nice on your CV and residency application.
Get in touch with faculty early and establish a mentor. See "Important people to know to help with application/match issues" below.
The subspecialties of general surgery include colorectal, endocrine, surgical oncology, cardiothoracic, hepatobiliary, transplant, plastics, vascular, pediatrics, breast, laparoscopic/minimally invasive surgery, trauma, burn, critical care.
Other surgical subspecialties include: otorhinolaryngology (ENT), orthopaedics, urology, ophthalmology.
General Surgery: 5 years
Orthopaedics: 5 years
Urology: 5 years
ENT: 4 years
Ophthalmology: 4 years
General Surgery Subspecialties: 1-3 years additional training after completing general surgery residency
Categorical: Students match into five year general surgery training positions that lead to eligibility for Board Certification in General Surgery. They are applied to and matched into out of medical school.
Designated Preliminary: One to two year general surgery training positions for residents who have already been aceepted into another specialty, but who are completing prerequisites for that specialty. Usually the first 1-2 years of residency training for urology, orthopaedics, ENT, radiology, anesthesia or emergency medicine.
Non-Designated Preliminary: Posiitions for residents who at the time of admission to a program have not been accepted into any specialty. Usually one to two years. Students may match into the positions or the positions may be available during the scramble process.
Two types of residency training programs are available: Academic and Community-based. Academic training programs are part of an established University and generally have more academic and research opportunities available. Community-based residency programs are often conducted in a private hospital, serving a given community. These programs tend to focus on clinical skills and training. Some community programs are University Affiliated and tend to have more research opportunities available for their residents.
Are you interested in basic science (Bench) research or clinical research? The summer between the MS1 and MS2 years of medical school provides a great opportunity for research in either area as you have time to dedicate to these endeavors. You can work in concert with a faculty member at the University to complete NIH funded research during your MS1 summer. Otherwise, you will need to find a faculty member with whom you can on a project.
The Surgical Society website has a resource for those students interested in surgical research that lists available opportunities for students. Otherwise, you will need to approach faculty in your area of interest to inquire about various opportunities. Dr. Thomas Whitehill in the Department of Surgery is a great person to consult initially. He can help align you with a faculty member in the area of research that interests you.
First and foremost, work hard. Do as well you can in your MS1/MS2 classes, USMLE Step I, and in your clinical rotations.
Get involved with the CU Surgical Society. Attend the lectures and events to begin making contacts with faculty and to further cultivate your interests in a future surgical career.
Get involved in research.
Get to know surgery residents. They will be a tremendous resource for you in the future.
Get in contact with more senior students or CU SOM alumni that are/have trained at other surgical residency programs (See Alumni Page on Surgical Society website).
Get to know faculty, especially Drs. Nehler (General Surgery Residency Program Director), Whitehill (Third and 4th Year Course Director) and Schulick (Department Chairman).
This depends on your goals and personality. There is no one answer for everyone.
Denver Health: offers the most rigorous experience and the most representative experience of a surgery residency. Requires a very self-sufficient personality to do well.
University Hospital: great contact with departmental faculty. You will see more specialized surgical cases. Very nurturing environment. More didactic teaching sessions.
AHEC sites: great clinical and operative experience. Often you are the only student and get to first assist on cases. Downside is you don’t get contact with CU faculty or formal teaching sessions; however, many students who go into surgery feel that this was their best surgical rotation.
Veteran's Administration: In some cases students act like the primary care provider for the team. A safe place to learn about managing a patient pre and post-op. Valuable SICU and clinic experience.
St Joe and Rose: Private hospitals. St. Joe has a community-based general surgery residency program. Consistently praised for their lecture series. Rose has lots of OR time but very little clinic time.
You will need to complete at least one (maybe two) surgical subinternships at the beginning of your MS4 year. Whether you complete them at University Hospital, Denver Health, or St. Joesph’s, is really up to you and is often based upon where you completed your MS3 rotation.
If you are going into general surgery, complete at least one general surgery subinternship. You can also complete subinternships in other surgical subspecialties if you like.
Surgical externships provide a great opportunity to visit another institution, work with them, have them get to know you, and to evaluate the program/area of the country prior to the residency application process. You will receive a lot of different advice as to whether completing an externship can either help you or hurt you in terms of your application to that program. The general rule of thumb though is that if you visit another institution, work hard and do well, you will help yourself and be able to evaluate whether a particular program will match your personality or if you would like to consider living in a certain area of the country.
RESIDENCY RELATED QUESTIONS:
Over the past five years, general surgery has become quite competitive. Many attribute this to the adoption of the 80 hour work week restriction and its application to residency training. When evaluating how competitive you are as an applicant, consider a few different variables. 1. What kind of a program you are interested in (academic vs. community). 2. What are your board scores/grades? Academic programs tend to be more competitive with matched candidates having USMLE Step 1 scores averaging in the 220-235 range (of course, this average goes up when considering the premier academic training programs). Community programs tend to have USMLE Step 1 averages in the 210-220 range.
Most surgery programs look very favorably on an "Honors" grade in your MS3 surgery clerkship rotation and may factor in the grades you received in your Medicine and OB/GYN rotations.
Alpha Omega Alpha (AOA) status also tends to be highly coveted among surgeons at many of the premier academic training programs.
Other factors that enhance one's competitiveness include research, leadership roles, involvement in surgery interest group, international experiences/mission work.
The most important piece of advice is to talk with a faculty mentor who will give you honest feedback as to how competitive you are as a candidate.
UCD General Surgery Mentor/Faculty: Ask your mentor questions often and early on desirable programs, how to go about applying, etc. Ask many different people whose opinion you can trust...you will receive a wide variety of opinions and advice. Ultimately it will come down to a culmination of the opinions of many and perhaps, most importantly, your own "gut feeling" as to what will be best for you in the long run.
Surgery Residents: These individuals may often be your best source of information. Ask both current CU residents as well as those at the programs you visit. At each program you visit, you will most likely be provided a list of current resident email addresses. Take advantage of this opportunity. Overall, residents are a great resource and are willing to give advice about a process they have already been through.
AMA-FREIDA (Fellowship and Residency Electronic Interactive Database): http://www.ama-assn.org/ama/pub/medical-students/medical-students.shtml. A database of all accredited institutions offering general surgical residencies. You can specify the search for programs that meet your criteria. From the search results, you can follow links to each program's home web site, which can be helpful in getting a general idea of the program's educational emphasis.
CU Surgical Society Website: Has helpful links to FREIDA, the American College of Surgeons and the Women's Surgery Group. There is also a contact list of previous UCD medical students/alumni and the respective residency to which each has matched. Contact the source first hand and hear their opinion of a program you may be interested in.
The American College of Surgery: www.facs.org. Follow the medical student links to get to the online version of the little red book, "So You Want to Be a Surgeon...A Medical Student Guide to Finding and Matching With the Best Possible Residency", which has information from many programs that supplemenmt FREIDA nicely, including percentage going into private vs. academic practice, etc. Also has good interviewing tips and advice to help you decide if surgery is the specialty for you.
The Association of Women Surgeons: www.womensurgeons.org. Has a residents and students list-server where you can post questions about interviewing, programs, etc. There is also a career resource center that has good descriptions of various specialties, vascular, plastics, etc. If you join, you'll receive a book, "The Pocket Mentor" that is a must-read for any woman considering a career in surgery.
The general advice you will likely receive is to rank approximately 10 programs to give yourself the best chance of matching. For most students this usually means applying to between 20-30 programs and interviewing at between 10-15. You should discuss your application list with Drs. Nehler and Whitehill (see below) prior to the end of August, and you should consult your mentor as well to gain their perspectives in order to individually tailor your status as a competitive candidate to your list.
Each program has an idea of the ideal candidate within the context of their program's educational emphasis. Therefore, write about your career goals, your strengths, and what attracts you to their "type" of program. This is in addition to a general piece about your interest in and commitment to succeeding in surgical training. Furthermore, including several experiences or personal traits that make you unique and an interesting candidate is important. Ask yourself, "Would I want to seek this person out in a crowd to talk to based upon this statement?" The bottom line is whatever you choose to write about, most surgery programs want to know why you want to be a surgeon, a little about where you see yourself in the future, and some evidence that you are committed to surgery. Remember that the field of surgery is generally pretty conservative. Save the melodramatic stories and infamous quotes for another time. Surgeons are interested in what you have to say, not what Shakespeare said in the late 18th century.
Mark Nehler, MD, General Surgery Residency Program Director
Thomas Whitehill, MD, Medical Student Program Director
Frederick Grover, MD, Chair, Department of Surgery
Thomas Robinson, MD, Associate General Surgery Residency Program Director
David Fullerton, MD, Chair, Division of Cardiothoracic Surgery, Cardiothoracic Surgery Residency Program Director
Any and all surgery residents/fellows
Surgical Sub-I’s are an important step in the process as they provide excellent experience and direct contact with faculty who are involved in resident selection. It is best to have at least one surgical sub-I on the dean's letter. Often times more than one may be beneficial, especially if it is in another discipline outside of a general surgery sub-I (i.e. critical care, the burn unit, SICU, or other). Also, if you are interested in another program or just want to see what is out there, a visiting rotation is very helpful. These rotations give you essential inside information that you may or may not get on interview day. When you visit another program and do well (and you will) you will have a leg up on the rest of the competition.
Keep in mind, it is not uncommon to be asked on the interview trail what surgical rotations you’ve taken up to that point. Have an idea of what you will say about each experience.
This largely depends on where you want to go. At private, community based programs without a big emphasis on research, it's not important.
At big academic programs (i.e. Michigan, Wash U, Penn, Pitt, Stanford, UVA, Vanderbilt, Duke, MGH, Brigham and Women’s, Hopkins) research is very important, and most of these programs have mandatory research year requirements (mostly 2 years) during residency. As a result, for these type of programs, you should have some kind of research or equivalent academic pursuit or extra-curricular activity (e.g. international clinical project) on your application. If you want to go into academic medicine you should have some research on your application and should be able to comment thoughtfully on your specific role and the focus of the research as a whole. If you haven’t done any yet, it is never too late to start a project with someone here at the University.
Keep in mind, if your application is strong in other areas (boards, extracurricular activities, leadership positions, etc.) you can still be a "competitive" candidate even at University programs.
There is a certain amount of gamesmanship to constructing your interview schedule, particularly if you intend on interviewing at 10-15 different programs. Write out a calendar with the available interview dates for each program to which you have applied; there will be tremendous overlap. As you receive each invitation to interview, do not wait to accept the invitation- email and indicate an interest in one of the offered dates as the slots may fill quickly. Keep in mind that you may soon receive an invitation from another more desirable school, requiring you to then cancel the first one. If you are organized and have a vague idea of the programs you would most like to visit, there should be a minimal number of times you will have to cancel scheduled dates. Remember, canceling an interview is not bad so long as you do it professionally, with enough time for that program to fill your vacancy. The week before your interview is not sufficient notice.
Take advantage of the opportunities you have to interact and communicate with the residents at those programs that intrigue you. Contact them by email after you visit and keep in touch. Many program directors ask for resident feedback about each applicant. This can be very helpful to you if you have made a good impression on those residents.
Get in touch with former CU students who are residents at the programs to which you are interested and/or applying. It helps to establish a contact with a resident early. If they are well respected within their program, and you hit it off, they can help you out a ton.
The world of academic surgery is surprisingly small and, unlike other specialties, the training is rather long. Therefore, asking about transitions in program leadership during your 5-7 years of training is very important. If a program’s current reputation and your desire to train at that institution is based upon the Chair of that department and he or she is planning to leave in 3 years, you may want to reconsider where you rank that program on your list.
Given the impending changes that are forthcoming in the near future regarding surgical resident education requirements by the RRC, you may want to ask about each programs vision/plan for evolution and how they plan to meet new requirements (e.g. surgical simulation curricula and resources).
Some programs are developing unique programs and opportunities for rural surgery, international experiences, and public health certification. These are all good things to ask about.
There appears to be a trend toward specialization of surgical resident education, and several fields (vascular, plastics, CT) are moving toward “integrated training programs.” Asking about a program's perspective on this could change your impression of that place as a potential place to train.
Recognize that the field of General Surgery has become much more competitive over the past 3-4 years, and in terms of number of applicants for available positions was the second most competitive field in 2005-2006. With this in mind, APPLY EARLY. Start working on your personal statements early. Ask for LORs as early as possible. Most of all, complete your ERAS Common Application Form with Personal Statement and be prepared to send them out as early as possible (usually ERAS opens on September 1st). The sooner you get your application to the programs, the better chance you have to get interviews early.
Carefully consider and discuss with your spouse, fiancée or significant other each program and its associated environment (both living and working) when developing your application and Rank Order List. If possible, have them travel with you to certain programs. Put them in touch with either residents and/or spouses of residents at those programs that peak your interest. You need to consider their wellbeing in this decision. Consider the quality/expense of living in each place, employment opportunities for your significant other, school systems, family support, etc. Remember, 5-7 years is a long time and a big commitment that you are asking of them too. A happy home life leads to a happy work environment and to a successful match, and the best match for you is that which meets the needs for both you and your family.
One of the most helpful things you can do in preparation for interviews is to learn as much as possible about the training requirements and changes that are on the horizon in General Surgery training. Incorporate this information into questions that you can ask at each program. Many programs seem to want to see you how well you can keep a conversation going by simply beginning the interview with, “So what do you want to know about our program?”, or “What can I do for you?” Be prepared for this, and ask stimulating and intelligent questions that are tailored to each program.