MD General Surgery Interest- Mixed Performance

[Medstudentin]

Hello,
I usually dislike these posts, but I am having a huge amount fo anxiety regarding this and want to talk more about it with people who might have some honest input.

I am an American Med student interested in general surgery (but also very open to OBGYN yet general surgery comes first).

I have done great in my preclinicals and then life happened:

1) I really did not do well on my step 1 (literally barely passed so keep that in mind).
2) I failed my Family med shelf.

Otherwise I am heavily involved in research and have done a significant amount of it (surgery mainly, but also in IM a bit). I also work with an Ivy league med school on some research. I have a VERY solid and strong relationship with PIs (2 surgeons) in all these places.

I also have a very solid volunteering experience and have even gotten very prestigious awards regarding that.

If I really want to go into general surgery.... am I delusional? Should I scrap it and think of something less competitive? I am obviously planning on having serious corrections to what I am doing and studying and how I am approaching my studies lately.

Thank you.

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[DOVinciRobot]

Go for it, but have a plan 1b

 

[GoSpursGo]

Play around with this website: https://public.tableau.com/app/prof...ram/viz/ChartingOutcomes2020/ChartingOutcomes

The numbers are the numbers. The match rate for Gen Surg is 28% over the past 5 years for applicants with a score <200. For OB/Gyn it's 54%, which is still basically a coin flip. That doesn't take into account the additional red flag of your need to remediate your FM shelf.

You're going to need your connections to make your match. I suggest that you have an honest discussion with the PD at your school's surgery and OB/Gyn programs, as those are going to be your best shots at finding a spot. If you get a lukewarm response, then you just need to make a personal decision about how much risk you're willing to take on to pursue your specialty of choice. At the end of the day, not everyone gets to be in their preferred specialty.

I honestly don't think there's any point in reaching out to the Ivy programs--you are simply going to be screened out.

 

[altblue]

The idea that you ought to get a 235+ to prove yourself for Surgery is silly, but if you're barely passing Step and failing a shelf, you might want to ask yourself what life problems are interfering with your academics and your career. Any surgical program is gonna be incredibly demanding on most people with stable physical and mental health, let alone those with other struggles. For me, I have a set of coping skills and solid academic performance with no red flags - yet as an M3, I'm not certain surgery would be worth the toll on my well-being

It might be possible for you, sure, but you might want to do some soulsearching and address those issues - regardless of what you decide to pursue. We're all human and we all experience tragedy, but we need to find ways to effectively cope, be it delaying an exam or seeking out our support system so we can compartmentalize more effectively

 

[operaman]

You failed your family medicine shelf; how did you do on surgery and IM? Family is generally considered an easier shelf.

Im going to assume you haven’t taken those exams yet, and if that’s true then you have much bigger fish to fry soon. Failing/remediation of your surgery clerkship would potentially be the nail in the coffin, not to mention you still have to pass all the other shelves and CK to graduate.

Your best shot of matching will be your home program so make sure you absolutely kill it on that rotation. Definitely have a backup plan, meaning you need to make a great impression across the board because you never know where you may have to end up.

 

[deleted50541]

Your step I score is gonna definitely weed you out from a lot of gen surg interviews. Having a strong showing on your surgery rotation, both the shelf and clinical grade, will help though if you can get your foot in the door. I agree that your home programs will be your best bet for matching, which ever match you choose.

I've had the gen surg vs OB/GYN debate many times with students. Your scope of surgical practice is relatively limited compared to gen surg and much of your day-to-day is medical management. Would that be enough for you to satisfy your surgical leanings? If you're thinking gyn-onc in the future, that's a different story, but also a more competitive route.

As others said, it's time for some serious soul searching.

 

[Medstudentin]

You failed your family medicine shelf; how did you do on surgery and IM? Family is generally considered an easier shelf.

Im going to assume you haven’t taken those exams yet, and if that’s true then you have much bigger fish to fry soon. Failing/remediation of your surgery clerkship would potentially be the nail in the coffin, not to mention you still have to pass all the other shelves and CK to graduate.

Your best shot of matching will be your home program so make sure you absolutely kill it on that rotation. Definitely have a backup plan, meaning you need to make a great impression across the board because you never know where you may have to end up.

I have had some intense life challenges lately that have piled up and limited my ability to do well. However, I am def not blaming this solely on that. I have done incredibly well before these changes happened and have been excelling with honors. This is why I am hoping I can bounce back soon and I have been heavily focused on being able to figure out what the core problem is.
Do you think my home program is better than the program associated with my PI? my PI is very well involved there and well known and I think can possibly have a big say on whether I am accepted there or not. I will still offer my best in my home program but was wondering if focusing there too would be reasonable.

 

[operaman]

I have had some intense life challenges lately that have piled up and limited my ability to do well. However, I am def not blaming this solely on that. I have done incredibly well before these changes happened and have been excelling with honors. This is why I am hoping I can bounce back soon and I have been heavily focused on being able to figure out what the core problem is.
Do you think my home program is better than the program associated with my PI? my PI is very well involved there and well known and I think can possibly have a big say on whether I am accepted there or not. I will still offer my best in my home program but was wondering if focusing there too would be reasonable.

Home program has the potential to be a better shot simply because you will rotate there and will hopefully make very good impressions. Having another connection elsewhere is good to though. Depending on how programs do ranking, their impact may be somewhat limited though and it would be a huge ask to get an entire faculty to overlook so many red flags when so many of them haven’t met you.

Both are still long shots of course, but people who know you might be willing to look at you more holistically rather than screening you out entirely. No program wants to get stuck with a difficult resident who needs excessive remediation and terminating a resident is a huge barrel o’ suck that nobody wants either. You’re clearly at high risk for both, but multiple stellar rotations and strong test performance going forward may help.

Even so, you need to be prepared for the very real possibility of having to select a different field.

 

[GoSpursGo]

I have had some intense life challenges lately that have piled up and limited my ability to do well. However, I am def not blaming this solely on that. I have done incredibly well before these changes happened and have been excelling with honors. This is why I am hoping I can bounce back soon and I have been heavily focused on being able to figure out what the core problem is.
Do you think my home program is better than the program associated with my PI? my PI is very well involved there and well known and I think can possibly have a big say on whether I am accepted there or not. I will still offer my best in my home program but was wondering if focusing there too would be reasonable.

I hear ya, life happens. Unfortunately, the cold hard truth is that what programs get hundreds of applications, they need some way to cull apps, and your score is not going to get past the screen at most GS programs. It may not be your fault, but you need to be realistic about that being the reality.

As to the sway of your PI, you need to have an honest conversation with them as well. I would generally suspect that if you were an average or slightly below average applicant that they could bring you over the finish line, but I suspect that they're not able to bring someone from the "do not interview" pool to the rank-to-match pool. But again, they can probably tell you more accurately than we can.

 

[deleted50541]

Do you think my home program is better than the program associated with my PI? my PI is very well involved there and well known and I think can possibly have a big say on whether I am accepted there or not. I will still offer my best in my home program but was wondering if focusing there too would be reasonable.

Based on your post, this PI is at an Ivy league institution, no? Unless you've got other stellar credentials and are doing an early surgical sub-I at that institution where you can show your potential as a strong candidate, then your PI's name alone won't be enough.

The PI's support certainly can't hurt, but you're going up against typically very strong candidates at these places that again will weed you out early in the application process. It's the reality of a process that's only gotten more competitive over the years.

 

[Medstudentin]

Based on your post, this PI is at an Ivy league institution, no? Unless you've got other stellar credentials and are doing an early surgical sub-I at that institution where you can show your potential as a strong candidate, then your PI's name alone won't be enough.

The PI's support certainly can't hurt, but you're going up against typically very strong candidates at these places that again will weed you out early in the application process. It's the reality of a process that's only gotten more competitive over the years.

one of them is, the other is not.
I was offered a surgical sub-I (ortho) in another institution, but was planning on doing one in my PI's institution as well.

 

[DOVinciRobot]

one of them is, the other is not.
I was offered a surgical sub-I (ortho) in another institution, but was planning on doing one in my PI's institution as well.

An ortho sub-I won’t help you for GS

 

[Chelsea FC]

Does your school report the failed FM shelf? Cause I know my school won’t show it if you pass the remediation.