Best Programs for Surgical Specialties

[VascSurg Gunner]

Hi all,

 

First time poster long time lurker. I'm a second year medical student at the University of Ottawa, and I was wondering what are considered the "best" surgical/subsurgical programs from a residency perspective. Obviously, all Canadian programs are good, but I've heard that some programs allow their residents to do more cutting, some have a crowding of learners, some lack bread butter presentations due to training being distributed between centres, some avoid open surgeries like the plague while others still provide exposure of open surgeries etc... 

 

Putting aside "prestige" or emphasis on research and focusing strictly on clinical experience, what are your thoughts on programs that are most sought after for the experience they provide?

 

thanks 

[DocBrown9]

I'd argue that there's no such thing as the best surgical program, there's only the surgical program that best fits your specific needs. For the vast majority of surgical programs in Canada you will come out competent in bread and butter procedures (less confident in some research heavy ones but really those residencies are designed for academia and you will likely be doing a fellowship anyway so it balances out). The most important thing in my opinion when looking at surgical programs is fit and location. Operative exposure ends up being similar throughout the country (in fact the program I visited with the most operative exposure had residents telling me to avoid the program at all costs if I didn't have family in the city). How supportive staff and senior residents are will be the biggest difference. While location may not seem important early in med school, during electives it makes a huge difference being close to your support structure. 

When looking at operative exposure, the presence of fellows and complex surgical equipment (robots) tend to change how much "cutting" you get to do. During your electives, you need to talk to residents and ask about whether fellows or residents get priority for cases. You also need to realise if you really value open exposure, you may be best off going to a centre with less MIS staff or robots.

I know my answer is very general but I can't really tell you about all surgical programs given how different they can be at different institutions. If you truly value clinical exposure over academia, small programs in smaller cities tend to be more clinically oriented as a general rule. 

[Edict]

The experience that people look for really varies, this is why not everyone is chasing one program or another. The question is really broad and no one can really give you an answer because it really depends on the specialty and the specific set up of that program which often changes year to year anyways. 

These are the general principles though: 

I think if you want to operate, look for programs that don't have as many fellows or have more community surgical rotations. 

If you want to do research, look for programs that have research programs that interest you on their websites 

If you want to do less clinical work, generally community surgery doesn't rely on residents or fellows and this ultimately means less "scut" for you to do.