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Do people back-up with surgery?


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Like say top choice was Cardiac but also ranking Gen Surg or OB/GYN. Would that work if Gen Surg was 1st choice and OB/GYN second? Or do people back up surgery with FM/IM or not at all.

Just a curious question, I know v little about the process.

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Semantics (and perhaps slightly off topic), but I prefer to think of it as 'parallel planning' in this scenario. Meaning that you must be certain you enjoy both specialties significantly more than FM. Particularly regarding surgical specialties, where the opportunity cost is high (re: time investment, lifestyle detractors, risk of unmatched etc). Otherwise, you are better off pursuing FM as the alternate career path. Some surgical specialties are more similar to one another than others, but some certainly are vastly different (in operative technique, patient population, pathophysiology) and thus, you should not extrapolate that simply because, for example, Cardiac Surgery is your supreme interest, that General Surgery/OBGYN would be a better substitute than FM if your interest in GSx is as surface level as 'it's still surgery.' Of course, this is just my opinion, so take it with a grain of salt. 

As for if it's doable... it certainly is (although given how competitive surgical specialties are in general, it seems to be a tactic people shy away from nowadays, but I myself, along with several people I know successfully parallel planned 2 or even 3 surgical specialties this cycle). Just make sure you can construct a coherent narrative wherein both specialties meet your personal/professional goals, and are able to expound on why a particular specialty is ultimately the best fit for you. It's all in the storytelling. You've just gotta sell it. 

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I think prior to the elective cap this year it wasn't possible for most candidates to have competitive applications in more than one surgical discipline.  

As you can see by checking the link below, that for all three surgical disciplines you mentioned, most matched CMGs had three or more elective in the given discipline.  Unless your school offers a LOT of elective time then it's harder to "max out" for each program. 

https://www.carms.ca/data-reports/r1-data-reports/electives 

That said, I think some surgical programs are becoming less competitive - e.g. vascular has consistently unfilled positions and even cardiac had an unfilled spot this year.  Last year there were quite a few 'left over' surgical positions including urology, gen surg, ortho and even obs/gyn.

So trying to pair two complementary disciplines where one is 'more competitive' and one is 'less competitive' with some overlap could work.    

For example, a cardiac with vascular surgery 'parallel plan' may work or maybe cardiac/gen surg.  

Like the poster above said, surgical disciplines are all quite different, with different cultures/patient populations even work/life balance.  

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https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl11e.pdf

https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl12e.pdf

Above is some data from the 2020 cycle. Specifically, the first is a table listing the number of first choice applicants to all R1 entry disciplines nationwide. The second is a table listing the quota (number of seats across Canada) for each R1 entry discipline. For a given discipline of your interest, take the quota as the numerator, and number of first choice applicants as the denominator, and you'll generate an estimate of the 'competitiveness' (or supply:demand) of a particular specialty. Traditionally, Plastics, OHNS are the most competitive. Cardiac surgery and vascular surgery tend to wax and wane quite dramatically by year as even small changes in interest significantly changes the landscape for their competitiveness (i.e. 5 more students interested in cardiac/vasc surgery can drastically change it's 'competitiveness' given only 8/9 seats across Canada). Neurosurgery is consistently competitive as well, with a self-selecting cohort. Urology had an anomalous year in 2020, but is usually quite competitive as well. General surgery is generally less competitive than those previously mentioned (caveat again being the fluctuating competitiveness of Cardiac/Vasc surg) but is still considered to be moderately competitive, with demand always > supply. Lastly, orthopaedic surgery has fallen off dramatically in competitiveness, likely due to job market considerations. 

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On 5/14/2021 at 9:34 AM, AB27 said:

I definitely prefer the term 'parallel planning'. Do you know which surgical specialties or more or less competitive (is there a list I should be looking at)? There are so many CaRMS tables lol.

A detailed analysis of competitiveness for all major specialties was done, analyzing from different viewpoints, including over time.  The bulk of the analysis is 2020, but the historical graphs for surgery are also insightful.

It's interesting to note that Pediatrics for instance is now approaching the competitiveness of ENT.

Last year Cardiac was one of the most competitive specialties (but had an unfilled spot this year).  There is definitely year to year fluctuation, but it's also possible there might have been a candidate 'in mind' for this year's spot in Round 2.  For Cardiac Surgery, gunners are usually self-selected and generally fairly strong candidates.  

Vascular it seems is getting progressively less competitive as is also indicated by unfilled positions year to year. 

Ortho and NeuroSurgery are very competitive in Quebec which probably tilts the numbers further from what they would be.  I think Neurosurgery might have the worst job market out of any surgery.  

https://forums.premed101.com/topic/112056-current-carms-competitiveness-schools-and-specialties/

 

 

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On 5/13/2021 at 9:33 PM, AB27 said:

Like say top choice was Cardiac but also ranking Gen Surg or OB/GYN. Would that work if Gen Surg was 1st choice and OB/GYN second? Or do people back up surgery with FM/IM or not at all.

Just a curious question, I know v little about the process.

Happens all the time. People generally parallel plan or are truly undecided between two or even three surgical specialties. Often they are related

Cardiac/Vasc/Gen are common, Gen/OB/Uro is common as well. Generally speaking, people try to bridge the gap between two related specialties if they are undecided by doing research relevant to both or doing electives in both. In general, if you are an overall strong well rounded candidate, multiple specialties will want you and as long as you display some genuine interest, you will be ranked highly enough to match. 

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