Advice about backing up with General surgery

[juicyprunes]

Just wondering if anyone has any advice about backing up with general surgery??...i.e. doing additional electives in gen surg? how to obtain interviews despite obviously being interested in a surgical subspecialty (e.g. based on previous electives) and being honest without shooting oneself in the foot?

 

Thanks!!

[Kirsteen]

Hi there,

 

I've spoken to Gen Surg Program Directors in the past and some are acutely aware of the importance of ranking those candidates who are genuinely interested in Gen Surg as opposed to simply using it as a back-up. This, given that they'd ended up with less than ideal phalanges of Gen Surg residents (or empty spots) after having ranked those who really wanted Plastics, ENT, etc. Given that, these folks mentioned that they are on the lookout for any red flags that would lead them to believe that a candidate was using Gen Surg as a back-up. Not all Gen Surg PDs may feel this way, but it might be useful for you to know that some do.

 

Cheers,

Kirsteen

[lostintime]

Is there really any specialty/program now that doesn't get mad if you're using them as back-up? The only one I can think of is family, and maybe they even get mad if it's in a competitive city.

[Kirsteen]

Hi,

 

Some (although not all) Program Directors may be especially sensitive to those applicants with obvious back-ups if they feel their program has been burned in the past. It might be an idea to do some due diligence and determine whether or not the program(s) of interest to you have a PD that feels this way, then you can at least try to prepare in advance, i.e., tailor your letter and/or interview answers to this sensitivity if you do have obvious back-ups.

 

Cheers,

Kirsteen

[bones]

Hi,

 

Some (although not all) Program Directors may be especially sensitive to those applicants with obvious back-ups if they feel their program has been burned in the past. It might be an idea to do some due diligence and determine whether or not the program(s) of interest to you have a PD that feels this way, then you can at least try to prepare in advance, i.e., tailor your letter and/or interview answers to this sensitivity if you do have obvious back-ups.

 

Cheers,

Kirsteen

 

Hello,

 

How does one go about finding this out? Asking the residents?

[Kirsteen]

Hello,

 

How does one go about finding this out? Asking the residents?

Absolutely.

 

Cheers,

Kirsteen

[svp2k5]

Another thing to consider is that some programs have been burned with residents switching out when a spot becomes available in another subspecialty. This is another reason why they are iffy about taking people they believe are backing up.

[BlackJack]

Don't back up with something you couldn't see yourself doing for the rest of your life. Remember, once you've signed a contract through CaRMS, its binding. They say medical residency is the last sweatshop in the Western world, so don't go through it if you will hate the subject matter.

[juicyprunes]

So what if you're a person that just has to do something surgical??...i.e. I'd rather do general surgery than family medicine...do I need to do more than one elective in gen surgy to show "genuine interest"?

[Kirsteen]

So what if you're a person that just has to do something surgical??...i.e. I'd rather do general surgery than family medicine...do I need to do more than one elective in gen surgy to show "genuine interest"?

Hi,

 

If you're truly set on general surgery then presumably, if you'd had the time to plan them, you'd have more than one elective in the specialty anyway. If you don't then you may have a tough time convincing some centres that this is what you'd like to do. Not to say it can't be done, it can, but in the fight for any specialty spot you'll be up against those who have been planning to secure a spot at a given program for some time, i.e., they'll have a full house of electives, contacts, etc.

 

Cheers,

Kirsteen

[coastalslacker]

So what if you're a person that just has to do something surgical??...i.e. I'd rather do general surgery than family medicine...do I need to do more than one elective in gen surgy to show "genuine interest"?

 

yes, you need to do more than one.

[bones]

Sorry for hijacking the thread, but let's say one wants to ultimately match to gen surg in, say, Edmonton. I would obviously want to do a gen surg elective in Edmonton at some point.

 

If I really want to match to Edmonton, would it be useful to do another elective in, say, plastics or ortho, in Edmonton so that the gen surg people will see that I'm serious about Edmonton as a location? Or, would it be "more attractive" in the gen surg people's eyes that I do another gen surg elective in, say, Winnipeg, to show that I'm serious about gen surg as a speciality (which could help my chances of getting matched to gen surg in Edm)?

 

I can see the answer to this question being "it depends on the program director", but I'm wondering if there's any other wisdom people can give me based on experience?

[Kirsteen]

Sorry for hijacking the thread, but let's say one wants to ultimately match to gen surg in, say, Edmonton. I would obviously want to do a gen surg elective in Edmonton at some point.

 

If I really want to match to Edmonton, would it be useful to do another elective in, say, plastics or ortho, in Edmonton so that the gen surg people will see that I'm serious about Edmonton as a location? Or, would it be "more attractive" in the gen surg people's eyes that I do another gen surg elective in, say, Winnipeg, to show that I'm serious about gen surg as a speciality (which could help my chances of getting matched to gen surg in Edm)?

 

I can see the answer to this question being "it depends on the program director", but I'm wondering if there's any other wisdom people can give me based on experience?

Hi,

 

Whenever I'd completed an elective in two specialties at the same location it seemed unusual for the PDs or other staff to have buddies in the other specialty so there was little chance of any advantageous cross-talk. Furthermore, I completed a Gen Surg, Radiology and Plastics elective in Toronto (before I'd made up my mind inre: specialties) and I don't think that having completed those electives in Toronto helped convince anyone that I fancied Toronto as a centre for residency. In retrospect, I think it would be more risky to go for electives in multiple specialties at one centre as opposed to the same specialty at two different centres.

 

What's more important is conveying to those who you're working with that you're keen about their program. For example, I really liked the idea of Gen Surg in Montreal. I opted for a 5-week elective there, 2 weeks of which were spent with the Program Director. During that time I was invited out to dinner with the PD and had a good amount of face time with him. By the end of the elective I was convinced that I was very happy with their program and would be pleased to go there for residency and he certainly knew this. Therefore, I had effectively removed 99% of any doubt that there may be that, had I chosen Gen Surg, I would have ranked very highly on my list. (Of course, when I changed to Radiology, he was one of the first people I notified that I'd opted for something different.)

 

Cheers,

Kirsteen

[bustylegs]

Hi,

 

If you're truly set on general surgery then presumably, if you'd had the time to plan them, you'd have more than one elective in the specialty anyway. If you don't then you may have a tough time convincing some centres that this is what you'd like to do. Not to say it can't be done, it can, but in the fight for any specialty spot you'll be up against those who have been planning to secure a spot at a given program for some time, i.e., they'll have a full house of electives, contacts, etc.

 

Cheers,

Kirsteen

 

I don't know when it started, but in order to graduate, all Canadian medical students now need to have completed electives in at least 3 different direct CARMS entry programs. Each elective needs to be at least 2 weeks in length.

 

This policy creates a different set of expectations, since program directors now (at least surgical specialties at U of T) actually want to see students who are diverse in their elective selections. Nonetheless, Kirsteen's advice about backing up still applies.

 

It'll be even more difficult for students who have their elective blocks after CARMS application to demonstrate elective diversity, since diversifying means less time spent in the specialty of your choice.

 

Headaches!

[bones]

I don't know when it started, but in order to graduate, all Canadian medical students now need to have completed electives in at least 3 different direct CARMS entry programs. Each elective needs to be at least 2 weeks in length.

 

This policy creates a different set of expectations, since program directors now (at least surgical specialties at U of T) actually want to see students who are diverse in their elective selections. Nonetheless, Kirsteen's advice about backing up still applies.

 

It'll be even more difficult for students who have their elective blocks after CARMS application to demonstrate elective diversity, since diversifying means less time spent in the specialty of your choice.

 

Headaches!

 

 

Yup. In this case, it may make sense to think of doing your "diversification" electives in the same centre that you want to match to, because then it will look like you are serious about the centre.

 

Thanks Kirsteen for your info!

[juicyprunes]

this is just a rant, but....why are we expected to KNOW what we want to do before 3rd year is even over - heck! sometimes you have to "know" before 1st year so that you can have all your ducks lined up in a row. I think programs (mainly surgical ones) should respect the fact that people can have interests in multiple specialities - even when it comes to CaRMS crunch time.

 

The diversification rule is all fine and dandy, but it is not particularly difficult to fulfill it (i.e. through electives in summer of year 2/post-CaRMs electives) - so you still get people that do 20 weeks of electives in X, and of course, more "proof" of their interest.

 

OK...that was my rant.

[Kirsteen]

this is just a rant, but....why are we expected to KNOW what we want to do before 3rd year is even over - heck! sometimes you have to "know" before 1st year so that you can have all your ducks lined up in a row. I think programs (mainly surgical ones) should respect the fact that people can have interests in multiple specialities - even when it comes to CaRMS crunch time.

 

The diversification rule is all fine and dandy, but it is not particularly difficult to fulfill it (i.e. through electives in summer of year 2/post-CaRMs electives) - so you still get people that do 20 weeks of electives in X, and of course, more "proof" of their interest.

 

OK...that was my rant.

Hi,

 

I agree that it can be very difficult to figure out your career path early, or even later, on. This might have been one of the thrusts for introducing the elective diversification rule, i.e., it forces students to go and try other specialties.

 

However, even if you do end up committing early (or late) to one specialty or another, it's up to you to be able to adequately convince the Program Director and other folks within the program that you really want that specialty and/or the centre as well. This can be achieved effectively in many different ways.

 

Cheers,

Kirsteen

[BlackJack]

The crux of the matter is that the restrictive nature of CaRMS forces medical students to make uninformed career decisions early in their educations. This applies to the plastics gunner who is making the moves since day one of medical school, all the way to the family medicine aspirant who is taking a more relaxed path through their education. Neither really knows what their supposedly desired careers entail, and many end up disappointed years down the road due to their initial misconceptions.

 

Instead of being forced to make such far-reaching decisions so early and blindly, medical students should be able to experience medical practice in such a way that allows them to gain wisdom, however many years it takes, of which part of medicine truly interests them and is congruent with their future life plans.

 

How to do this is quite simple: open the first round CaRMS up to anyone with an MD degree, regardless of whether you matched years ago, or whether you matched in the second round as opposed to the first. Should you have matched to the easy-to-obtain family medicine in the past, worked a few years, and realized that interventional radiology is the bomb, you should be able to have the opportunity to compete for a radiology residency. Such a system would also be free of the coercive nature of return-of-service agreements, nor would re-applicants be restricted to limited, and often undesirable, re-entry positions.

 

I believe that this is a necessary step in improving the medical climate of students, physicians, and ultimately the general public. Satisfied physicians who have options to advance their careers are those who will serve the public better.

[abcwxyz]

The crux of the matter is that the restrictive nature of CaRMS forces medical students to make uninformed career decisions early in their educations. This applies to the plastics gunner who is making the moves since day one of medical school, all the way to the family medicine aspirant who is taking a more relaxed path through their education. Neither really knows what their supposedly desired careers entail, and many end up disappointed years down the road due to their initial misconceptions.

 

Instead of being forced to make such far-reaching decisions so early and blindly, medical students should be able to experience medical practice in such a way that allows them to gain wisdom, however many years it takes, of which part of medicine truly interests them and is congruent with their future life plans.

 

How to do this is quite simple: open the first round CaRMS up to anyone with an MD degree, regardless of whether you matched years ago, or whether you matched in the second round as opposed to the first. Should you have matched to the easy-to-obtain family medicine in the past, worked a few years, and realized that interventional radiology is the bomb, you should be able to have the opportunity to compete for a radiology residency. Such a system would also be free of the coercive nature of return-of-service agreements, nor would re-applicants be restricted to limited, and often undesirable, re-entry positions.

 

I believe that this is a necessary step in improving the medical climate of students, physicians, and ultimately the general public. Satisfied physicians who have options to advance their careers are those who will serve the public better.

 

And then how would all the recently graduated students match to anything?