best general surgery programs in the country?

[futuredoctor87]

best general surgery programs in the country and why?

 

Thanks

[shaka84]

What are you looking for? Research? Big program? Resident supportive?

 

Shaka

[futuredoctor87]

I'm looking for a lot of hands on experience and the most realistic view into the world of a surgeon. I would also like to do some research, but that is a lower priority than lots of OR time.

[Med0123]

This is highly subjective and dependent of your future plans. Each of the 17 general surgery programs have a good reputation and lead to the formation of a competent surgeon who will be able to manage adequately a surgical unit at the end of his training.

 

Most of my advices are somewhat general since I wanted to stay in a particular province. Therefore, I did not interview across all Canada and I don't know all the 17 programs. But here are some facts I know :

 

In most programs, you will operate 4-5 days a week from PGY-3 to PGY-5 (in your surgical rotations). If you seek a lot hands on experience since PGY-1, I suggest you to get your training in a more "community"-based university (smaller town). Big academic center are great for good exposure to weird cases/ultra new technologies, but consider there might be more fellows "stealing" your OR time. Will your technical exposure suffer? Maybe a little bit. You'll have research/MSc opportunities in every programs and dedicated research rotations since it is a RCPSC mandatory requirement (the length of this dedicated time varies).

 

You should ask senior residents/Program Director where most of their graduates end up after their training (fellowship and academic, fellowship and big community hospital, small community hospital, rural/remote area) and see if it fits your expectations.

 

Also, keep in mind that being trained in smaller programs doesn't necessarily mean that the academic road will be closed forever. There's a selection bias in which smaller programs tend to be ranked higher by people who know by the end of med school they do not want to pursue their residency with a fellowship and therefore the rate of residents pursuing further training in these universities is lower than in bigger universities... However, the staff surgeons training you have a fellow, they will give you support for research if you ask to and they have connections with PDs from programs offering fellowships.

 

Take into account the general atmosphere in the program and if residents appreciate working there 80+ hours a week. You'll spend in this program 5 of your best years in your life, make them enjoyable! Ask yourself the same question about the city where you'll get your training (friends, family, atmosphere of the city, sports, etc.)

 

It is really during the interviews time in january/february where you'll get the real opportunities to ask those questions and to determine what is the best general surgery program in Canada... for YOU!

[likeyouknowwhatever]

I agree with what's been said above- everywhere in Canada will train you well, and each program has their strengths.

 

I did notice 2 things while on the interview tour this year that helped me make my final decision.

 

First, institutions tend to hire more from within. For example, if you look at the list of Toronto general surgery staff, the majority did their residency in Toronto. That is not to say that you need to do residency in Toronto to get a job there, and many AMAZING surgeons working in Toronto trained elsewhere, but if there is a compelling reason for you to want to end up in a certain location, consider doing your residency there.

 

Second, look at where graduates of the program go for fellowships, and see if certain schools tend to match more graduates to whichever fellowship you're interested in (if you know yet!).

[itimebomb2]

I find the best way to learn about programs is to see the program firsthand, as well as to hear from other places some objective 3rd party opinions. I have compiled the following:

 

Ottawa: Extremely collegial program - this year apparently got 6 of the top 8 candidates that they ranked. Great rapport between residents and staff.

 

Alberta: A little old school in style, larger program. Feedback from residents was good - attended a journal club with at least 30-40 attendees- lots of drinks and food- I think it says a lot about the program that they're able to hang out as a huge group of friends.

 

Toronto: Everyone's experience will vary since there are so many hospitals and staff. I did not find them intimidating - there were moments of "Toronto"-ness but overall a very academically strong program with tonnes of opportunities for research and specialization. Lots of fellows which definitely encroaches on operating experience - but also increases the expertise available around you.

 

Queens: Was not impressed. Residents weren't that happy about being there, and neither were many of the staff. Lots of complaints, low volumes - situated between Ottawa and Toronto - no surprise. Small program. Limited OR experience.

 

McMaster: Not a particularly popular program from the perspective of other places, and a few rumours. Have been plagued in the past by dropouts and royal college failures but tend to be a reflection more of individual than the program. All of the residents I have met seem very pleased and go out of their way to make that known - but take that for what it is worth. I enjoyed working at Mac. Strong academic focus, great small city with cheap housing, stone's throw from TO and not particularly intense.

[Aequora]

What universities have a general surgery residency that better prepares residents for a fellowship in trauma surgery? I would think that the University of Toronto would be appropriate since St. Michael's and Sunnybrook are Level 1 Trauma Centres, but I just don't know the level of exposure general surgery residents would have to that environment. I recall them having a four month rotation in trauma services, and it's probably possible to focus an elective on it as well. But how does it compare to other residencies?

[Lactic Folly]

If you're going to immerse yourself in a certain area during fellowship, wouldn't you rather solidify your training during residency in all the other areas *not* covered by the fellowship?

[NLengr]

What universities have a general surgery residency that better prepares residents for a fellowship in trauma surgery? I would think that the University of Toronto would be appropriate since St. Michael's and Sunnybrook are Level 1 Trauma Centres, but I just don't know the level of exposure general surgery residents would have to that environment. I recall them having a four month rotation in trauma services, and it's probably possible to focus an elective on it as well. But how does it compare to other residencies?

 

I think every center except Queen's and NOSM (someone can correct me if I am wrong) is a level one trauma center.

 

Toronto as a city probably has the most trauma, obviously the bigger the city, the more trauma.

 

Of course "lots of trauma" in Canada is like "a bit of trauma" in the US.

 

Can't comment on the quality of trauma experience in each center, but I don't think it's going to be amazing in any Canadian city. Unless we suddenly lower driving safety standards and become much more violent.

[Aequora]

If you're going to immerse yourself in a certain area during fellowship, wouldn't you rather solidify your training during residency in all the other areas *not* covered by the fellowship?

 

I'm not sure. However, during those five years of residency in General Surgery there is quite a broad-base of training. I think that rotating through other surgical specialties and the subspecialties of general surgery should be sufficient exposure to "all other areas." Especially with only one elective available to focus on something specific. But, I could understand that perhaps focusing an elective on another surgical field could be beneficial in the long-term, depending on what types of patients you're exposed too. There is also the reality that you may change your surgical interests later on. But in the original case, what other surgical specialties better prepare you for trauma, if not trauma itself?

[coastalslacker]

I think every center except Queen's and NOSM (someone can correct me if I am wrong) is a level one trauma center.

 

.

 

Queen's is a level 1 trauma centre. Typically we're either the 2nd or 3rd busiest centre in the province in terms of "trauma". We get a big stretch of the 401 and some dumb dumb people with ATVs and snow mobiles. Kingston General and the Ottawa Civic go back and forth in terms of volume of traumas.

 

I don't know how that translates to trauma cases that get taken to the OR for gen surg. Not the stabbings/gun shots that Toronto gets, although the prisons in the area do yield a reasonable number of stabbings.

[gs12345]

You will see lots of trauma at UBC, U of A, Calgary, Toronto, Mac, London, and Dal.

Adequate amounts at U of S, Manitoba and Ottawa.

On the low side for Queens, NOSM, and MUN.

[northernnurse]

NOSM actually has multiple rotations for trauma based in Toronto's trauma centres to provide experience since it recognizes those opportunities are not as readily available up north.