General Surgery Residency

[FutureDoc6666]

How competitive is it to obtain a GS residency in Ontario? Is it hard to find a job after residency? How much do GS make roughly anyway?

[rmorelan]

How competitive is it to obtain a GS residency in Ontario? Is it hard to find a job after residency? How much do GS make roughly anyway?

 

It is competitive - say around a 85% chance of getting it you apply for it broadly - less if you restrict your self for residency location.

 

There are some job restrictions right now - who knows what it will be in 10-15 years of course. Hard to do that with any field.

 

Varies of course, but after you go through the long hall to get there billing estimates of 350K-400K are not unusual. You some expenses to take out of that though.

[FutureDoc6666]

It is competitive - say around a 85% chance of getting it you apply for it broadly - less if you restrict your self for residency location.

 

There are some job restrictions right now - who knows what it will be in 10-15 years of course. Hard to do that with any field.

 

Varies of course, but after you go through the long hall to get there billing estimates of 350K-400K are not unusual. You some expenses to take out of that though.

 

Do your chances get better if you do a fellowship?

[rmorelan]

Do your chances get better if you do a fellowship?

 

You mean after to actually get a job somewhere? sure - in fact fellowships (sometimes more than one) are becoming the total norm (similar to a lot of fields).

 

If you want to work at a major centre then it is all but required.

[Mandibular]

to my knowledge, there actually wasn't any advertised international position in the country since January 2013

[NLengr]

You mean after to actually get a job somewhere? sure - in fact fellowships (sometimes more than one) are becoming the total norm (similar to a lot of fields).

 

This is sad but true. It's an indication of a problem in both the job market and the training system.

[rmorelan]

This is sad but true. It's an indication of a problem in both the job market and the training system.

 

part of it too is it just is taking that much longer to learn everything you need to know to actually do anything is some specialties - some fellowships are still in my mind almost pointless functionally but annoyingly still required practically to advance in your career - but many are truly necessary to learn an area well enough to actually practise.

[Med0123]

in radiology, how is a fellowship in MSK really that necessary to practice in an academic environment? why is a fellowship in knee and ankle required to practice in a community based hospital in a town of 60k people? it just doesn't make any sense, we are training to many specialists...

[rmorelan]

in radiology, how is a fellowship in MSK really that necessary to practice in an academic environment? why is a fellowship in knee and ankle required to practice in a community based hospital in a town of 60k people? it just doesn't make any sense, we are training to many specialists...

 

yeah there are some that just are out of whack (although I am not completely sure about the exact specifics).

 

Then there are things like interventional radiology - ha, you need that fellowship time.

[Lactic Folly]

in radiology, how is a fellowship in MSK really that necessary to practice in an academic environment?

There is just so much to know that it is impossible to cover each area in depth during residency. If you are being hired as an MSK person, academic or community, you will be expected to be the go-to person for difficult cases and consult with orthopedic surgeons (and even teach fellows in an academic centre), so the added experience from a fellowship would be of much value.

[NLengr]

The thing is, if you look at the studies, what we have done is taken cases that used to be done by senior residents and have made it so they are now done by fellows. As a result, you get less exposure during residency.

 

From a surgical point of view, fellowships don't add skill. What adds skill is practice. It's case load, not extra training that makes you good. What fellowships should be about is training academic surgeons to do research and pursue new treatments. I know plenty of community non fellowship surgeons who could out operate academic fellowship surgeons because, quite frankly, the community guy had much higher volume.

 

I think a huge driver for fellowships is the academics themselves. They love fellows. You get extra slave labour to do things like research in your name, run your clinic or cover your OR's. I don't think for a second that academia would support a reduction in fellowships. It's too much of a cash cow for them. That's another reason you see the academic guys go on and on about fellowships being the end all and be all.

[NLengr]

There is just so much to know that it is impossible to cover each area in depth during residency. If you are being hired as an MSK person, academic or community, you will be expected to be the go-to person for difficult cases and consult with orthopedic surgeons (and even teach fellows in an academic centre), so the added experience from a fellowship would be of much value.

 

The thing is in many community practices, you don't need that level of expertise. You need someone who is very good at bread and butter stuff. The freak cases are then sent to the academics.

 

For example, if you are a ortho in Sarnia, you need to be very good at the general operations of ortho (hips, knees etc). What you don't need there is a guy with some super special knee reconstruction in athletes. You ship those one or two patients a year off to the Academic center 2 hours away. Unfortunately, we are now seeing people having to get those crazy fellowships in order to go to Sarnia and do bread and butter ortho.

[Lactic Folly]

The thing is in many community practices, you don't need that level of expertise. You need someone who is very good at bread and butter stuff. The freak cases are then sent to the academics.

Agreed - my comment was aimed at the question on academic radiology. A fellowship is not required to practice general community radiology either, but may be desired by larger private practice groups where there is subspecialization within the group.

[cdnmaple]

in radiology, how is a fellowship in MSK really that necessary to practice in an academic environment? why is a fellowship in knee and ankle required to practice in a community based hospital in a town of 60k people? it just doesn't make any sense, we are training to many specialists...

 

So it goes.

 

A recent posting for general surgery in a community hospital wanted someone with both MIS and surgical oncology fellowships.

[rmorelan]

So it goes.

 

A recent posting for general surgery in a community hospital wanted someone with both MIS and surgical oncology fellowships.

 

ha - I wonder if they will get it. I mean people ask for all kinds of strange things in job postings. When I was a programmer people used to ask for so many years experience with a particular programming language - a number of years that often exceeded the number of years a particular language was even in use, i.e. the request was impossible. Like everyone else hospital admins can dream

[rmorelan]

Agreed - my comment was aimed at the question on academic radiology. A fellowship is not required to practice general community radiology either, but may be desired by larger private practice groups where there is subspecialization within the group.

 

Makes sense - speed is important in private practises as well and if there is one person who can accurately and quickly go through a part of their volume it helps the overall group.

[cdnmaple]

ha - I wonder if they will get it. I mean people ask for all kinds of strange things in job postings. When I was a programmer people used to ask for so many years experience with a particular programming language - a number of years that often exceeded the number of years a particular language was even in use, i.e. the request was impossible. Like everyone else hospital admins can dream

 

As I understand it, they did. Which raises the high likelihood that it was a targeted recruitment posting. Rumour has it they still had over 30 applicants though I doubt many of them had the requested background.

 

It kind of reminded me of some job postings you see for people trying to bring specific workers/family members into the country. They're required to post to prove that this individual is the only one that will fit the bill and no local applicants will suffice. I remember one I saw posted in the prairies for a specially trained sushi chef (and they listed some kind of sushi credentials) who could play classical guitar.

 

Edit to add: While the applicant-to-position ratio on that Gen Surg/MIS/Surg Onc job was a rumour, I also know that an even smaller regional hospital had over 30 applicants for an ortho posting, some of whom were lucky enough to be previously licensed as GPs and were "biding time" doing GP work while trying to get an Ortho job.