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Gen Surg Backing Up With Ortho?


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The recent CaRMS match has taught me one thing - BACK UP! Even if you think you're a competitive applicant, it's not worth the risk of going unmatched. Of course there was a lot of success stories, but its the devastations that we all remember!!

 

With that in mind, I'm planning on backing up my general surgery application with ortho - I would be happy doing ortho as well. I'll most likely hit up 1-2 ortho pre-carms electives and 1 post-carms as well. 

 

Would this be a reasonable back up? I know ortho is slightly less competitive than gen surg - but I know I'm limited with my fewer number of electives as well!

 

Thoughts?

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Watch out.  The classic path is to back up Ortho with Gen Surg.  When you apply to Gen Surg they may think that you're backing up the other way and rank you lower.  Even if Gen Surg is more competitive right now (I honestly have no idea) very few people will do anything in Ortho unless they're interested in it.  Only one match last year in Ortho was second choice v. 9 in Gen Sx. Subjectively, Gen Surg is very touchy about being treated as a back-up.  Also, post-CaRMS electives are useless other than hinting to selection committees that you changed your mind late and are scrambling.

 

The classic back-up for Gen Surg is Family or second round Gen Surg (there are always vacancies).

 

On a personally biased note, you may want to look into your choices a bit.  In my experience, the day-to-day practice of Gen Surg and Ortho are very different.  Most people who like one hate the other. 

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I'll have about 4 pre-CaRMS Gen Sx and have strong research in Gen Sx as well. Would that help differentiate me? I know theres a lot of beef with these two specialties and I don't want to piss of my number 1 - but at the same time, I don't want to back up with something I have no interest in doing. I'll most likely do 1 pre-CaRMS and 1 post-CaRMS ortho. I have some minor research that wasn't very fruitful in it as well.

 

I love operating - I've spent time in both fields and while they're different, I actually enjoy the differences in their own way. Gen surg has the medicine aspect to it, which I enjoy and the patients tend to be very sick. Ortho has a lot less medicine but they operate A LOT which I definitely like. They also have very concrete solutions to most of the problems they encounter - fix the fracture - which I like. I also love MSK anatomy and find it fascinating.

 

What do I want to be overall? Probably a general surgeon - the combined surgical and medicine care for patients appeals to me. But if I couldn't do that - I could be very happy in ortho since I'd still get to operate. Family med and internal - neither appeal to me as neither involves surgical management. I love being in the OR and I love the direct, concrete approach to surgical problems (although of course there is variation, etc): taking out an appendix/fixing a fracture is acutely interventional and fascinates me a lot more than managing diabetes/COPD exacerbations with medications and other more long term interventions. 

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That sounds like a pretty reasonable gen surg application, though I would not expect it to yield many ortho interviews. I'm sure you can spin a handful electives easily enough during a gen surg interview, especially when they're coming post or peri-CaRMS, an interest in trauma being the main overlap. 

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That sounds like a pretty reasonable gen surg application, though I would not expect it to yield many ortho interviews. I'm sure you can spin a handful electives easily enough during a gen surg interview, especially when they're coming post or peri-CaRMS, an interest in trauma being the main overlap. 

 

Yeah I worry about the number of ortho interviews I'll get - I'm thinking at least at the school I do an elective at and my home school as my core ortho rotation was really good and yielded a letter? If I get at least 3 or 4 I'd be happy. I'll apply all over Canada for both ortho and gen surg. Is that a realistic expectation?

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Watch out.  The classic path is to back up Ortho with Gen Surg.  When you apply to Gen Surg they may think that you're backing up the other way and rank you lower.  Even if Gen Surg is more competitive right now (I honestly have no idea) very few people will do anything in Ortho unless they're interested in it.  Only one match last year in Ortho was second choice v. 9 in Gen Sx. Subjectively, Gen Surg is very touchy about being treated as a back-up.  Also, post-CaRMS electives are useless other than hinting to selection committees that you changed your mind late and are scrambling.

 

The classic back-up for Gen Surg is Family or second round Gen Surg (there are always vacancies).

 

On a personally biased note, you may want to look into your choices a bit.  In my experience, the day-to-day practice of Gen Surg and Ortho are very different.  Most people who like one hate the other. 

 

Programs are F***ing with the system when they do this and they should get called out for it.

 

I agree with Gen Surg and Ortho being WILDLY different. I see zero overlap between the job and the personalities who are in them.

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Yeah I worry about the number of ortho interviews I'll get - I'm thinking at least at the school I do an elective at and my home school as my core ortho rotation was really good and yielded a letter? If I get at least 3 or 4 I'd be happy. I'll apply all over Canada for both ortho and gen surg. Is that a realistic expectation?

I wouldn't expect a lot of Ortho interviews or high enough rankings. Another issue is that the interview periods might overlap.

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I know someone who applied to 3 surgical programs (including gen surg.) and got into none of them... (But she did match). In my opinion, backing in another surgical field is not realling backing... and is not enough if you really want to match. But it is your choice weither you would prefer taking a year off (and taking the risk of not matching the year after) or go into a non-surgical program. 

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Having participated in the selection process this year from the other end... not a good idea.

It shows on an application when someone is backing up, and you likely won't get much interviews. If you do get interviews, unless this interview is stellar, you will probably not be ranked very high up the list.

As ortho is a very demanding specialty, with grueling hours and lots of study (like any surgical specialty), they look for applicants that are very motivated and would not see themselves do anything else.

Overall, backing up a surgical specialty with another surgical specialty is never a good idea...

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Having participated in the selection process this year from the other end... not a good idea.

It shows on an application when someone is backing up, and you likely won't get much interviews. If you do get interviews, unless this interview is stellar, you will probably not be ranked very high up the list.

As ortho is a very demanding specialty, with grueling hours and lots of study (like any surgical specialty), they look for applicants that are very motivated and would not see themselves do anything else.

Overall, backing up a surgical specialty with another surgical specialty is never a good idea...

 

I totally agree with this and should mention that I've been a selection committee member for many years. 

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I fell victim to this as well. Applied for another very competitive surgical specialty and also gen surg. Would have been incredibly happy doing either. Didn't match to any surgical specialty but still matched. It is certainly disappointing that it becomes an "all or nothing" for a lot of surgical specialties and despite someone genuinely being happy with either outcome, it is not believed by the selection committee and results in lower ranking. 

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I fell victim to this as well. Applied for another very competitive surgical specialty and also gen surg. Would have been incredibly happy doing either. Didn't match to any surgical specialty but still matched. It is certainly disappointing that it becomes an "all or nothing" for a lot of surgical specialties and despite someone genuinely being happy with either outcome, it is not believed by the selection committee and results in lower ranking. 

just to clarify...you ranked 2 surgical specialties + another specialty? 

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I am not aiming for gen surgery or any surgical speciality.

Having the chance to speak with the program director of gen surg and surgeons in the selection committee at my home school, they definitely prefer to see candidates to have done almost all their electives in gen surgery. Gen surg is definitely demanding in terms of hours and dedication, they want candidates who are 100% sure that they want to be gen surgeons. As soon as they see that you are backing up with another surgical specialty, you fall a bit behind the list.....Probably it is different in other schools :)

Gen surg is becoming more and more competitive, since they are reducing the number of residency spots....

The recent CaRMS match has taught me one thing - BACK UP! Even if you think you're a competitive applicant, it's not worth the risk of going unmatched. Of course there was a lot of success stories, but its the devastations that we all remember!!

 

With that in mind, I'm planning on backing up my general surgery application with ortho - I would be happy doing ortho as well. I'll most likely hit up 1-2 ortho pre-carms electives and 1 post-carms as well. 

 

Would this be a reasonable back up? I know ortho is slightly less competitive than gen surg - but I know I'm limited with my fewer number of electives as well!

 

Thoughts?

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I fell victim to this as well. Applied for another very competitive surgical specialty and also gen surg. Would have been incredibly happy doing either. Didn't match to any surgical specialty but still matched. It is certainly disappointing that it becomes an "all or nothing" for a lot of surgical specialties and despite someone genuinely being happy with either outcome, it is not believed by the selection committee and results in lower ranking. 

 

Did you split your electives? Like 3 gen surg/2 ortho - or did you do a majority of them in one surgical specialty with 1-2 in another and still not get a surgical specialty?

 

I'll be doing 4 general surgery electives, have general surgery research, etc - so I'm not worried about looking like I'm not all in, since I think my app says general surgery more than anything...

 

My one ortho elective - I think i can swing that to general surgery as "I want to gain trauma exposure". But heres the thing- not backing up is too risky but backing up means you give away at least one pre-CaRMS so no matter what I back up with....so no matter what - I'd have to explain the one non-general surgery elective to the committee! Does this make sense?

 

I guess - how would anyone backup without doing at least 1 pre-CaRMS elective in your back up? Does every single person who matches to surgery do ALL pre-CaRMS in their surgical specialty of choice? 

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  • 2 weeks later...

Did you split your electives? Like 3 gen surg/2 ortho - or did you do a majority of them in one surgical specialty with 1-2 in another and still not get a surgical specialty?

 

I'll be doing 4 general surgery electives, have general surgery research, etc - so I'm not worried about looking like I'm not all in, since I think my app says general surgery more than anything...

 

My one ortho elective - I think i can swing that to general surgery as "I want to gain trauma exposure". But heres the thing- not backing up is too risky but backing up means you give away at least one pre-CaRMS so no matter what I back up with....so no matter what - I'd have to explain the one non-general surgery elective to the committee! Does this make sense?

 

I guess - how would anyone backup without doing at least 1 pre-CaRMS elective in your back up? Does every single person who matches to surgery do ALL pre-CaRMS in their surgical specialty of choice? 

I did 1-3wk gen surg, 1-3wk burns (which could either be plastics or gen surg), 3 plastics, 1 rad, 1 anesthesia. 

 

I also had general surgery research, although my first choice discipline was plastics. 

 

Had more general surgery interviews than plastics despite having applied to all the plastic surgery programs and only 5 general surgery (something I now regret) and matched to non-surgical specialty.

 

Good luck with your upcoming match. My recommendation would be to apply broadly to both and hope for the best!

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I did 1-3wk gen surg, 1-3wk burns (which could either be plastics or gen surg), 3 plastics, 1 rad, 1 anesthesia. 

 

I also had general surgery research, although my first choice discipline was plastics. 

 

Had more general surgery interviews than plastics despite having applied to all the plastic surgery programs and only 5 general surgery (something I now regret) and matched to non-surgical specialty.

 

Good luck with your upcoming match. My recommendation would be to apply broadly to both and hope for the best!

By non surgical do you mean you ended up in either rads or anesthesia? Those are still pretty good and I know of people transferring to gen surg 

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  • 3 weeks later...

25 more residency spots being cut in Ontario this year; you can almost bet ortho is going to make up at least a couple of them with how saturated the job market is. All of the surgical specialties, with possibly the exception of gen surg, will be at risk of losing a position or two next year across the province. 

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