Guest Kirsteen Posted May 7, 2002 Report Share Posted May 7, 2002 Hi guys, I'm wondering about surgical residencies. It seems that, for the Match you can select general surgery or a number of other surgical residencies, e.g., plastics, cardiac, etc. However, I've ran into a few people these past weeks who landed in their non-general surgical specialties via general surgery, e.g., a reconstructive plastic surgeon and an ENT (this one's for you Ian, he termed his specialty, "ear, nose and wallet", (the wee bugger), and said his schedule was pretty grotesque). I know that to enter some surgical specialties, e.g., vascular, you have little choice but to go the gen. surg. route and then sub-specialize from there, and for others, e.g., cardiac, you can move straight into the cardiac residency, or do three years of a gen. surg. residency and then move into it. Is there any info out there as to how all of this works? Is there any table, for example, outlining which surgical specialties you can reach from gen. surg.? Is it more difficult to enter a surgical specialty residency, e.g., cardiac, ENT, etc., directly or via the gen. surg. route? Is there any difference to these approaches at all? Lots of questions. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted May 7, 2002 Report Share Posted May 7, 2002 I've heard of Ear, Nose, and Wallet before. I think that's an eastern expression. Out west, I've heard it referred as Ear, Nose, and Tennis! Irrespective of that, many of the ENT surgeons here work pretty big hours (a lot hover in the 60 hour work week) which is pretty significant after all that training. As far as I know, there is no table delineating which fellowships can be attained by which specialty. What I think is important to realise, is that in the past, General Surgery was much more of a jumping off point into subspecialties than it is today. I think today's graduates are looking to enter directly into a subspecialty rather than toil in General Surgery-land for "x" number of years before entering the subspecialty. This is probably what your two surgeons did; I bet they've been out of residency for quite some time. In this regard, Canada is significantly ahead of the US for some specialties. Here, you enter into cardiac surgery, thoracic surgery, and plastic surgery immediately after medical school, whereas in the US, most of these programs are entered after spending a variable number of years in General Surgery first (although there are now integrated plastics spots in the US like we have). As far as the fellowships that you can get into after general surgery, they would include: Transplant (livers, pancreas, +/- kidneys) Trauma Endocrine Hepatobiliary Surgical Oncology Vascular Pediatric Colon and Rectal I'm sure there are others, perhaps in laparoscopic surgery, etc. The fellowships available after Otolaryngology include: Head and Neck Cancer Sinus and Nasal / Sinonasal Pediatric Facial Plastic and Reconstruction Otology / Neurotology Laryngology The fellowships available after Obstetrics and Gynecology include (and probably others): Maternal/Fetal Medicine aka Perinatology Gynecologic Oncology Reproductive, Endocrine and Infertility Urogynecology The fellowships available after Orthopedic Surgery include (and I don't know much about Ortho): ?Sports Med Trauma Pediatric Spine Probably every other limb, eg. Shoulder, Knee, Hips, etc The fellowships available after Urology include (again, don't know much about this one): Transplant (kidneys) Probably one for urinary tract cancers, another for reproductive med, another for endoscopic surgery. Anyway, I think the bottom line is that there's lots of fellowships available out there, which in general expand upon the area of the body that the original residency dealt with. What is not usually possible however, is to do one residency and then get a fellowship in an unrelated area; you'd have to do a second residency. ie. You can't do an Orthopedics residency, and then try to do a Urology fellowship such as kidney transplants. General Surgery is the funny one in this equation because the variety of fellowships afterwards is pretty vast; you can get to quite a few different areas within General Surgery. Ian UBC, Med 3 Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted May 8, 2002 Report Share Posted May 8, 2002 Great! Thanks for that extensive post and shedding some light on the world of surgery, Ian. Kirsteen Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted May 8, 2002 Report Share Posted May 8, 2002 Ian - Would you happen to know what subspecialties are available for ophthalmology? Specifically, is there a pediatric subspecialty? Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted May 8, 2002 Report Share Posted May 8, 2002 Ophthalmology has a bunch. Not sure if this is even close to comprehensive, but here in Vancouver, the following seem to be subspecialties within Ophtho. Whether they are true fellowships of their own, I couldn't tell you, but certainly there are people in Vancouver with a serious focus to one of the below areas: Pediatric Oculo-Plastic Retinal Cornea/Anterior eye Glaucoma Neuro-Ophthalmology Cataract I'm sure there's also an oncology subspecialty within there somewhere. Ian UBC, Med 3 Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted May 8, 2002 Report Share Posted May 8, 2002 Pediatric is the one I'd be specifically interested in. . . I used to work at a day camp with the CNIB in Ottawa and am sort of interested in working towards correcting vision impairments in kids. Thing is, I don't want to be 'that guy' shooting for opthalmology and find many of the other specialties interesting. Still, it's good to know that option is out there! Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted May 9, 2002 Report Share Posted May 9, 2002 Hi Ian, I just remembered one of your points, above, which I didn't add to later on, which I should, as it may prove useful at some point (although hopefully not, given that you're hoping to move straight into ENT post-graduation). Yes, you're absolutely spot on with respect to gen. surg. acting as a jumping point in previous years. This seems to have been the case for at least one of the surgeons--the plastic surgeon. However, the ENT guy is ~1 year into an ENT residency after having spent a couple of years in gen. surg. Judging by his appearance I'd say that this probably dovetails with his graduation from medical school just a few years ago, i.e., he didn't look that old at all. Therefore it appears that here, in TO anyway, this sort of gen. surg. springboarding can be done. By the way, I didn't go into the circumstances around his move, but if I run into him again (albeit, highly unlikely) I'll ask. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest katwoman2003 Posted July 27, 2004 Report Share Posted July 27, 2004 Gen Surg is one of my interests for residencies and from conversations with a couple of residents here in Calgary I heard that Gen Surg was not very popular before due to the lifestyle of the residency itself. However from the recent CARMS stats, it's becoming more and more popular. I was wondering if anyone out there can shed some light on how competitive it's going to be the next few years, and how should I prepare for the match if Gen Surg is what I'm going for (e.g. research, electives, etc.)? Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted July 28, 2004 Report Share Posted July 28, 2004 You should still be able to match into General Surgery no problem, if you're willing to be flexible as to where you train. It's pure hypothesis on my part, but I think a lot of people ranked General Surgery as a backup this year in CaRMS due to all the unmatched carnage that happened in CaRMS 2003. General Surgery is always going to be lower down on the competitive list for surgical specialties as long as its work hours and compensation are poorer than the other surgical subspecialties like Urology, Plastics, ENT, Orthopedics, Ophtho, etc. As with any other field, research, strong electives with good letters of recommendation, and good interview skills will take you far. Ian Link to comment Share on other sites More sharing options...
Guest jmh2005 Posted August 29, 2004 Report Share Posted August 29, 2004 Make sure that you know exactly what you are getting into if you decide to go the Gen Surg route. This speciality is very, very demanding in terms of hours and overall lifestyle. During my Gen Surg clerkship I met a very amazing resident who was just finishing up her 2nd year; she was a walking fountain of knowledge. She went into Gen Surg because she found it fascinating, rewarding and filled with opportunties to really make a difference and then she didn't mind the demanding hours. But things do change...and your priorities can easily change. She is an incredibly strong person who chose her speciality with her eyes open, yet she found herself realizing that she couldn't continue to work as hard has she has been over the past few years. She felt she was just giving up too much outside of medicine. She just changed her specialty in July. Its a very difficult lifestyle...just make sure you are aware and prepared...This is just one example, however and many people choose this speciality and do just fine, handle the hours and seem balance everything...I just thought I would share my thoughts with you... Best of luck Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted August 29, 2004 Report Share Posted August 29, 2004 Hi there, jmh2005, do you mind if I ask what specialty this person switched to? Did they have a challenging time doing so? Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Guest jmh2005 Posted August 31, 2004 Report Share Posted August 31, 2004 The person I was talking about switched to Anesthesia. It didn't sound like she had a hard time at all making the switch...a couple of meetings with program directors...I think making the decision to switch for her, was much more difficult. Its easier to make a switch when you already have 5 years of funding in tow. It's apparently far more difficult to go from Family Medicine to say FRCPC Anesthesia for example (2 vs 5 years of funding are allocated when you match...). Hope you have been enjoying your first month in Calgary! J Link to comment Share on other sites More sharing options...
Guest Kirsteen Posted August 31, 2004 Report Share Posted August 31, 2004 Hi there J, Thanks for your response and insight. I didn't realize that it might be easier to switch if you already had a long residency ahead of you. As for the first month at UofC, it's been brilliant. Best of luck to you this fall! Cheers, Kirsteen Link to comment Share on other sites More sharing options...
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