Monthly Archive: May 2012

Spotlight Interview: Matching in General Surgery

 

A General Surgery Resident’s Perspective:  From an interview with a general surgery resident at Orlando Health in Orlando, FL

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the general surgery match?

Moderately difficult. The average USMLE Step 1 score is usually in the high 220s, but higher for the sought after programs.

 

  •  What must a student do to match well in general surgery?

Your USMLE Step 1 score is the most important factor. Letters of Recommendation are very impotant and some should come from surgeons you have worked closely with. If you are interested in a research institution then research publications and presentations are very important.

 

  • What are residencies looking for in a general surgery applicant?
They are looking for someone who is Intelligent; they use Step 1 scores to establish this. They are also looking for someone who is passionate and hard-working; they can learn this through the activities you list and from the things mentioned in your letters of recommendation. It is important to be easy to work with, you can show this to programs during your interview.

 

  • What should students look for in a general surgery residency?

From a training standpoint, I think that surgical simulation experiences and structured education lectures/curriculum are something that every applicant has to be aware of. These experience are paramount in your surgical training. As you probably know, operative experience volume and variety is one of the most important factors (i.e. how many mastectomy vs whipple cases). You should know these statistics about each of your programs of interest.

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

Letters of recommendation should be from faculty that can speak to your strengths in clinical decision-making and surgical skills. Personal statements should not be about how you always wanted to be a surgeon, but why you decided to be a surgeon. Rank programs that provide you with a high operative experience and well-defined simulation/education curriculum

 

  • What do you wish you knew before application/interview season?  

Be sure to prepare your  letters of recommendation early. Plan to interview at about 10-15 programs. If you plan to interview at highly competitive programs, you might need to plan on a bit more interviews.

Editor’s Note: I 100% agree with preparing your LOR early.  Many of the attendings are extremely busy and 1 month notice may not be enough. Start asking at the end of your third year if you find individuals who could write great letters.

 

  • What other advice do you have for students applying to general surgery residency?

The best advice I ever received about deciding to do general surgery was “If you can’t do anything but general surgery and be happy as a physician then you should do surgery. Otherwise do the other specialty”. General surgery is a much more family-friendly specialty than it used to be. The egos and personalities that used to predominate the specialty are gone, surgeons are expected to be calm and mild-mannered today and exist well with their non-surgical counterparts. The best part of being a surgeon is being able to diagnose and treat the problems our patients face. When all other options fail and other specialties are uncertain what to do they will consult a surgeon to help, so you will be the go-to person where-ever you practice

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

Spotlight Interviews: Why did you choose general surgery?

A General Surgery Resident’s Perspective: From an interview with a general surgery resident at Orlando Health, in Orlando, Florida.

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to General Surgery?

I appreciate the combined operative and medical management of patients. Surgeons make definitive management of patient issues. There is a great variety of operative procedures. As a general surgeon I am able to care for both long and short term patient management scenarios. There is a great deal of job opportunities and availability. I enjoy team-based patient management.

 

  • Describe a General Surgeon’s typical work day?

I usually wake up at 0400,I am at hospital by 0500 to round on patients until about 0700. I will be in the OR from 0700 until about 1600 with intermittent 30-60 minutes breaks between cases to eat, follow-up on patients, and see new consults. From 1600-1800 we follow-up on outstanding patient issues and setup for following day. On good days, I return home and from 1800-2000 I study for following day cases and current patient problems. On non-operative days, simply change the OR times  to clinic from 0800-1600.

 

  • What type of lifestyle can a General Surgeon expect?  

As a general surgeon I work weekends at least 2-3 times per month. The amount of free time you will have is extremely dependent on your sub-specialty choice. Private practice surgeons enjoy significantly more free time while surgeons in academic practice spend more time with research and have less operative/clinic time generally. Call is usually taken for 24 hours periods and you will be working most of the day and night. Some surgeons have a tendency to scheduling elective cases during their call days, but this depends on how difficult your call is.

 

  • What is the average salary of a General Surgeon?

The overall salary of a surgeon is highly variable amongst sub-specialties, typically  between $250,000-$500,000.

 

  • What is the job market like for General Surgeon?

There is no lack of general surgery positions. I would say they are extremely available for both private practice and academic positions. There is some variability among sub-specialties. However, overall, we are one of the most high recruited specialties.

 

  • What can you tell us about General Surgery Sub-specialties?

Residency for general surgery is 5 years mandatory and more commonly 1-2 years research years during PGY2 or 3. Therefore, many general surgery residencies last 6-7 years before fellowship. Fellowships typically last 1-2 years. Subspecialties have more call and higher salary. Additionally, sub-specialties are generally in more demand than general surgeons.

 

  • What are the potential downsides of General Surgeon that students should be aware of?

The schedule is less flexible due to emergent surgical problems. Surgical shift hours are not reliable and typically cases will be delayed or run over and require staying at the hospital beyond a call or shift. This leads to a schedule that can be variable. Training programs are not as “intense” as they were historically, although there are still high expectations of surgical residents. There are not many other residents/doctors who work as hard as general surgeons.

 

  • What else would you tell medical students who are considering General Surgery?

One thing students should realize is that there is more peri-operative management being handled by hospitalist services for elective surgical problems. Therefore, some of the duties and responsibilities of a surgeon 20 years ago and being placed in the hands of non-surgeons. Additionally, surgical critical care services are beginning to  limit the medical management requirements of general surgeons.

 

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.

 

Spotlight Interview: Matching in Psychiatry

 A Psychiatry Resident’s Perspective:  From an interview with Dr. Frazier a psychiatry resident at UC Irvine Medical Center in Irvine, California

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the psychiatry match?

Overall, it is not a very competitive specialty.

 

  •  What must a student do to match well in psychiatry?

Mainly, you must show interest in the field. Let people know you’re interested when you’re in your rotation. Doing some research also helps you know if you like the field. Research may also help to get a good letter from someone at your university.

 

  • What are residencies looking for in a psychiatry applicant?
Solid letters of recommendation, a good personality (more important here than in many other specialties), to a lesser extent good board scores (not as important, but they will definitely help you!)

 

  • What should students look for in a psychiatry residency?

Look for a program that trains physicians in what you want to do. Are you interested in research? Choose a program that supports that. Are you interested in clinical work? Choose one that focuses more on that. Also, make sure you get along with the residents. I recommend an away rotation to your top school(s) if you can.

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

Identify your letter writers early on. A few from psychiatry, one from medicine, one from family medicine or something else. For ranking, just choose the place that you want the most. Don’t try to game the system!

 

  • What do you wish you knew before application/interview season?  

Interviews are generally very laid back. Still prepare, but don’t stress them too much. Have a few questions for the interviewers.

 

  • What other advice do you have for students applying to psychiatry residency?

Again, identify letter writers early. They mean a lot for residency in general, but maybe even more for psychiatry. Other than that, enjoy your career!

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the Match, The Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

Spotlight Interview: Why did you choose psychiatry?

A Psychiatry Resident’s Perspective: From an interview with a psychiatry resident at UC Irvine in Irvine, California

Part of an interview series entitled, “Specialty Spotlights“, which asks medical students’ most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to Psychiatry?

I like the idea of working with the whole person. I feel like in psychiatry you address a person’s social, financial, and relationship concerns, which in my mind are the most important part of life.

 

  • Describe a Psychiatrist’s typical work day?

There are different fields in psychiatry, but what I’m interested in is private practice. I’ll probably end up splitting my days between therapy and medication management appointments. Therapy appointments usually go an hour, med management about 15-20 minutes. In those visits the person already has a therapist but consults a psychiatrist for medications.

You can also work in an inpatient setting in a hospital, work for the prison system, do telemedicine (something else I’m interested in), work with children, geriatrics, forensic, or almost anything else you want. I like the variety of the specialty.

 

  • What type of lifestyle can a Psychiatrist expect?  

Psychiatry has the big advantage of being a less demanding specialty. Depending on your working situation, you might be on call once a week or so. Even the psychiatry residency usually has weekends off! Most private practice psychiatrists work around 30 hours per week.

 

  • What is the average salary of a Psychiatrist?

Again depends on your situation, but you’ll see something like $200,000 as an average. In California, psychiatrists generally take cash only and charge around $300 an hour.

 

  • What is the job market like for Psychiatrist?

There’s a big need for psychiatrists. In particular, child psychiatry needs more people.

 

  • What can you tell us about Psychiatry Sub-specialties?

Child psychiatry: 2 extra years after residency (but you can eliminate your 4th year of adult and make it 5 years total for adult and child). There is more demand for this field. The salary is generally higher. The lifestyle is about the same for this and all the others.

Forensic psychiatry: 1 extra year. Harder to get a footing in this one, but pays very well once you do ($1000 per hour for testifying in court). Custody hearings can be part of this specialty.

Geriatric psychiatry: 1 year. Not too sure about the job market. I imagine it’s in high demand. Probably similar salary to adult.

 

  • What are the potential downsides of Psychiatry that students should be aware of?

It definitely takes a certain personality to do the job and do it well. You need to be able to separate yourself from some of the sad stories you’ll come across. You also need to be able to set boundaries well with people.

 

  • What else would you tell medical students who are considering Psychiatry?

It’s a great job and something to definitely consider. Some people say there’s not much medicine involved, which is as true as you make it. You can definitely go a more therapy-centered route if you prefer. But, if you love the medicine and research side, there’s plenty of opportunity for that as well. The brain isn’t very well understood.

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.