General Surgery

Clinical Specialty Advisor: Alex Nelson, DO, FACS

Where can I find important statistics around the specialty? 

Click on the Resources link. Select Charting the outcomes: Mean programs ranked 14.1, Mean Step 2: 253, Mean number research exp 4.2, Mean number of abstracts, presentations and pubs 10.9, Mean volunteer exp 4.5.

What general advice do you have for someone choosing this specialty?

Make sure you are positive that you want to pursue it. Surgical training and practice are grueling at best. Early exposure to ensure it is what you want is crucial. 

What are the top three areas that students can focus on to help prepare themselves for a successful residency application and a successful transition to residency? (i.e. grades/academics, professionalism, any of the categories listed above, etc.)?

As far as application-boosting- strong Step 2, solid research experiences, and glowing letters are crucial. Also important to develop leadership and time management skills, and find ways to support personal wellness despite a hectic schedule. 

What resources would you share with a student who is just starting to research their interest in this specialty and/or wants to learn more specifics of this specialty (anything from what a typical day may look like to specifics on rotations, specialty specific residency info, fellowships)?

American College of Surgeons website and the  American Board of Surgery website. You can also search on individual program websites and subspecialty organization sites. 

What subspecialties exist with this specialty?

Many: Plastics, vascular, cardiothoracic, surgical oncology, pediatric surgery, endocrine, colorectal, minimally invasive, bariatrics, trauma/ surgical critical care, transplant, hepatobiliary. 

What does a typical workday or work week look like (hours/schedule/shifts, work setting, team based environment, acuity, etc.)?

This will vary significantly depending on the subspecialty and practice setting. For example, an academic surgeon will likely have some time devoted to administrative, educational, or research responsibilities. Their time in clinic vs OR will vary depending on subspecialty. For instance, I primarily elective surgeon like surgery oncology, endocrine or minimally invasive; will book most of their surgeries from clinic with maybe a small number coming from inpatient consults. Trauma surgeons spend considerably less time in clinic and will usually also spend time to providing critical care in ICU's. 

What are the important traits, qualities, and/or considerations recommended for physicians in this specialty?

Strong leadership and communication skills are a must. Surgeons must be capable of quick thinking and decision-making. 

How does the specialty work differ in various settings (e.g. a private vs community vs an academic environment)?

For me, I spend 1.5 days in clinic and 2-3 days in the OR. I only work at one hospital and my office is across the street. I try to reserve one day per week for academic pursuits, but this is not always possible. I work with residents and students essentially every day. 


For a private practice or community surgeon, their time will be essentially completely devoted to patient care and running their practice. They may also cover multiple hospitals. 

What does training for this specialty look like (how many years, is a separate prelim year needed, etc.)?

General surgery programs are a minimum of 5 years. Many university programs require additional mandatory research time that may be 1-2 years. Separate prelim years are not required. 

What types of experiences might strengthen my future residency application, especially in areas of service, leadership, and research? 

The more research the better, especially if targeting higher-powered academic institutions. But research never hurts an application. Applicants that stand out also have some sort of extracurricular activity where they have done something meaningful. I.e., it is less desirable to see an applicant involved in many organizations with marginal involvement and more impressive if they started an organization or made significant contributions to an established one.

Is there a specialty interest group?  If not, what other networking options would you recommend?  Are there any specific national organizations or committees I should join?

We have a surgery interest group. Other organizations that may be beneficial to consider are the American College of Surgeons, The Association of Women surgeons, or the specific organization belonging to a subspecialty you are interested in. The grand majority of these organizations will have medical student chapters. 

What advice would you offer MS1s and MS2s who are interested in this specialty?

Study hard! Do not just aim for a passing grade in your courses. Really try to assimilate everything you can, especially in anatomy, physiology and pathology. Seek out research opportunities and mentors early on. Find an extracurricular organization that you can really delve in to and make your mark on. 

How and where can I find other mentors for this specialty?

Reach out to your clinical specialty advisor. I can help you based on your current interests. 

Is there anything else in addition to the suggestions above that could aid my future application, now that Step 1 is P/F?

Aim for at least 250+ on step 2. Board scores will not guarantee you match, but a low score may limit the number of interviews you receive. 

Which group and association memberships might strengthen my future residency application (e.g., AOA, GHHS, MSG, Specialty specific groups, etc.)? 

AOA and Gold humanism are big pluses. 

How important are Step 2 scores to this specialty?

Vital

Are publications important to this specialty? Is there a general number of publications or presentations I should be aiming for?  How important is it for these to be within the specialty I am pursuing?

They are important. The absolute importance will vary depending on the type of program you are targeting. General surgery residencies can generally be categorized into university/ academic, hybrid and community programs. Smaller community programs will place less emphasis on research. University programs will recruit students with more robust research backgrounds and often will include dedicated research years as part of the residency. Hybrid programs fall somewhere in between. 
 

Are there any special considerations when applying for residency?

Things to consider include the culture of the program. Some programs continue to be somewhat malignant, ie, the residents may be mistreated or overworked. Location may be important to you depending on your preference and other circumstances. The type of program, ie, university vs hybrid vs community, is a major factor. University programs will be more successful at placing graduates into competitive fellowships, but they may see less time in the OR or have to compete with fellows for big cases. Residents at community programs may get more OR time early in training and a higher volume of cases, but may not have a strong track record of placing graduates in competitive fellowships. 

What is a general recommendation for how many programs to apply to (recognizing that this may vary based on student situation)?

This will vary highly based on the strength of your application and the caliber of institutions you are targeting. Top-tier programs will be highly competitive. Smaller programs in less desirable locations might be easier to match in to if you are a slightly weaker applicant. In general, applying to anywhere from 30-70 programs is reasonable. 

What letters of recommendation are recommended for this specialty (e.g. from research, physicians within this specialty, academic, etc.)

Letters from surgeons are crucial. Any letters from non-surgeons should NOT be used, with the only exception being from a research mentor that knows you extremely well. Even then, I would still recommend obtaining 3 letters from surgeons. Strong letters are from academic surgeons of higher rank who have worked with you personally. Community surgeon letters are better than non-surgeon letters but will carry much less weight. 

If other disciplines are appropriate for letter of recommendation writers, are there specific specialties you would strongly recommend?

See above. 

How competitive are the residency programs in this specialty?

As mentioned, this will vary depending on the caliber of programs. General surgery as a whole is becoming more competitive but is less competitive than other surgical specialties like ENT, urology, orthopedics, and plastics. Top-tier programs will be much more competitive. 

When do programs typically offer interviews?

This varies by program. But they may start coming in within a week or two of submission or may take longer based on the size of the program and how many applications they have to review. At Banner, we review applications about 2-3 weeks after the application opens. We start sending interview requests shortly thereafter. 

What is UA COM-P's history with matching in this specialty?

I don't have the numbers, but from my memory I would say our students have a strong history of securing solid general surgery spots. I will be tracking this prospectively as time goes on. 

Are away rotations required for this specialty and if so, when should I plan to do them?

Required- no. I do recommend at least one away rotation to see how things are done at another institution. It is also beneficial to do one or more early in the fourth year to obtain strong letters of rec. Another reason to consider an away is if you are targeting a part of the country where our students have not typically matched. That said, it is very possible to match well without doing any away rotations. 
 

Additional Information for General Surgery

General Surgery is an exciting and dynamic field of medicine incorporating advances in technology and surgical management.  The field is defined by taking a direct intervention through anatomic manipulation to treat disease.  Surgical residency involves 5 years of training and a number of academic centers offer and even require 1-2 years of research in addition.  General Surgery is a competitive residency.  Solid USMLE performances, specialty specific research, conference presentations and publications demonstrate significant academic prowess.  Strong performance on your clinical rotations demonstrate your stamina and skill set and are equally important.

Surgery Student Interest Group

Click here to visit the Surgery Interest Group website

General Surgery Specialty Newsletter Report

Additional Resources

Click here to visit the American College of Surgeons website