From the Editor

From the Editors: Advice to young hopefuls


 

Most mature surgeons and surgical educators have been asked by hopeful young medical students: “What can I do to improve my chances of becoming a surgeon?” We all want to give our aspiring students encouraging yet truthful answers. The following are typical questions we get from students, and we have tried to provide responses that are both helpful and realistic given the individual circumstances. Do young hopefuls query you about what it takes to become a surgeon? If so, we invite you to let us know what kinds of questions you get and how you respond. We all want “the best and the brightest” to join our profession, and we can help make that happen by offering sound advice to those who come to us asking “How can I become a surgeon?”

Dear Dr. Hughes,

I am a first-year medical student and want to become a surgeon! Everyone tells me I have to have at least two publications to even be considered for an interview. Is this true? What is the best area of research for me to pursue to assure a match in a surgery residency?

Unpublished in the Midwest

Dear Unpublished,

Like almost everything in life, the answer to your question is “It depends.” Surgery is a field that covers such a wide range of opportunities and training options that there is no “perfect” path to residency. More than anything at the M1 level, you need to keep your options open for any discipline. During the next 3 years, you’ll find out much about yourself and about the breadth of medicine. You need to understand who you are as a person before deciding on a specialty and especially before embarking on a research project. Research is a crucial part of surgery, but research just to have a publication for your resume is not a good enough reason to take this on during medical school.

The pursuit of knowledge through research is best undertaken because you have a passion for a particular subject. Most program directors will see right through “insincere” research – that is, research done to puff up a resume but lacking underlying value or relevance to your personal interests.

Dr. Tyler G. Hughes, clinical professor in the department of surgery and director of medical education at the Kansas University School of Medicine, Salina Campus

Dr. Tyler G. Hughes

In addition, medical school is a process of transforming what you know and how you think. It requires your full attention. Among the keys to being able to choose a residency rather than simply praying you get a slot somewhere is the accumulation of real knowledge, doing well on Step I of the United States Medical Licensing Exam (USMLE) examinations (Step II is actually less important overall), and having teachers and mentors who know you well enough to give honest and accurate letters of reference for the programs to which you apply. If along the way you find an area of study that bears the fruit of research, great – but four mediocre papers will not overcome a low class ranking or a low Step I score. If you instead focus on being the best student of medicine you can be, you are likely to find yourself in the happy position of having good grades and a good academic profile, which may or may not include a publication or poster. While you can try to “game” the match system by filling your application with papers and writing a passionate personal statement, ultimately you’ll be great at your chosen field because you love it. Good luck (and make sure your life on social media is one that doesn’t require complicated explanations).

Tyler Hughes, MD, FACS

Dear Dr. Deveney,

I am in the middle of my third year of medical school. I have wanted to be a rural general surgeon ever since I shadowed the surgeon in my home town and saw the impact he made on the lives of his patients – and they made on his. Unfortunately, I do not do well on standardized tests and scored only 216 on USMLE Step 1. I did earn “Honors” in my surgery clerkship, but only a “Pass” in Medicine, with other clerkships still pending. What can I do to maximize my chances of a successful match in a surgical residency?

Discouraged in Denver

Dear Discouraged,

Since medical students are applying to a larger number of programs every year, surgical training programs receive far more applicants than they can interview. Most programs use USMLE Step 1 score as a convenient way to filter applicants and interview only students who have scored above an arbitrary threshold, such as 220, 230, or 240. We all know that USMLE Step 1 score does not correlate well with how good a surgeon you will be, but it does correlate with the likelihood of passing the American Board of Surgery Qualifying Exam on the first attempt. Programs are in part judged on their Board passage rate by both applicants and by accrediting agencies. Your score of 216 means that you will need to apply widely to programs across the country.

Dr. Karen E. Deveney, professor of surgery and vice chair of education in the department of surgery, Oregon Health & Science University, Portland

Dr. Karen E. Deveney

Given your interest in rural surgery, you should focus on community and independent programs that often have fewer fellows and specialty residencies to expand the breadth of your clinical experience. Look at the list of residencies that have a rural track or focus. You can find information about these programs on the American College of Surgeons’ website in the online guide entitled “So You Want to be a Surgeon.” Apply now to do a visiting rotation at one or more of the programs that most appeal to you. Ask the program director at your school which programs he/she recommends that would be within your reach.

I urge you to join the American College of Surgeons as a student member and attend the 2018 Clinical Congress meeting. Attend its medical student program, and meet as many program directors as you can at the “Meet and Greet” receptions.

Programs in which you will thrive are ones that value a person who pitches in and helps the team get the daily work done. Surgery is a team sport! You need to be unfailingly pleasant and positive and be able to tie a knot and suture an incision smoothly. Chance favors the prepared mind and hands! Good luck!

Karen E. Deveney, MD, FACS

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