question about obtaining residency...

[RAMAIR57]

I am a first termer and was wondering how difficult it would be in obtaining a residency in urology. I have looked at the placements online, and I see very few urology placements and it got me concerned. Is urology one of the tougher specialties to get into? Is it super competitive? In other words, would I have to get staright A's, ace the usmles, etc just to have a shot at a urology residency in the US? Any help on this is appreciated!

[geoff]

Probably that would be correct.... lots of A's, good USMLE scores, great LORs and some contacts...that's the goal..... put you're head down and you'll have something to bargain with later...... and if you change your mind...which so many of us have.... again..you'll have options.
Geoff

[Nimitt]

Urology is a super competitive residency because of the few number of spots available compared to other residencies and because of the salary and lifestyle for US grads let alone for foreign grads. Not impossible but very very and let me add very hard. However, I know at Brookdale one of the residents is a foreign grad and didnt do so hot on his step 1 but did awesome on step 2 and had great LOR and had a great interview (he could be the exception I dont know!). Grades matter very little when applying for residency especially your first two years. 3rd and 4th year grades matter more and step 1 and 2 matter alot as well as LORs (from attendings in the field you want to apply in). Strong LOR make a huge difference. Then if you want urology, you would do a urology rotation say where you are interested in applying and you would do anything to impress the crap out of them. I was told by this urology resident who has become a good friend that urology is a funny field in tht if they like you alot and you impress them scores wont weigh as much and that was true for his case. I know for a fact he had not connections in this department at Brookdale.

Nimitt
4th year
SGU SOM

[RAMAIR57]

ok, thanks for the responses. Pardon my ignorance, but what are LOR's?? Also, how does grading work during the clinical years? I guess the first two years grades dont mean much, but how exactly are u graded in clinicals?

[rokshana]

Sorry, but urology is second only to derm in competitiveness. Three years ago 60% of the people who applied for urology matched in urology(I'm sure the numbers are probably still the same), so really aren't any unmatched spots(problem is that there aren't many urology spots, usually only 2-3 per program(some are bigger, my friend who matched at Barnes-Jewish at Wash. U had 6 in his class), leaving a lot of people out in the cold. And that's US grads (only seen one "match" for sgu, that was at Sloan-Kettering and as far as I know Sloan-Kettering has a fellowship program, not a residency program). Most people who get the urology spots are top in their class, with great Step I and II scores, and are AOA(alpha omega alpha- medical honor society). It will be near to impossible to get a urology spot straight out.
The good news is that urology is a pretty small field, everybody knows everybody and a great Letter of Rec (LoR) (ALL the residency directors either know each other or know of each other) from a well respected and liked residency director (or academic urologist) will carry you a LONG way. If there is a med school near you with a urology program, you should see if you can do some work with someone.
The other thing that is possible, is that believe it or not PGY-2 slots do become available (some decide that they don't want to do urology after their surgical internship) and it is possible to get one of those slots (had a friend who tried to match Urology last year, didn't match, did a prelim surgery year and got into an open PGY-2 slot in Utah) and sometimes its possible not to have to redo the intern year(but that varies from program to program.
The other thing, finally, is to see if you can transfer out to a us school.
Sorry for the pessimistic piece, but there are just some residencies that are out of the reach of sgu students and IMHO urology is one of them(but hey, steph got rad/onc and that's crazy competitive, soo...)

[Nimitt]

I wouldnt say they are out of reach just very very hard to obtain. There are grads who have gotten ortho at Univ. of Texas South western and Derm at Harvard as well as urology and neurosurgery. Of course those people are the exception. If those kind of residencies are all you want then you may want to consider transferring after the 2nd year. But these residencies are not impossible. Derm, Uro, ortho they are all up there in the top 5 hardest residencies to get whether uro is the second hardest or derm it really doesnt matter.

Nimitt
4th year
SGU SOM