Thread: Surgery Dilemma

So, I'm one of the unlucky students who has been literally moved from state to state to finish my clinical rotations. By the end of this year, I'll have been to 4 different hospitals in Maryland, New York, New Jersey and Connecticut! And it turns out that I'll have to go to 2 new ones next year, just to finish my cores! And that's not even the least of my problems. It turns out that there is no-ACGME approved surgery rotation that is available for me in 2011 until May, and even that isn't confirmed. And the last rotation that the school has confirmed for me ends the first week of February. So far I already have had 9 weeks of bridge time between my rotations. As you can imagine, I'm not too pleased with this unplanned break, especially since I've been asking about availability since September of this year!

So, these are my questions:

(1) There is one AOA-approved surgery spot available during the first week of March. Should I go for this spot? Is it advisable considering I'm a Canadian, and plan to practice in Canada? I know I should go straight for the source, but I don't know who the source should be in this case.

(2) If I decide to wait it out until May, I know I can complete some electives during that time. Should I also try and write the Step 2 CK without having completed surgery? Is this completely unadvisable? I know the Step 2 CS can be done. Not sure about the Step 2 CK. Or should I save the CK for August, and have the score come in after the first date for ERAS?

Thanks so much for all your help.

Sincerely,
Epsilon

repeated again. VMD problems.

sounds like he is doing his cores in 3rd yr just that the ACGME surgery core isn't scheduled until late (correct me if i am wrong).

to the OP did you ask for a clinical center and get tunred down or didi you ask for a non clinical center hopsital to start?

I requested a clinical center. But I was placed at a site that wasn't even on my list. And then I foolishly inquired about the possibility of taking 2 weeks off in August for a family event. They recommended starting at a non-clinical center hospital. And, voila, now I'm stuck living out of a suitcase.

The things that bugs me the most is that I've been asking about ACGME-accredited surgery spots since August of this year. I originally thought I started asking only in September, but it turns out my first email with them was back in August. And they kept telling me that availability is not known, and that I'll be contacted as soon as a spot becomes available. Now they're telling me that they have no availability for several months with May being the first likely month. So I don't really know what I could've done differently.

Originally Posted by Epsilon

I requested a clinical center. But I was placed at a site that wasn't even on my list. And then I foolishly inquired about the possibility of taking 2 weeks off in August for a family event. They recommended starting at a non-clinical center hospital. And, voila, now I'm stuck living out of a suitcase.

The things that bugs me the most is that I've been asking about ACGME-accredited surgery spots since August of this year. I originally thought I started asking only in September, but it turns out my first email with them was back in August. And they kept telling me that availability is not known, and that I'll be contacted as soon as a spot becomes available. Now they're telling me that they have no availability for several months with May being the first likely month. So I don't really know what I could've done differently.

well, frankly, there are a lot of things you could have done(or not done). Was the site you were originally assigned (though not on your list) a clinical site with all acgme rotations? you could have kept that.

Or did you appeal the original prelim site to get a site that was more of your preference? appealing generally works.

of course as you now realize taking prolonged breaks puts you at the bottom of the totem pole and ends with you getting the crumbs....doesn't matter if you asked as early as the break you requested....that break put you in no man's land...you're not the priority for anyone anymore....your term's students have been placed before you and the next term's class take priority over you for clincal center placement.

and while it doesn't help you, for those in basics its a lesson to be learned...ask for a clinical center, appeal if you don't get what you want and above else stick with a clinical center and stick to the schedule of your term....asking for time off when you can avoid it (death or illness in the family is one thing, family vacay is another) is a bad idea.

better ti take the later acgme surgery spot and the bridge time with electives or if surgery is the last core for you, do your hard core study for CK and then take it a couple of weeks after surgery (that should put you with taking it in aug).

I have heard that the last year more and more people are not getting any of their 3 choices and not many have been successful in appealing. I have also heard that starting next term no more preliminary spot will be given, just the final one.

I would use that time to take CS and study for CK and possibly even take it before surgery. Surgery is not one of the higher yield subjects. You can get what you need to from usmle world surgery questions and surgical recall.

Thanks for all the input, guys!

So far, Roskhana recommends doing step 2 CK in August, and Cripsy recommends doing it in April. Any one else have any input?

Oh, and I don't know if this changes things:

"The target date for reporting Step 2 CK scores for most examinees testing from August 12 through mid-September will be Wednesday, October 6, 2010."

Basically, how important is having a step 2 CK score when ERAS opens in September. And does the surgery rotation really give you a level of familiarity with the material tested on the Step 2 CK exam which cannot be obtained by studying from books?

Crispy's answered some of these questions. I guess I just want to hear any other perspectives. Once again, thanks everyone!

Originally Posted by Epsilon

Oh, and I don't know if this changes things:

"The target date for reporting Step 2 CK scores for most examinees testing from August 12 through mid-September will be Wednesday, October 6, 2010."

Basically, how important is having a step 2 CK score when ERAS opens in September. And does the surgery rotation really give you a level of familiarity with the material tested on the Step 2 CK exam which cannot be obtained by studying from books?

Crispy's answered some of these questions. I guess I just want to hear any other perspectives. Once again, thanks everyone!

based on that reporting date, i would agree with crispy....october is too late for that CK to come out...you want to give yourself every edge you can and having a complete application on sept 1st should be your goal.

sirgery isn't so stressed and most of its trauma which you can get in an EM rotation(it will meet your 4th yr primary care rotation) and like crispy said, surgery recall will give you what you need.

I just realized that's for 2010, and I'm writing it in 2011. Hmm...I have a decent GPA and Step 1 scores but I also require visas. I guess with the increase in competitiveness, it makes sense for me to get the complete application in by Sept 1. But what about all the August class students? Won't they be writing the Step 2 CK in August? Doesn't this put them at a disadvantage? I wonder if going to the UK is an option...

i'm sorry to hijack but on the discussion of having step 2 in time..why is it so important to have step 2 in time for ERAS application? especially if one has a pretty strong step 1.