Non-traditional Route

I am a PGY3 General Surgery resident who has recently decided to make the switch to Orthopedics to pursue a career in hand surgery. Not having worked in the Orthopedics world prior to this, I am concerned that I may not be as competitive as medical students who have spent 2-4 years pursuing an Orthopedics position.

In your experience, how has the academic Orthopedic world treated experienced residents that are making the switch to Orthopedics?

Personally, I excelled clinically in a top 15 surgical residency, earning resident of the year as an intern. My evaluations, which are not available unfortunately through ERAS, are univerasally amazing, highlighting excellent operative technique, intelligence, strong interpersonal skills, and an impressive work ethic. My Step 1 score was poor due to inattention to preparation, however, and I remember that many programs set a cutoff for interviews.

Does a history of a surgical resident who has excelled for years in the academic environment outweigh a weaker medical school resume?

As interview season approaches for the 2010 Match, I find myself a bit nervous that I may not be in training next year. I would appreciate your thoughts on this, thank you!

The key issue will be whether you can get your "foot in the door" for an interview where your surgical experience, maturity, and future potential will likely be assets that you can demonstrate. A low USLME step 1 score in addition to being a general surgery transfer may be quite challenging so make sure you apply quite broadly.

good luck --

wnl

The other option for hand surgery would be through plastics. If you don't match and you finish general surgery, you could try to get a plastics fellowship.

Is it not possible to get a hand fellowship from a general surgery program? I personally know of two gen surg residents in my hospital who secured hand fellowships. If you want to do hand, but aren't generally interested in ortho, that would seem like a better option instead of throwing away three years of gen surg and then doing another five in a specialty that you aren't all that interested in.

Just my two cents, maybe the attendings could chime in.

It is possible to do a hand fellowship after general surgery, however, you may be limiting your job opportunities. I'm not sure how many ortho groups would hire someone who essentially has one year of orthopedic training.

The route to doing hand from general surgery is a possibility, however, not if you want to be competitive and at the top of the academic world I think. One year of hand training as a fellow after 5 clinical general surgery years would be the entirety of my hand experience. You do not learn any techniques in General Surgery such as plating/wiring bone, splints/casts, intra-articular injections, etc. Even going the plastics route would requires 3 years of plastics fellowship before the hand fellowship, and you are limited to mostly soft tissue cases. The Orthopaedics route seems to offer the best training and chance to work at a top 10 academic hospital. One can also tie in sports and elbow/shoulder to be an upper extremity expert, whereas plastics does not focus on this. Thank you for the posts everyone, I appreciate the input!