Is there any benefit to programs with 2 years of general surgery vs 1 year only programs? Does it make you more comfortable in performing open procedures?Is there a list somewhere of programs with 2 years of Gen surg? I was looking on Freida and they only mention the length of the Urology part.I would really appreciate any input on this.
Of course there is benefit. The question is whether or not it's the best use of your time. Obviously the AUA thinks 5 years is enough time to train competent urologists, and if I want more guided training, I think an extra year or two of fellowship at the end of your training is better than a year of scutwork at the beginning of your training.
BTW, the AUA website lists all of the residency programs in the country with info on length of program, contacts, hospitals in which rotations are done, dedicated research time.
If you look on the left side toolbars, click on "residency programs links". Once you're there, you can filter a list of programs by state, number of years of gen surg, etc.
Freida's a good place to start but there's a lot of caveats...it can be out of date (as more and more programs switch to 1 year), doesn't show which places do something more than 1 year but less than 2 (like 18 months), and there's no way to know how much urology is built into that "gen surg" time (which can be significant). Honestly, we should really just create a list here, I bet we've interviewed at most of the programs in the country & can keep updating it as things change...
2 years general surgery is a double edged sword. you get really good at managing sick patients. it makes you a better doctor. will it make you a better urologist? probably not on most days. however, when you get that patient a few weeks out from a cystectomy in the ER who is febrile and looking shocky, you'll know what to do. it'll be so second nature that you'll look like a superstar while the ER resident is running around with hishead off ranting about the sepsis protocol and getting access and what antibiotics to start and so on. the central line, fluids, and CT scan will be done before he gets his head out of his ass. or, when that patient who is a few weeks out from a partial nephrectomy comes to the ER with back pain, hematuria, and a BP of 70, you can resuscitate them without batting an eye until IR gets there to embolize the pseudoaneurysm. so, how often does this really happen? so far, a couple of times a year. what about when you get out into practice? probably almost never unless you do oncology.
How much does one get out of one versus two years (usually 1.5) General Surgery. Likely, not much. Most people are not comfortable managing situations they managed 10+ after their residency. There is a lot of liability for Urologists to place central lines and chest tubes along with running codes. Also, most Urology residents I know did not enjoy there time in general surgery and were relieved to do Urology. Most programs are going to 1 or even < 1 year of general surgery. They are not increasing their general surgery time. Especially with the government and Medicare wanting to cut residency funding.That being said, I would never choose or prefer a program that did two years general surgery instead of one. However, many of the programs that require 2 years of general surgery are in desirable locations (California) so they are happy just to be in that location. Location means a lot when deciding a residency program.To find out what programs have two years of general surgery, you likely need to visit their website or call the program itself.
i kind of like the idea of the system back in the day where the subspecialties would poach residents in their third year of general surgery. so you did 3 years general surgery and then 3 years of urology. and then you graduated the biggest bad ass ever.