Would like some advice..Step 1 - 248. Mostly honors in all first and second year classesThird year - Medicine H, Surgery HP (I know this will hurt), Pediatrics H. Awaiting ObGyn, Psych, Family Med.Research - 1 publication second author (non-uro). Recently started doing Uro research (not sure if project will come through to publication)1. Competitive?2. Any advice on dual applying to General Surgery as back up? How do you go about this..as programs will know I am a Urology applicant as they will see Urology research and SubI in 4th year
You have a pretty solid step 1 score and hopefully strong third year grades. The HP may reflect poorly at some places (I spoke to a notable PD/chairman that pointed out that he often looks at surgery grade to assess "how hard they work under pressure/tough hours") but shouldn't be a deal breaker. I think the biggest things you can do now is get solid aways and work your butt off and try to get involved in research. It's great you are getting involved with research and if you have a residency program at your school try to push for even an abstract at a regional conference, just to have something to actually put on ERAS. Be able to talk about what you did and how you plan on finishing up what you started.Applying to general surgery is definately doable as a backup. The biggest issue is getting letters of rec. Ideally you would want all from gen surg people, but you could get away with 1 urology. Most people schedule their interviews late in the season (you can cancel them if you get enough love from urology programs).
Here's the deal... the vast majority of people will match at their home or an away. So choose these carefully and work your glutes off on these rotations. Here's how the match works in a nutshell:-------If you're a high-end applicant (amazing letters, 260+ step 1, AOA,research fellow/tons of publications, almost all H's grades, etc etc.) there are two likely scenarios:1. You do well on your aways or home sub-I and you match there2. You don't do well on your sub-Is, you will likely still match but at a mid-tier/lower tier placeThere is a small chance that you will match at a very top-tier place you did not do a sub-I at but it is UNLIKELY no matter your credentials unless you have some sort of connection to the place (letter writer), express tons of interest (multiple days of re-visiting, emails saying #1, etc.), or are the next Pat Walsh in the making... but even then it's unlikely because programs don't like takign a chance on someone they don't know when they have many similar applicants who they do know (i.e. did an away there). -------If you're a low-end applicant (<240, non-AOA, little research, mostly HP grades, etc.) there are two likely scenarios:1. You choose appropriate aways at mid-tier or low-tier places and excel and you will match there or your home institution2. You don't matchThere are always a few stories of low-tier applicants matching at top-tier places but this again is very unlikely even if you did an away there (programs get many competitive applicants that they liked durign the sub-Is). As a low-tier applicant I would recommend doing three aways total: two aways at mid/low tier places and then if you think you're good with people take a chance at an upper-tier more competitive place.Overall, it is not that hard to match into urology if you play your cards correctly. So, as a low-end applicant to almost guarantee a match I would do 3 aways (4 if you're able) at low-tier places and go to only low-tier interviews. That really maximizes your chances assuming you're a normal person and don't sabotage yourself on the aways. -------If you're a middle of the road applicant (240-260 step 1, good/decent letters, AOA, few publications, mix of H/HP grades) it's more of a crapshoot.I think being a middle of the road applicant can be the most dangerous in terms of not matching. The main reasons for middle of the road applicants going unmatched when low-end applicants do match is because the low-end applicants choose their aways and/or interviews more wisely. If you're middle of the road and you want to avoid being one of the horror stories on the did not match thread of 2015, then do the following:1. Apply very broadly. Goto interviews at all departments, not just the most competitive ones. Say hypothetically you apply to 120 programs as a middle of the road applicant, you likely will get enough interviews at good places that you could in theory line up an interview season of mostly high-end competitive places. However, that is setting yourself up for a non-match. If you are truly middle of the road and did not do an away at an upper tier place but then get invited for an interview there, it is most likely a "waste" of an intervew. You could be using this interview date to match at a place that you actually have a shot. It is highly advisable to go to the less competitive interviews as well.2. Do aways at 1 mid-tier and 2 upper tier places. You have a legitimate shot of matching at an upper tier place as a middle of the road applicant. But you also need the back-up of the mid-tier away.
I had very similar stats as you. Basically same step 1, honors in all rotations, AOA, no publications and involvement in one project. I got offered 15 interviews, went on 12, and matched at my #1. All this to say do two away rotations. Try to get a letter from both, and I don't think you'll need to apply Gen surg. I also know people with similar stats didn't match, so be aware of that and apply broadly. Most of my interviews were from high second tier schools, and the school I matched at is a tweaner between 1st and 2nd. Just be realistic.