Is General Surgery Residency Match Possible For IMGs?

Interview with Dr. Kevin Sugumar

General Surgery is gaining popularity as a residency choice. Over the period of time it has become one of the most competitive specialties to Match in USMLE.
With the above acceptance here comes a few critical questions which are generic yet very imperative to understand.

• What does it take to Match in General Surgery?
• What are the challenges as an IMG to pursue General Surgery as a specialty for residency?
• Is a general surgery residency match possible as an IMG?
• What all an IMG can do to crack USMLE with this specialty?
• What are some IMG friendly programs in general surgery?

I did my medical school in five and a half years with training and after that I did my General Surgery residency in India. I got into one year of contract with the residency. Simultaneously, my wife and I wanted to have an academic career in the US. And hence I landed up contemplating – what does it take to match in General Surgery for an IMG??
You can break the answer of this question in three parts :
 Clarity & confidence – It is very important that you must know what to do exactly to Match into this specialty. Before you commence your preparation you need to get it right and should be clear and confident in your head that you want to do your residency in General Surgery. For that, connect with as many people as you can who have gone through a similar journey. Reach out to everyone you know or even if you don’t know.  Connect with people on social media, ask questions, take advice, learn from the mistakes and the learnings of others. Do your research and figure out what were the experiences of other people who have travelled the same route of residency with General Surgery as specialty. This will help gain clarity in your decision of doing residency in this specialty and also will infuse confidence in your decision.

Hard work – Once you have done all the research and made up your mind, it's the show time now. Time to grind and sweat and put your 100% into preparing for this specialty. As it's an accepted fact about General Surgery to be one of the most aggressive specialty to crack through, you don’t have any other option except for doing hard work and putting yourself completely into it. Get into rotations, be it research, volunteering activity or electives. These hands on or telerotations will boost up your CV. There is no upper limit for it. The more you have, the better and this is going to take the most of the duration of your time.

Packaging  – After all the experience and learnings you have gained through your hard work, how you package your strenuous effort matters. You can have 10 – 15 publications and you can match in 5 programs. Hence, it all depends on how you package everything.
 
Once you are clear with the above three crucial key aspects  of what it takes to match in General Surgery, you come across some other doubts related to the process. Lets take up these questions one by one :
SCORES – How important are scores to match in General Surgery?
Having anything more than 240 is definitely a plus point in General Surgery. Scores reflect your hard work, preparation level and inclination towards this specialty. So fix it in your mind that a really good score will help you get through this specialty for sure.

ELECTIVES – Is doing electives as part of your MBBS beneficial?
I did not do any electives while pursuing my MBBS. When I decided to come to the US , all I was left with were a couple of observerships. It was tough here in the US to get observership in General Surgery, but then I managed to do two observerships at last. The smart choice here would be to do your electives during your MBBS and it is surely going to ease out the hurdles ahead.

US RESEARCH – How does doing research in the US impact your application?
Good score + home country experience + research in the US is undoubtedly an added advantage. For me, the most heavy part of my application was doing research. It helped me to connect with people who were ready to help me with it. You need to show or convince people that you can really deliver work as per the expectation and you are reliable. You just need to get these simple steps right and you will be able to manage a good letter of recommendation. Your research tenure should be substantial enough.

CHALLENGES – What are the major challenges that an IMG should expect to face while choosing General Surgery as specialty?
The first ever challenge that I faced after finishing my residency was that I had to reappear for Step 1 & 2. Fortunately my wife was my 24/7 study partner and that helped me a lot to crack this. It took about a year to finish all my Step exams, including Step 3.
The second challenge was when I was looking for a research job. It involved emailing a lot of people, to find out who is interested in doing research, etc. It took me approximately six months to find a research job. I gave several interviews as I had no research experience  and was applying for a research position. It's like you are asking for an ocean when you just have a drop. This was the most trying and challenging phase of my entire career till date.
HOME COUNTRY EXPERIENCE & MED SCHOOL BRAND – How vital is the home country experience and the med school brand?
Program directors take a keen interest in your home country experience. The level of involvement while gaining experience in your home country reflects your determination and hard work indeed.
With regards to your med school brand, if you have an alumni from the same med school it gives a push to your application of course.
With these basic clarity you definitely are going to gain confidence whether General Surgery is the right specialty for you or not.
While dealing with all these challenges and resolving them I came across USMLE Sarthi. I joined Sarthi just before the ERAS application started. Although I had a good CV and 3 – 4 publications at that point of time, I was still under confident about how to put all this together, whom to email, what and how to project these publications in my personal statement and CV or in the interview. The videos from Sarthi came to a rescue indeed. They have wonderful panelists. They do great job of explaining things and making things look less complicated. They have good interactive sessions where you can put forward questions which you can't ask to anyone else.  They are extremely honest in giving you the answer, after all, you don’t want a manipulative answer which makes you happy rather you seek realistic feedback which can help you become better version of what you are right now. Apart from interview preparation, the post application outreach, how to write emails, how to communicate with programs is very crucial, as in General Surgery you need to tailor your application while applying to various institutions. And here Sarthi team was very instrumental.

Few quick tips to applicants applying for General Surgery specialty :

1. Keep it clear in your head and decide.
2. Hard work is the only way and  forget all the shortcuts.
3. Reach out to people. Use your network, social media to the fullest.

What residency pathway you want -  General surgery has both categorical and prelim residency programs, where in a categorical program is one where you apply to the program from medical school and that’s where you’re going to do all five years of your General Surgery residency. Then there are prelim surgery positions, where you’re only attending that program for part of your overall residency training. Both are good to go, whichever you feel are capable of cracking, choose that pathway.

Dr. Kevin Sugumar