Surgical Residency

[kpsmith32]

I’m a current clinical year student who will be done in August. I have a lot of interest in surgery, mainly orthopedics, but really like the OR in general. I was wondering if any surgical residency grads out there could chime in on your residency program, if you think it’s worth considering for a new grad right out of school, and maybe some of the requirements/factors programs take heavily into consideration. I’m considering both surgical residencies and ortho specific residencies. 

I like the idea of a residency because of the obvious learning experience and great opportunities it would provide. However, there aren’t any residencies in the area I go to school (Indianapolis, IN) which is also where I’m from. I say this not because I wouldn’t be willing to move for a year, but because it’s where I see myself working. Therefore, I’m concerned I’d be at a disadvantage not being from the area where the residency is. 

There are some threads that somewhat touch on what I’m asking, but to be honest most are pretty outdated so I figured I’d try to get some fresh perspectives. Thanks in advance for any input/advice!

[PAtoMD]

Someone posted about surgical residencies on reddit the other day.  Maybe some of your questions could be in here

 

 

 

[kpsmith32]

5 hours ago, SR0525 said:

Someone posted about surgical residencies on reddit the other day.  Maybe some of your questions could be in here

 

 

 

Thanks!

[LT_Oneal_PAC]

9 hours ago, kpsmith32 said:

Thanks!

I wouldn’t take any advice from that. Not a single one of them had done a residency.  I’ve never met anyone who has done a residency and regretted it. 

There was a PA here who had done a CT residency and raves about it. He was independently managing critical care surgical patients and all kinds of crazy stuff around the hospital, not to mention what he did in the OR. Matt something...used to be really active but something came up in his life I think and pulled him away.

[PAtoMD]

9 minutes ago, LT_Oneal_PAC said:

I wouldn’t take any advice from that. Not a single one of them had done a residency.  I’ve never met anyone who has done a residency and regretted it. 

There was a PA here who had done a CT residency and raves about it. He was independently managing critical care surgical patients and all kinds of crazy stuff around the hospital, not to mention what he did in the OR. Matt something...used to be really active but something came up in his life I think and pulled him away.

Agreed. The only people who say don’t do one are ones who havent. 

[LT_Oneal_PAC]

15 minutes ago, SR0525 said:

Agreed. The only people who say don’t do one are ones who havent. 

I will say I have heard second hand from people who haven’t done a residency that so and so friend did one and didn’t think it was necessary, but I’ve never heard it from the mouth of a residency grad.

i suspect anyone who says they did one and bad mouths it, didn’t really do a residency, but likely one of those 6 month OTJ training programs where they don’t give you dedicated lecture time, off service rotations, time in the simulator, etc.

Have a friend who said they did a 6 month post grad residency in neuro, but said it was basically poor wages in exchange for experience and no real training involved. THAT is NOT a residency. A residency follows ACGME guidelines with dedicated weekly lectures and protected education time outside of clinical work, off service rotations mirroring a physician residency, exams assessing competency, and done at a teaching facility (not a private institution or group).

[Kaepora]

I know an NP who did the surgical residency at UPMC and she said it was incredible/amazing/every other superlative you can think of.  It was just her and a PA training right alongside the residents - no discernible difference between them.  They have a cardiac surgery concentration now as well.  Her description made me kinda want to do it, but, you are paid so poorly...

[LT_Oneal_PAC]

21 minutes ago, ACNPstudent said:

I know an NP who did the surgical residency at UPMC and she said it was incredible/amazing/every other superlative you can think of.  It was just her and a PA training right alongside the residents - no discernible difference between them.  They have a cardiac surgery concentration now as well.  Her description made me kinda want to do it, but, you are paid so poorly...

Not disagreeing the pay is low comparatively, but part of me thinks it’s funny that we (myself included) complain about a salary that so many people would love to have. I catch myself talking to my buddy and complaining about how little I make in residency, and then feel like complete $h!t because he has the same salary with 2 more kids and a wife that also doesn’t work. Granted he works less than half the hours I do, but still.

[Kaepora]

26 minutes ago, LT_Oneal_PAC said:

Not disagreeing the pay is low comparatively, but part of me thinks it’s funny that we (myself included) complain about a salary that so many people would love to have. I catch myself talking to my buddy and complaining about how little I make in residency, and then feel like complete $h!t because he has the same salary with 2 more kids and a wife that also doesn’t work. Granted he works less than half the hours I do, but still.

It's all relative, sure. But I make more as an RN than I would doing the residency. Plus, one can simply get a job in surgery making twice as much than if I did the residency. Yes, the training opportunity would be incredible, but even so... without sounding high and mighty or ungrateful, the low salary does make a big difference. 

[LT_Oneal_PAC]

43 minutes ago, ACNPstudent said:

It's all relative, sure. But I make more as an RN than I would doing the residency. Plus, one can simply get a job in surgery making twice as much than if I did the residency. Yes, the training opportunity would be incredible, but even so... without sounding high and mighty or ungrateful, the low salary does make a big difference. 

Agreed and everyone has to decide what it is worth to them. It was more of side comment/philosophical point rather than minimizing the complaint.

[kpsmith32]

I appreciate all responses. One other thing I was thinking about that has also been brought up in other threads is the fact that, with so many programs and new grads coming out every year, eventually EVERY market could become saturated...and that a residency might be that thing that gets you a job over 5 others who aren’t residency trained. 

On the flip side, I could hope to play my cards right by getting a good surgical job out of school that would allow me to gain 5+ years experience and that could be just as beneficial...

Anyway, obviously no right answer but I appreciate all the commentary. Definitely going to continue to explore my options. 

[LT_Oneal_PAC]

1 hour ago, kpsmith32 said:

I appreciate all responses. One other thing I was thinking about that has also been brought up in other threads is the fact that, with so many programs and new grads coming out every year, eventually EVERY market could become saturated...and that a residency might be that thing that gets you a job over 5 others who aren’t residency trained. 

On the flip side, I could hope to play my cards right by getting a good surgical job out of school that would allow me to gain 5+ years experience and that could be just as beneficial...

Anyway, obviously no right answer but I appreciate all the commentary. Definitely going to continue to explore my options. 

I think a residency may even teach skills one may never learn OTJ. Even EmedPA admits that there are things residency grads do that he hasn't fully learned in 20 years of experience even working solo jobs. 

I'm not saying residency is for everyone, because it's not. Some people just don't derive happiness from career satisfaction. My buddy is a genius in every way, but he's cool with not seeing that MI. He doesn't care to know how to put in a chest tube. He just wants plenty of money with plenty of time of so he can retire early while working as little as possible. That's cool (and I honestly consider it sometimes). But if you want a job where you truly get to practice to the fullest scope, that's not going to happen 95% of the time without a residency.

Thats what I think it boils down to. What makes you tick. Is it money, hobbies, or knowing you're fulfilling your potential at your job.

Plus If residency and job experience are the same, why do we count it for physician's training and not our OTJ experience? Why do they have residency at all if it's all the same. Just thoughts.

[pitou]

On 12/23/2017 at 1:14 PM, LT_Oneal_PAC said:

I think a residency may even teach skills one may never learn OTJ. Even EmedPA admits that there are things residency grads do that he hasn't fully learned in 20 years of experience even working solo jobs. 

I'm not saying residency is for everyone, because it's not. Some people just don't derive happiness from career satisfaction. My buddy is a genius in every way, but he's cool with not seeing that MI. He doesn't care to know how to put in a chest tube. He just wants plenty of money with plenty of time of so he can retire early while working as little as possible. That's cool (and I honestly consider it sometimes). But if you want a job where you truly get to practice to the fullest scope, that's not going to happen 95% of the time without a residency.

Thats what I think it boils down to. What makes you tick. Is it money, hobbies, or knowing you're fulfilling your potential at your job.

Plus If residency and job experience are the same, why do we count it for physician's training and not our OTJ experience? Why do they have residency at all if it's all the same. Just thoughts.

 

I notice the PGY-1, are you a PA who made the switch to MD/DO?

[LT_Oneal_PAC]

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[LT_Oneal_PAC]

46 minutes ago, pitou said:

 

I notice the PGY-1, are you a PA who made the switch to MD/DO?

No, I’m a EM PA residency in my first year.

[JDayBFL]

As someone who is finishing a surgical residency/fellowship this month-- here are a few thoughts:

1) Considering how hard it may be to find good OTJ training, a residency/fellowship is a sure proof way to gain experience in the OR, procedural skills, and learn the finer academic knowledge to function in the top 25% of PAs in your specialty. Not saying you can't achieve it without a residency-- but it's impossible to replicate (didactic component, procedural training, SIM labs, research, experience in big/complex cases, etc)

2) having a fellowship/residency in your resume will open a million doors that are not possible if you are a new grad out of school. I actually had a hospital recruiter call me 30 minutes after submitting my CV and online application to a job and wanted to schedule an interview specifically because of residency/fellowship, no other questions asked (this was also a job that preferred 2-5 years of experience in said subspecialty). 

3) Respect from surgeons who see that you are going through the same rigorous didactic and early morning/late night schedule that they went through. It's street credit that goes a long way when you start wanting to expand your scope of practice. It's a level of trust that sets you apart. 

4) Money. Pretty simple, more training lead to more skills and autonomy which always leads to more money. 

There are some downsides to doing a residency/fellowship and it's definitely not for everyone (I think you have to evaluate your overall career goals/sacrifices before doing one). Prepare yourself for a beat down, but overall the positives outweigh the negatives BY FAR! 

(Also, that Reddit thread was trash, haha)