General Surgery Residency Match: BEAT more than 1900 Applications

Learning about the specialty

General surgery is a specialty in which all medical students rotate during the third year of medical school. If you suspect general surgery, or any surgical subspecialty might interest you, we recommend trying to schedule this core general surgery rotation as early in the third year as possible. General surgery residency starts in the PGY1 year and is five years in total. Many surgical residents do further surgical subspecialty training, however. And, some general surgery residents who are hoping for academic careers or to pursue a competitive subspecialty, do a year of research during residency. General surgery is a very competitive specialty in which to match. Therefore, discovering and establishing your interest in the field as early as possible is recommended.

What criteria are most important to match in general surgery?

Understanding what criteria are most important to general surgery program directors and admissions committees will allow you to position yourself as well as possible to match in the specialty. It is important to know how competitive you are for general surgery by reviewing data published by the National Residency Matching Program (NRMP). This data includes the 2018 Program Director’s Survey and Charting Outcomes in the Match for all three applicant types (allopathic students, osteopathic student and international students). By summarizing this data, together with our own knowledge of what makes a successful applicant, we will outline what you should do to match!

RELATED: Beat 43,157 Match Registrants: Important ERAS Residency Personal Statement Tips

General Surgery Residency Match

In 2018, there were a total of 1,319 general surgery positions offered in the NRMP match and a total of 1,955 applicants for those positions.

General Surgery Elective/Audition Rotations

Interestingly, general surgery is not a specialty that wholeheartedly recommends audition rotations. In 2018, only 48% of program directors surveyed felt this was an important factor when deciding whom to interview. However, there may be some program directors at more competitive programs who recommend audition electives as a way to gain exposure to another institution, prove yourself on another “turf” and to have letters of reference from somewhere other than your home institution. Where to complete audition electives will largely depend on your competitiveness as an applicant and geographic preferences. Ideally, audition electives should be completed by October of the application year. For general surgery in particular, it is important to discuss the possibility of doing audition rotations with an advisor or mentor from your home medical school.

General Surgery Letters of Reference

Letters of reference from academic surgeons with whom you have worked directly are the most important letters in your profile. If possible, strong letters of reference from leaders within an academic surgery department, such as a chair, program director, or clerkship director will also bolster your overall candidacy. If you have done any surgical research, a letter of reference from the principal investigator with whom you worked is equally valuable. We recommend a minimum of two letters from academic surgeons, but, if it’s possible to obtain three or four letters of reference from academic surgeons, that is considered ideal.

Allopathic US Senior Medical Students:

Cumulatively, 1,955 applicants applied for 1,319 general surgery residency positions in 2018. Of those 1,955 applicants, 1,157 were US senior medical students. 185 US senior general surgery applicants did not match in to general surgery residencies last year. Therefore, 16% of allopathic US senior general surgery applicants did not match making general surgery a very competitive specialty based on the data.

This is the data for those US senior medical students who matched successfully:

• Mean number of contiguous ranks: 13.1
• Mean number of distinct specialties ranked: 1.0
• Mean USMLE Step 1 score: 236
• Mean USMLE Step 2 score: 248
• Mean number of research experiences: 3.6
• Mean number of abstracts, presentations, and publications: 6.2
• Mean number of work experiences: 3.2
• Mean number of volunteer experiences: 7.0
• Percentage who are AOA members: 18.7
• Percentage who graduated from one of the 40 U.S. medical schools with the highest NIH funding: 28.9
• Percentage who have Ph.D. degree: 2.0
• Percentage who have another graduate degree: 18.7

Osteopathic Medical Students

Cumulatively, 1,955 applicants applied for 1,319 general surgery residency positions in 2018. There were 134 osteopathic applicants. Of those, 67 matched. Therefore, 50% of osteopathic medical student general surgery applicants matched in general surgery.

The data for those osteopathic students who matched successfully:

• Mean number of contiguous ranks: 9.4
• Mean number of distinct specialties ranked: 1.1
• Mean COMLEX-USA Level 1 score: 613
• Mean COMLEX-USA Level 2-CE score: 666
• Mean USMLE Step 1 score: 238
• Mean USMLE Step 2 CK score: 248
• Mean number of research experiences: 2.0
• Mean number of abstracts, presentations, and publications: 3.2
• Mean number of work experiences: 3.6
• Mean number of volunteer experiences: 5.8
• Percentage who have a Ph.D. degree: 0.0
• Percentage who have another graduate degree: 23.4

Because general surgery residencies are very competitive for osteopathic students, it is recommended that students have a minimum of two audition electives (at least one at an allopathic residency program) and a minimum of two letters of reference from allopathic academic general surgery faculty. It is also advisable that osteopathic applicants take the USMLE. Many programs will not consider COMLEX scores in place of the USMLE.

Keep in mind that osteopathic medical students can also apply to AOA-approved general surgery residencies if they are also accredited by the ACGME. As more osteopathic programs are ACGME approved, the matching rates of osteopathic students could shift.

United States International Medical Student/Graduate (IMG) Data

Cumulatively, 1,955 applicants applied for 1,319 general surgery residency positions in 2018. There were 204 US IMGs who applied for general surgery. A total of 66 matched. Therefore, only 32% of US IMG general surgery applicants matched in general surgery.

Below is the data for those US IMG applicants who matched successfully:

• Mean number of contiguous ranks: 6.3
• Mean number of distinct specialties ranked: 1.3
• Mean USMLE Step 1 score: 237
• Mean USMLE Step 2 score: 245
• Mean number of research experiences: 2.2
• Mean number of abstracts, presentations, and publications: 4.2
• Mean number of work experiences: 3.2
• Mean number of volunteer experiences: 4.4
• Percentage who have a Ph.D. degree: 0.0
• Percentage who have another graduate degree: 21.8

Because general surgery residencies are very competitive for US international students, it is recommended that students complete a minimum of two audition electives and obtain a minimum of two letters of reference from academic general surgery faculty.

Non-US International Medical Student/Graduate (IMG) Data:

Cumulatively, 1,955 applicants applied for 1,319 general surgery residency positions in 2018. A total of 258 non-US IMGs applied and 66 matched. Therefore, a total of 25.5% of non-US IMG general surgery applicants matched in general surgery.

Below is the data for those non-US IMG applicants who matched successfully:

• Mean number of contiguous ranks: 3.4
• Mean number of distinct specialties ranked: 1.2
• Mean USMLE Step 1 score: 242
• Mean USMLE Step 2 score: 249
• Mean number of research experiences: 5.2
• Mean number of abstracts, presentations, and publications: 15
• Mean number of work experiences: 5.4
• Mean number of volunteer experiences: 3.5
• Percentage who have a Ph.D. degree: 5.3
• Percentage who have another graduate degree: 21.1

Because general surgery residencies are very competitive for non-US international students, it is recommended that students complete a minimum of two audition electives and obtain a minimum of two letters of reference from academic general surgery faculty.

Looking for the raw residency match data?  Be sure you click below:

• 2018 NRMP Match Results
• Charting Outcomes in the Match 2018
• Charting Outcomes in the Match for U.S Osteopathic Medical Students and Graduates 2018  
• Charting Outcomes in the Match for International Medical Graduates 2018      
• 2018 NRMP Program Director Survey

Need further inspiration?

• Reddit residency personal statement 
• Reditt Residency
• Reddit Residency Match 2019
• SDN Residency
• SDN Internal Medicine

General Surgery Residency Interview: Who is invited?

Based on the 2018 Program Director’s Survey published by the NRMP, the following factors were most important in deciding who to invite for a general surgery residency interview:

1)  Any failed attempt in USMLE/COMLEX

There is no question that a USMLE/COMLEX failure is a deal breaker for many programs. However, in our experience, this is “easier” to overcome if you are a US allopathic student. The 2018 Program Director’s Survey indicated that 53% of programs rarely consider an applicant with a Step 1 failure and 46% never consider an applicant with a Step 1 failure.

2) USMLE Step 1/COMLEX Level 1 score

It is a fact of life that your performance on Step 1 or COMLEX 1 will impact the likelihood that your application is “screened in” and that you will be invited for an interview. Many programs automatically screen out applications if the Step/COMLEX 1 score falls below a certain threshold. The 2018 Program Director’s Survey indicated that 85% of programs have a “target score” they like to see applicants earn on Step 1. The average number for that cutoff is 220. By the same token, some programs automatically grant interviews for students with scores above a certain threshold. That threshold varies but is typically 230 or higher for Step 1. Keep in mind that not all programs offer automatic interviews. If you don’t do as well on Step 1 as you would have liked, take Step 2 CK early in the fourth year and do as well as you can!  The mean Step 2 CK score for US seniors who matched was 248.

3) Evidence of Professionalism and Ethics

You might ask how your professionalism and ethics might be assessed based on your written application. Program directors glean information about your personal characteristics and traits from your general surgery personal statement, ERAS written application, and letters of reference. This is why it is important to compose your personal statement and ERAS work, research, and volunteer experience entries thoughtfully. It is empowering to know that the outcome of your application season is, in part, within your control at this stage of the process.

4) Grades in clerkship in desired specialty, personal statement, class ranking and quartile, letters of recommendation in the specialty.

Letters of recommendation from academic general surgeons who know you well are of the utmost importance and was considered one of the most important factors in deciding whom to interview. By the same token, grades in general surgery rotations and electives as well as class rank were considered extremely important to general surgery program directors when deciding whom to interview. Interestingly, in contrast to many other specialties, the personal statement is one of the most influential factors in deciding who will be selected to visit the program and interview as well.

When should you apply?

Forty seven percent of programs extend general surgery interviews in October. Therefore, it is important to send your ERAS application in early!

Now, assuming you are selected for an interview, what factors influence how (and if) you are ranked?

Here’s the list:

• Interactions with faculty during interview and visit
• Interpersonal skills
• Interactions with housestaff during interview and visit

As you can see, after the interview, it is your “interview performance,” interpersonal qualities, and how you are perceived by anyone and everyone you meet that will influence how you are ranked (and even if you are ranked) the most. This is why, no matter how strong an applicant you are, it is important to be comfortable with the interview process. It is also valuable to know yourself; are you an introvert or more of an extrovert? What types of social situations make you comfortable or uncomfortable? During residency interviews you will be meeting many new people and having numerous conversations with strangers. Be prepared! While your USMLE scores, grades, letters of reference and written application will still be considered after you interview, it is how you perform on your interview day itself that will most greatly influence your rank position at any program where you interview.

What if you don’t match or you feel you need personalized help?

Applicants often feel lost, confused and overwhelmed by the residency application process. This is where MedEdits can help. We have helped hundreds of applicants match successfully. Whether you need a fourth year planning strategy, help with your personal statement, interview help, or any other guidance related to the residency match, we will make sure you are positioned as well as possible to match well!

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