r/SurgicalResidency

Repost from last month. Anesthesia position is in MI, and looking to stay in MI / metro Detroit.

I am a non-US IMG. I graduated medical school in June 2025, passed USMLE Step 1, and plan to take Step 2 this year. I have strong LORs and peer-reviewed publications.

I was admitted to Stanford Medicine’s MSc in Epidemiology & Clinical Research, starting September 2026. The programme takes 2 years. I have no guaranteed funding. To cover first-year costs I would need to take a loan of approximately $20,000 at 2.64% interest with a cosigner. My long-term goal is categorical general surgery, then a cardiothoracic fellowship, then academic cardiac surgery.

Option A — Enroll September 2026: I apply to residency in September 2027. That makes me YOG3. I would have Stanford on my ERAS application and roughly one year of research publications from the programme. I take the $20k loan.

Option B — Defer to September 2027: I apply to residency in September 2028. That makes me YOG4. I have one extra year to take Step 2 without pressure, build publications, and potentially secure a full scholarship for Stanford. But there is no guarantee the scholarship comes through, and I lose one year.

My questions:

For IMG surgical applicants — how much does YOG3 vs YOG4 actually matter in practice?

Does a Stanford MSc affiliation realistically help a non-US IMG get interviews for categorical general surgery?

Would you take a $20k loan at 2.64% to start now, or wait one year and hope for better funding?

Especially interested in hearing from surgical IMGs, current residents, and program directors.

4th year med student feeling confused about what to pursue. Have been aiming for surg subspecialty, but feeling unsure lately. Not sure if I'm burnt out or if my priorities are different or what. I have away rotations lined up in the specialty, but not feeling thrilled. Still love the field and everything, I just have a hard time imagining myself going through the however many years of surgical residency. I know all residency sucks, but I think surgery is a different beast. Did a few rotations in gen surg and did not love it. Did not like the vibes/misery/yelling and belittling that I saw the residents go through while they worked their butts off. Did rotations in this surg specialty and liked it but kind of dreaded the long OR days tbh. Enjoyed shorter procedures/surgeries and clinic days the most. With that being said, I am also wanting to start a family in residency and would like to have a few children and be present as a mom in the future. Unless I go into PP, I would need to take call, which is ok but I'm not overly thrilled about it. Wondering if I make a super late jump to another specialty. Not sure what specialty. Feel like life is too short and I want to be as present as possible for my family. That's all. Wish I would have spent more time exploring other procedural specialties. Feels like it's getting a little late in the game to make a switch.

I'm wondering if I have a good shot at academic programs in the middle atlantic, mountain, and pacific regions, all of which I have family ties

Board scores

• Step 1: Pass (1st attempt)
• Level 1: Pass (1st attempt)
• Step 2 CK: 260
• Level 2: Pending (expected 8/4)

Clinical performance

• Honors: General Surgery, OB/GYN, Family Medicine, Psychiatry
• High Pass: Internal Medicine, Pediatrics
• Pass: OMM

Academics

• GPA: 3.53
• Class rank: 50–75th percentile
• Sigma Sigma Phi

Research/Letters/Sub-Is

• 10 research items
• 3 so far (both home program PD and surgical chair, M3 surgery attending)
• Home program and two aways

Hey everyone, looking for some advice from current ortho residents, attendings, or anyone who’s been through the match as a DO.
How important is taking USMLE Step 1 if you’re already taking COMLEX Level 1 and plan to take USMLE Step 2? Since Step 1 and Level 1 are both pass/fail now, I keep hearing completely different opinions. Some people say Step 1 is basically required, while others say most programs are fine with a Level 1 pass as long as you have a strong Step 2 score.
My current plan is to take Step 1, but if I can’t fit it in before third-year rotations, how much would that realistically hurt my chances? Would I still be competitive for most orthopedic programs with Level 1 + a strong Step 2, or is not having a Step 1 pass going to close a lot of doors?
I’d appreciate any recent experiences or program-specific insight. Thanks!

Hello guys,
I’m starting my clerkships after the PhD, and I was hoping to talk to someone further along in the training who intends to pursue surgery while interested in research. I’ve had trouble connecting with non-onc surgeon scientists in my home institution, and I’d really like to get some advice on the pathway to residency and how to be fully prepared. Generally, most in-house and visiting mdphd’s I’ve met have dissuaded me from surgery, but I struggle with the idea of totally giving up surgery. At the same time, I absolutely love the lab and envision a career where I could find some type of split without completely giving up on a life outside of medicine. Would love to hear your experiences. Thank you!
Ps I’m more than happy to pursue a grueling residency, so long as attending life is amenable to some type of research/lifestyle flexibility. Thanks!

I just joined Gyne-onco residency and i feel like an idiot.
My basic concepts are very bad and what i read in my Obs-gyne residency feels like nothing in comparison to what is required of me here. Apart from surgical skills which i completely lack its the knowledge i am suffering most at.
Can you please suggest me some good study sources so that i stop feeling embarrassed at every round?
P.S. i know about the standard books that are expected of me to read but right now i need a shortcut kind of book/paper/link/anything which gives me a basic idea of everything in a short time for now.
Please help me out!

Hi guys. I'm an MS4 applying to general surgery this year and was putting in my first central line last week with the ICU PA guiding me. I got the needle into the IJ but felt so warm because I was struggling to get it to break skin in the first place as it's my first time. The stopper (idk if that's what it's called lol) was also stiff so I had trouble aspirating once it was in too but eventually got blood when i pulled the needle out slightly. I usually can tell when I'm about to faint so I let the PA take over and finish the rest of the procedure.
I know this is normal and he reassured me afterwards that I did great, but also feel discouraged since placing central lines is a big part of residency. Did you all have a similar experience the first time you did a central line?
Lol hoping to have more opportunities to try again though. I guess this is good experience before I start my aways.

Hi everyone! I’m applying to both MD and DO schools this upcoming cycle. My heart is set on MD, but I know my stats may not be the strongest, and I may have a better shot at DO schools.

I’ve always been very interested in surgery. I have a little under 100 hours of surgical shadowing, and I find the field fascinating. I also have 4,000+ clinical hours across primary care, GI, allergy/immunology, and the ER. From this experience, I feel pretty confident that I’m not interested in primary care or family medicine.

I was wondering how common it is for DO students to match into surgery and potentially specialize later on (my aim is to subspecialize - open to anything, interested in thoracic, vascular, ct, onco, plastics, trauma). What does that process typically look like? Is it still worth attending a DO school if my long-term goal is surgery? I would really appreciate any insight. Thanks!!!!

Edit: Thank you to everyone responding! I definitely feel more confident about applying DO. I honestly can’t see myself doing anything other than surgery that would make me equally happy.

tl;dr: I'm a new professor and my spouse is applying OMFS residency. No OMFS programs in our city, closest are ~2.5 hours away. Do we: (1) prioritize nearby programs and do semi-long-distance, (2) have them rank freely and I try to move jobs, or (3) do full long-distance for 4–6 years? Looking for advice/perspectives!

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Hi medspouses! I’m seeking advice/stories from anyone in a dual-career relationship where both careers are somewhat inflexible..

My spouse is applying to OMFS residency soon, and I’m a tenure-track professor at a large R1 institution. I just started my faculty job last summer and I love it. This specific job, department, and institution are an amazing fit, and the type of job I have is also extremely rare. Job has good pay, stability, and long-term career potential.

The difficult part is that there is no OMFS residency in our current city (let’s call it City X). The closest OMFS programs are about 2.5 hours away in City Y. So my spouse and I are trying to figure out our match strategy...to the extent that there can even be one.

Spouse has a very strong application and is likely to match somewhere (based on feedback from attendings/program directors). Some stats (because I'm a scientist): overall OMFS match rate is ~55%, and for those that do match, there is a ~50% chance of matching to your #1 program and 70% of matching to your top 2 ranked programs.

OMFS is obviously still very competitive, and we know nothing is guaranteed. Like many aspiring OMFS residents, my spouse would ultimately be happy just to match.

All that being said, we are currently considering the following options:

• Option 1: Have spouse prioritize the closest residency programs to my job in City X.
  • There are about 3–4 programs within a roughly 2.5-hour radius. If they could match at one of those, I would likely split my week between City X and City Y (e.g., 3-4 nights in City X during the week and spend weekends in City Y).
  • Pros:
    • keep my current tenure-track job and avoid the uncertainty of me trying to re-enter the academic job market
    • we would be within driving distance
  • Cons:
    • living apart/commuting for weekends for 4–6 years sounds tough (and because they are the resident, the burden is almost entirely on me)
    • if we have kids during residency (not sure yet, but we are both 30 right now), the logistics could become much harder
• Option 2: Have my spouse rank OMFS programs according to their true preferences and then I would try to find a job wherever they match
  • The challenge is that academia is not exactly easy to move around in... My profile is somewhat competitive, but the tenure-track job market is even more so. A comparable job may simply not exist in the same area. Worst-case scenario, I might take a lower-paying lecturer position, a less ideal academic job, or temporarily leave academia for industry.
  • Pros:
    • we can live together during residency—maybe easier to support each other emotionally and practically during residency, also makes it easier to have kids
    • spouse could make their rank list based on program fit, training quality, and career goals rather than being constrained
  • Cons:
    • giving up my tenure-track job for uncertainty of job market which could have long-term consequences for my own career trajectory and...resentment
• Option 3: Just be entirely long distance
  • I stay in City X and he ranks according to preferences and trains wherever he matches. He returns to City X after 4-6 years of training.
  • We honestly don't prefer this option even if we both get to do what we want career-wise... I think being together to some extent is important enough to us but would still like to hear perspectives if anyone has gone this route.

If anyone has been in a similar situations:

• Has anyone been the non-medical spouse with a career that was also difficult to relocate? How did you protect your own career while supporting your partner?
• How is doing long-distance or semi-long-distance marriage during residency? How did it go? Was it sustainable?
• How much did you actually see your partner during a demanding surgical residency?
• Would living apart during the workweek feel that different from living together, given the hours? Are small moments at home still really important despite overall less time spent together?
• Question for the resident: how much did it matter to you emotionally or practically to have your spouse physically living with you?
• If you had kids during residency, how much would that change your advice?
• Looking back, do you wish you had prioritized geography, program fit/prestige, family stability, or the non-medical spouse’s career differently?

I know the match is unpredictable and we can only control so much. We’re just trying to gather real stories and perspectives to help us think through rank lists and what kinds of compromises are realistic!

Any advice or perspective would be really appreciated!

Hey everyone,

I’m a student developer looking into how we can completely disrupt traditional surgical training. I want to build something highly engaging, visual, and neurodivergent-friendly—focused on spatial learning and active simulation rather than memorizing endless walls of textbook text.

To do this right, I need your brutal honesty:

1. What is one specific procedure or anatomical system that felt completely dry or impossible to learn from a lecture?
2. Where does current medical education completely fail visual or hands-on learners?

Drop your biggest frustrations below. Don't hold back!

If someone completes their surgical residency in Hungary, is a British citizen, has gmc registration, how likely will they be able to get a job as a specialist in the UK (in 5 years time?) would it be anywhere near as difficult as it was post grad to find a job at junior level?

Please share your own experiences so I don’t feel alone.

Hi all, I’m a urologist and I’ve been building a web-based Urology Oral Boards Coach for residents, fellows, and recent grads preparing for oral boards.

The basic idea is that you start a case and it behaves like a text-based oral boards examiner. It asks follow-up questions, withholds data unless you ask for it, pushes you on management decisions, introduces complications, and can run either in a more exam-like mode or a more teaching-heavy/open-book mode. There’s also dictation if you’d rather speak your answer and edit it before submitting.

I’m opening it as a free 7-day beta and would really appreciate blunt feedback, especially from urology residents/fellows/recent grads. No credit card needed.

Link: https://urologyboardscoach.com

Beta code: UROLOGYCOACH

The code should work for the first 30 signups. If it runs out and you still want to try it, message me directly and I can send additional invites.

Main things I’m trying to figure out: does the examiner feel realistic, are the cases detailed enough, is the feedback useful, does the scoring feel fair, and is the signup/onboarding annoying?

Obvious disclaimer: this is educational board prep, not medical advice, not affiliated with any board or society, and still very much in beta.

If you try it, I’d genuinely appreciate harsh feedback. The goal is to make it useful, not precious.

Hey guys,

So as the title suggests, I am an IMG about to graduate and thinking to apply prelim surgery. My hopes for categorical got shattered when I saw how unlikely it is to match straight out of med school.

I scored high on step 2 and did four sub-i’s in surgery, I’m trying to not lose hope and actually give one-two years of my life to the small chance of becoming categorical.

The only issue is I rotated at big institutions, and they told me “you can enter as a prelim and then you will repeat PGY1 categorical, you’re a smart guy” .

Another institutions said I am a great match to their program. But they don’t take foreigners as PGY1 categorical.

Any prior prelims here with some experience? Should I just choose the best program fit and have no expectations? What would be your advice to actually convert prelim->categorical the best way possible ?

I am aware it was quite a long post, so thank you for anyone offering help.

Hi everyone,

I’m a medical student from RCSI Bahrain and I’ll be in Year 4 when applying for electives in the US (surgery specialty).

I’m trying to understand what is realistically possible and what I need to prepare in advance.

I have a few questions:

1. What US hospitals or universities are realistic for international students (especially for surgery electives)?
2. Is USMLE Step 1 required or just preferred for most programs?
3. How early should I apply (6 months / 1 year in advance)?
4. Are there any hospitals that are more IMG-friendly and lower cost?
5. What are the biggest reasons international students get rejected?

I’m mainly looking for realistic advice from people who have applied or done electives in the US as international students. Any guidance would be really appreciated.