A general surgery residency—whether you pursue it at a top-ranked institution or a community-focused program—demands intense dedication, both mentally and physically. Balancing work and life can feel impossible, at least for a few years, but completing your five-year training as a general surgery resident sets you on the road to advanced surgical careers. From thoracic and vascular to orthopedic or transplant, general surgery is a stepping stone to multiple specialties. Let’s explore some well-regarded programs in the US and Canada, plus insights on how to get accepted and what to expect from training.

Your Path to General Surgery Residency Success

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Great General Surgery Residency Programs in the US

  • Mayo Clinic College of Medicine and Science
  • Montefiore/Albert Einstein College of Medicine
  • Vanderbilt University School of Medicine
  • University of Alabama School of Medicine
  • Icahn School of Medicine at Mount Sinai

General Surgery Residency Programs in Canada

  • University of Toronto
  • University of Alberta (Faculty of Medicine)
  • Michael G. DeGroote School of Medicine (McMaster)
  • Northern Ontario School of Medicine
  • Dalhousie University School of Medicine

What Is a General Surgery Residency?

Simply put, it’s a multi-year training period (usually at least five years) that equips you with foundational surgical knowledge and skills essential for all sorts of surgical interventions. A general surgeon often faces unpredictable, urgent scenarios—treating trauma patients, removing diseased organs, or correcting congenital anomalies. Over time, you might choose to pivot into subspecialties, but general surgery training underscores core surgical approaches and fosters a wide-ranging knowledge base.

As a resident, you’ll refine:

  • Technical surgical abilities (handling scalpels, sutures, laparoscopes)
  • Decision-making under pressure (trauma cases, emergency ops)
  • Teamwork with OR nurses, anesthesiologists, fellow surgeons
  • Patient communication about procedures, outcomes, risks

It’s a rigorous undertaking, but for those who thrive on variety and hands-on complexity, it can be immensely rewarding.

What’s Involved in a General Surgery Residency (US)

In the United States, general surgery residencies last a minimum of five years, with the possibility of more if you pursue further specialization. From day one, you’ll face challenging hours—some residencies run up to 80 per week, though duty-hour rules keep a lid on extremes.

Residency life typically includes:

  1. Clinical Rotations: Inpatient wards, ICU, pediatric surgery, vascular, trauma care, and more.
  2. Didactic Sessions: Lectures, conferences, and journal clubs to solidify theoretical surgical knowledge.
  3. Progressive Autonomy: As you advance, you handle increasingly complex procedures, with senior residents or attendings supervising.
  4. Board Exam Prep: Most programs incorporate practice exams or reviews for the American Board of Surgery Qualifying Exam.

What You Need to Get into a General Surgery Residency (US)

Some programs might list specific cutoffs, but in general, strong USMLE Step 2 CK scores (often above 220) count heavily. Being in the top 25% of your med school class helps, too. Other pluses:

  • AOA membership (if you’re recognized for academic excellence)
  • Surgeon’s recommendation letters
  • Surgical experiences during clerkships or research
  • Published papers (bonus, not always required)

While these are not universal must-haves, they certainly boost your odds. Ultimately, showing a genuine passion for surgery—through rotations or volunteering—matters as well.

Applying to a General Surgery Residency (US)

All US-based programs use the ERAS (Electronic Residency Application Service). You’ll typically:

  1. Upload your transcripts, MSPE, letters of recommendation (3–4), Step 1/Step 2 scores, personal statement, CV.
  2. Interview if selected. Many top programs weigh interviews heavily, so prep thoroughly.
  3. Rank programs in the NRMP match. Then hope for a positive Match Day outcome.

General surgery remains a robust field, so competition is moderate to high. The more advanced or prestigious programs often look for significant research exposure or top-tier letters.

How General Surgery Residencies Are Structured (US)

You generally spend 5 years:

  1. Early Years: Foundational surgical rotations (often rotating through specialties like vascular, trauma, cardiothoracic).
  2. Mid Years: More complex cases, possibly research blocks or electives if the program includes them.
  3. Chief Year: You’ll oversee junior residents, manage schedules, handle administrative duties, and step into the OR more independently.

Mayo Clinic (for example) organizes rotations in blocks, each focusing on a specific surgical theme: acute care, vascular, critical care, transplant, etc. Some programs also require you to pass In-Training Exams or practice boards along the way. By year five, you might be a chief resident, refining leadership and advanced surgical approaches.

What’s Involved in a General Surgery Residency (Canada)

Similar to the US, Canada’s general surgery programs often span five years. The first few years cover basic surgical knowledge, after which you do more specialized general surgery rotations (like GI surgery, trauma, or oncology). But a key difference is the Competence by Design (CBD) model, which measures you by entrustable professional activities (EPAs) rather than purely time-based modules.

What You Need to Get into a General Surgery Residency (Canada)

Canadian residencies go through CaRMS. Requirements typically include:

  • Transcripts
  • MSPR (Medical Student Performance Record)
  • 3–4 letters of recommendation (preferably from surgeons)
  • CaRMS personal letter
  • CV

Some programs might require additional proof of language proficiency or alternative test scores. Also, consider doing a surgery elective or an away rotation in the program you want to join. That direct exposure can be a huge advantage.

Applying to a General Surgery Residency (Canada)

  1. Gather Docs: Transcripts, references, personal statement, and exam results (MCCQE).
  2. Submit via CaRMS.
  3. Interview: Some programs do panel-style interviews; others might do MMI or scenario-based stations.
  4. Rank: After interviews, you finalize your rank list, CaRMS matches you.

General surgery in Canada sees a stable applicant pool, but each program may have fewer positions. So thorough research and a robust application remain crucial.

How General Surgery Residencies Are Structured (Canada)

5 years typically:

  1. Year One: Basic rotations in surgery, emerg, ICU, or internal medicine. Some incorporate a “boot camp” approach.
  2. Year Two–Three: Expand into distinct branches: trauma, GI, endocrine, thoracic, etc. Possibly short stints in obstetrics or ortho, depending on the curriculum.
  3. Year Four–Five: More autonomy, advanced surgeries, chief resident tasks, and final board exam prep. Some programs include flexible elective blocks or research stints.
  4. Competence by Design: You’re assessed continuously on EPAs—like complex laparoscopic procedures or leadership in the OR.

How to Get into a General Surgery Residency

  1. Letters of Recommendation
     Try to get references from seasoned surgeons who’ve seen you demonstrate skill and passion in the OR or clinic.
  2. Embrace “Scut Work”
     Rolling up your sleeves in med school rotations—volunteering for extra tasks—can earn the respect of attendings.
  3. Research
     Conducting or publishing surgical research can separate you from others, especially in the US.
  4. High Board Scores
     In the US, Step 2 CK matters; aim above 220. In Canada, board scores are less central, but good MCCQE results never hurt.
  5. Consider a Gap Year
     General surgery is demanding, so some take a break between med school and residency for personal reasons or to deepen their profile.

FAQs

  1. How long are these programs?
     Typically 5 years, but you can add 1–2 more for subspecialty fellowships.
  2. Is it competitive?
     Moderately so. The workload can deter some. In Canada, fewer slots mean it’s still a tough field.
  3. Do surgeons really work 80 hours a week?
     Regulations limit hours, but yes—heavy schedules aren’t uncommon.
  4. What if my Step 2 or MCCQE score isn’t great?
     Strong letters, rotations, or references might help offset it.
  5. Research is mandatory?
     Not typically mandatory, but it’s a plus in top-tier programs.
  6. Can I do a fellowship after general surgery?
     Absolutely: trauma, thoracic, vascular, transplant, etc.
  7. Which is better, US or Canada?
     Both are highly respected. US has more positions, Canada has fewer but thorough training.
  8. What about lifestyle?
     Early on, it’s demanding. Over time, you can shape your practice to find a better balance.

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Here’s to Your Success,
 Team at SOS Admissions

(Note: This content is for general insight. Always confirm official requirements with individual programs. Stats or quotes cited are illustrative only. Copyright © 1998–2024 SOS Admissions. All rights reserved. By using our site, you acknowledge our cookie policy.)

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  • General Surgery Residency
  • Residency Application
  • Surgical Residency Program
  • Becoming a Surgeon