How this DO matched into an academic research-integrated general surgery residency program

Brittany Cuff, DO, just began her seven-year research-integrated general surgery residency program at Penn State with her sights set on a career in surgical oncology. An ambitious and well-accomplished person with a determined attitude, she is the only DO in her categorical class this year. In this edited interview, Dr. Cuff shares information about research-integrated general surgery programs and her unique path.

Where did you go to undergrad and medical school?

I went to St. Lawrence University in New York state, and I majored in biology and religious studies. I then attended Edward Via College of Osteopathic Medicine (VCOM) – Carolinas Campus in Spartanburg.

Why did you choose general surgery?

During third year, I discovered that I loved being in the operating room and working through surgical cases. I really love all of medicine, and I found that general surgery encompasses vast knowledge and skill within a single discipline. I love the challenge of striving for excellence in medicine and surgery and integrating both to optimally care for the patient.

General surgery also opens doors to a wide variety of fellowship options. I am interested in surgical oncology, for example, but others include trauma, transplant, breast, pediatric, cardiac, bariatric, plastic and minimally invasive surgery.

Tell me about the research program and how it’s different from the traditional general surgery training model?

Traditional general surgery training programs are five years long. Upon graduating, you can go into practice or into fellowship.

Programs differ, but my program begins with two years of clinical and surgical training, followed by two professional development years (research years), followed by completion of the last three years of surgical training, for a total of seven years.

During the two professional development years, attendees complete research and additional training. My program funds an ancillary degree of your choosing such as an MBA, MPH or even a Master of Engineering. You can also complete a fellowship during this time; for example, a senior resident at my program completed a critical care fellowship.

Because you are relieved of many of your clinical duties during your professional development years, it is a rejuvenating time for many residents who often also take time to write, go to conferences and nurture family relationships. Many of my senior residents had children during this time. Although it is a longer path, in my perspective it decreases the likelihood of burnout and provides a more sustainable foundation to a surgical career.

Who should consider a research residency as opposed to the traditional five-year model?

Students who do not want to be limited in competitive fellowship opportunities or who are passionate about research should consider programs with a research track. Two extra years is a big commitment, so do a lot of introspection about your long-term goals and see if it fits. As a DO interested in surgical oncology, I felt that the research track put me in a position to be prepared and competitive.

How many audition rotations did you complete?

Five. Some were month-long rotations, and some were two-week rotations. Looking back, I think two weeks is sufficient to get to know programs and for them to get to know you. 

To how many programs did you apply?

120 programs.

How many interviews did you complete?

I was offered 32 interviews and completed 25.

How many programs did you rank?

20 programs.

Did you apply exclusively to programs with research tracks?

No, I applied to programs both with and without. Of the programs I interviewed with, only five had research tracks.

You do not specifically select to apply to the research track on ERAS, and sometimes it’s difficult to even tell which programs offer research years. You will need to do your own research and express interest throughout the interview and application process.

What factors weighed into your rank order decisions?

For me, the most important factor was how the program would prepare me to successfully match into a surgical oncology fellowship. The academic capabilities and history of fellowship match success of the hospital were weighed heavily in my decision-making in addition to many other factors such as location, culture and cultural fit.

What was it like applying to a research program as a DO?

Talking to my co-residents, many of whom came from large, well-known MD programs, we did have different experiences. They were able to apply with the expectation of interviews at top academic programs, whereas I felt I needed to rely more on my auditions, board scores and other performance metrics to prove myself and open doors.

The bias is changing, but it does still exist. I believe I was denied interviews I deserved because of DO bias. However, being strategic in my applying served me well. For example, I mainly applied to programs who had at least accepted one DO in the past, knowing that increased my chances of obtaining an interview.

Did you take a research year? Why or why not? What advice do you have for students considering a research year?

No, I did not. I do not think DO students need to take a research year to match into a competitive specialty. Instead, focus on making good connections and work on time management to accomplish a lot during your four years of medical school. Everyone is different, so talk to your mentor and people who have done research years in the past to aid in making your decision.

You definitely want to have some research experience on your CV, and, no matter what it is, be able to speak articulately and passionately about it. Know it inside and out, and be prepared to be asked about it during interviews.

What should applicants focus on regarding board exams?

Work hard to take and score well on Level 2 and Step 2 CK.

What final advice do you have for a student wanting to follow in your steps? 

Know your worth. You are worth more than a program that is going to abuse you. Seek programs and people who you like and who will support you and be there for you when difficult times come.

Utilize your resources. Even when it feels uncomfortable, be open and willing to ask people for help and to leverage your connections. Connections are what helped me get to where I am today.

If there is a program you really love, communicate your interest clearly and often in a professional manner. Programs want people who want to be there.

At the end of the day, the most important part of your application is who you are. Programs not only evaluate your accomplishments and your CV, but they also want to know they can get along with you every day for the next five-seven years. Cultivate your personality and interpersonal skills, be a team player and make meaningful connections with people.

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