Someone brought up applying to both preliminary and categorical positions. I went unmatched last year. Since then I have and worked hard to improve my credentials but still remember what happened and do not want to repeat it. My goal is to do a preliminary year and then go into PM&R because I want to help people with disabilities. I see two hurdles – PM&R has become extremely competitive and it seems preliminary positions may be more competitive than categorical ones. In the event that I do not match into PM&R I would rather continue in medicine the next year and try to go into PM&R later. So I am thinking about applying to both prelim and categorical medicine positions and explaining where I am. I am interested in medicine and would consider finishing a residency in it but am more interested in PM&R. In this situation how would an application be viewed if you select both preliminary and categorical positions? What would program directors prefer?

Let me answer my own question. Decide what you really want to do and then go for it. Otherwise you may come across as being insincere and will also make things more difficult for programs. If you want to go into categorical medicine apply for categorical medicine. If you plan only to stay in medicine the first year and then move into the advanced position apply for a preliminary medicine or surgery position.