10-13-2002, 05:40 PM
I am in the process of applying to IM residency programs. Some programs have both a traditional categorical track and a separate primary care track.
Does anyone know if you can apply to both the categorical and primary program at one program?
Do programs have strict quota for the categorical spots and the primary care spots (e.g. 10 categorical and 5 primary) and is the application process/interview/selection somewhat independent for the 2 programs?
On reviewing websites of several programs, it seems like some programs have quite different curricula for the 2 programs and with others, it's quite similar except for the number of electives vs. outpatient months.
10-14-2002, 12:54 PM
Jon, I also have applied to IM programs...many with both categorical and primary care tracts. I have been told by several of the faculty at my school to go ahead and apply to both tracts so that is what I have done at those residency programs that have both. Wish that I had answers for your other questions...hopefully someone else will! :-), Makimo
Here's the thing: With the advent of HMO's and managed care, schools were pressured by the government, and society in general, to provide an answer to the apparent abundance of specialists at the time. There was no way to determine which applicants would do primary care and which would specialize, but it was clear that tomorrow's primary care physician would require some different skills than the specialist. So, the key is that the primary care tracks are designed to have more outpatient exposure/blocks. They focus on outpatient management of illness as well as inpatient, but with heavier outpatient emphasis than categorical programs. The hope of the program bigwigs is that you will do primary care at the end; of course as we all know, many train in primary care residencies and wind up specializing, so you can't force someone to stay primary care. However, if your program is not that prestigious and you are in the primary care track, it will be harder to get a fellowship than in a categorical spot. This sort of makes sense because why should they expend all their resources in designing a program to have people "specialize" in primary care, and not do it. For example, an ivy league program will probably place about 60% or more of their primary care residents in fellowships, whereas a less prestigious program will have >70-80% stay in primary care. The bottom line is that you may apply to both tracks at one hospital. Just know that if you match in the primary care track, you will get more outpatient training, and may not have as ample an opportunity at a fellowship as the categoricals in that same program. (unless you're at Harvard, Yale, etc.)
Hope this helps.
P.S.---The interview process is exactly the same, and most require an interview for each separately, seeing as the PD's are different. There are also almost always different "quotas" as you mentioned. Most primary care tracks have a different number (usually less, but not always) than the categorical.
10-29-2002, 09:32 AM
Primary, as DR said, is more focused on people that don't want to specialize later whereas traditional categorical is not. But there are even more programs that have preliminary IM year, which is just a 1-year internship. Good luck!