preliminary vs. categorical

srbutros said:

I have two quetions and the feedback I will get from you guys will appear to be very critical in making some decisions.

I was wondering if preliminary spots or categorical spots are more competitive in university based programs in internal medicine?

Also what are the chances of switching into categorical after doing a preliminary year? I know there is no such thing as a guarantee but is it usually achieved one way or another, say switching to another PGY2 program but still landing in a good spot?

Thank you very much

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Really hard to say.... prelim positions serve a different function than categoricals so you have a different pool of people applying to it (people beginning their training at the PGY-2 level, namely neurology, rads, rad onc, derm, optho, anesthesia). A lot of these specialities are competitive in their own right, so in that regard, many prelims have competitive package when applying for different prelim positions.

Prelims can convert to categorical in some instances: 1) either they did not secure a PGY-2 position during the regular match and/or 2) decide that they like IM and wish to continue on in it. There are a couple of hoops to jump through (securing funding, making up outpt experience that was not done as a prelim etc.) This is generally done with approval of the PD, and maybe the chairman. As a way to gain an IM residency, I really couldnt give you a perspective on that.

medgator said:

Prelims can convert to categorical in some instances: 1) either they did not secure a PGY-2 position during the regular match and/or 2) decide that they like IM and wish to continue on in it. There are a couple of hoops to jump through (securing funding, making up outpt experience that was not done as a prelim etc.) This is generally done with approval of the PD, and maybe the chairman. As a way to gain an IM residency, I really couldnt give you a perspective on that.

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Is converting from prelim to categorical done often enough to not be uncommon? Does it necessarily depend on one of the categoricals dropping out? Is this easier/harder at a top academic center rather than a no-name community program? Can this reflect poorly on competitive fellowship (i.e. cards, GI) admissions?

Thanks!

prelims are really competative nowadays.
categoricals are not.
most people who show interest in their categorical programs are usually absorbed. have seen it happen more than once in my program.
i'm a cat. medicine .
has no effect ( major) for fellowships.

Why are prelims more competitive than transitional years? (Or are both more competitive?)

way more competative than prelims.
if you wanted to get into Rad or rad onc, why would you like to 6-8 months of floors when you could get away with 5 or under?

spyrogyra1 said:

way more competative than prelims.
if you wanted to get into Rad or rad onc, why would you like to 6-8 months of floors when you could get away with 5 or under?

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Exactly right.... transitionals are much more competitive. If you wish to use it for cat. surg or med though, you cannot do so, thus it is only useful if you know you want to do non-med and non-surg specialties that begin at PGY-2 (rads, rad onc, anesthesia, PM&R, derm etc.) for sure.

If that's the case - that transitionals are much more competitive than prelims - are there reasons for picking a medicine preliminary year?

sdnetrocks said:

If that's the case - that transitionals are much more competitive than prelims - are there reasons for picking a medicine preliminary year?

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If you like medicine that much and want the one-year experience of getting a better foundation in it before you begin your actual residency. Transitionals are generally cushier and allow you more elective time. That is why many people opt for them, and thus make them more competitive than prelim spots. I personally chose an IM year because I knew that once I started my training (rad onc), I wouldn't see it anymore (I wanted a foundation in it).

sdnetrocks said:

If that's the case - that transitionals are much more competitive than prelims - are there reasons for picking a medicine preliminary year?

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Some anesthesiology residents choose to do a prelim medicine year to get a solid foundation in medicine and critical care (ICU).

I was wondering the same thing myself as I was staring at the MyERAS form.

If I'm interested in a categorical spot, should I bother with ticking the preliminary box as well? Can you apply for a categorical and then only offer you a prelim spot, like a test-drive for a year?

treesap said:

I was wondering the same thing myself as I was staring at the MyERAS form.

If I'm interested in a categorical spot, should I bother with ticking the preliminary box as well? Can you apply for a categorical and then only offer you a prelim spot, like a test-drive for a year?

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That isn't how it's set up to work, but it does happen a lot.

treesap said:

I was wondering the same thing myself as I was staring at the MyERAS form.

If I'm interested in a categorical spot, should I bother with ticking the preliminary box as well? Can you apply for a categorical and then only offer you a prelim spot, like a test-drive for a year?

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I know people from my school would also apply to the prelim track and hope to switch into the categorical program because they perceived there was more competition for categorical positions at the higher ranked programs. In general, the competition for prelim spots is fierce (i.e. future dermatologists, rad oncs, radiologists) at the programs with "easier schedules". For example, "Jokewood" in Michigan and "Scripps Merciful" in California. Another potential way of getting into a program is to apply to the primary care track and then later on apply for fellowship. Some programs frown on this kind of attitude though.