A Horrid Hypothetical

[ihearttimgunn]

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Sorry if this has been covered before, but I honestly can't find anything like it on SDN. Maybe aprogdirector knows, or someone else has been in the same boat...
Let's say you match to an advanced spot, but fail to match to a prelim spot. Then, horror of horrors, you are also unable to get a prelim spot in the scramble. What happens then? You can't fulfill your commitment to the advanced spot without a prelim spot, so does your inability to get a prelim spot make you a match violator??!?!!?? Or, is it likely that the advanced program could "pull strings" to get you a spot as a prelim at their own institution, even if officially there were no open spots, possibly by throwing that department some funding or something? (I have heard of this happening at my own institution...) Or, will your advanced program hold your spot for you for the next year after, giving you another year to find a prelim (meanwhile, leaning on their prelim program HARD to let you in this time)? Or... what? You wander forever adrift, in a no-man's-land?

 

[dpmd]

None of the above. You either suck it up and go to the undesirable prelim spots that are left, or you just don't get your advanced spot. They aren't going to hold it for a year though they might help you land an empty spot at that institution (we have had a EM resident to be as a surgical prelim here for the last few years, I don't know if they keep it open for them or if they would just rather have someone they know has a job next year versus someone trying to get into surgery). There are always spots left during the scramble, it just might mean you have to do a surgical prelim instead of a medicine one, or that you have to go to (insert undesirable city or program here) instead of (insert desired city or program here).

 

[lord_jeebus]

There is no way you won't get prelim surgery.

Even if, somehow, you couldn't get a spot in the scramble, there has to be a surgery PD somewhere willing to make a spot for you to get your cheap labor.

 

[ihearttimgunn]

Thanks, guys, but I was actually talking about in neurology which requires a prelim medicine year, not a prelim surgery year, which makes the scenario a great deal more competitive...

 

[dpmd]

Looking at the NRMP data it looks like in the last four years there have been about a hundred or two prelim medicine positions unfilled. I imagine if you are a good enough applicant that you match in neurlogy, then those programs would be interested in you during the scramble. I don't think I heard of anyone matching an advanced position but not getting a prelim in the match or scramble.

 

[dragonfly99]

Agree with above...really you should be able to get an IM prelim spot somewhere, unless you just didn't interview enough places. If you are worried you won't get one, get ready to hustle in the scramble to get yourself a spot. Program directors (such as your future neuro program director) have been known to pull strings to make spots for people (prelim ones) but it's really not their responsibility and you can't 100% count on that.

 

[Raggaman]

Sorry if this has been covered before, but I honestly can't find anything like it on SDN. Maybe aprogdirector knows, or someone else has been in the same boat...
Let's say you match to an advanced spot, but fail to match to a prelim spot. Then, horror of horrors, you are also unable to get a prelim spot in the scramble. What happens then? You can't fulfill your commitment to the advanced spot without a prelim spot, so does your inability to get a prelim spot make you a match violator??!?!!?? Or, is it likely that the advanced program could "pull strings" to get you a spot as a prelim at their own institution, even if officially there were no open spots, possibly by throwing that department some funding or something? (I have heard of this happening at my own institution...) Or, will your advanced program hold your spot for you for the next year after, giving you another year to find a prelim (meanwhile, leaning on their prelim program HARD to let you in this time)? Or... what? You wander forever adrift, in a no-man's-land?

OP, I am in a similar boat, and posted a very similar post today in the neuro section. I failed to get any prelim interviews for whatever reason. I think I only applied to competitive ones without thinking or maybe I really suck. Now my top 3 spots are advanced. #4, 5 and 6 are cat. Now I am thinking if I should risk a scramble and loose it all, or stick safely to the categorical ones (less desirable locations). My thoughts are that if I was competitive enough i would've atleast got 1 or 2 prelim interviews.

 

[Law2Doc]

There is no way you won't get prelim surgery.

Even if, somehow, you couldn't get a spot in the scramble, there has to be a surgery PD somewhere willing to make a spot for you to get your cheap labor.

Well, the only catch I see is if you are stuck looking in a certain geographical region, there may theoretically not be any prelim spots up for grabs in the scramble. I could see folks with family issues getting into this kind of bind. But if you are a US allo med student and willing to travel anywhere for a year and work in a malignant place with horrid hours, then there really shouldn't be a problem.

 

[Samoa]

You could always do a prelim at your own med school. That way you don't have to move. And they might be somewhat more lenient about giving you time to move.

 

[dragonfly99]

I would talk with your medical school now...see if they can somehow design a prelim year for you. If not, you have to think about if you want to do what lawdoc suggests, and risk scrambling into a less desirable location for a year, in order to still be able to rank your 1-2-3 desired programs first.