Applying during prelim year

[switchh]

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Hi everyone - I am currently applying for ENT this cycle however it looks like the chances of me matching are pretty slim. In the case that I don't match, I'll be soaping for anesthesia. If I am not able to secure a anesthesia spot, I'll do a prelim surg year. My question is if I apply for next year when I am doing my surg prelim year, will I only be able to apply for R1 slots or can I apply for CA1 slots as well? If it's the latter, but I have to repeat intern year again? Also, are my chances of matching next year in anesthesia going to be lower than if I were a fourth year med student. thanks!

Also, if I match into anesthesiology through soap, I'm guessing it will be probably in a not so desirable place. Will that be very detrimental to my future career or will it have very little impact? Thanks.

 

[BigMAC3]

I think you can apply to both R1 and CA1 spots...but if you were to match to a CA1 spot, you'd just to have to find something else to do for a year (I personally think that could be nice, research/travel...not necessarily a bad thing). A surgery internship will count for anesthesiology. You won't need to repeat intern year.

I've heard rumors that last years SOAP had some pretty good programs (that definitely seemed like they just didn't rank enough of their applicants). But your odds of matching in a desirable program/location are better if you go the non-SOAP route.

 

[twoliter]

Hi everyone - I am currently applying for ENT this cycle however it looks like the chances of me matching are pretty slim. In the case that I don't match, I'll be soaping for anesthesia. If I am not able to secure a anesthesia spot, I'll do a prelim surg year. My question is if I apply for next year when I am doing my surg prelim year, will I only be able to apply for R1 slots or can I apply for CA1 slots as well? If it's the latter, but I have to repeat intern year again? Also, are my chances of matching next year in anesthesia going to be lower than if I were a fourth year med student. thanks!

Also, if I match into anesthesiology through soap, I'm guessing it will be probably in a not so desirable place. Will that be very detrimental to my future career or will it have very little impact? Thanks.

You won't have to repeat an intern year. You can apply to both PGY-1 and PGY-2/CA-1 spots. It depends on whether the program has any open incoming CA-1 spots to be available to you. It's kinda confusing, but your options would be to match into a categorical (doing all four years with that program including repeating PGY-1 year), match into an advanced (CA-1) position to start immediately after your first PGY-1 year (depending on what programs have those slots available), or match into an advanced position to start the following year (meaning you could either do another intern year, which is what I did, or find something else to do for a year, such as a paid research job, moonlighting, etc.). Something to consider would be to try to do an elective with the anesthesia department at your program if you end up having to SOAP into a surgical prelim to get a foot in the door. Also, if you do end up repeating your intern year, I would recommend a medicine year since you'll be worn out from your surgical year and it'll give you a little of both sides for anesthesia.

 

[switchh]

Thanks to you both for your replies!

If I am able to secure an anesthesia position through soap that may not be the most desirable(I don't mind this) but will it negatively impact my future career(ie looking for fellowships, etc)?

Also, are you at an inherent disadvantage when you try and apply while doing a prelim year as opposed to when you're applying as a fourth year med student in terms of the way the program looks at you? Thanks again!!

 

[notyep06]

Don't resign yourself to a undesirable program just yet - just google "unfilled spots NRMP" and there's a PDF for 2013. Apparently in 2013, there were 31 categorical and 13 advanced spots available across 19 programs in the SOAP for anesthesiology. Some spots were at Harbor-UCLA, Maryland, BU, UMass, Michigan (4 spots there, and it's a highly regarded program) - you get the picture. Also, anesthesiology tends to have a decent number of R1 spots each cycle for current interns since a sizable number of people switch into it, so you might not have the availability of an MS4 applying into anesthesiology, but you should be able to find a spot at a decent program. No clue on the fellowship thing though. Good luck!

 

[switchh]

Thanks for the quick replies!! I was trying to look online to see if I can find more info on how many R1 spots are offered but wasn't able to find much. Does the number of R1 spots offered change much every year?

 

[norwood]

Thanks for the quick replies!! I was trying to look online to see if I can find more info on how many R1 spots are offered but wasn't able to find much. Does the number of R1 spots offered change much every year?

By "number of R1 spots offered," do you mean the total number of nationwide intern positions or the number that go unfilled on match day? The number of nationwide intern positions is set, on a hospital-by-hospital basis, and can only be changed by the powers that be (i.e., ACGME) - an individual hospital can't just say, "Hmm, let's get 5 interns for next year, because the 2 we had this year weren't enough." Although I don't personally agree with ACGME on a lot of things, this is probably good, because it avoids having a huge oversupply of R1 positions with a "who gets voted off the island?" mentality. Intern year is stressful enough without encouraging gunner-ism among the R1's.

I would strongly suggest going for a categorical position, if that's an option, to avoid the stress and uncertainty of reapplying. Yes, it might affect fellowship, but at least you have a diploma from a residency. It also avoids the situation where you're completing your first intern year and then match into a categorical program, starting as an intern.

 

[switchh]

By R1 spots, i meant the number of spots that I can apply as a prelim where i can step into the programs as a CA1 or a PGY2 after I finish my prelim year. So you're saying it is better to scramble into a categorical than take a risk by starting prelim year in hopes of applying to a better selection of PGY2 spots that may be offered during the next cycle of eras?

 

[norwood]

By R1 spots, i meant the number of spots that I can apply as a prelim where i can step into the programs as a CA1 or a PGY2 after I finish my prelim year. So you're saying it is better to scramble into a categorical than take a risk by starting prelim year in hopes of applying to a better selection of PGY2 spots that may be offered during the next cycle of eras?

Ah, you're talking about your rank list, not just about what to do if you have to scramble.

I'd still rank prelims. I'm saying that if my choice were between a prelim year and a categorical program, all other things being equal, I wouldn't worry about the prestige of the categorical program - unless we're talking the kind of problems that make a residency fold or lose its accreditation.

Each year, there are a lot of prelims trying to get an R2 spot - or even another prelim R1 spot just to stay in the system. Some of the R2 spots that do show as available have a list of people already lined up for them. That's why if someone offers you a categorical position, I would recommend grabbing it.