Are categorical programs more competitive?

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Definitely. Categorical spots within programs that have both kinds are more competitive.
- Moving is annoying
- Getting prelim/TY interviews can be hard for many physiatry applicants
 
Would it be better to apply to advanced with a prelim? My concern is that I'll match to a prelim that's in a different state than the residency. Moving twice would be very problematic for my SO (career-wise), so perhaps only categorical would be the best choice for us?
 
That's something only you and your SO can answer. The way you make your rank list dictates the most likely possibilities. You have to rank things based on how reasonable you feel the outcomes are. If there's an outcome you or your SO are unwilling to accept, don't even rank it. What would happen if you ended up there? It sounds like applying categoical only would be best for you guys.
 
I would also keep in mind though that if you don't match, you will most likely have to do a different specialty, considering PM&R will probably be completely filled again. It's only one year. I would consider ranking some advanced positions last and sticking out a year of long-distance relationship if needed. A year of long distance is entirely doable and would not be the end of the world for most relationships. I guess it just depends how comfortable you feel in getting a categorical spot (if you have a lot of interviews with programs that have a lot of categorical spots it could easily be fine, particularly if you are a strong candidate), and how willing you are to take the risk of not getting into PM&R. However, I'm always the "better safe than sorry" type!
 
Something to consider...

You will adapt much quicker to a program within a hospital you have previously worked. Categorical definitely has its advantages.
 
There's no reason why you couldn't do advanced.
If you don't mind being physically separated from your SO for a year, then she could find a job directly where you get your advanced spot, then you could join her there after a year.
 
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