Categoral vs Advanced

[Guillemot]

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I am applying to both categorical and advanced positions. Each seem to have their own pros and cons.

Categorical:

pros: camaraderie with fellow interns, getting to know institution, potentially a well designed curriculum (institution dependent)

cons: higher hours compared to ty, some categorical curriculum are better than others


Advanced:

pros: TY year would be nice, might be cool to check out a new area of the country for 1 year before moving somewhere else

cons: i have concerns about learning all I need to learn in a TY. Prelim med is too many gen medicine ward months and would prefer not to do one.


Some of the anesthesia programs to which I am applying have only advanced, only categorical, some mix of the two. Im not really sure which is the best choice. I want to be trained well without working unnecessarily hard.

 

[EdPierce]

some ideas:

first: keep in mind that transitional years are a total gamble. could be great, could be much worse that a prelim med year, it depends a lot on the layout of the program over the year so dont get hung up on the fact that it is a TY, a cushy prelim med spot could be much better overall

categorical

may be easier in that you dont have to move, you get to know the hospital you will be at, your year may have some anesthesia in it.

but you will likely be working in a major university (since that's where your anes program is) and that can mean brutal months during the year when not on elective - now your not only doing medicine/surg months your doing it at (e.g.) NYU/Brigham/Case where everyone is way into medicine/surg and you just want to chill and learn the basics


advanced

you can go to a program in the same city as your anes program and not have to move.

you can pick out a cushy program either prelim med or transitional.

the hospital may be small, affluent, and just focus on the horses.

i went to a small cushy prelim med program in the same city as my anes program and could not have been happier. like you i was worried medicine months would have been too much, but it all depends on environment. id rather do 12 medicine months there than one at my anes institution

 

[IveGotTwins]

Why does everyone forget about the prelim surgery year? I did one and loved it.

It may be because I HATED IM in med school but to me it seems ridiculous to do a prelim medicine year.

Doing a year of surgery you get used to the flow of the OR, get more procedures, and get used to the surgeon personality.

I have been told by my classmates that IM ward months do little to help when it comes time to move on to anesthesia. If you are lucky enough to get sub-specialty rotations like cardiology and pulmonary then those would be of some benefit. But who is going to get priority when it comes to assigning those rotations? The categoricals or the pre-lims? Who is going to get stuck in GI clinic, rheumatology clinic, or that extra night float?

Just my opinion of course. Many would rather admit 10 patients for homelessness than I&D one peri-rectal abscess. No matter what you choose or how bad it is they can't stop the clock.

One caution for those seeking the cush TY year: you may think "if I only work 30-40 hrs I'll spend the rest of the time reading anesthesia". Well that's a great plan and if you follow through with it then awesome. But my classmates who did TY years aren't anymore prepared than the rest of the advanced class because they didn't actually spend the extra time reading. When you're grinding it out as a pre-lim intern in something you are learning something and something is better than nothing.

Good luck.

 

[Gasmaster]

No question, categorical is a much better option than advanced. You build relationships that the advanced folk don't get. And in the end, once you hit CA-1 year, you're basically on your own sitting in an OR alone.

 

[MTGas2B]

Why does everyone forget about the prelim surgery year? I did one and loved it.

👍

I think this is a great route as well. Find a nice community/private gen surg residency. They need prelims too, just like the academic places. As a prelim intern I scrubbed almost every day when my service was operating, also negotiated some ICU time.