categorical and preliminary at the same hospital

[SSMD]

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just wondering about applying to categorical and preliminary spots at the same hospital...good? bad? will they look down upon this...as if i am saying "i'm not sure i can get the categorical spot?"...when in fact i simply want to avoid the scramble at all costs??...

Thanks!!

 

[njbmd]

just wondering about applying to categorical and preliminary spots at the same hospital...good? bad? will they look down upon this...as if i am saying "i'm not sure i can get the categorical spot?"...when in fact i simply want to avoid the scramble at all costs??...

Thanks!!

Hi there,
The problem would be if you got the prelim slot but there was no PGY-2 slot available to you when you had finished your first year. You would still have to leave your program. People are not dropping out of programs that often to guarantee that you would get a second-year categorical slot. There is a big difference in the teaching of categorical and prelim residents so you would miss out on some things that you really need for a general surgical career. If you want to do surgery, apply for a categorical slot at a wide variety of programs and be sure that you have enough interviews to get a slot. Most people who do not match, do not apply to enough programs at various levels. Get a good faculty advisor and make sure that you apply to programs where you have a chance of matching.

If you are not a stellar applicant, apply to good, solid community programs. You will get plenty of good operative experience/teaching and you can still do a fellowship if you make good contacts and do some research. There are plenty of surgical slots out there for people who really want to do surgery. If you have a poor USMLE Step I score and poor grades, do an audition rotation and work very hard. Again, you will catch the eye of someone who can help you get a categorical slot or at least write a letter for you.

Do not apply for prelim unless you have a PGY-2 slot available. Good luck!

njbmd 🙂

 

[Winged Scapula]

I would respectfully disagree with my colleague's response.

While I cannot comment on the treatment of Prelims at other programs, the Prelims at our program have the exact same rotations (ie, speaking on non-designated Prelims) as the Categoricals, same call schedule, and are in the OR the same amount of time aS the Categoricals. Frankly, I don't think the attendings make a distinction nor do the residents.

I agree that by taking a Prelim position you are risking being out of a job as a PGY2, given that the number of open Categorical positions in the scramble is exceedingly low and the OP wishes to avoid the scramble, wouldn't it be preferable to have a position for a year, rather than sit out the match?

Again, while I cannot speak for other programs, we have long accomodated Prelims who have worked hard and expressed an interest in staying on as a Categorical. Many programs with residents going in and out of the lab can do so, as there may be positions opening up in the 3rd year (this would necessitate being a Prelim for 2 years). We've tried to be up front with residents in such position - I suppose you could find yourself in a program where you'll be "promised" consideration and then end up jobless after one or two years, but I'd hope that most PDs would be honorable and really try to find you a Categorical spot if you do well during your Prelim year(s). Thus, I don't think its a guarantee that you'll be jobless or even have to leave your program after the first year. A good PD will assist you in finding a PGY2 position, even if it means at another program.

The trick is that you must rank all Categorical positions you might desire before any Prelim positions on your Rank List. This way you will match to a Categorical position before a Prelim one. Caveat: do not rank a position at a program you wouldn't be happy at simply because its a Categorical one.

Finally, we get candidates every year who rank us both for a Categorical and a Prelim program. We realize that getting a Categorical position is growing more and more difficult and don't see this as a lack of interest, but rather a sincere desire to find a position at a program they like.

 

[SSMD]

Thank you both for the helpful info...i was not planning on ranking the prelim spots before the categorical spots...but i think that i understand that applying for both positions at the same hospital is not a bad thing per se. Has the difficulty of obtaining a categorical position really increased? I have heard that it is simply a change in the number of applicants that programs are ranking, in essence, lowering the bar for admission to ensure that their categorical spots get filled?? Any idea??