Categorical in a community program vs. prelim at a University program

[DocTan]

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Hi all. I have a question. I am struggling between ranking a very small community categorical program vs. yale prelim. I think if I go to Yale for a year, I will have a chance to get into a better program the next year. Btw, I am an IMG so I have to take this into consideration.

 

[drrouz]

Hi all. I have a question. I am struggling between ranking a very small community categorical program vs. yale prelim. I think if I go to Yale for a year, I will have a chance to get into a better program the next year. Btw, I am an IMG so I have to take this into consideration.

It is my opinion that getting a categorical position is harder this year then last year and there are no signs that next year will be any different. As an IMG you have an even harder time getting a categorical position. I would take a categorical spot over a prelim spot. you will be surgeon at the end of 5 years and you will have a chance at most fellowships (I would find out where graduates have gone from the community program). The only way I see an advantage to going prelim and hoping to get a "better" spot in the match next year is if you are shooting for an extremely competetive fellowship (ped's) in which case you need a university program.

Good luck!

 

[Pilot Doc]

TAKE THE CATEGORICAL SPOT!! There is absolutely no question. It's like asking if you would rather marry a decent poor person or be the mistress of a
rich person and hope that they'll marry you after a year.

As mentioned above, you are almost guaranteed to be a surgeon 5 years later. Prelims are disposable residents that serve to flesh out a call schedule.

If you are truly unhappy with a community program, you should go to a respected university program, do research for 1-2 years then reapply.

 

[Winged Scapula]

ACKK!!! Rank any Categorical position you could possibly see yourself at over a Prelim position. As others have noted, there is no guarantee that that Prelim position will transition into a Categorical one, or that you will be anymore successful in next year's match. Its pretty hard to be kicked out of a Categorical position, so you have some semblance of assurance that you will become a surgeon; you do not as a Prelim.

While Yale may seem more prestigious than a community program, there is no across the board reason why you can't successfully start at a community program and get a fellowship, if that's what you're considering.

 

[merlin]

Examining the other side of the issue, wouldn't doing a prelim year actually make you a more attractive candidate as it shows not only your dedication but also presumably shows you can do the work required of intern year? Although I know the opposite is true, it seems doing a prelim would be more beneficial than research but alas, research holds a special place in the whole process...Also, as a student at a US school, would doing a prelim make you a worse candidate the second time around under the presumption that you should have matched the year before? These are all just food for thought as the process continues. Cheers.

 

[geekgirl]

Examining the other side of the issue, wouldn't doing a prelim year actually make you a more attractive candidate as it shows not only your dedication but also presumably shows you can do the work required of intern year? Although I know the opposite is true, it seems doing a prelim would be more beneficial than research but alas, research holds a special place in the whole process...Also, as a student at a US school, would doing a prelim make you a worse candidate the second time around under the presumption that you should have matched the year before? These are all just food for thought as the process continues. Cheers.

i understand your thoughts, but i concur with the other opinions. you can just as easily switch categorical programs (sort of, if you are willing to restart) than to move from a prelim to a categorical position. being categorical (even at a place you don't want to be forever) gives you leverage to move on. you may have to restart, but at least you have proven yourself in a "permanent" position. so at the end of 5 years, or even at the end of 1 or 2, you can switch if you want to. and if you hate it, find a research spot for a year or so and move onwards.
best of luck.

 

[merlin]

i understand your thoughts, but i concur with the other opinions. you can just as easily switch categorical programs (sort of, if you are willing to restart) than to move from a prelim to a categorical position. being categorical (even at a place you don't want to be forever) gives you leverage to move on. you may have to restart, but at least you have proven yourself in a "permanent" position. so at the end of 5 years, or even at the end of 1 or 2, you can switch if you want to. and if you hate it, find a research spot for a year or so and move onwards.
best of luck.

I completely agree with the previous assessments as well. It is in no way easy to switch from a prelim position to a catagorical position. What I was proposing was the situation in which someone had absolutely no problem doing another intern year. In that case, would doing a prelim year at a big name and then applying for a PGY1 catagorical make them a more competitive candidate?

 

[locitamd]

Unfortunately, the sad reality is that at Yale there are IMG's who are now PGY-2 prelim and still desperately trying to find categorical spots (anywhere). Rumour has it they had the highst inservice exam scores (tied with a chief) but are nonetheless still unsure of their futures. I have a hunch that if they had to do it over again, they would have chosen the community categorical.

 

[Winged Scapula]

Unfortunately, the sad reality is that at Yale there are IMG's who are now PGY-2 prelim and still desperately trying to find categorical spots (anywhere). Rumour has it they had the highst inservice exam scores (tied with a chief) but are nonetheless still unsure of their futures. I have a hunch that if they had to do it over again, they would have chosen the community categorical.

Pot calling the kettle black here, but Yale Surgery residency doesn't exactly have the same prestige as its undergrad programs. There have been numerous problems over the years, including that mentioned above.

 

[Winged Scapula]

I completely agree with the previous assessments as well. It is in no way easy to switch from a prelim position to a catagorical position. What I was proposing was the situation in which someone had absolutely no problem doing another intern year. In that case, would doing a prelim year at a big name and then applying for a PGY1 catagorical make them a more competitive candidate?

If the choice was do Prelim year vs do nothing, sure doing a Prelim year as a way to prove oneself for a future Categorical position is not a bad idea. You will have a few months under your belt to show that you can handle the work, get LORs, etc. Its a tough existence - you're essentially doing an audition rotation for a year!

However, since the OP appears to be weighing a Prelim position at what is presumed to be a more prestigious program vs a Categorical position at a community program (apparently less valued by the OP), we are not advising him/her to give up a possible Categorical position over a Prelim one.

 

[locitamd]

Yale Surgery residency doesn't exactly have the same prestige as its undergrad programs.

...which is the case for several of their residency programs, not just surgery. Unfortunately, many applicants get blinded by the name and risk giving up catgorical spots for it...

 

[geekgirl]

TAKE THE CATEGORICAL SPOT!! There is absolutely no question. It's like asking if you would rather marry a decent poor person or be the mistress of a
rich person and hope that they'll marry you after a year.

As mentioned above, you are almost guaranteed to be a surgeon 5 years later. Prelims are disposable residents that serve to flesh out a call schedule.

If you are truly unhappy with a community program, you should go to a respected university program, do research for 1-2 years then reapply.

this is true. listen to this advice.
there is some mental association with "prelim" (i.e not as good) that is not there with "categorical" - fair or not. so it's hard to move upward from a prelim spot - even if done at a good place.

 

[merlin]

I agree...in no way should the OP go for the Yale prelim position with the intention of trying to transfer into a top catagorical position. The much more intelligent move would be to go for the comm. catagorical, but I still think that if the OP's intention is to go to a university program, doing a prelim and then applying PGY1 isn't that bad an ideal...but then again, I haven't been an intern yet...so my opinion isn't worth that much.
cheers with whatever you choose to do.

 

[Winged Scapula]

...which is the case for several of their residency programs, not just surgery. Unfortunately, many applicants get blinded by the name and risk giving up catgorical spots for it...

Indeed.

 

[Soon2BENT]

i too was blinded by all these big name programs and am currently in the process of inteviewing at a few. sure its going to look nice on the CV at the end of training, but i think what everyone needs to ask is, "will i be comfortable here for 5-7 years?" sometimes, the smaller, less known program tends to be the place where you'll get the best training. i've already had one program i was suprised by move up my rank list, when I at first had no intentions of really wanting to go there (thought i'd use it for practice since it was close...now i'm strongly thinking of making it my #1). i think if the opportunity to get a spot that has you secure for 5-7 years is better then going for a 1 year program and hoping things work out better. through all this interviewing, i think all the programs are starting to look the same and now its coming down to 1. do i like the residents 2. how is the faculty i meet?


in essence, rank the categorical higher (if all else fails, PGY1 positions never fill even at the so called "top programs")

 

[Roux-en-Y]

TAKE THE CATEGORICAL SPOT!! There is absolutely no question. It's like asking if you would rather marry a decent poor person or be the mistress of a
rich person and hope that they'll marry you after a year.

As mentioned above, you are almost guaranteed to be a surgeon 5 years later. Prelims are disposable residents that serve to flesh out a call schedule.

If you are truly unhappy with a community program, you should go to a respected university program, do research for 1-2 years then reapply.

Listen to this man as he speaks the truth!
As to whether you'll have to "settle" for a community program is debatable...
You will definitely be settling for any prelim spot including Yale, BIDMC, Penn, WashU, Duke, etc.

 

[Vincristine]

Any categorical >>>>> any prelim. Listen to everyone else. I know a number of good prelims who would be thrilled to have something to do after June '06.