Categorical Positions in Neurology

[medsRus]

Why isn't there a movement for neurology programs to be all inclusive (PGY-1-4), instead of advanced (PGY-2) positions where we have to fend for a preliminary IM or transitional spot?

Based on the 2009 NRMP data, it looks like Emergency Medicine and Anesthesiology are really making strides on this front, for they are consistently lowering the PGY-2 and increasing PGY-1 postions.

This brings me another questions: are the neurology boards/societies strong enough to take a solid piece of the neurorads/imaging/pain-management/and other fields where specialties clash? It seems like the other groups are succeeding on these avenues (and in finances).

---

Members don't see this ad.

 

[Amos]

Why isn't there a movement for neurology programs to be all inclusive (PGY-1-4), instead of advanced (PGY-2) positions where we have to fend for a preliminary IM or transitional spot?

Based on the 2009 NRMP data, it looks like Emergency Medicine and Anesthesiology are really making strides on this front, for they are consistently lowering the PGY-2 and increasing PGY-1 postions.

This brings me another questions: are the neurology boards/societies strong enough to take a solid piece of the neurorads/imaging/pain-management/and other fields where specialties clash? It seems like the other groups are succeeding on these avenues (and in finances).

1) As has been mentioned before on the forum, medicine programs at some places don't like other specialties forcing them to take applicants they have not officially interviewed/signed off on. This problem is even more acute in peds-neuro, where many people have trouble getting into peds programs at high powered places, so they have to go elsewhere for the first part of their training.

2) Some people like the flexibility of being able to do their prelim year elsewhere. Maybe they like their current location, maybe their spouse needs a year to look for a job, maybe they have sick family members in a certain region, maybe they have always wanted to live in Cali for a year, etc.

The best solution seems to be to have mostly categorical spots, with a couple advanced spots. Programs that are all advanced or all categorical will get burned with certain types of applicants.

 

[medsRus]

1) As has been mentioned before on the forum, medicine programs at some places don't like other specialties forcing them to take applicants they have not officially interviewed/signed off on. This problem is even more acute in peds-neuro, where many people have trouble getting into peds programs at high powered places, so they have to go elsewhere for the first part of their training.

2) Some people like the flexibility of being able to do their prelim year elsewhere. Maybe they like their current location, maybe their spouse needs a year to look for a job, maybe they have sick family members in a certain region, maybe they have always wanted to live in Cali for a year, etc.

The best solution seems to be to have mostly categorical spots, with a couple advanced spots. Programs that are all advanced or all categorical will get burned with certain types of applicants.

Fine, I understand these points -- it's nothing new to me. But, I presume that they are not unique to neurology applicants. So, how did anesthesiology find it easier to accomplish the transition to more categorical (starting at PGY-1) programs?

Actually, I made some stats from the new 2009 data:

Neuro Positions Offered in the Match
PGY-1 = 160 in 2007, 177 in 2008, 196 in 2009 (23% increase 07=>09)
PGY-2 = 379 in 2007, 398 in 2008, 385 in 2009 (1.6% increase 07=>09)
Note: As of 2009 match, 34% of all neuro. positions were PGY-1 based

Anesthesiology Positions Offered in the Match
PGY-1 = 575 in 2007, 666 in 2008, 733 in 2009 (27% increase 07=>09)
PGY-2 = 763 in 2007, 698 in 2008, 641 in 2009 (19% decrease 07=>09)
Note: As of 2009 match, 53% of all anesth. positions were PGY-1 based

 

[exgatr]

I think there is a movement to increase the number of categorical programs. I've noticed that places with large, influential neuro departments can strong-arm the IM residencies a little and get a good deal. Plus, the better the neuro program, the better the average applicant and IM will be much more likely to oblige.

The program I'm at has an awesome, supportive neuro department and a stellar (although tough) IM program.

 

[typhoonegator]

I think there is a movement to increase the number of categorical programs. I've noticed that places with large, influential neuro departments can strong-arm the IM residencies a little and get a good deal. Plus, the better the neuro program, the better the average applicant and IM will be much more likely to oblige.

I think you hit the nail right on the head with this one. Medicine programs don't care where their prelims go after their intern years, they really care if they are going to be getting decent interns. Really strong neuro programs attract the kind of people that will not blow-off internship, and are likely to do a very good job in their PGY-1 year. These kind of neuro programs have no trouble (usually) getting medicine to accept their applicants for prelim years. I think, overall, the entering credentials of neuro applicants is rising, and with that, we should have less and less trouble getting included PGY-1 years in neurology residency. At least I hope so.

 

[KillingMeSmalls]

The numbers don't tell the entire story. There are programs out there that are advanced, but still guarantee prelim spots to everyone who matches into their advanced positions, although they are not formally categorical positions. True, these are minorities, but they're out there.

 

[Amos]

There are a lot of horror stories floating around out there, but has anyone heard of someone not getting a prelim spot that applied to several prelim programs in a broad geographic distribution?

I can only think of 2 places I interviewed that didn't either have categorical slots or didn't bend over backwards to help you secure a prelim position.