Categorical vs. Advanced programs

[26B]

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In recent years, there has been an increasing number of categorical spots in anesthesia, and I know many prefer that because it takes away the hassle of having to apply for a separate prelim-year spot.

I'm in a slightly unique situation, as I will be couples matching and my SO is applying to a specialty that requires a transitional/prelim year. As a result, I will be applying to both categorical and advanced anesthesia programs, and will probably be ranking the advanced spots higher since couples matching with 1 person doing categorical and 1 person doing advanced is not an ideal combination compared to both people going for PGY-2 spots.

My question is, for anesthesia programs that offer both categorical and advanced spots, is there any difference in training? I've heard that some categorical anesthesia programs will integrate some anesthesia training and OR time into the PGY-1 year, so I'm not sure if I'd be missing out by doing a prelim medicine year elsewhere.

 

[Mman]

there is no difference in your ultimate anesthesia training whether you do a 4 year combined vs 3 year advanced + separate internship. Might a month or two of anesthesia at the same program as an intern help smooth your transition as a CA1? Sure. But that's pretty minor. Most programs I've heard of treat their interns as glorified 4th year med students on their anesthesia rotations. They can't give you all the training to be alone in the OR doing your own cases all day so you get paired up with a resident for the day.

 

[sevoflurane]

In recent years, there has been an increasing number of categorical spots in anesthesia, and I know many prefer that because it takes away the hassle of having to apply for a separate prelim-year spot.

I'm in a slightly unique situation, as I will be couples matching and my SO is applying to a specialty that requires a transitional/prelim year. As a result, I will be applying to both categorical and advanced anesthesia programs, and will probably be ranking the advanced spots higher since couples matching with 1 person doing categorical and 1 person doing advanced is not an ideal combination compared to both people going for PGY-2 spots.

My question is, for anesthesia programs that offer both categorical and advanced spots, is there any difference in training? I've heard that some categorical anesthesia programs will integrate some anesthesia training and OR time into the PGY-1 year, so I'm not sure if I'd be missing out by doing a prelim medicine year elsewhere.

You are not missing out on anything... however---> a categorical anesthesia position will give you "anesthesia appreciation months" during PGY-1.
It was exactly what I needed after a long month in Trauma Surgery. It is a great decompresion month and a fresh reminder of where you will be going.

 

[2Fast2Des]

I'd recommend a program that has anesthesia integrated into intern year. As in you're on your own after 2 month orientation. I felt I became better in my other rotations after having been in the OR

 

[AdmiralChz]

Being involved with resident recruitment now for a couple years, I can say that there is simply very minimal demand for advanced positions (almost everyone we interview is interested in categorical). Many high level programs have had difficulty filling advanced spots through the match - so they are slowly transitioning to more categorical spots. That being said, that will take several years (as having to set up rotations for more interns is not something that can happen as the snap of your fingers) so there are still many advanced spots available. Let them know you are interested in the advanced spots, and you will find it may even help you because it is a much, much smaller pool of applicants (at least, qualified applicants).

There are certainly advantages to doing internship at your program (i.e. not having to move twice), but the Anesthesiology RRC pretty rigorously defines what needs to be done during intern year and only a very limited amount of anesthesiology exposure is allowed (there are so many months that need to be done in EM, IM, Peds, etc...) and many programs (like my medical school's) that get PGY-1s lots of OR exposure find themselves having to put PGY-2s to "intern" rotations like Peds Wards - so beware.

You might feel behind for 2-3 months as an advanced resident, but trust me you will quickly get the hang of the hospital and the charting software and you'll be part of the team. Same end result.

 

[Psai]

People say that you get to know the system and the people if you do the first year there. The programs that I recall having advanced as well as categorical spots include brigham, umich, nyu, mgh, hopkins but my knowledge might be wrong or out of date as I know programs are moving more and more spots to categorical.

I have heard residents say that the people who do the rigorous medicine year at their home institutions are better prepared and have a stronger medicine background but my guess is that it probably won't make much difference in the end.

For your goal it may be easier to target big cities. It's easier to match together in places with many residency programs such as New York or California or Texas or Massachusetts than it is for both of you to try to get into Mayo for example.

 

[NNoor]

How does advance work? do i just apply for prelim/transitional only? Then next year apply for CA1 anesthesia? or Does ERAS gives us an option to apply for 2018 CA1 right now? thank you

 

[Mman]

How does advance work? do i just apply for prelim/transitional only? Then next year apply for CA1 anesthesia? or Does ERAS gives us an option to apply for 2018 CA1 right now? thank you

you have to apply for both your internship and advanced spots at the same time and you fill out 2 different rank lists for the match, 1 for the prelim and 1 for the residency to follow.

 

[bkg912]

Disclaimer: I'm dual posting this in another thread since in need of advice ASAP. Wasn't sure where it fit better.

When applying through ERAS, is it better to check both categorical and advanced with regards to programs? My plan was to focus on Categorical (I feel I'm competitive, Step 1 249 although go to a newer allopathic school), but then Anesthesiology residents I've talked to suggested to check both since it's only 1 interview and the rank lists are likely the same. I know it doesn't hurt to apply both, but it's mentally exhausting trying to map out all of the prelim/TY possibilities that accompany an advanced position. Would appreciate any and all advice! Thank you.

 

[deleted697127]

Unless you have a concrete reason for preferring advanced like family, I think it just seems like a safer bet for applicants to say they want to do categorical on interview day to get to know the program, build a strong foundation, not have to move twice, avoid extra applications/time off for interviews, etc. But at the same time, I know very few people who regret their transitional years.

It's the anesthesia training that matters.

 

[Psai]

Disclaimer: I'm dual posting this in another thread since in need of advice ASAP. Wasn't sure where it fit better.

When applying through ERAS, is it better to check both categorical and advanced with regards to programs? My plan was to focus on Categorical (I feel I'm competitive, Step 1 249 although go to a newer allopathic school), but then Anesthesiology residents I've talked to suggested to check both since it's only 1 interview and the rank lists are likely the same. I know it doesn't hurt to apply both, but it's mentally exhausting trying to map out all of the prelim/TY possibilities that accompany an advanced position. Would appreciate any and all advice! Thank you.

It's really not that "mentally exhausting". You just choose another mini match list with the prelim program.

By the way, doing a rigorous intern year really does seem to make a difference in knowledge base and early transitioning.