couple n00b questions

[Green Pirate]

---

Members don't see this ad.

I'm not in med school yet, so I probably should not be worrying about this right now, but I'm just curious about the way some things work on the other side.

1) how is research different for med students than it is for undergrad students? are you allowed to take a more active role in some research projects? are research positions easily available or do you have to pull strings to get them?

2) are you allowed to apply to several different types of residency programs? For example, say you want to try to become a neurosurgeon, but given nsg's highly competitive nature, is it fair game to apply to neurology residencies as an "alternative"?

thanks.

 

[Tired]

1) how is research different for med students than it is for undergrad students? are you allowed to take a more active role in some research projects? are research positions easily available or do you have to pull strings to get them?

Highly variable depending on your school, location, and the PI. This is a better question to ask in your interviews, to help you decide on a school. It will also make you look interested in research, which most med schools find desirable in applicants.

2) are you allowed to apply to several different types of residency programs? For example, say you want to try to become a neurosurgeon, but given nsg's highly competitive nature, is it fair game to apply to neurology residencies as an "alternative"?

Yes, you can do this. There are logistical issues involved here though, since you will have a limited amount of time to do 4th year elevtive rotations in your specialty of choice. Obviously you want to maximize your chances in the 'more competitive' field that is your first choice by doing rotations in it. However, you cannot completely blow off your 'less competitive' backup by not doing any rotations in them and expect to get many interviews. This is one reason that Transitional and Prelim spots are the more traditional "backup".

Good luck with your apps, when you get there.

 

[Green Pirate]

thanks... I understand most of what you're saying, except you kind of lost me with the "transitional" and "prelim" spots. Can you explain to me what exactly these are?

 

[BatmanMD]

The are basically 3 types of residents.

Catagorical: you'll have a resident and get training for the # of years needed. For example 5 years for surgery, 3 for family practice. You are guaranteed a spot for those years (unless you screw up and get fired!)

Prelim: You have a spot for 1 year. You can do a medicine prelim spot, and rotate through int med, just like any other intern or a surgery prelim spot. A lot of surgical specialities require a surgery prelim (urology, neurosurg..)

Transitional: prob the best 1 year commitment. You have flexibility to pick and choose surgical or medicine (usually a combination of both), people in Rads, Derm, Optho, usually get these.

Only the catagorical will get you board eligible though....

 

[Tired]

The are basically 3 types of residents.

Catagorical: you'll have a resident and get training for the # of years needed. For example 5 years for surgery, 3 for family practice. You are guaranteed a spot for those years (unless you screw up and get fired!)

Prelim: You have a spot for 1 year. You can do a medicine prelim spot, and rotate through int med, just like any other intern or a surgery prelim spot. A lot of surgical specialities require a surgery prelim (urology, neurosurg..)

Transitional: prob the best 1 year commitment. You have flexibility to pick and choose surgical or medicine (usually a combination of both), people in Rads, Derm, Optho, usually get these.

Only the catagorical will get you board eligible though....

Good description BatmanMD, just let me add a few more things in case this isn't clear to the noob.

If you get a categorical spot, you are essentially committed to the residency program, and they are guaranteeing you a spot throughout. If you get a "prelim" spot, you will do one year, and then typically reapply to multiple programs in an attempt to get a "categorical" spot to finish out the residency in that field.

In effect, you want the categorical spot. The prelim spot is what you get when you can't score the categorical spot.

 

[Wizard of Oz]

Research--if you are talking about bench lab work, the extent of your involvement is typically not that different from undergrad, but the reason is because as a med student, you just don't have that much time available unless you voluntarily take a year off (or are MD/PhD). Med schools usually have more NIH money and funding for students, so the quality of your science often has the potential to be better.

Okay, now I'm standing by for that ever-so-present SDN contradiction ("That's not true at my school....!") I definitely agree with Tired's comments on the matter. There is great variation.

On the topic of preliminary/transitional years, I don't want the noob to think that people who do them are not competative. Usually a match list will show both a prelim and a categorical in the specialties that require both. The transitionals go to competative matchers because transitionals are rare (and of variable quality) and popular.

You will take USMLE step 3 after you've done a year of residency (formerly referred to as "the intern year"). A preliminary year is REQUIRED in stuff like EM, rads, anesthesiology, derm, psych, etc. in some cases to give the student a broad enough look at medicine to master step 3 and in others to build a foundation. You usually match BOTH the prelim and the categorical during M4 with the understanding by your categorical place that you will not be showing up there until a year has passed.

It is often true that you stay with a prelim only when you are unsure of what you want to do or are stuck with one as a result of being a poor applicant, but there are plenty of cases in which a really good applicant has to scramble for a prelim because they just weren't good ENOUGH to match derm or rad onc and put all of their eggs in one basket (or thought that they were "promised" a match under the table). Traditionally, the vast majority of American grads get a categorical match during M4.

The saying is probably true that most American grads will get what they want, but if you are using neurology as a "back-up" for neurosurgery, I'd say that you haven't put a lot of thought into your career decision. One is very competative, time-consuming, rare, tough to match, and extremely high paying. The other is very easy to match and has a completely different lifestyle associated with it.

 

[Tired]

On the topic of preliminary/transitional years, I don't want the noob to think that people who do them are not competative. Usually a match list will show both a prelim and a categorical in the specialties that require both. The transitionals go to competative matchers because transitionals are rare (and of variable quality) and popular.

Yeah, this is a really good point. Many residencies require that you complete an intern or transitional year prior to starting "residency" (which is strictly defined as the training *following* internship, although we often gloss over this fact). Competitive folks will match to both their prelim/transitional spot and residency straight off. Other less competitive students will be able to only match to the prelim/transitional spot, and are left looking for a residency later. Obviously the latter is a relatively undesirable situation to be in, but it is common, and seems to usually work out okay.

Thanks for pointing out the nature of transitional spots. There are a lot of them out there, but the general consensus seems to be that some are great and others are terrible. Definetely talk to a lot of people about which transitional programs to apply to, if you decide to go that route.

 

[Green Pirate]

First of all, thanks everyone for explaining the natures of the different residency programs... I was completely unaware of the existence of prelim/transitional years. I was under the impression that you apply to a residency, are guaranteed the number of years needed to acquire board certification, and the general surgery or internal medicine "intern" year was included in that plan.

I actually have another question though. Say you land a categorical residency. Since you have to take your Step 3 after the first year of residency, do your Step 3 scores impact your ability to continue in that categorical residency? Do categorical residencies have a cut-off score for residents to attain in order to continue? If so, what happens to those who don't meet that requirement?

The saying is probably true that most American grads will get what they want, but if you are using neurology as a "back-up" for neurosurgery, I'd say that you haven't put a lot of thought into your career decision. One is very competative, time-consuming, rare, tough to match, and extremely high paying. The other is very easy to match and has a completely different lifestyle associated with it.

yeah that's probably true, but at this point in my educational journey, the nervous system has become the one system that my tiny undergrad brain finds the most interesting. at the same time, I like the manual aspect of a surgeon's practice. I'm sure my horizons will be greatly broadened during my clinical rotations (you know, six years from now... -_-).

 

[typhoonegator]

To clarify Prelim and Transitional positions:

You certainly could match into a prelim/transitional spot for your PGY-1 year via the match, without matching in a categorical program for the PGY-2 year. You could then make an attempt to re-apply for a categorical position during your PGY-1 year (no small feat). However, this is not what they are intended for. Many surgical and medical specialties require a prelim year prior to matriculation. Hence, you require a PGY-1 prelim year, AND a categorical position to start the PGY-2 year. To further complicate matters, there are prelim surgery and prelim medicine positions. Neurosurgery, for instance, matches for the PGY-2 year, and requires you to obtain a separate prelim surgery internship. Neurology also matches for the PGY-2 year, and requires a separate prelim medicine internship. Some programs help you procure these internships or offer them as bundles with the categorical match, but some do not. Transitional year positions are a bit different, and give you a broader internship experience, but with less depth. For instance, you get to do some OB-GYN and peds in a transitional year at the expense of some medicine or surgery blocks. Hence, they are usually not acceptable for categorical programs other than radiology, rad-onc, and sometimes ophtho.

Hope this is helpful.

 

[Green Pirate]

yes that was quite helpful, typhoonegator. I'm still curious though... what purpose does the Step 3 exam score serve?

 

[Tired]

yes that was quite helpful, typhoonegator. I'm still curious though... what purpose does the Step 3 exam score serve?

Step 3 is generally taken during or just after your intern year. It is a prerequisite exam you must pass to be a licensed physician.

I would be curious to hear opinions on its role in getting residency/fellowship slots. I have been told by residents that no one cares about your actual score, only that you passed.

 

[typhoonegator]

If you are taking Step3 during your residency with the sole purpose of working towards licensure, then there is no reason to try to get a stellar score. There are no fellowship doors that will be opened or closed based merely on your Step3 score. That being said, some people coming from other countries or who have performed below their expectations on Steps 1&2 choose to take Step3 much earlier, often prior to residency, in an attempt to rock it in order to enhance their portfolios.

Bottom line: if you are comfortable with your Step1 and Step2 scores, and are hunkered down in residency, then there is no reason to to bust your butt on Step3. Besides, you won't really have much time to study for it anyway.

Just think of it as another hoop to jump through -- and you don't get style points.