Diff b/w categorical and preliminary??????

[tool]

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Can someone please explain the diff to me? I am interested in doing Internal Medicine...if a program has both should I apply to both? Please help...thanks!!

 

[axm397]

Preliminary is 1 yr - usually for ppl going into other field which require a year of internal medicine internship. (i.e. derm, anesthesia, PM&R, neurology, radiology, etc. etc.) Categorical is what you want if you want to go into internal medicine and complete a 3 yr residency.

 

[tool]

Preliminary is 1 yr - usually for ppl going into other field which require a year of internal medicine internship. (i.e. derm, anesthesia, PM&R, neurology, radiology, etc. etc.) Categorical is what you want if you want to go into internal medicine and complete a 3 yr residency.

So if I want to do IM is it pointless to apply for preliminary? Or say I can do my prelim year somewhere and then do 2 more years at another program??? Basically will it count as my intern year??

 

[b&ierstiefel]

So if I want to do IM is it pointless to apply for preliminary? Or say I can do my prelim year somewhere and then do 2 more years at another program??? Basically will it count as my intern year??

If you are doing a residency in IM, the first year is an intern year. For all intensive purposes, this is equivalent to a preliminary year. However, typically you will complete your intern year at the same place where you will do the rest of your IM residency program. So basically if you will be applying to IM, you only apply to IM. You don't apply to separate prelim year programs like those folks who apply to let's say rads, opthy, derm, rad onc, etc.

 

[AJM]

So if I want to do IM is it pointless to apply for preliminary? Or say I can do my prelim year somewhere and then do 2 more years at another program??? Basically will it count as my intern year??

To sum up what everyone is saying in more basic terms, if you want to do IM you should apply to categorical programs. It is pointless to apply to prelim programs, especially since it can raise a red flag -- the only people who apply to IM prelim programs are those people who are going into other specialties that happen to require a prelim year. So programs will think that you are not committed to IM if you apply to both categorical and prelim positions.

So apply categorical. Don't worry about the prelim stuff -- those are for folks doing derm, ophtho, anesthesia, etc.

 

[AJM]

So if I want to do IM is it pointless to apply for preliminary? Or say I can do my prelim year somewhere and then do 2 more years at another program??? Basically will it count as my intern year??

One more thing -- a prelim year does count as an intern year in IM, but residents in IM do not do their training that way. They ususally train all three years at the same program. If you want to switch programs, you can try to transfer between two different categorical programs.

 

[zeloc]

To sum up what everyone is saying in more basic terms, if you want to do IM you should apply to categorical programs. It is pointless to apply to prelim programs, especially since it can raise a red flag -- the only people who apply to IM prelim programs are those people who are going into other specialties that happen to require a prelim year. So programs will think that you are not committed to IM if you apply to both categorical and prelim positions.

So apply categorical. Don't worry about the prelim stuff -- those are for folks doing derm, ophtho, anesthesia, etc.

Reviving an old thread. So do all residency programs get a list of every program that the student has applied to? Otherwise how would they know if you were applying to both categorical and prelim, unless you are applying to both at the same institution. I am just trying to figure out how the application process works.

I think it would be interesting to be able to do residency at more than one institution because each will have its own intellectual flavor and atmosphere, as well as a different patient population, etc, but I guess there's no real way to do this for a person going into IM? My current plan is to do a 3 year internal medicine program (I think this is required) and then do a fellowship in nephrology. If someone did a prelim or a categorical and then tried to transfer after the first year, how would this work in terms of spots open at other programs? Would you just do 2 years at a place that had a 3 year categorical program? Thanks for any info.

 

[Winged Scapula]

Reviving an old thread. So do all residency programs get a list of every program that the student has applied to? Otherwise how would they know if you were applying to both categorical and prelim, unless you are applying to both at the same institution. I am just trying to figure out how the application process works.

I think it would be interesting to be able to do residency at more than one institution because each will have its own intellectual flavor and atmosphere, as well as a different patient population, etc, but I guess there's no real way to do this for a person going into IM? My current plan is to do a 3 year internal medicine program (I think this is required) and then do a fellowship in nephrology. If someone did a prelim or a categorical and then tried to transfer after the first year, how would this work in terms of spots open at other programs? Would you just do 2 years at a place that had a 3 year categorical program? Thanks for any info.

Programs do not get a list of where you have applied, so they wouldn't necessarily know that you had applied elsewhere in another track unless word of mouth happened or you told them.

I highly recommend against moving programs unless you absolutely have to. Besides the sheer hell of physically moving all your stuff, you have to start all over getting to know people, the town, the politics of the new hospital, computer systems, etc. Not worth it, IMHO.

If however, you were deadset on doing this, you would have to find a PGY2 spot at another program which had opened up due to a newly funded position, resident leaving, dying, etc. Most would not make you repeat the first year as long as you had the required rotations.

 

[AJM]

Reviving an old thread. So do all residency programs get a list of every program that the student has applied to? Otherwise how would they know if you were applying to both categorical and prelim, unless you are applying to both at the same institution. I am just trying to figure out how the application process works.

Residency programs don't get a list of the programs you've applied to, but if you apply to prelim and categorical at the same program, they will definitely know. Besides, if you even mention the plan of applying to both prelim and categorical to any of the IM residents at your home institution, then your home program will find out about it.

I agree with Kimberli about the transferring issue. Transferring simply for the sake of gaining a different experience is just not worth it. You will have to learn completely new hospital systems, get to know a totally different set of attendings, and pack up all of your stuff to go to a new area. Not only that, but even if you transfer as a PGY-2 to a new program, and even if you like the other housestaff you're joining, you will always be viewed as an outsider by the rest of the housestaff, even as late as the end of your PGY-3 year. I've seen this happen to a number of people who have transferred in the past.

Changing the faculty you'll be working with is also a bigger issue than you think, especially if you're planning on applying to fellowships. Most people apply relatively early in their 2nd year. Usually you rely on faculty you initially met as an intern and then have further contact with in your second year in order to help you out, write letters, and make phone calls for you. By transferring in the middle of this, you will be disrupting the longitudinal relationships that you will be making with the faculty that are so crucial to fellowship applications (besides, as most fellows know, fellowship apps are more about who you know and who likes you than they are about how good you really are). Not only that, but your program director letter (similar to the Dean's letter for residency apps) would be written by your new PD, who will have only known you for about 3 months by the time he/she writes the letter. Not really ideal if you're looking for a strong letter by someone who knows you well.

Okay, I'll get off my soapbox now. I think you get the idea that I think transferring IM programs just to get a different experience is a bad idea. If you want a variety of experiences, I would recommend going to a different program for fellowship than where you do your residency -- that should provide you with enough diversity. 😎

 

[medgator]

Preliminary is 1 yr - usually for ppl going into other field which require a year of internal medicine internship. (i.e. derm, anesthesia, PM&R, neurology, radiology, etc. etc.) Categorical is what you want if you want to go into internal medicine and complete a 3 yr residency.

Prelims and categoricals are generally treated the same with regard to the year's schedule (number of ICU rotations/electives etc.) The major difference is probably a lack of a half-day outpatient continuity clinic for the prelims. This of course makes sense considering they are only there for a year. Some programs (I know U Maryland does this) require their prelims to do clinic. If you were to convert to a categorical, you might need to make up the first yrs clinic time sometime later in residency during an elective month.

 

[zeloc]

Thanks for the great responses everyone!

 

[pr.usmle]

hello everyone.
i wanted to find out how competitive these prelim med tracks are. as an IMG, will i have a problem getting in?
and is it true that a lot of prelim med seats remain unfulfilled?
i want to purse psychiatry.. and it also involves a yr of internal medicine.. so will it also benefit me?
please let me know if someone can throw some more light on all this and more
regards to all
Pramit

 

[Swaydaa]

You will have NO problem finding an open preliminary postion....trust me.

At my program, the categorial people get treated WAY better. They have an easier schedule and fill all the elective slots first. I faxed them my list for elective choices (cardio consults/pulmonary etc.) and told them I was going into anesthesia. They put me in HEME consults, Infectious diseasea consults, and Renal consults???? Yeah those will help me with anesthesia!?

 

[AwesomeO-DO]

If i want to go into IM but really want to be a hospitalist, which would be better: prelim or categorical?

 

[medgator]

If i want to go into IM but really want to be a hospitalist, which would be better: prelim or categorical?

A hospitalist is an internist by training, meaning you have to do the categorical (3-year) track (so you can be boarded in internal medicine). As stated previously, preliminary positions are simply a 1-year position for people doing an advanced PGY-2 residency like radiology, rad onc, derm, optho, or anesthesia.

People who decide they would like to convert from a prelim. to a categorical medicine/surgery resident have to talk to their PD and may in fact need to jump through a few hoops for this change to occur.