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Diff in a preLim and a categorical??
Started by IMSurg
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Preliminary spots are notoriously hard to obtain since they allow you to be a surgeon after only 1-2 years of training. Most applicants for prelim spots have USMLE scores of at least 230+ as well as several publications. Don't let the number of prelim spots that go unfilled every year fool you, as these programs have such high standards that they could not find anybody to fill the spots, thus they leave them unfilled instead of filling them with sub-par candidates.
Categorical spots on the other hand are a full 5 years and are meant for residents who can't manage to become fully qualified surgeons in 1-2 years like the prelim residents do. Thus the training is extended and sometimes there is even 1-2 years of mandatory research thrown in to make sure the catergorical residents who had no research experience/publications coming out of med school can actually learn to think on their own and add to the field of surgery instead of just following mindless and routine surgical protocol day in and day out. Even more insulting is that not only do categorical residents have to take 5+ years to finish, but at the end of it all they have to take written and oral exams by the American Board of Surgery to make sure they actually know what the heck they are doing. Prelim residents do not have to take such exams.
Unfortunately, some prelim residents who cannot hack it have no choice but to try to transfer into the slower categorical route. Very few, if any, categorical residents every transfer to prelim programs since most of them are unable to learn everything it requires to be a surgeon in 1-2 years like the prelim residents. Finally, categorical residents who are still deficient in ability after their training go on to do additional 1-3 year fellowships in order to make them competent. You'll never see a prelim resident do a fellowship, since virtually all of them are competent surgeons after only 1-2 years. That being said, categorical spots are not too hard to match into these days, with even places like Duke, UCSF, and Mass General routinely filling every year since they'll virtually take whoever applies.
Categorical spots on the other hand are a full 5 years and are meant for residents who can't manage to become fully qualified surgeons in 1-2 years like the prelim residents do. Thus the training is extended and sometimes there is even 1-2 years of mandatory research thrown in to make sure the catergorical residents who had no research experience/publications coming out of med school can actually learn to think on their own and add to the field of surgery instead of just following mindless and routine surgical protocol day in and day out. Even more insulting is that not only do categorical residents have to take 5+ years to finish, but at the end of it all they have to take written and oral exams by the American Board of Surgery to make sure they actually know what the heck they are doing. Prelim residents do not have to take such exams.
Unfortunately, some prelim residents who cannot hack it have no choice but to try to transfer into the slower categorical route. Very few, if any, categorical residents every transfer to prelim programs since most of them are unable to learn everything it requires to be a surgeon in 1-2 years like the prelim residents. Finally, categorical residents who are still deficient in ability after their training go on to do additional 1-3 year fellowships in order to make them competent. You'll never see a prelim resident do a fellowship, since virtually all of them are competent surgeons after only 1-2 years. That being said, categorical spots are not too hard to match into these days, with even places like Duke, UCSF, and Mass General routinely filling every year since they'll virtually take whoever applies.
Please note that the above post by A.S. is either completely in jest or a deliberate attempt to confuse you.
Preliminary positions are designed for people who need 1-2 years of General Surgery before going onto either a Surgical subspecialty (ie, ENT, Ortho, Neurosurg) or those who have the option of doing either prelim surgery or medicine and for some insane reason choose surgery (ie, these are generally Anesth, Rads, Derm residents).
Prelim residents are sometimes people who have been unable to match into a Categorical position and are hoping to prove themselves and gain a categorical position. Categoricals are the full 5+ years leading to board eligibility in general surgery if completed successfully.
Hope this helps.
Preliminary positions are designed for people who need 1-2 years of General Surgery before going onto either a Surgical subspecialty (ie, ENT, Ortho, Neurosurg) or those who have the option of doing either prelim surgery or medicine and for some insane reason choose surgery (ie, these are generally Anesth, Rads, Derm residents).
Prelim residents are sometimes people who have been unable to match into a Categorical position and are hoping to prove themselves and gain a categorical position. Categoricals are the full 5+ years leading to board eligibility in general surgery if completed successfully.
Hope this helps.
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What on earth are you talking about Kim? Stop messing with the young lad. This is only like the 1000th time this same exact question has been asked here, and I thought it was time to give a definitive answer since the same response given over and over apparently isn't sinking in.
It's not like you've never been guilty of asking the same type of questions.
Normally I'm not a big fan of your posts, but that was a great response, AS!
A stupid question deserves a stupid answer. Go back and search if you have a basic question.
I'm looking forward to the question "What is surgery, anyway?" to come up soon.
A stupid question deserves a stupid answer. Go back and search if you have a basic question.
I'm looking forward to the question "What is surgery, anyway?" to come up soon.
Hmmm...perhaps, except that this is inaccurate since most of us have matched into categorical positions.
You are absolutely correct, AS - except its probably the millionth time its been asked, at least in the last 6 months.
Your response was quite creative and I enjoyed reading it - however, I do occasionally have to do some moderatin' and can't have our naive newbies be led astray.
I'm sure you understand.
Indeed I do.
Ugghh....reminds me of when I was an MSIII, doing surgery; I don't know what started it, but this PGY-V (who was only in the 3rd clinical year, because he got put in the "dungeon" for 2 years) talked about that for 45 minutes on some metaphysical slant, and still, I don't know what his perception of surgery is. I thought it was use of operative technique for therapy or palliation.
Silly me.
Being a relatively casual reader of this site and occasional contributer, I have had the *cough* pleasure of reading quite a few of AS's posts and replies. In fact, it is interesting, if one were interested, to look at his/her profile and note that this person makes 7.42 posts per day, on average.
Being that I am currently a categorical resident, I have noticed that often the posts are filled with unsubstantiated information. I would like to echo the post by Kim Cox regarding what a preliminary surgical spot is. I'm not sure what AS is smoking or whom his supplier is, but I would recommend a refund and to change suppliers. So much more AS diarrhea of the mouth, or fingers as it is.
Being that I am currently a categorical resident, I have noticed that often the posts are filled with unsubstantiated information. I would like to echo the post by Kim Cox regarding what a preliminary surgical spot is. I'm not sure what AS is smoking or whom his supplier is, but I would recommend a refund and to change suppliers. So much more AS diarrhea of the mouth, or fingers as it is.
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So when somone speaks of intergrated plastics that is not the 2 year prelim plus 3 of fellowship? It is its own thing?
AS's post was making sense to me because the structure of 2years being more competitive than the 5 looks like the comapison between intergrated plastics and non.
AS were you also joking about the research? I know with regard to the prelim spots you are joking but what about intergrated plastics, where you actualy to compete for a spot that allows you to finish faster? anyone?
AS's post was making sense to me because the structure of 2years being more competitive than the 5 looks like the comapison between intergrated plastics and non.
AS were you also joking about the research? I know with regard to the prelim spots you are joking but what about intergrated plastics, where you actualy to compete for a spot that allows you to finish faster? anyone?
Integrated PRS is NOT 2 years of Prelim surgery followed by 3 years of PRS fellowship.
Integrated PRS is a residency applied for as a final year medical student and is generally a "3+3" or "4+2" (although a couple of 5 year programs do exist) - meaning you do either 3 or 4 years of general surgery followed by 3 or 2 years of PRS. These are all done in the same program and you match into them at the same time; they are not applied for separately.
So yes, Integrated PRS is its "own thing". If you did 2 - 3 years of Prelim gen surgery you would NOT be able to transfer into an Integrated Program; Integrated programs have required rotations (ie, PRS, Neurosurg, ENT) that you might not complete as a Prelim gen surg resident.
Two years of Prelim surgery are NOT more competitive than the full 5 years.
Research is not required for an Integrated PRS residency, but since it is amongst the most competitive residencies around (ie, less than 30% match rate), anything you can do to bolster your application is a good idea.
Please ignore A.S.'s first post - what he writes is meant in jest. The "informati0n" is "misinformation" and is incorrect.
Just to clarify:
I don't think any true "integrated" PRS programs are 4+2. Most are 3+3. A couple are 3+2 (UTSW, UTMB are the only ones that come to mind). There are 20 integrated PRS programs. From day one of residency, you are under the authority of the PRS program director (GenSurg does not own you) and are recognized as a plastics resident by the ABPS and the PRS RRC.
There are "combined" PRS programs that are an imitation of the integrated model. These programs match you into a general surgery position with the "promise" that in PGY4 or PGY5, you will become a PRS resident. For the first 3-4 years you are a General Surgery resident. Your PRS chair/PD has no control over you, but they often have a good working relationship with the GenSurg PD. You are not recognized by the American Board of Plastic Surgery or the PRS RRC as a plastics resident until your true plastic surgery years start. In general, this isn't much of a problem, but if your program runs into difficulties (it happens fairly regularly), the PRS establishment is not required to place you in another PRS program if you aren't into your PRS years. This has hurt people in the past.
Check out the ABPS website for an explanation of the different training schemes:
http://www.abplsurg.org/training_requirements.html
I don't think any true "integrated" PRS programs are 4+2. Most are 3+3. A couple are 3+2 (UTSW, UTMB are the only ones that come to mind). There are 20 integrated PRS programs. From day one of residency, you are under the authority of the PRS program director (GenSurg does not own you) and are recognized as a plastics resident by the ABPS and the PRS RRC.
There are "combined" PRS programs that are an imitation of the integrated model. These programs match you into a general surgery position with the "promise" that in PGY4 or PGY5, you will become a PRS resident. For the first 3-4 years you are a General Surgery resident. Your PRS chair/PD has no control over you, but they often have a good working relationship with the GenSurg PD. You are not recognized by the American Board of Plastic Surgery or the PRS RRC as a plastics resident until your true plastic surgery years start. In general, this isn't much of a problem, but if your program runs into difficulties (it happens fairly regularly), the PRS establishment is not required to place you in another PRS program if you aren't into your PRS years. This has hurt people in the past.
Check out the ABPS website for an explanation of the different training schemes:
http://www.abplsurg.org/training_requirements.html
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Thanks so much 🙂
Note that Dr Cox is a PGY3, meaning that she is in a 5-year categorical surgery program. So obviously her "advice" will be heavily biased since she was not able to get into a competetive 2-year surgical program. Take her advice on such matters with a proverbial grain of salt.
🙄
At any rate, I'm closing this thread since the answer to the OP's question is in the Sticky at the top of the page.
At any rate, I'm closing this thread since the answer to the OP's question is in the Sticky at the top of the page.
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