endgame dilemma

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miami-j

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One of the programs I really like is undergoing some changes. Specifically, they're moving from a 2,3,4 residency to an integrated 1-4 year program. It starts this July. However, the approval for this change came rather late and they'll remain listed in the NRMP match as a 2,3,4 program.

Over email, the directors have assured applicants that, if they match into the program, they're guaranteed a spot as a first year (PGY-1, EM-1) if they want it. But they're ok if people choose to go elsewhere for their internship year, and come back in 2006 for a PGY-2, EM-1 year (the rotations in this PGY-2/EM-1 year would be different, with much more ED time than the PGY-1/EM-1 year).

Got it? Good. Because this scenario raises some interesting questions, and I'd like your advice:

1. If I really want this program for all four years, then I'm going to have to rank them as a 2,3,4 with NO secondary rank list, ie, leave my list of potential prelim spots blank. Then, during match week, my Dean will call me and tell me I didn't match into a prelim spot, and I'll have to explain that I think I know what happened, and no, I don't want to scramble. This seems reasonable on one level, but at another, deeper level, it scares the crap out of me.

2. As it turns out, there is a prelim program in the same city that I kind of liked. It has a lot of neat elective months, good facilties, and is pretty competitive. I might just create a secondary match list with this program on it, and nothing else. Maybe, though, it would be a hassle to move across town at the end of intern year (especially if, say, I'm on an ICU rotation). Maybe it's be a pain to llearn the ropes at my third (and fourth) hospital in three years. Maybe I'll miss out on bonding with my fellow residents, and disrupt my relationship with faculty members. I just don't know how much weight to put on these factors.

Any advice people could give would be appreciated -- especially if you're speaking from personal experience with prelim years or 1-4 programs.

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Apollyon said:
If I had to guess, you're talking about Mt. Sinai and NYC. The prelim place sounds like Cabrini (where categoricals take it up the ass, so the prelims can have it cush), or maybe the Flushing Hospital.

Well, you didn't have to guess...

Now howsabout some of that advice, people?
 
Talk with your Dean of Student afairs and explain this to him/her. Of all the people I can think of with the experience to help you on this that is the most likely source of helpful advice. I talked to my Dean about this hypothetical situation and he suggested you do what you 1st suggested if you feel you have an excellent chance of matching at that program, but if you don't feel confident then you should create the secondary match list with the one prelim spot on it to CYA. Good luck.
 
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