Absolutely false! This was true about two years ago but now, with the eighty hour work week, surgery is again very competitve for categorical. Prelim is wide open but only allows you 1(sometimes 2-3 I hear) years of general surgery training with NO guarantee that you will get a categorical spot.
To answer the OP's question, it is difficult, but not impossible. Like anything, great USMLE step I score, LOR's, publications, and strong audition rotations will help significantly but still no guarantee. Good luck.
Keep in mind that there are some missing matches on this list. Many US med schools compile the residency placments and post it themselves. My understanding is that the placement lists of Ross and SGU (and perhaps some of the other major Caribbean schools) require the students to report their placements.
This year SGU matched a student into diagnostic radiology at Brigham and Women's (one of Harvard Med's major teaching affiliate hospitals) and that match is not listed.
The older lists are probably slightly more accurate, but are probably missing residency placements as well and sometimes the PGY-1 years may be listed, but the PGY-2 years may be missing.
Categorical means that you will be able to complete all five years of general surgery training while prelimary positions usually only allow for one year of general surgery training.
If you want to be a general surgeon, you want a categorical position. Some non-general surgery residencies require a preliminary surgery year, such as ENT. Others enter prelim. positions with hopes to make a good impression and secure a categorical spot.
My understanding is that the placement lists of Ross and SGU (and perhaps some of the other major Caribbean schools) require the students to report their placements.