i am confused about the types of residency program

[pro1212]

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i wanna know more about the types of residency program
preliminary vs transitional
advanced etc....
community vs university


what is the effect of being not fresh graduate (3 or 4 years PG ) on my chances for getting a residency ?

 

[gro2001]

University program: a residency program at a hospital that is the primary teaching site of a medical school.

Community program: not a university program. May still be a teaching hospital.

Teaching hospital: there are residency programs at this hospital.

Preliminary and transitional years are not residency types but a year of medicine/surgery/rotations through different departments that are done prior to the rest of residency. Sometimes as a requirement (some specialities such as anesthesia, dermatology, radiology require such a year and these tracks are called 'advanced' because of this requirement) and sometimes for failure to match into a categorical spot. The difference between prelim and transitional is that transitional is understood to be 1 year only while a prelim may or may not continue in the categorical track.

Categorical means that consecutive years are 'guaranteed' assuming you meet all the requirements.

If I messed anything up, anyone is welcome to jump in with corrections.

 

[gutonc]

i wanna know more about the types of residency program
preliminary vs transitional
advanced etc....
community vs university

These questions get asked all the time and are specialty dependent. Please do an advanced search. In lieu of that, read through every single link on this page and then come back and ask a more specific question if you're still confused.

The easiest one to answer is that community programs are in community hospitals and university programs are in university hospitals. The general rule is that Uni programs are more competitive and will give you more options for fellowship than a community program will. But this is specialty and program specific as well.

what is the effect of being not fresh graduate (3 or 4 years PG ) on my chances for getting a residency ?

This is easy. Unless you've spent the intervening years winning a Nobel Prize or publishing several first author articles in Science, Nature, Cell, NEJM and the like, it's a huge disadvantage over being a fresh grad. Rage against the machine all you want but that is the reality.

 

[gutonc]

Preliminary and transitional years are not residency types but a year of medicine/surgery/rotations through different departments that are done prior to the rest of residency. Sometimes as a requirement (some specialities such as anesthesia, dermatology, radiology require such a year and these tracks are called 'advanced' because of this requirement) and sometimes for failure to match into a categorical spot. The difference between prelim and transitional is that transitional is understood to be 1 year only while a prelim may or may not continue in the categorical track.

This is about 45% correct.

Prelims are year of training in IM, Peds or Surg (with a few random OB/Gyn and FM options) and provide a year of training in that specialty prior to beginning an advanced residency or, in lieu of matching into a categorical program. They sometimes can translate into a categorical position (in IM anyway) but most Gen Surg programs use prelims as scut monkeys and, unless you have an advanced program lined up, are generally considered dead-end options.

Transitional programs (TY) are extremely competitive, often cush programs with rotations through a variety of specialties. Think another year of clerkships/electives where you're actually responsible for the patients but nobody cares about your progress as long as you get the work done.

 

[pro1212]

This is easy. Unless you've spent the intervening years winning a Nobel Prize or publishing several first author articles in Science, Nature, Cell, NEJM and the like, it's a huge disadvantage over being a fresh grad. Rage against the machine all you want but that is the reality.

i am still practicing medicine in my home country Egypt , 1st two years post graduation as a GP and may be 1 year in a residency program . I know that matching depend on filters , one of which is year of graduation .This filter does not differentiate between practicing and non practicing doctors . is there any way to have my practicing years, before applying to residency programs , get reviewed by the directors of residency programs .

and that is after sure giving up Nopel prize 😎

thank you and thanks to gro2001 for your response to my post

 

[gutonc]

i am still practicing medicine in my home country Egypt , 1st two years post graduation as a GP and may be 1 year in a residency program . I know that matching depend on filters , one of which is year of graduation .This filter does not differentiate between practicing and non practicing doctors . is there any way to have my practicing years, before applying to residency programs , get reviewed by the directors of residency programs .

Not really. A filter is a filter. Again, even if you did score a Nobel in the intervening years, if they cut things off at 4 or 5 years post-grad, it won't matter. Now...many filters are "soft" meaning they'll run a search with all the filters they want, review those applications and invite people for interviews, then re-run a search with a different subset of filters and invite from that batch. It's an iterative process. But once they send you a rejection, they're unlikely to go back.

That said, one of the major reasons for the X year cutoff is expiration of Step scores and the other is knowledge and training getting stale. If you haven't started on the Steps yet (most states require 7 years max between passing Step 1 and Step 3 or they won't license you, and no program wants to train a person they know can't get licensed) that's kind of a moot point. Also, your education and training is clearly not getting stale.

So you're different from the IMG who has been trying to Match for several years and failing, or even the one who comes to the US, does a PhD and then tries to Match. Again, the filters will not be kind to you but not every program uses that filter and if you can burn through the Steps in a year or two, you will clear that hurdle.

Finally, applying to residency is cheap...you can send your app to 100 programs for ~$1200-1300 (about the same as applying to 10 med schools). So if you decide to come here, you really have nothing to lose from a financial standpoint.

 

[Smurfette]

This is easy. Unless you've spent the intervening years winning a Nobel Prize or publishing several first author articles in Science, Nature, Cell, NEJM and the like, it's a huge disadvantage over being a fresh grad. Rage against the machine all you want but that is the reality.

i am still practicing medicine in my home country Egypt , 1st two years post graduation as a GP and may be 1 year in a residency program . I know that matching depend on filters , one of which is year of graduation .This filter does not differentiate between practicing and non practicing doctors . is there any way to have my practicing years, before applying to residency programs , get reviewed by the directors of residency programs .

and that is after sure giving up Nopel prize 😎

thank you and thanks to gro2001 for your response to my post

The ERAS application for residency program allows for you to enter any post graduate training/practice you've done. The entire app is what program directors get to review. I don't know if they can or do automatically filter for actual experience (my guess is most programs do not filter this, but they do filter USMLE scores/class rank/etc.)

Being a foreign medical grad (I am assuming you didn't go to med school in US and then leave for Egypt) will also be a disadvantage to you in the process of finding a position here, even with your practice experience.