IM Prelim Match Interested in Categorical Internal Medicine

[andpatel1994]

I had previously posted this in a different section but realized this may be a better place to post it. I did find threads about similar topics but I had a few extra questions not listed there. Anyways here goes:

I am a DO student who applied to anesthesia this year and matched into a 1-year program which is either an IM prelim or a TY, but I did not match into an advanced anesthesia spot. I was on the fence between anesthesia and IM throughout my entire application cycle and after having completed a few more IM rotations during the past few months which I really enjoyed, I realize my heart is really in IM and not in anesthesia. I hope to complete an IM residency rather than pursuing an anesthesiology residency but was unsure about how the application process works. I had heard that some of the possible options are to reapply IM through ERAS and the MATCH, find an open PGY-2 spot, or continue on in my current program if my PD will allow it. I was unsure about the time frame about when to reach out to my PD and if there is anything I should do during the summer before my rotation starts to get a head start. Would I need to take USMLE Step 3 or COMLEX Level 3 to be competitive for reapplication? I was also unsure how much being a prelim student would hurt my chances of getting interviews/matching as a PGY1 in an IM categorical if that is the route I choose to take.

Just for some further info, I have Step 1 23X, Step 2 24x, COMLEX 1 60X, COMLEX 2 55X, all passed on the first try. As far as I am aware with both feedback from my school as well as programs I reached out to, I do not have any red flags on my application besides maybe dropping 50 points from COMLEX level 1 to level 2.

I truly appreciate any advice or insight anyone could give!

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[Chads2]

Did you find out IM prelim or TY? If you’re an IM prelim, you may be able to find your way into a categorical IM PGY2 spot if you make it clear to your program that that’s what you want. With TY, you will have to enter next year’s match and you may have to do another PGY1 year in IM.

 

[Hellopitty]

Talk to your IM PD, it's possible to jump into a PGY2 medicine if someone leaves or a spot open for some other reason. If not, apply for medicine and anesthesia next cycle, if you do well in your prelim year, you can likely end up at the same program as a categorical.

If TY, apply for R positions in anesthesia, so you can start as CA1 that July. But 1 extra year of training is nothing in the long run.

 

[collegestud2013]

If you're in a prelim IM program, don't bother reapplying through the Match if you want to do IM All IM spots in the Match start at the PGY-1 year so you would be repeating intern year. I would try to talk to your PD early if you can be converted from prelim to Categorical IM at the end of your PGY-1 year at the same program. This usually can only happen at the same institution if another categorical resident leaves or the program is able to expand its number of spots. At most programs, the main schedule difference between categorical and prelim PGY-1 year at most IM programs is that prelim often doesn't have a significant amount of outpatient (ambulatory) clinic, so that experience may be new for you starting PGY-2 year.

If you're not able to stay at the same program, you can always transfer to a PGY-2 position at another program (and these tend to open around March-May each year as PGY-1 interns want to relocate for personal/geographic reasons, the program is just malignant, or if they are switching specialties). If you are able to transfer to a more reputable program, it may also have its benefits if your goal after IM residency is to do a competitive fellowship and your current program is not well known (e.g. lower tier community with no in-house fellowships).

 

[Hellopitty]

That's true, prelims usually don't do clinic, but instead do more floor

 

[andpatel1994]

Sorry for the late reply, was really busy with moving. I ended up matching to TY after all.

 

[NotAProgDirector]

In that case, if you want to be able to switch to an IM PGY-2 next year, you need to ask your program to maximize your IM experience. Hopefully your institution has an IM program.

 

[andpatel1994]

In that case, if you want to be able to switch to an IM PGY-2 next year, you need to ask your program to maximize your IM experience. Hopefully your institution has an IM program.

Thank you for the reply. They do have IM and they are going to try to maximize my IM experience but my current PD has said this might be an issue. He mentioned that prior TY residents in the past have had a hard time transferring in to their IM program because they require you to repeat pgy1 year which results in funding issues. I'm not sure about the details about how the funding issues work, this was something I wanted some clarification on. Would this preclude me from matching at any PGY1 position? Though I would obviously prefer not to repeat intern year I am not opposed to repeating it if it means I can complete my training.

 

[NotAProgDirector]

Read this: Medicare’ Payments for Graduate Medical Education: What Every Medical Student, Resident, and Advisor Needs to Know | AAMC

Your program will get decreased funding for your last PGY if you start as a PGY-1 again. For many programs, it's not a problem.