Interesting notes on 2019 THE MATCH

[965978]

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My guess is that they knew they'd be able to cherry-pick some outstanding candidates through other channels outside the match and SOAP. I read later on that the program filled but didn't see who those residents are and where they went to school. Very curious...

I think they left the PGY1 positions empty and a year later just recruited some people into the PGY2 positions from prelim surg programs.

 

[meronebib]

Unlike applying to med school, a residency applicant who is 1,2,3 years out of being a med student is considered damaged goods. "Why didn't this person match the first, second, third time?", "what red flags are in this person's file that prevented him/her matching x number of times?". Think about it from a residency program's perspective. The point of the program is to graduate residents. Too high a failure rate gets them on probation and even shut down by the ACGME. The number 1 reason a program will not take a student is because their STEP scores are poor, failed STEP multiple times which all points to failing their board certification exams. There's no reason for a program to take a chance on someone like this when they can choose from a perfectly fine group of NEW graduating medical students. This is why failing to match the first time around is devastating and causes extreme anxiety in a lot of MS4s. And to your "lose no time" you actually are losing a whole year of potential attending income. More if you fail to match multiple years. Not to mention your loans come due and are accruing interest the entire time you're not doing anything.

But aren’t you doing something during your prelim year? Like is it possible to not match derm, but to match into a prelim, and then try again for derm after the prelim is done?

Also note I’m legitimately asking these questions, not trying to make a point or anything. I’m entering med school in the fall, so I’m trying to learn here.

 

[sunshinefl]

But aren’t you doing something during your prelim year? Like is it possible to not match derm, but to match into a prelim, and then try again for derm after the prelim is done?

Also note I’m legitimately asking these questions, not trying to make a point or anything. I’m entering med school in the fall, so I’m trying to learn here.

You can try, but the thing is that in a particular Match cycle, you match for both your first year position and your advanced position (Derm in this case) at the same time. So Derm positions that would start at the end of the prelim year were already filled in the cycle they got their prelim year.

So yes it is possible to apply again, but it is not the normal route and not an easy path. They would have to apply to Derm positions that start after a gap year between the prelim and advanced positions.

 

[907914]

You can try, but the thing is that in a particular Match cycle, you match for both your first year position and your advanced position (Derm in this case) at the same time. So Derm positions that would start at the end of the prelim year were already filled in the cycle they got their prelim year.

So yes it is possible to apply again, but it is not the normal route and not an easy path. They would have to apply to Derm positions that start after a gap year between the prelim and advanced positions.

Do a lot of programs that have prelim year followed by specialty years also have direct-residency slots? My only example to compare to is UW physiatry has 16 PGY2 positions matches each year and 4 direct to PGY1. Is that common?

What is the point of the prelim/transition year?

 

[ciestar]

Do a lot of programs that have prelim year followed by specialty years also have direct-residency slots? My only example to compare to is UW physiatry has 16 PGY2 positions matches each year and 4 direct to PGY1. Is that common?

What is the point of the prelim/transition year?

A LOT. Anesthesia, Rads, Derm, Psych, PM&R, Ophtho, Neuro, Urology....

Yes, it is common. Reason being what i posted above this sentence. The surgery program I am rotating on has four PGY-1 pre-lims and 5 categorical. Two of the four pre-lims are going into IR and have to complete it. The other two are both FMGs.

Point is general medicine training basically. Learn how to do it all before jumping into your desired specialty.

 

[907914]

A LOT. Anesthesia, Rads, Derm, Psych, PM&R, Ophtho, Neuro, Urology....

Yes, it is common. Reason being what i posted above this sentence. The surgery program I am rotating on has four PGY-1 pre-lims and 5 categorical. Two of the four pre-lims are going into IR and have to complete it. The other two are both FMGs.

Point is general medicine training basically. Learn how to do it all before jumping into your desired specialty.

Gotcha. But if you have demonstrated general competence through rotations and perhaps did an elective rotation at the residency you are matching for, they may give you one of those categorical slots as a high-speed individual who has shown prior dedication to the specialty and demonstrated quality of general care already?

 

[sunshinefl]

Do a lot of programs that have prelim year followed by specialty years also have direct-residency slots? My only example to compare to is UW physiatry has 16 PGY2 positions matches each year and 4 direct to PGY1. Is that common?

What is the point of the prelim/transition year?

You are asking about programs that do both advanced and categorical positions, correct?

Some offer built-in/guaranteed first year in house (categorical). But they are still completing the basic prelim medicine/surgery/TY curriculum the first year. The ones who match there for the full residency aren’t magically jumping into the specialty advanced training early.

 

[907914]

You are asking about programs that do both advanced and categorical positions, correct?

Some offer built-in/guaranteed first year in house (categorical). But they are still completing the basic prelim medicine/surgery/TY curriculum the first year. The ones who match there for the full residency aren’t magically jumping into the specialty advanced training early.

Gotcha, so you do the general suck filled intern year (good reason for the suck, I guess) followed by the specialty, regardless of categorical/prelim status.

I know there are some specialties/residencies that you do jump right in (a few EM I have seen) but is that fairly uncommon?

 

[sunshinefl]

Gotcha, so you do the general suck filled intern year (good reason for the suck, I guess) followed by the specialty, regardless of categorical/prelim status.

I know there are some specialties/residencies that you do jump right in (a few EM I have seen) but is that fairly uncommon?

Yes, you got it now!

As to your new question, the ones I can think of offhand that are directly in their specialty training starting year 1 are IM, FM, Peds, EM, General surgery.

 

[907914]

Yes, you got it now!

As to your new question, the ones I can think of offhand that are directly in their specialty training starting year 1 are IM, FM, Peds, EM, General surgery.

Gotcha, primary care. Makes sense, being that intern/prelim year is designed with general knowledge/primary care in mind. Thanks!

 

[sunshinefl]

Gotcha, primary care. Makes sense, being that intern/prelim year is designed with general knowledge/primary care in mind. Thanks!

Oops thought of another one— pathology.

 

[907914]

Oops thought of another one— pathology.

As a premed, Path, EM and physiatry are the three specialties I am looking at the hardest. Glad to know that at least 2 of the three are that way, I guess.

 

[965978]

Just to be clear, matching into a categorical residency means that you will do your intern year and full residency in the same program?

 

[ciestar]

Just to be clear, matching into a categorical residency means that you will do your intern year and full residency in the same program?

Yes. Prelim you can be at two different places PGY-1 into PGY-2

 

[differentiating]

You can try, but the thing is that in a particular Match cycle, you match for both your first year position and your advanced position (Derm in this case) at the same time. So Derm positions that would start at the end of the prelim year were already filled in the cycle they got their prelim year.

So yes it is possible to apply again, but it is not the normal route and not an easy path. They would have to apply to Derm positions that start after a gap year between the prelim and advanced positions.

I believe reserved (R) positions, available in some specialties, are the exception to this. They’re designed for people who have done prelims or alternate equivalents, and I believe they start year-of like pgy1 positions do. It’s certainly not something to gamble on, though, given how few there are in a given specialty per year.

 

[Unlimited Apps]

Yes, you got it now!

As to your new question, the ones I can think of offhand that are directly in their specialty training starting year 1 are IM, FM, Peds, EM, General surgery.

Doesn't Neuro and ortho both also have start-to-finish residency programs without a prelim/transitional year, unlike the other surgical subs like optho and uro? Obviously, they probably do some general surgery training in that first year.

 

[differentiating]

Doesn't Neuro and ortho both also have start-to-finish residency programs without a prelim/transitional year, unlike the other surgical subs like optho and uro? Obviously, they probably do some general surgery training in that first year.

I presume you mean neurosurg, not neuro? Because the latter definitely requires a prelim year.

 

[Unlimited Apps]

I presume you mean neurosurg, not neuro? Because the latter definitely requires a prelim year.

Yep, sorry was referring to surgical subs and meant neurosurg.

 

[sunshinefl]

Doesn't Neuro and ortho both also have start-to-finish residency programs without a prelim/transitional year, unlike the other surgical subs like optho and uro? Obviously, they probably do some general surgery training in that first year.

Yep, sorry was referring to surgical subs and meant neurosurg.

Hmmm I’m honestly not familiar with what neurosurgery and orthosurgery do the first year.... those are probably the lowest 2 on my interest list haha. Hopefully someone more knowledgeable about those specifically can chime in.

 

[lagbydesign]

Doesn't Neuro and ortho both also have start-to-finish residency programs without a prelim/transitional year, unlike the other surgical subs like optho and uro? Obviously, they probably do some general surgery training in that first year.

Yes, neurosurg, ortho, PRS, and ENT are fully "integrated", meaning no separate intern year. Speaking for ortho, interns can now enjoy 6 months of ortho rotations (trauma, general, VA, etc), and 6 months of ortho relevant rotations (plastics, vascular, ED, etc). Then it's straight ortho from PGY-2.

 

[Unlimited Apps]

Yes, neurosurg, ortho, PRS, and ENT are fully "integrated", meaning no separate intern year. Speaking for ortho, interns now enjoy 6 months of ortho rotations (trauma, general, VA, etc), and 6 months of ortho relevant rotations (plastics, vascular, ED, etc). Then it's straight ortho from PGY-2.

I find it interesting how some surgical subs are fully integrated (neurosurg, ortho, PRS, ENT) while some aren't (uro, optho). I know that neurosurgery used to have a prelim year of general surgery followed by PGY-2 through PGY-6/7 of neurosurgery. Wonder if ortho/PRS/ENT has a similar history?

 

[lagbydesign]

I find it interesting how some surgical subs are fully integrated (neurosurg, ortho, PRS, ENT) while some aren't (uro, optho). I know that neurosurgery used to have a prelim year of general surgery followed by PGY-2 through PGY-6/7 of neurosurgery. Wonder if ortho/PRS/ENT has a similar history?

Ortho and ENT do. The integration is something that has happened over time. Thank God, because who wants to do a flipping gen surg internship when you're doing a surgical sub? Also, I think the increase in field specific rotations might help to mitigate the loss of acquired experience secondary to duty hours.

PRS originally started out as a fellowship (and still can be) of gen surg. It lasted two years after a 5-7 year GS residency. Now it's three years. This is called the independent route. There's also the combined route, where you do 3 years of GS and 3 years of plastics. Lastly, there's the integrated route, which is in the top 3 most competitive residencies to match into. This route also has multiple years of GS interspersed throughout the residency. There's advantages and disadvantages of doing the independent vs the combined vs the integrated, but I won't go into it here. There's also the competitiveness of the plastics fellowships in the independent/combined routes to consider.

 

[Unlimited Apps]

Ortho and ENT do. The integration is something that has happened over time. Thank God, because who wants to do a flipping gen surg internship when you're doing a surgical sub? Also, I think the increase in field specific rotations might help to mitigate the loss of acquired experience secondary to duty hours.

PRS originally started out as a fellowship (and still can be) of gen surg. It lasted two years after a 5-7 year GS residency. Now it's three years. This is called the independent route. There's also the combined route, where you do 3 years of GS and 3 years of plastics. Lastly, there's the integrated route, which is in the top 3 most competitive residencies to match into. This route also has multiple years of GS interspersed throughout the residency. There's advantages and disadvantages of doing the independent vs the combined vs the integrated, but I won't go into it here. There's also the competitiveness of the plastics fellowships in the independent/combined routes to consider.

Yea it makes sense (atleast as a yet-to-be medical student using logic lol) to me that the surgical-subs would be better organized as complete standalone programs rather than having everyone do the same year of GS followed by separate paths. You probably swap out a lot of "unnecessary" GS stuff with more surgical-sub related exposure/experience.

As someone interested (at least at this point) in some of the surgical subs, this whole match process seems so daunting and stressful! Hopefully if I do find that one of the surgical subs is ultimately what I want to do, I get to experience a positive and successful match process come 5 years from now (though who knows how crazy the process will be by then!!).

 

[lagbydesign]

Yea it makes sense (atleast as a yet-to-be medical student using logic lol) to me that the surgical-subs would be better organized as complete standalone programs rather than having everyone do the same year of GS followed by separate paths. You probably swap out a lot of "unnecessary" GS stuff with more surgical-sub related exposure/experience.

As someone interested (at least at this point) in some of the surgical subs, this whole match process seems so daunting and stressful! Hopefully if I do find that one of the surgical subs is ultimately what I want to do, I get to experience a positive and successful match process come 5 years from now (though who knows how crazy the process will be by then!!).

Totally agree. Yeah, not looking forward to the arms race that is the match. Really hoping the field I end up choosing decreases in competitiveness. That's wishful thinking, but a person can hope, lol.