Let's say for example you want to do a derm residency (PGY-2-4). You need to find separately a transitional or preliminary year (PGY-1). What happens if you get into derm but not an intern year? What happens if you get into the intern but not term? Also, I read somewhere that you can do an internal medicine and then do a competitive specialty. How would this work since they last for more than one year? Would you swap out of internal med after PGY-1 into a three year derm program or complete internal med in its entirety and then do the three year derm?