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Intern year

srleslie

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    I'm doing research and learning about the medical school/residency process. I am somewhat confused about the TY/Prelim Intern year following medical school. I was under the impression that one applied directly to residencies after graduation. Does one apply to the intern year first, and then choose a field to do a residency in after that? How does this work? I did a search but couldn't find anything.
     

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      I'm doing research and learning about the medical school/residency process. I am somewhat confused about the TY/Prelim Intern year following medical school. I was under the impression that one applied directly to residencies after graduation. Does one apply to the intern year first, and then choose a field to do a residency in after that? How does this work? I did a search but couldn't find anything.

      Most residencies include the intern year and you apply for the entire training track during your final year of medical school.

      Some residencies have a required internship year which is not part of the final training track and you must apply for the internship and the residency program (which will start as a PGY-2 or "Advanced Match") during your final year.

      See the NRMP: http://www.nrmp.org/res_match/index.html

      If you applied for an internship year in an Advanced Match specialty and waited until your internship year to apply for residency, you would likely have to sit out a year (ie, these programs match a year ahead of time).

      Thus, Transitional Year and Prelim year programs are for those specialties which require such a year before going onto further training (ie, Anesthesiology, Rads, etc.).
       

      dragonfly99

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        OP.
        I agree it can be confusing. It confused me also early on in med school when I found out about it. It would be kind of nice if we all did an internship before having to figure out what we want to do forever (career-wise). It's not really that way in this country though, unfortunately (IMHO).

        As mentioned above, some fields require a transitional or prelim year (kind of like a warmup where you gain general medical knowledge). These are basically some of the specialty fields (anesthesiology, neurology, etc.). They want you to have some basic knowledge of practicing medicine in a hospital setting before they teach you the specifics of your specialty. Because of they way hospitals have set up the residency system, you pretty much have to appy for the first year (PGY1) and the 2nd year (PGY2) in these type programs at the same time. So basically you'd be applying for something like an internal medicine PGY1 ("medicine prelim year") and a bunch of neurology PGY2 programs (neurology residency) all at the same time during your 4th year of med school.

        There are basically 3 types of these "warmup" type PGY 1 years.
        -"medicine prelim year" (intern year run by internal medicine department of a hospital). Used for neurology, sometimes anesthesiology and radiology, sometimes opthalmology, and some other fields.
        -"transitional year" (usually includes rotations through a variety of fields, not just internal medicine, and tends to be cushier and have less call [though not always], tends to be harder/more competitive to get than IM prelim year). Can be used for radiology, opthalmology, a few other fields (but not for neurology and surgical fields).
        -"surgical prelim year" (intern year run by a hospital's surgical department). Can be used to get ready for a PGY 2 year in anesthesiology, opthalmology, radiology, and sometimes as a back door way to try to get into things like ENT, urology, general surgery categorical residency, other surgical residencies if the med student didn't originally match into one of those fields but wanted to. Surgical prelim years tend to be the worst hours and hardest work (though some IM years have up to 11 months of Q3 and Q4 call, the daily hours don't tend to be as long as with surgical prelim years).
         
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        Law2Doc

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          It's not really that way in this country though, unfortunately (IMHO).

          It was exactly this way in the 1980s (and earlier) in this country. Greater specialization demand has eroded this to some extent. But there are quite a few paths that require preliminary years, and between these and the categorical medicine and surgery PGY-1 years, I'd say the majority of med students do an "intern" year to some extent even now.
           

          srleslie

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            OK, so to sum up what you all are saying, you attend the intern at the same institution you get accepted to for residency, if the residency requires an intern year, right?

            If you change your mind during intern year, you can match again for a different field but you may have to sit out a year? Do I have it all right, lol?
             

            Law2Doc

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              OK, so to sum up what you all are saying, you attend the intern at the same institution you get accepted to for residency, if the residency requires an intern year, right?

              If you change your mind during intern year, you can match again for a different field but you may have to sit out a year? Do I have it all right, lol?

              Um no, you aren't summing it up right at all. If you are doing an advanced program residency, you apply for both the preliminary (intern) year and the advanced (post intern year) programs. Meaning you go on two sets of interviews, and can end up in different places for the first and subsequent years. Doesn't matter if the same program has both prelim and advanced programs, you have to match in both to be at the same place the whole way through.
               

              medsRus

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                "transitional year" (usually includes rotations through a variety of fields, not just internal medicine, and tends to be cushier and have less call [though not always], tends to be harder/more competitive to get than IM prelim year). Can be used for radiology, opthalmology, a few other fields (but not for neurology and surgical fields).

                Why can't neuro go through transitional year programs?
                 

                srleslie

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                  Um no, you aren't summing it up right at all. If you are doing an advanced program residency, you apply for both the preliminary (intern) year and the advanced (post intern year) programs. Meaning you go on two sets of interviews, and can end up in different places for the first and subsequent years. Doesn't matter if the same program has both prelim and advanced programs, you have to match in both to be at the same place the whole way through.

                  Ok that makes sense now, and cleared up the confusion. If you apply to an advanced program residency, you can end up doing your intern year somewhere else and it doesn't matter where.
                   
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