Internship, TY, PGY2 residencies

[themule]

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Can someone explain this to me. I have no idea how all this works. I know that you apply for your residency but what is the TY and why would you do it? Also what's a PGY2 residency. Thanks.

 

[DrYoda]

TY= transitional year.
PGY= post graduate year

PGY1,2,3... are years 1,2,3 of residency.

Certain specialities require a seperate internship year, and start on PGY2, whch is why you see people matching both TY and PGY2. They'll do a one year TY for PGY1 and then start their specialty of interest at PGY2.

 

[themule]

TY= transitional year.
PGY= post graduate year

PGY1,2,3... are years 1,2,3 of residency.

Certain specialities require a seperate internship year, and start on PGY2, whch is why you see people matching both TY and PGY2. They'll do a one year TY for PGY1 and then start their specialty of interest at PGY2.

What specialities? I've seen Derm has both a PGY1 and PGY2 residency. Why the 2?

 

[DrYoda]

What specialities? I've seen Derm has both a PGY1 and PGY2 residency. Why the 2?

Off the top of my head: Rads, anesthesia, neurology, rad onc, and Optho. I'm sure I'm missing some. Lots of surgical subspecialities(ENT, Urology, ortho) also require them but I did a quick search and it looks like they're commonly built in.

Sometimes the intern year is build in, which I'm guessing is why you have derm programs starting at PGY1 and PGY 2

 

[MrBurns10]

In the specialties that require a separate intern year (as mentioned by DrYoda), there are both categorical and advanced programs. Categorical programs have an intern year that is combined with the residency, so you'll have a PGY-1 match. Advanced programs, which are more abundant, start at PGY-2 so on a match list you'll see "Transitional or Prelim Year" and a Radiology/Anes/Ophtho/etc match that begins as a PGY-2.

 

[themule]

In the specialties that require a separate intern year (as mentioned by DrYoda), there are both categorical and advanced programs. Categorical programs have an intern year that is combined with the residency, so you'll have a PGY-1 match. Advanced programs, which are more abundant, start at PGY-2 so on a match list you'll see "Transitional or Prelim Year" and a Radiology/Anes/Ophtho/etc match that begins as a PGY-2.

So what do you do for the TY/Intern year? Is that assigned by the NRMP?

 

[Mr hawkings]

So what do you do for the TY/Intern year? Is that assigned by the NRMP?

Mostly internal medicine but i think for the most part it is designed keeping in mind that you are only there for a year as a TY so each program designs its own schedule of rotations as they see fit. Some are more cush than others and some make you work harder than others.
From what i've seen its like 3rd year, but paid.

 

[MrBurns10]

So what do you do for the TY/Intern year? Is that assigned by the NRMP?

No, you apply for a prelim or transitional year. Some specialties want either an internal medicine or surgical prelim year, though intern years in FM and others exist as well. Transitional years tend to be more cush because you rotate through various specialties and you typically have fewer call months with more electives.

 

[canal]

so let me see if I get this before I have to apply in September:
lets say I am trying for pm&r which half of its residency programs begins at pg2, that means I would have to:
(1) apply to pg1 pm&r categorical for 2010
(2) apply to pg1 TY or prelim for 2010
(3) apply to pg2 pm&r advanced for 2011

All at the same time, so come match day, I could either be matched for (1) ONLY or match (2) AND (3) together or (3) ONLY or (2) ONLY. Now, if I only matched for either (2) or (3) only, I would have to scramble for the missing (2) or (3) right? Sorry if that looks confusing..I am trying to understand this myself, so if anyone can correct/confirm.

 

[MrBurns10]

so let me see if I get this before I have to apply in September:
lets say I am trying for pm&r which half of its residency programs begins at pg2, that means I would have to:
(1) apply to pg1 pm&r categorical for 2010
(2) apply to pg1 TY or prelim for 2010
(3) apply to pg2 pm&r advanced for 2011

All at the same time, so come match day, I could either be matched for (1) ONLY or match (2) AND (3) together or (3) ONLY or (2) ONLY. Now, if I only matched for either (2) or (3) only, I would have to scramble for the missing (2) or (3) right? Sorry if that looks confusing..I am trying to understand this myself, so if anyone can correct/confirm.

So you will have a primary and a secondary list. The secondary list would contain your prelim rankings for each PM&R program and this secondary list would only go into effect if you match at a PM&R program. So, for example, your match list would look like (with fake names):

1. U of New York- PM&R
---1. U of New York TY
---2. Manhattan Med Center Prelim medicine
---3. Long Island TY
---4. Long Island Prelim Surgery
---etc.
2. U of Pennsylvania PM&R
---1. Philadelphia Med Center TY
---2. Pittsburgh TY
---3. U of New York TY
---4. Manhattan Prelim
3. U of Delaware Categorical
And so on...

So if you matched at U of NY PM&R, it would then go to your secondary rank list containing those NY programs you mentioned. If you matched to U Penn PM&R, it would go to that secondary rank list. If you matched at U of Delaware categorical, it contains a built-in intern year and no secondary list is necessary for this option. It is possible to match to a PGY2 program (such as U of NY) but not to a prelim on your rank list. In this case, you would just scramble for a prelim position. If you did your list this way as I've written, you would not just match at a prelim spot...if you didn't match PM&R, you would need to scramble for both. However, if at the end of your primary list you put down prelim positions, then it would be possible to match at only a prelim program and you would have to scramble for just a PM&R program (an advanced one, not categorical).

Does that make sense?

 

[Mr hawkings]

So you will have a primary and a secondary list. The secondary list would contain your prelim rankings for each PM&R program and this secondary list would only go into effect if you match at a PM&R program. So, for example, your match list would look like (with fake names):

1. U of New York- PM&R
---1. U of New York TY
---2. Manhattan Med Center Prelim medicine
---3. Long Island TY
---4. Long Island Prelim Surgery
---etc.
2. U of Pennsylvania PM&R
---1. Philadelphia Med Center TY
---2. Pittsburgh TY
---3. U of New York TY
---4. Manhattan Prelim
3. U of Delaware Categorical
And so on...

So if you matched at U of NY PM&R, it would then go to your secondary rank list containing those NY programs you mentioned. If you matched to U Penn PM&R, it would go to that secondary rank list. If you matched at U of Delaware categorical, it contains a built-in intern year and no secondary list is necessary for this option. It is possible to match to a PGY2 program (such as U of NY) but not to a prelim on your rank list. In this case, you would just scramble for a prelim position. If you did your list this way as I've written, you would not just match at a prelim spot...if you didn't match PM&R, you would need to scramble for both. However, if at the end of your primary list you put down prelim positions, then it would be possible to match at only a prelim program and you would have to scramble for just a PM&R program (an advanced one, not categorical).

Does that make sense?

This may be the best explanation i've seen.

Thanks

 

[Teej]

So some follow up questions for this thread are 1) do you also interview at the prelim position, and 2) are programs accommodating enough so that you can go to a school one time to interview for both an advanced position and the prelim year--the travel could become cost prohibitive.

 

[PeepshowJohnny]

So some follow up questions for this thread are 1) do you also interview at the prelim position, and 2) are programs accommodating enough so that you can go to a school one time to interview for both an advanced position and the prelim year--the travel could become cost prohibitive.

1) Depends. Some places, even if they're listed as advance, will say that an interview with the prelim medicine/surg or TY is not necessary because those PDs will "honor" their interview impressions. However, most will require you to interview separately.

2) Depends. Several times I was able to tack on a shortened interview with a prelim medicine program after my interview for an advanced position (one or two short interviews, which were mostly a description of their structure and call schedule). However, for especially competitive transitional years (i.e. cush) or prelims at prestigious institutions, they keep their own schedule and you're at their mercy and may require you to make two trips. In fact, one of my prelim medicine interviews at a famous hospital was longer than the majority of my radiology interview days.

 

[Teej]

Thanks for the heads up. Once I finally get through fourth year, I'm hoping to work it out so that I only have to move once.

 

[MrBurns10]

This may be the best explanation i've seen.

Thanks

my pleasure

 

[Law2Doc]

So some follow up questions for this thread are 1) do you also interview at the prelim position, and 2) are programs accommodating enough so that you can go to a school one time to interview for both an advanced position and the prelim year--the travel could become cost prohibitive.

1) Yes. It's a totally separate program.
2) Unfortunately, usually no. Generally the programs aren't really affiliated beyond being in the same hospital. So the PD of PM&R and the PD of IM, TY, etc don't coordinate things. You might find out you have an interview in PM&R and find out a month later you have a TY interview at the same place, or vice versa.

 

[Law2Doc]

so let me see if I get this before I have to apply in September:
lets say I am trying for pm&r which half of its residency programs begins at pg2, that means I would have to:
(1) apply to pg1 pm&r categorical for 2010
(2) apply to pg1 TY or prelim for 2010
(3) apply to pg2 pm&r advanced for 2011

All at the same time, so come match day, I could either be matched for (1) ONLY or match (2) AND (3) together or (3) ONLY or (2) ONLY. Now, if I only matched for either (2) or (3) only, I would have to scramble for the missing (2) or (3) right? Sorry if that looks confusing..I am trying to understand this myself, so if anyone can correct/confirm.

Bear in mind that because the transitional years are historically "cushier" programs than preliminary IM or surgery, the most cushy of these spots are often snapped up by the ROAD specialties and rad onc people. Some end up being the most competitive places in the match simply because the best people from the most competitive fields are vying for them. So far far more often if you are doing something more in the middle of the spectrum, like PM&R or Neuro, you will be looking hardest at prelim IM programs, and a TY will be more of a long shot.

 

[canal]

so would you suggest that I rank prelim/med. higher than TY to ensure my chance with prelim?

 

[DoctorPardi]

so would you suggest that I rank prelim/med. higher than TY to ensure my chance with prelim?

That's a whole other story. The applicant is supposed to get the benefit in that ranking their true preference higher is actually best for them right? Versus trying to rank somewhere they think they can get in highest.

 

[MrBurns10]

Bear in mind that because the transitional years are historically "cushier" programs than preliminary IM or surgery, the most cushy of these spots are often snapped up by the ROAD specialties and rad onc people. Some end up being the most competitive places in the match simply because the best people from the most competitive fields are vying for them. So far far more often if you are doing something more in the middle of the spectrum, like PM&R or Neuro, you will be looking hardest at prelim IM programs, and a TY will be more of a long shot.

I don't think that's a fair statement to make. There are plenty of neuro-bound folks with good numbers who will land TY spots, and plenty of below-average ROAD folks who are prelim-bound. Your statement implies (intentionally or not) that people with the numbers for TYs go ROAD and those who don't go neuro or PM&R. TYs don't care what your advanced specialty will be, so I think it's best to leave it as an individual thing and not make generalizations. I don't think you necessarily meant it that way, but it makes it sound like people not going into the ROAD fields have a poor chance of landing a TY spot when it actually has nothing to do with their specialty decision.

And yes, applicants should rank programs in whatever order they want. The computer algorithm more or less favors the applicant.

 

[Law2Doc]

I don't think that's a fair statement to make. There are plenty of neuro-bound folks with good numbers who will land TY spots, and plenty of below-average ROAD folks who are prelim-bound. Your statement implies (intentionally or not) that people with the numbers for TYs go ROAD and those who don't go neuro or PM&R. TYs don't care what your advanced specialty will be, so I think it's best to leave it as an individual thing and not make generalizations. I don't think you necessarily meant it that way, but it makes it sound like people not going into the ROAD fields have a poor chance of landing a TY spot when it actually has nothing to do with their specialty decision.

And yes, applicants should rank programs in whatever order they want. The computer algorithm more or less favors the applicant.

Well, I'm saying SOME of the TY programs, those regarded as cushiest, end up being the most competitive slots in the match because some of the BEST applicants of the most competitive fields apply to them. I agree that if you are a superstar (regardless of what you are going into, be it neuro, PM&R or a ROAD), you will have a better shot at a TY program than someone merely eking their way into a competitive advanced program. But if you look at the Charting Outcomes of the Match publications you will see that PM&R, for instance, does not tend to draw a lot of the more competitive applicants (I assume they go into ortho), and neuro similarly doesn't historically post impressive numbers. Again, if you have amazing numbers and loved neuro you probably could get a TY leading into your neuro. But the folks with the highest board scores just don't seem to be as interested in neuro based on the NRMP publications. So you can be an average gas or rads applicant and might not have a prayer at a TY program because some of the better derm, rad onc and optho folks snag all the spots. I agree that TYs don't care what advanced specialty will be, but all I'm saying in that when you look at the average Step scores etc, the folks who land derm tend to be more competitive than the folks who land neuro. And if you look at some of the cushiest TY rosters, they tend to be heavily stacked with derm, optho, rads and rad onc types. So yes I am saying that STATISTICALLY, the folks who don't go into a ROAD or Rad Onc path don't tend to have a great shot at landing the better TY slots (because statistically those are the fields requiring prelims that draw the folks with the better numbers) and yes I do agree with you that whether you get a TY slot has nothing to do with your specialty choice.

I agree there is no negative to ranking places you want over places you think you'll get. The Match algorithm doesn't punish longshots.

 

[Gasdude]

Im a silent observer on SDN, i didnt match this year and will hence be applying come september. does anyone know what the chances of matching in anesthesia are with a year of research after graduation?

responses will be much appreciated...

thx all...