Lots of questions about residencies

[theWUbear]

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I have a lot of general questions about residency - I was wondering if someone could answer them, or even better if someone could point me to a resource (like a float chart of the pathway to each specialty through all residencies and fellowships, that would be sweet) that contains FAQ information about residencies.

1. Prelim year? Which specialties demand that you do a prelim year? What are the reasons for doing a prelim year? What are the types of prelim year programs into which people match (i.e. medicine prelim, surgery prelim)

2. Transitional year? Which specialties demand that you do a prelim year? What are the reasons for doing a prelim year? What are the types of prelim year programs into which people match?

3. What is the track for training to go into interventional radiology

4. Do specific residency programs have "concentrations"? For instance, could Med School A's internal medicine residency be one that claims to focus on Subspecialty A?

 

[chronicidal]

You can see page 3 of the NRMP report to see how many positions are PGY-1 vs. PGY-2 ("advanced", require a prelim/transitional year). Note that ophthalmology and urology are separate from the NRMP. Non-integrated plastic surgery (starting with PGY-4 or PGY 5) programs and neurotology subspecialty residency also goes through the SF Match, separate from the NRMP.

This site has a general list of how training goes for different specialties.

For interventional radiology, the most common path is a prelim yr + 3 yr in radiology + 1 yr interventional rads fellowship. However there are four yr categorical radiology residencies, too.

 

[theWUbear]

You can see page 3 of the NRMP report to see how many positions are PGY-1 vs. PGY-2 ("advanced", require a prelim/transitional year). Note that ophthalmology and urology are separate from the NRMP. Non-integrated plastic surgery (starting with PGY-4 or PGY 5) programs and neurotology subspecialty residency also goes through the SF Match, separate from the NRMP.

This site has a general list of how training goes for different specialties.

For interventional radiology, the most common path is a prelim yr + 3 yr in radiology + 1 yr interventional rads fellowship. However there are four yr categorical radiology residencies, too.

chronicidal - impressive work. Thanks.

More questions for anyone, based on the NRMP document:

For some specialties, let's take Derm for example: The majority of programs are PGY-2 programs. Questions:

1). What are the choices for year one? What is the most common choice for year one?

2). There are 9 spots for Derm that are PGY-1. Why are they not PGY-2 like the rest of them? Are they highly competitive? Are they different?

3). Can someone explain 'transitional year' to me? 🙂

 

[theWUbear]

For interventional radiology, the most common path is a prelim yr + 3 yr in radiology + 1 yr interventional rads fellowship. However there are four yr categorical radiology residencies, too.

What do you mean by 'categorical' here? Does this mean they are radiology residencies with a specific emphasis, as I was eluding to in my first post, or something else?

 

[circulus vitios]

What do you mean by 'categorical' here? Does this mean they are radiology residencies with a specific emphasis, as I was eluding to in my first post, or something else?

I'm probably wrong but I think a categorical residency is one where you start training in your specialty right away. That is, you don't do a preliminary or transitional year of medicine or surgery.

 

[circulus vitios]

Some quick googling found this:

Categorical means that you have a position guarantee for the FULL length of training for the specialty (5 years for Gen Surg, 3 years for IM, and so on).

On the other hand, with a Preliminary position you only have a ONE year contract with a designated specialty. Once you are done, you will have to look for a second year position either in the same specialty or higher training specialties like Derm, Rads, Uro, etc.

The Transitional year is kind of a preliminary position. Is also ONE year only, but you are not attached to any specialty in particular. You can combine rotations in OB-GYN with PEDS, or IM with Gen Surg... whatever suits your interest for that year. Once you are finish, you will also have to find a second year position in a designated specialty. Bear in mind though, that some specialties like Rads for example, usually require a minimum numbers of months in IM rotations. And if you didn't have them during your transitional... your year will be useless for that specialty.

In any case Categorical is always better, and that's what you should shoot for

.

 

[Law2Doc]

What do you mean by 'categorical' here? Does this mean they are radiology residencies with a specific emphasis, as I was eluding to in my first post, or something else?

Right now there are two paths to become an interventional radiologist. Most do a prelim/transitional year followed by 4years of diagnostic radiology residency, followed by a one year fellowship in IR. However a small number of IR programs now offer a categorical path, where you skip the diagnostic radiology path. It's very much a minority of places that do this, and makes you less marketable, because you can't read studies on top of your IR procedures and a lot of groups likely are going to want this flexibility.

As to your prior questions, the paths that require prelim/transitional years are radiology, derm, anesthesiology, optho, PM&r, neuro, nuclear med, and possibly one or two others. Most allow folks to do transitional year, which are frequently fewr hours than a prelim, but are thus harder to land. The prelims are in IM and surgery in most cases.

 

[werd]

chronicidal - impressive work. Thanks.

More questions for anyone, based on the NRMP document:

For some specialties, let's take Derm for example: The majority of programs are PGY-2 programs. Questions:

1). What are the choices for year one? What is the most common choice for year one?

2). There are 9 spots for Derm that are PGY-1. Why are they not PGY-2 like the rest of them? Are they highly competitive? Are they different?

3). Can someone explain 'transitional year' to me? 🙂

in "categorical" derm residencies, matching to derm at that program automatically matches you for a general (usually medicine-y) prelim year at that program. the PGY-1 spots for derm represent these categorical positions (where you do a prelim year then 3 years of derm at the same program).

the most common pgy-1 year is a medicine prelim year, followed by transitional year... other things like peds prelim, surg prelim, and ob-gym prelim are less common but you can.

i think of transitional years as being like an MS-5 year. you rotate through many departments and usually have some elective time as well. they tend to be a little easier on the hours than, say, medicine or surgery prelim years. in "prelim" years, you're essentially an intern for that department for the year. in transitional years, you are in many different departments and rotations.

 

[theWUbear]

Really great information from all of you - thanks for stopping by and sharing!

 

[Long Way to Go]

The prelims are in IM and surgery in most cases.

Is it possible to do a prelim year in a field that isn't IM, surgery, or pediatrics?

 

[Law2Doc]

Is it possible to do a prelim year in a field that isn't IM, surgery, or pediatrics?

Werd mentioned OBGYN above. I think I had seen that some of the advanced specialties accepted prelims in a couple of other fields as well, although I have never met anyone that did. Truthful, 99.99% of the folks you meet who did prelims will have done either the IM or surgery year. Surgery may make sense for the more surgery oriented paths such as optho or IR, and maybe anesthesia. Everyone else is going to o IM, unless they are lucky enough to land one of the cushy transitional year gigs, or unless they miscalculated or are geographically hindered and have to scramble into a surgery prelim.

 

[DrBowtie]

Many pathways to interventional radiology and by the time you get to that point, it may even have broken away from diagnostic rads all together (some people are pushing for that).

1. Traditional Pathway (Most common): Prelim Medicine/Surgery/Transition (1 year) + Diagnostic radiology residency (4 years) + VIR fellowship (1 year)

2. DIRECT Pathway (less common): Prelim Medicine/Surgery/Transition (2 years) + Diagnostic radiology residency (3 years) + VIR fellowship (1 year)

3. Integrated Clinical Pathway (least common): Prelim clinical rotations dispersed throughout years 1-2 + Diagnostic radiology residency (~3.5 years) + VIR fellowship (1 year).

 

[smq123]

Is it possible to do a prelim year in a field that isn't IM, surgery, or pediatrics?

There are a few (maybe 2-3, at most) Family Medicine preliminary internships. These are generally at military hospitals, because I think that they are designed to train those who will soon deploy on a General Medical Officer (GMO) tour of duty - usually those who went through med school on a military scholarship.

OB prelims are generally designed for people who wanted to do OB and didn't match. Some OB prelims aren't even available during the regular interview season, and only become available during the scramble. So they're not really viable options either.