Matched prelim IM, planning to reapply to categorical IM, advice?

[geauxgata]

I failed to match my advance specialty but instead matched my prelim IM. I want to pursue categorical IM now but I’m confused on how to approach this.

Do I go through the main match again for a PGY1 categorical IM spot? Will programs have issues with funding for me? Will they even interview me as a prelim IM? I would be happy to redo an intern year if it means accomplishing my career goals.

How do people go about reaching out for PGY2 open spots? Do you just email PDs and PCs with your application and inquiry?

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[GoSpursGo]

You have a good 3-4 months before you really even need to decide if you're reapplying through ERAS, so the decision between either looking for an open PGY-2 spot vs. reapplying is not looming. Don't prematurely come to a decision on your plan without really thinking about what you're trying to accomplish. I would spend the next few months thinking about what you want in an IM program and your future program, and then decide how best to achieve those goals.

By far, the easiest path forward is that you do well in your prelim, your prelim program likes you, a PGY-2 spot opens up there (or they open one for you), and boom, you proceed as if you were always a categorical resident. That's possible at some programs, while at other programs it's a no-go unless one of their categorical residents drops out for some reason. That's a question you need to ask your PD, and I think that's fair to bring up in the near future. Your PD obviously knows that you need to find something to do after your prelim, so knowing that you want to stay in IM will help him figure out how to help you. On your side, if you want to do general IM then staying at your program is also probably the easiest thing to do unless you have a strong need to geographically relocate ASAP. OTOH, if you're hoping for a fellowship then you need to evaluate whether or not you can do that at your prelim program.

Second easiest option is that you find an open PGY-2 position and are able to slide into that after your prelim. These positions are not widely publicized, so if either your PD tells you that they likely won't be able to open a slot for you OR if you decide that you can't achieve your career goals at your program, you'll still need your PD to help you find these positions. These sorts of positions do open up, but you generally only hear about them through word of mouth or cold-emails.

Finally, you can always reapply. There are countless threads about your funding question, but suffice to say the funding issue will be a problem for some programs and not a problem for others. You say now that you will "happily redo intern year"... I will gently suggest you may not feel the same way in about 12 months 🙂 But regardless, this would be my last choice by far unless you really can't find a PGY-2 position. Aside from how painful repeating intern year is, you're also going to struggle getting time off for interviews while on an intern schedule.

 

[geauxgata]

You have a good 3-4 months before you really even need to decide if you're reapplying through ERAS, so the decision between either looking for an open PGY-2 spot vs. reapplying is not looming. Don't prematurely come to a decision on your plan without really thinking about what you're trying to accomplish. I would spend the next few months thinking about what you want in an IM program and your future program, and then decide how best to achieve those goals.

By far, the easiest path forward is that you do well in your prelim, your prelim program likes you, a PGY-2 spot opens up there (or they open one for you), and boom, you proceed as if you were always a categorical resident. That's possible at some programs, while at other programs it's a no-go unless one of their categorical residents drops out for some reason. That's a question you need to ask your PD, and I think that's fair to bring up in the near future. Your PD obviously knows that you need to find something to do after your prelim, so knowing that you want to stay in IM will help him figure out how to help you. On your side, if you want to do general IM then staying at your program is also probably the easiest thing to do unless you have a strong need to geographically relocate ASAP. OTOH, if you're hoping for a fellowship then you need to evaluate whether or not you can do that at your prelim program.

Second easiest option is that you find an open PGY-2 position and are able to slide into that after your prelim. These positions are not widely publicized, so if either your PD tells you that they likely won't be able to open a slot for you OR if you decide that you can't achieve your career goals at your program, you'll still need your PD to help you find these positions. These sorts of positions do open up, but you generally only hear about them through word of mouth or cold-emails.

Finally, you can always reapply. There are countless threads about your funding question, but suffice to say the funding issue will be a problem for some programs and not a problem for others. You say now that you will "happily redo intern year"... I will gently suggest you may not feel the same way in about 12 months 🙂 But regardless, this would be my last choice by far unless you really can't find a PGY-2 position. Aside from how painful repeating intern year is, you're also going to struggle getting time off for interviews while on an intern schedule.

Thanks for your advice!

I would definitely prefer to just move on into a PGY2 position, but it's just daunting to think about how to approach it. This year will definitely be filled with a lot of struggle and it's been really tough for me to process it but I am willing to take on the challenge. I totally agree about my mindset being more hesitant about restarting an intern year but having this note of uncertainty of my career now feels awful and if repeating an intern year can assure me a career, I would be ok with it, no matter how painful lol.

When do you recommend I should start cold emailing programs about open PGY2 positions?

I know I have some time before I actually put anything into action, but having a plan makes me feel better, I guess it makes up for the uncertainty that comes with a prelim IM position with no advanced position.

 

[geauxgata]

I will be reapplying for categorical IM this upcoming match after failing to match an advanced specialty.

Any advice on how to approach this? How did you manage interviews while on an intern schedule? Any issues along the interview trail with being a "reapplicant"?

 

[GoSpursGo]

I will be reapplying for categorical IM this upcoming match after failing to match an advanced specialty.

Any advice on how to approach this? How did you manage interviews while on an intern schedule? Any issues along the interview trail with being a "reapplicant"?

I've merged your new thread with your existing one since this question doesn't really require a separate thread.

 

[NotAProgDirector]

Many people who want to transition from a prelim PGY-1 to IM PGY-2 end up applying to the match. Programs with open PGY-2 spots for the next year interview them as part of their interview process, and then offer them a PGY-2 position instead. The candidate withdraws from the match. Your PD will also be able to let you know about PGY-2 openings when they hear of them. if somehow you don't get a PGY-2 spot by February, then you stay in the match for a new PGY-1.

This assumes you are not on a J visa. J Visa holders cannot repeat a PGY year in the same field.

 

[geauxgata]

Many people who want to transition from a prelim PGY-1 to IM PGY-2 end up applying to the match. Programs with open PGY-2 spots for the next year interview them as part of their interview process, and then offer them a PGY-2 position instead. The candidate withdraws from the match. Your PD will also be able to let you know about PGY-2 openings when they hear of them. if somehow you don't get a PGY-2 spot by February, then you stay in the match for a new PGY-1.

This assumes you are not on a J visa. J Visa holders cannot repeat a PGY year in the same field.

Thanks for your response!

That makes me feel more hopeful. It's been kind of a rocky time emotionally for me these past couple of weeks lol. My plan is to ultimately just exhaust all of my options and apply to the match while also emailing about PGY2 positions.

Do you know if programs will openly tell you that they have a PGY2 spot open during the main match or is it just kind of sporadic with how they offer it depending on availability? I know it's probably a mix of the two but just curious with your experience!

Also, do you have any thought on how my status as a "reapplicant" would look?

For reference, I'm a USDO grad with 23X/51X/24X/56X.

 

[NotAProgDirector]

I expect it's variable. We try to tell people in advance that we have an open PGY-2 and that their interview will be for both PGY levels. Other programs may decide to contact the applicant immediately after the interview (if things went well).

Reapplicant is complicated. It always raises the question of how you ended up in this situation. I recommend being 100% honest -- you applied to (Rads/Derm/Whatever) last year, didn't match, and now have become more interested in IM. If you're really not applying to your adv specialty any more, then have your mentor who is writing you a letter include that in the letter -- they will only do this if you really are no longer applying, and it will remove concerns from programs that you're applying as a backup. Some programs won't consider you for a PGY-1 again due to funding issues, or simply because many people who repeat their PGY-1 are simply miserable -- it's (somewhat) fun to do the first time only. Not much you can do about that, and your real goal is to nab a PGY-2 spot anyway.