Matching GS or EM after TRI

[607955]

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Well I like both EM and GS. I plan on going for EM but if I don't match will do a TRI. Will I have a decent chance of matching in one of these specialties as a PG2 after my TRI?

 

[DO3]

Honest answer...no. Need to get one or other the first time around. It does happen, however, it's the exception rather than the rule. Everything is more competitive. That's especially true with those two specialties. Not matching would be a red flag on your app.

 

[HooliganSnail]

It is my understanding that doing a TRI will actually hurt you. PD's are less likely to take you if you have done a TRI. The possible exception would be at your home hospital, where you could have the opportunity to show off a bit.

 

[607955]

Man this sucks, well I plan on doing a TRI at a place with a GS and EM program. Hopefully I'll match so I won't have to deal with doing a TRI.

 

[drstar842]

A girl (DO) in our TRI just matched at Hahnemann/Drexel ER, so, it's not impossible. Good luck!

 

[Dr. Zombie]

@DocEspana can testify on how annoying it was for him to match EM after doing a TRI.

 

[drstar842]

@DocEspana can testify on how annoying it was for him to match EM after doing a TRI.

Oh, don't get me wrong...she's been telling me all year about how it's the worst...you are looking at like 2-3 elective months to audition, tops...having to go through each hospital's red tape to do a rotation as a physician (hell of a lot easier when your medical school takes care of all that crap, such as malpractice, etc)...applications, interview process and match all over again....ughhhhhh

 

[Siggy]

While it's better to match the first time through, the problem is that if you don't match you don't have much more of an option than a TRI or prelim year. What I have heard, though, is that a ACGME prelim year (especially surgical) might be a better match. However, it really depends on the program. Also, from talking to other students, ACGME programs tend to look more favorably on TRIs than AOA programs. Granted if you match into a 3 year ACGME program, it's my understanding that you still stay fully funded since you get 4 years of funding for EM.

 

[soufangwang]

good,PD's are less likely to take you if you have done a TRI. The possible exception would be at your home hospital, where you could have the opportunity to show off a bit.

 

[DocEspana]

While it's better to match the first time through, the problem is that if you don't match you don't have much more of an option than a TRI or prelim year. What I have heard, though, is that a ACGME prelim year (especially surgical) might be a better match. However, it really depends on the program. Also, from talking to other students, ACGME programs tend to look more favorably on TRIs than AOA programs. Granted if you match into a 3 year ACGME program, it's my understanding that you still stay fully funded since you get 4 years of funding for EM.

Pretty much this.

 

[Winged Scapula]

While it's better to match the first time through, the problem is that if you don't match you don't have much more of an option than a TRI or prelim year. What I have heard, though, is that a ACGME prelim year (especially surgical) might be a better match. However, it really depends on the program. Also, from talking to other students, ACGME programs tend to look more favorably on TRIs than AOA programs. Granted if you match into a 3 year ACGME program, it's my understanding that you still stay fully funded since you get 4 years of funding for EM.

Just to clarify (which perhaps doesn't need to be done): that is only true for EM programs.

TRI is not acceptable as an intern year ACGME General Surgery and the OP would have to repeat PGY-1.

I must admit one of our best interns did a TRI; he looked a lot less "lost" in the hospital than the others on July 1.

 

[DocEspana]

Just to clarify (which perhaps doesn't need to be done): that is only true for EM programs.

TRI is not acceptable as an intern year ACGME General Surgery and the OP would have to repeat PGY-1.

I must admit one of our best interns did a TRI; he looked a lot less "lost" in the hospital than the others on July 1.

In very rare situations (I know of two cases just in my current program) a very surgery heavy TRI year will be accepted as credit and they both started PGY-2.

With that said, they are both likely incredible outliers. I could write a ton of what I've learned from my intern year. But as far as it applies to EM, a TRI more or less eliminates you from aka programs (I got shockingly few invites) but many 3 year programs in the ACGME view it highly. Obviously not all, but it's not a bad move if you need a backup.

 

[607955]

But as far as it applies to EM, a TRI more or less eliminates you from aka programs (I got shockingly few invites) but many 3 year programs in the ACGME view it highly. Obviously not all, but it's not a bad move if you need a backup.

That's crazy, getting no love from DO programs when it's the AOA who blab nonstop about the importance of a TRI and being a well rounded doctor.

 

[Winged Scapula]

In very rare situations (I know of two cases just in my current program) a very surgery heavy TRI year will be accepted as credit and they both started PGY-2.

With that said, they are both likely incredible outliers. I could write a ton of what I've learned from my intern year. But as far as it applies to EM, a TRI more or less eliminates you from aka programs (I got shockingly few invites) but many 3 year programs in the ACGME view it highly. Obviously not all, but it's not a bad move if you need a backup.

They would have to be *very* surgery heavy, as the ABS requires 48 clinical weeks per year, with no more than 2 non-surgical months per year in the first 3 years (i.e., 6 months total during residency). A TRI that has 9 months of surgery and 2 months of off service rotations would be permissible (notwithstanding the present DO bias in ACGME general surgery). I've not seen any that surgery heavy but YMMV and as you say, those 2 are likely outliers.

 

[DocEspana]

They would have to be *very* surgery heavy, as the ABS requires 48 clinical weeks per year, with no more than 2 non-surgical months per year in the first 3 years (i.e., 6 months total during residency). A TRI that has 9 months of surgery and 2 months of off service rotations would be permissible (notwithstanding the present DO bias in ACGME general surgery). I've not seen any that surgery heavy but YMMV and as you say, those 2 are likely outliers.

Well both went to aoa programs, so if that changes anything for the 1st year reqs. But they were able to do a required month in GS.
4.5 months of electives in surgery.
SICU over the normal MICU requirement.
And an extra month of surgery salvaged from condensing the peds and OB requirements down to the bare minimum the AOA requires of a TRI.

Programs looked highly on 7.5 months on service, especially when they wracked up (not exaggerating) hundreds of surgery cases. I myself logged ~175 cases and I just did four months of surgery this year.

We took advantage of a policy that those on electives have priority over other interns to the OR. and again, those two are extreme outliers. I'm likely an outlier for how many cases I've logged and I've stopped trying to go surgery months ago.

Bottom line: you want the best chances for EM, TRI ain't bad. You want the best chances for surgery (especially acgme) its gotta be a prelim surgery. You can do A LOT as a TRI, but you need to be something impressive. Especially since it does hinder you in some ways you wouldn't suspect (ahem AOA em)

 

[Winged Scapula]

Well both went to aoa programs, so if that changes anything for the 1st year reqs. But they were able to do a required month in GS.
4.5 months of electives in surgery.
SICU over the normal MICU requirement.
And an extra month of surgery salvaged from condensing the peds and OB requirements down to the bare minimum the AOA requires of a TRI.

Programs looked highly on 7.5 months on service, especially when they wracked up (not exaggerating) hundreds of surgery cases. I myself logged ~175 cases and I just did four months of surgery this year.

We took advantage of a policy that those on electives have priority over other interns to the OR. and again, those two are extreme outliers. I'm likely an outlier for how many cases I've logged and I've stopped trying to go surgery months ago.

Bottom line: you want the best chances for EM, TRI ain't bad. You want the best chances for surgery (especially acgme) its gotta be a prelim surgery. You can do A LOT as a TRI, but you need to be something impressive. Especially since it does hinder you in some ways you wouldn't suspect (ahem AOA em)

AOA doesn't change the requirements of the ABS. I suspect that since they had more non-surgical rotations their first year, their PGY2 program simply removed them from the PGY2 and/or PGY3 schedules (so as not to exceed the 6 months total of non-surgical electives during junior years). But at any rate, if someone is a good candidate, many programs will do what they can to accommodate you; as you note, Prelim GS is the best option for surgery.

 

[607955]

Can you do a prelim GS and apply for an open DO PGY2 GS spot? Obviously I would be applying for ACGME spots as well if I went this route.

 

[DarkHorizon]

Gotta laugh at the naysayers. I know at least 10 people that got DO Ortho after doing a TRI year, which btw is a lot more competitive than ER or gen surg. I think it's def possible, at my hospital, at least 3 gen surg residents were TRIs.

To the OP, a lot of it depends on you application, how were your board scores, grades, LOR. And of course, your best shot would be a the hospital where you're based at, so how did they like you becomes the most important question.

If I were you OP, I would look at the TRI as a bump in the road if you unexpectedly didn't match into your choice of specialty. Stsy determined and you shall be rewarded.

 

[Winged Scapula]

Gotta laugh at the naysayers. I know at least 10 people that got DO Ortho after doing a TRI year, which btw is a lot more competitive than ER or gen surg. I think it's def possible, at my hospital, at least 3 gen surg residents were TRIs.

.

It has nothing to do with competitiveness but rather to do with different board requirements. Ortho has always been more DO friendly than ACGME GS and has completely different requirements for PGY1 many of which are off service rotations not typically allowed in GS.

If you can do a TRI that has rotations that are acceptable to an ACGME GS residency, then it might be fine but it's certainly easier with a Prelim GS year. No ones arguing that it's not possible just that it's more difficult; if you're already facing an uphill battle you shouldn't try and make it harder on yourself.

 

[DOaz]

What about anesthesia, does a TRI count for applying to advanced or open PGY2 positions? Will osteopathic anesthesia programs not consider someone with a TRI completed even though I would be willing to complete intern year again.

 

[DocEspana]

Anesthesia takes people from TRI all the time. Now of you match anesthesia, you need to either match into a open PGY-2 (uncommon but possible) or match the usual way, which means you take a year of between your TRI and your anesthesia starting.