Apr 21, 2015
Medical Student
I'll be starting my intern year in general surgery next week...
What would stop my program from not signing me to a PGY2 contract and taking one of the undesignated prelims from my program instead (if they liked one of them better)? Am I still competing for a job?
Dec 28, 2016
The only way this would happen is if you resigned or were asked to leave the program all together (cheating, poor clinical performance, etc.).

In these situations they would look for someone to fill your now vacant spot, a prelim is often the known quantity to do so. You are not competing with them for your spot - you're competing with yourself.


10+ Year Member
7+ Year Member
Apr 6, 2009
If you do poorer than them. Yeah. Your contract is annual.
About the Ads


Senior Member
15+ Year Member
Jun 18, 2005
New York
Attending Physician
This sounds stupid like it was from Grey's Anatomy or something. Stop watching that OP.
  • Like
Reactions: witzelsucht

Jolie South

is invoking Domo. . .
Moderator Emeritus
10+ Year Member
Jun 4, 2007
Deep in the Heart of Texas
Resident [Any Field]
Agree with above. They selected you as a categorical intern for a reason. They are not looking to drop you, unless you egregiously have poor performance, operate on people on the floor by yourself at nighttime, or something similarly bad.

Please treat your prelim co-interns nicely. They will be doing likely the same work as you. In some cases, they may be completing an intern year prior to going on to another specialty. In others, they did not match to general surgery and are stressed out about their life and career. Either way, no one wants to feel like a second class citizen.


Licensed to chill
5+ Year Member
Sep 18, 2014
Resident [Any Field]
I'll add that, in addition to helping your colleagues just being the decent thing to do, your prelim compatriots may be with you for more than one year - so you should have a vested interest in helping them out. My program this year matched one of our best prelim residents to a categorical intern spot, and let me tell you how happy I am that I'll be taking call next year with a very competent intern who already knows the system.


5+ Year Member
Apr 16, 2015
Attending Physician
My previous answer was brief...But to reinforce it.

The above is absolutely incorrect. In fact I would just about disregard anything from this poster.

Yes contracts are nominally annual.

But your program selected you in the match. Their goal is to train you as a surgeon. They aren't looking to compare you or drop you. It reflects incredibly poorly on them if you don't complete the journey.

You are 100% not "competing" with your prelim compatriots. Please do not think that as it will poison your relationship with your colleagues who can and should be good friends of yours.

Agreed. The description from the OP is known as a "pyramidal residency" and went away years ago. Despite how much better a prelim is than you, your job is not in jeopardy to them unless you did something worthy of being fired or not promoted, which is pretty hard to do now a days.


2K Member
15+ Year Member
Apr 27, 2004
Attending Physician
While it's a little silly to view it precisely as the two of you competing over one job, I think people are being a bit overzealous in rejecting the idea as absurd. There are certainly some ways in which you are competing with the prelim residents. You just aren't competing on an equal footing....you have the massive home court advantage. But yes, if you screw up badly enough you can be fired, and if this happens the rockstar prelim is probably the most likely person to replace you. And from the prelims perspective it is absolutely a competition. They will be judged based on how they compare to the categorical residents and this will shape the letters and support they get as they apply for a position the next year. It is absolutely in their best interest to show routinely that they are as good or better than you are. This doesn't mean they have to be unpleasant or rude or try to sabotage you. Teamwork and cooperation are skills they are being evaluated on as well.

So maybe it's better to say that you aren't competing with them so much as they are competing with you. It's very hard for you to lose this competition. But there are lesser ways to "lose" that don't involve being fired. There is a (friendly, positive IMO) amount of competition between all residents in a given class. No one wants to be the dud in their class. There are benefits to being seen as the stud in your class. And these impressions are generally formed by faculty early on and are hard to shake. So if you are the type of person who thrives on this competition then I don't think it's necessarily bad or wrong to view it that way.
About the Ads