options for prelim. year with anesthesiology residency

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cali

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I am wondering what people suggest for PGY1 year in anesthesiology. Are you allowed to do a year of anything you want whereever you want? How do people feel about doing a year of surgery versus a year of medicine? What are you supposed to expect to get out of the year? Anyone do a prelim. year in Hawaii or hear anyhting about it?

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A bunch of students from my school have done 4th year electives in Hawaii. Supposedly, the internships are no walk in the park. They work you.
As for prelims in general, there are many options and it depends on what you're looking for: an educational experience in either surgery or medicine, an easy year, a high salary, a desire to stay locally or try a new city, less months with call, less floor months, etc. There is so much variety in programs. For example, medicine prelims are generally considered harder than transitional years. However, there are many transitional programs that are harder than some medicine programs. You can get an idea by looking at the schedule, but you really need to ask the right questions when you're there for the interview.

I didn't apply to any surgery prelims. You work long hours and in some places may get stuck doing floor scut rather than scrubbing in. Some medicine prelims can have 6-8 months on the floors, up to 3 months in the unit (which is usually of interest to those entering anesthesia), little elective time and many months of call. A solid basis in IM is a good thing for an anesthesiologist to have. Transitional years offer more flexibility in general and vary widely. The easier ones are generally more competitive. I met many residents while interviewing that said those who did easier transional years didn't learn nearly as much (but they may have had a good time). A few programs offer a year in house that is specifically designed for anesthesia. I think this is ideal because you learn the hospital system, meet more people, and only move once. But it all depends on what you're looking for. I applied to a mix of IM prelims, trans programs, and 4 yr anesthesia programs.

MS 4
 
Anesthesiology is sort of a mixed bag on the PGY1 or CBY year - both terms used interchangably. You will find that approx 25% of programs will provide the CBY year as part of their program - a 4 year gas program. Another 25% will not offer anything but PGY2 slots, where you must secure your own prelim year. Finally, about 50% of programs will offer some slots that include the CBY & others that do not. So, the first thing you will need to learn about programs as you begin to compose you list of programs to research & consider is how many CBY slots and how many PGY slots they have.

Now, all gas programs will accept either 1 year of surgery or 1 year of IM or 1 year of an AOA internship (for the DOs-to-be in the crowd) as your prelim year. I came across a few programs who would accept essentially the first year from essentially anything other than psych or path as a prelim year...but those appeared to be the exception based upon my experience.

I would be wary of many surgical prelims. I interviewed at several places where I checked out the inside poop from folks who had done a surgical prelim. Frequently, as a prelim, you are the bitch-boy doing rectals, scut, notes, admissions & rarely, if ever, seeing the inside of the OR. However, there are some surg programs who flatly state that they do not make any differences. I am doing a surgical internship at Dartmouth, before I start gas there. During my surg interview, their position on prelims was flatly stated to be that they made no difference, the rotations were the same, the expectations were the same and that you would all have comparable quantities of time in the OR. I spoke with a couple of residents who independently confirmed that this was a reality.

IM programs - what can I say? Pre-pre-round, to pre-round to round, re-round and then round again!!! Sprinkle a couple of conferences & lectures in there....with a smattering of patient care...and you have a day in the life of an IM prelim!!!
 
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