PGY1 choices

[Shunnar]

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I am an IMG who is considering rads in the future...I have read in this forum many people talking about PGY1 and doing a TY before entering rads...so I have few questions:

1- Is it obligatory to do TY as PGY1? Like what is the percentage of programs requiring that?
2- What is the best thing to do in TY, if I do one? IM/surgery or EM for example?
3- Will I have to enter the match for rads again after finishing TY?
4- If I had the choice etween TY and doing a research in rads, which is better?

 

[Bradstein]

PGY-1 aka internship is a clinical year. You will be required to do one, it's not optional. There are multiple types:
Transitional year - tend to be "cush," most competitive, usually the obvious choice for people doing radiology. ACGME requirements are 4 "clinical" months which can be wards medicine, surgery, pediatrics, 1 month ED with 140 hours, 1 month outpatient/ambulatory medicine with 140 hours. The rest are electives. Programs very wildly in how they are structured, but that's the bare minimum you're going to get.
Internal Medicine prelim - Most common PGY-1 year available, you are treated like a categorical medicine intern, perhaps with more wards months. There are some very cush IM programs
Surgery - second most common, widely regarded as undesirable due to generally not seeing the OR much, running the floor. Some people like to do this if they're interested in interventional radiology, but I don't think anyone sees it as necessary to do IR.
Pediatrics - like IM prelim, except you work in pediatrics. There are only a handful left in the country.
Ob/gyn - apparently you can do a year in ob/gyn, I have never heard of anyone doing it, and only found out about it with unmatched spots list from the match
Family Medicine - years ago this used to be an option, now you may be able to find a FM program that will take you for a year if you contact them directly and then match as a "categorical" FM resident.

 

[Shunnar]

PGY-1 aka internship is a clinical year. You will be required to do one, it's not optional. There are multiple types:
Transitional year - tend to be "cush," most competitive, usually the obvious choice for people doing radiology. ACGME requirements are 4 "clinical" months which can be wards medicine, surgery, pediatrics, 1 month ED with 140 hours, 1 month outpatient/ambulatory medicine with 140 hours. The rest are electives. Programs very wildly in how they are structured, but that's the bare minimum you're going to get.
Internal Medicine prelim - Most common PGY-1 year available, you are treated like a categorical medicine intern, perhaps with more wards months. There are some very cush IM programs
Surgery - second most common, widely regarded as undesirable due to generally not seeing the OR much, running the floor. Some people like to do this if they're interested in interventional radiology, but I don't think anyone sees it as necessary to do IR.
Pediatrics - like IM prelim, except you work in pediatrics. There are only a handful left in the country.
Ob/gyn - apparently you can do a year in ob/gyn, I have never heard of anyone doing it, and only found out about it with unmatched spots list from the match
Family Medicine - years ago this used to be an option, now you may be able to find a FM program that will take you for a year if you contact them directly and then match as a "categorical" FM resident.

Thanks Bradstein! Your answers were very helpful.
What about questions 3 & 4?

 

[Nesir]

3) No, you will do 1 match year - but match at 2 programs; 1 for your intern year, 1 for advanced radiology.

4) Unfortunately you can't entertain this scenario. Sorry to say it, but there really is no way around a clinical intern year.

 

[Bradstein]

3) No, you will do 1 match year - but match at 2 programs; 1 for your intern year, 1 for advanced radiology.

4) Unfortunately you can't entertain this scenario. Sorry to say it, but there really is no way around a clinical intern year.

👍 QFT

 

[Shunnar]

3) No, you will do 1 match year - but match at 2 programs; 1 for your intern year, 1 for advanced radiology.

4) Unfortunately you can't entertain this scenario. Sorry to say it, but there really is no way around a clinical intern year.

Thanks so much 🙂
Last question: this intern year, is it the same as TY? And what field should I do in it?

 

[Nesir]

Could be splitting hairs at some places.

A "prelim" year is an intern year in either Medicine, Surgery, or Pediatrics. There you will often find yourself doing the same thing as the categorical residents if not worse (ie. more ICU months etc). A TY year is more of a hybrid year where at some places you do a little bit of surgery, a little bit of medicine, and a little bit of EM/peds, etc. Some offer more "elective" time as well.

Just from looking at websites, it seems that a lot of TY programs are structured as a prelim med year but with a little more elective time. The idea is that a TY year can potentially be less stressful than a prelim year.

That all being said, just looking at programs online, I have seen TY years that look like a lot more work than prelim years and vice-versa. Kinda a crapshoot these days.

 

[Shunnar]

Could be splitting hairs at some places.

A "prelim" year is an intern year in either Medicine, Surgery, or Pediatrics. There you will often find yourself doing the same thing as the categorical residents if not worse (ie. more ICU months etc). A TY year is more of a hybrid year where at some places you do a little bit of surgery, a little bit of medicine, and a little bit of EM/peds, etc. Some offer more "elective" time as well.

Just from looking at websites, it seems that a lot of TY programs are structured as a prelim med year but with a little more elective time. The idea is that a TY year can potentially be less stressful than a prelim year.

That all being said, just looking at programs online, I have seen TY years that look like a lot more work than prelim years and vice-versa. Kinda a crapshoot these days.

Ok thanks., you were very helpful..but there is something I didnt undertand well from you: Am I obliged to do a TY? (Enter the match for a TY) or I can do prelim internal or surgery if I want?

 

[colbgw02]

Ok thanks., you were very helpful..but there is something I didnt undertand well from you: Am I obliged to do a TY? (Enter the match for a TY) or I can do prelim internal or surgery if I want?

You can do prelim IM, prelim surgery, prelim FM, or any other approved internship. You are not required to apply to or complete a transitional internship, but you would probably be the only radiology applicant in the country not to apply to those programs. As already discussed, TY programs tend to cushier, so actively seeking prelim IM or surgery programs is tantamount to asking to work like a dog for little appreciable benefit.

 

[qxrt]

You can do prelim IM, prelim surgery, prelim FM, or any other approved internship. You are not required to apply to or complete a transitional internship, but you would probably be the only radiology applicant in the country not to apply to those programs. As already discussed, TY programs tend to cushier, so actively seeking prelim IM or surgery programs is tantamount to asking to work like a dog for little appreciable benefit.

Eh, TYs may have easier schedules on average, but they also in general tend to be in out-of-the-way places. I chose to do a prelim in an awesome city where there aren't any TYs available, and I didn't even bother attending any of the TY interviews I got.

 

[Shunnar]

You can do prelim IM, prelim surgery, prelim FM, or any other approved internship. You are not required to apply to or complete a transitional internship, but you would probably be the only radiology applicant in the country not to apply to those programs. As already discussed, TY programs tend to cushier, so actively seeking prelim IM or surgery programs is tantamount to asking to work like a dog for little appreciable benefit.

Thanks 🙂 that was helpful.
So when it is time for me to apply to programs, I will apply for TYs mainly (beside applying to radiology for the year after), and prelims as a back-up plan if I don't secure a TY.

 

[Meatball]

Does anyone think I have a chance at matching at a Transitional Year with a 218 step 1?

 

[Shunnar]

Does anyone think I have a chance at matching at a Transitional Year with a 218 step 1?

I am not that expert, but I guess if you apply broadly and for undesirable places you can get a position....also look orward towards the SOAP 🙂