Prelim Application Question

[sleepysloth]

So, I've heard that matching into a medicine prelim year is kind of difficult. I want to apply to some advanced anesthesiology positions, and was looking into prelim surgery programs. How many prelim surgery programs should I apply to in order to have a good chance of matching into an advanced position for PGY2 if needed? I'm in the second quartile, Step 1 220s, good clinical grades/ECs, extra degrees.

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[AdmiralChz]

So, I've heard that matching into a medicine prelim year is kind of difficult. I want to apply to some advanced anesthesiology positions, and was looking into prelim surgery programs. How many prelim surgery programs should I apply to in order to have a good chance of matching into an advanced position for PGY2 if needed? I'm in the second quartile, Step 1 220s, good clinical grades/ECs, extra degrees.

Hard in what way? The prelim surgery residents here get fairly annihilated (and this is common at many places) with several rotations averaging > 90 hours a week. 6 days per week just about the entire year. The medicine prelims here get outpatient rotations and elective time and don't spent NEAR as much time in the hospital.

Honestly I don't know many people that willingly choose to do a surgical prelim year, there typically isn't much education and scut work is pervasive (consult H&Ps, discharge summaries, receiving OSH transfers, getting people to rehab, etc...). Almost all either failed to match in GS or some other specialty. Almost all of our advanced residents complete a medicine prelim year or a transitional internship. Finally, advanced residency slots are drying up and many programs are going to mostly categorical spots - any reason why you aren't interested in that?

Anyway, back to your original question, you have solid stats and shouldn't have any trouble securing a prelim surgery spot. I'd try to do it at your home institution or your future advanced institution (there still are some residencies that don't have any categorical slots) to minimize moving over the next couple of years. I don't have specific numbers, but I would think if you could get >6-7 interview of prelims than you'd be fine.

 

[sleepysloth]

Hard in what way? The prelim surgery residents here get fairly annihilated (and this is common at many places) with several rotations averaging > 90 hours a week. 6 days per week just about the entire year. The medicine prelims here get outpatient rotations and elective time and don't spent NEAR as much time in the hospital.

Honestly I don't know many people that willingly choose to do a surgical prelim year, there typically isn't much education and scut work is pervasive (consult H&Ps, discharge summaries, receiving OSH transfers, getting people to rehab, etc...). Almost all either failed to match in GS or some other specialty. Almost all of our advanced residents complete a medicine prelim year or a transitional internship. Finally, advanced residency slots are drying up and many programs are going to mostly categorical spots - any reason why you aren't interested in that?

Anyway, back to your original question, you have solid stats and shouldn't have any trouble securing a prelim surgery spot. I'd try to do it at your home institution or your future advanced institution (there still are some residencies that don't have any categorical slots) to minimize moving over the next couple of years. I don't have specific numbers, but I would think if you could get >6-7 interview of prelims than you'd be fine.

Thanks for the information, is that >6-7 prelim interviews for medicine or surgery or both? I would ideally like to do the medicine prelim, and will probably will end up applying to prelim med now instead of prelim surgery since you've told me that it's not hard getting a prelim surg spot. I know my school gives preference to our students for prelim/transitional years and we have many sites.

I was applying to some advanced programs in addition go the categorical positions at some of the more competitive places. Hopkins and Emory are only advanced from what I can tell on ERAS.

 

[ljc]

I did 4 prelim interviews in person (3 medicine, 1 TY), 1 over phone, and had 3 additional that were included as part of my anesthesia interview. I matched at #2 on my prelim list. I think 6-7 is adequate, especially if you add a surgery prelim or 2 to the list. In terms of competitiveness, it's TY >> medicine >>>> surgery. Many surgery prelim spots go unfilled, because as mentioned above, it's mostly **** scut work. I'd apply to ~20 or so total prelim year programs with your stats.

 

[D4C]

So, I've heard that matching into a medicine prelim year is kind of difficult. I want to apply to some advanced anesthesiology positions, and was looking into prelim surgery programs. How many prelim surgery programs should I apply to in order to have a good chance of matching into an advanced position for PGY2 if needed? I'm in the second quartile, Step 1 220s, good clinical grades/ECs, extra degrees.

Don't underestimate matching into a medicine prelim, its probably harder than anesthesia at this point. Someone told me I should apply to as many/more prelims than anesthesia spots - thought they were paranoid. Well, I matched my number one anesthesia in an advanced program and ended up soaping for a prelim surg spot. I wouldn't apply to any, or very few, surgery prelims, just load up on medicine prelims and call it square.

 

[Katheudontas parateroumen]

So, I've heard that matching into a medicine prelim year is kind of difficult. I want to apply to some advanced anesthesiology positions, and was looking into prelim surgery programs. How many prelim surgery programs should I apply to in order to have a good chance of matching into an advanced position for PGY2 if needed? I'm in the second quartile, Step 1 220s, good clinical grades/ECs, extra degrees.

Your stats are fine to match into a prelim-medicine. But yes, also do not underestimate the process. Your best shots are your home program/in-state. I applied to 10-15 wet coast prelim/TY programs and only got 5 prelim and 1 TY of which most were in my state. Ranked 2 places and matched. So be strategic and you'll be fine.

 

[med-geek]

Hey guys i'm new on here

Don't underestimate matching into a medicine prelim, its probably harder than anesthesia at this point. Someone told me I should apply to as many/more prelims than anesthesia spots - thought they were paranoid. Well, I matched my number one anesthesia in an advanced program and ended up soaping for a prelim surg spot. I wouldn't apply to any, or very few, surgery prelims, just load up on medicine prelims and call it square.

what happens if you match into anesthesia and don't get into any prelim or vise versa?

 

[AdmiralChz]

Hey guys i'm new on here

what happens if you match into anesthesia and don't get into any prelim or vise versa?

If you match advanced (PGY-2) and do NOT match at a PGY-1 spot even after the scramble/SOAP (highly unlikely unless you refuse to apply to surgical prelims many of which will literally take any qualified candidate) then you would forfeit your PGY-2 position. I've never heard of such a situation for anesthesia (because the applicants that match are typically above average), but I suppose it happens in other fields.

Of course if you just match into a categorical program then it takes all that out of the question. Many programs are in the process of converting their spots into categorical.

 

[D4C]

Hey guys i'm new on here

what happens if you match into anesthesia and don't get into any prelim or vise versa?

Like what The Admiral said, you loose your spot if you don't get anything in the soap. Not at all likely if you apply to surg prelims (not all of them are nasty btw)

 

[ToKingdomCome]

Don't underestimate matching into a medicine prelim, its probably harder than anesthesia at this point. Someone told me I should apply to as many/more prelims than anesthesia spots - thought they were paranoid. Well, I matched my number one anesthesia in an advanced program and ended up soaping for a prelim surg spot. I wouldn't apply to any, or very few, surgery prelims, just load up on medicine prelims and call it square.

Pre-lim medicine is harder to match than anesthesia?

 

[D4C]

Pre-lim medicine is harder to match than anesthesia?

In general, yes. Don't have the data but you're competing with some very high scoring applicants for those spots.

 

[ToKingdomCome]

In general, yes. Don't have the data but you're competing with some very high scoring applicants for those spots.

Okay. Any Categorical spot plz take me

 

[AdmiralChz]

Pre-lim medicine is harder to match than anesthesia?

Prelim medicine is getting harder because many of the cushy transitional years have been closing over the last 10 years (those hospitals have largely converted to having community-based medicine residencies) forcing those applicants from Derm, Optho, Radiology into the prelim medicine applicant pool.

Some programs are more competitive than others just like anything else, if you have a strong enough application to match anesthesia I am sure you can find somewhere for prelim just apply somewhat broadly. That being said I almost ALWAYS recommend a categorical program unless you are tied to an area for some reason (most of our advanced residents were transfers from other programs or military).

 

[Low Flow]

And you can rank advanced and categorical positions in the same match, right? For example, categorical at institution A, advanced at institution A, prelim at institution B (or A?).

 

[Katheudontas parateroumen]

And you can rank advanced and categorical positions in the same match, right? For example, categorical at institution A, advanced at institution A, prelim at institution B (or A?).

Yes that is right. If a program has both categorical and advanced positions, you can rank them both. Also, there is a separate list you make for prelim programs that you can rank apart from your anesthesia rank list. If you match at a categorical program, then you go to that program. if you match an advanced position, then the match algorithm goes to match you from your prelim rank list to complete your match of Prelim + Adv.

 

[Katheudontas parateroumen]

Prelim medicine is getting harder because many of the cushy transitional years have been closing over the last 10 years (those hospitals have largely converted to having community-based medicine residencies) forcing those applicants from Derm, Optho, Radiology into the prelim medicine applicant pool.

Some programs are more competitive than others just like anything else, if you have a strong enough application to match anesthesia I am sure you can find somewhere for prelim just apply somewhat broadly. That being said I almost ALWAYS recommend a categorical program unless you are tied to an area for some reason (most of our advanced residents were transfers from other programs or military).

Agreed. I didn't have anyone that I know that didn't match into an anesthesia program. But a handful of my friends had to scramble for a prelim spot.

 

[dchz]

And you can rank advanced and categorical positions in the same match, right? For example, categorical at institution A, advanced at institution A, prelim at institution B (or A?).

Yes i did that when i ranked.