Prelim Match Wanting to Finish IM Residency

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pdmaes

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I applied to an advanced specialty and didn't match, but I did match for a preliminary medicine year at a strong academic program (truthfully I'm shocked - I was not the strongest applicant and thought I'd be more likely to match advanced and SOAP for prelim). I have a genuine interest in continuing on in IM rather than reapplying advanced next year. I almost dual applied to IM, and I thoroughly enjoyed my medicine sub-I in January (part of why I didn't dual apply was I hated my 3rd year IM rotation, but my sub-I was so much better and I think a better representation of what IM is like). [A small part of me has been having doubts about my advanced specialty for a few months and after getting over the shock of not matching, I have been looking forward to the possibility of training in IM.]

Does anyone have experience or advice as far as my options going forward? A few things I've read/heard are..

1. Some programs will keep their prelims on as categorical if they are interested and do well during the prelim year. This would be my ideal situation. Is this common or rare? Do you have to basically apply for their categorical program or do they come up with a PGY 2-3 year contract outside the Match?

1a. Should I go ahead and e-mail my PD about my interest in continuing IM? I don't want to come off desperate but I want to be able to hit the ground running when residency starts as far as getting mentors, LoRs, etc.

2. I heard that PGY-2 IM spots can open up throughout the year, and if your prelim PD likes you, they will help you secure one of those positions.

3. I can reapply IM the traditional way, but I have heard this is tricky because I'll have used up 1 of my 3 years of funding during my prelim year, and programs don't like to match residents that won't have funding for the whole 3 years.

If anyone has any insight or advice on any part of this, I would be so appreciative! Thanks in advance!! 🙂

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1. Yes, this can be done. Often it's because someone else drops out, but adding a spot can sometimes be done also. You would just get a PGY-2 contract outside the match. It's going to be program dependent.
1a. You could contact them now, or wait until your internship actually starts. I'd probably wait until you have completed 2-3 months, just to be certain this is really what you want to do. Your PD will expect that you will reach out before the ERAS cycle starts again in Sept.
2. Yes, this happens all the time. Spots usually open up later in the year.
3. You will probably get a PGY-2 spot somewhere, if you do well and your PD helps you.
 
Thank you very much for your detailed reply! I really appreciate it.
 
Just wanted to say that this happened to me and while shocking, ended up being an amazing thing for my life. My PD found a way for me to stay on as a PGY-2, but I didn't decide on this until Decemberish of intern year (if I remember right, I had even gone on a couple advanced specialty interviews intern year before I withdrew from the interview/match process).

100% agree with advice given above.
 
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