10+ Year Member
5+ Year Member
Feb 13, 2005
somewhere between Jackman and Spartanburg
Medical Student
This topic has probably been hashed out before. Both are acceptable to the academy but I know a particular PD and a particular chair in a mid-Atlantic state prefer people to do medicine years since there are so many medicine issues in rehab. They've asked applicants in the past during interviews. How would you answer if you've applied to both? - especially if you prefer the TY route.


Damnit Jim!
15+ Year Member
Mar 3, 2002
Attending Physician
this never came up on ANY of my interviews. They only cared if you were interested in the integrated intern year for their programs, so they could rank you for both spots. Some have separate interviews for that spot - I think maybe Mayo was one.
The only mid-atlantic interview I went to was spaulding.


SDN Moderator
15+ Year Member
Aug 25, 2003
Attending Physician
I think you can say that you are applying to both but you are looking to create a strong foundation in medicine for youself during you intern year and you understand the importance of a good intern year. I don't think there's any harm in saying you are applying to both TY and prelim but maybe not share the fact that you would prefer TY because it's more cush? :D

I actually ranked TY programs higher but ended up at a prelim intern program. So there's no way to predict where you will end up. PDs dont' have much say unless you are applying to prelim programs at his/her institution. He/she is probably more concerned about you getting a good foundation in medicine than the technicality of TY vs prelim year so as long as you acknowledge the importance of medicine, you should be off the hook.

BTW Lehigh TY is a very nice cush program. I also looked at Abington, Reading, York, and St. Luke.
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10+ Year Member
7+ Year Member
Oct 21, 2004
Attending Physician
I strongly encourage a transitional year

My department chair always encourages residents to do a year of prelim medicine, but I attribute that to him not having been a resident recently

The main skill of internship should be determining whether a patient looks toxic. The actual management is important as well, but the main issue is the "gut instinct" that a patient is sick and needs further management

The main benefit of doing a year with a lot of elective time are greater exposure to relevant fields (rheumatology, neurology, orthopedics, radiology, etc). It is not clear that doing more than 5 ward months really make someone better at internal medicine- the marginial learning of months 6-12 on the wards is far outweighed by a more broad clinical experience.

Plus, the real learning for most internal medicine programs is in years 2 and 3. Year 1 is mostly about workload, whereas transitional programs tend to have a lighter load with a more educational focus.

BTW, consider internal medicine programs with lots of elective time, instead of a transitional year. I did a year of internal medicine at Bassett Hospital in Cooperstown, NY, and it was an awesome year. I felt like I learned plenty of medicine in the 5 ward months and 1 ICU month, but also benefited from the 5 months of elective. And since it wasn't a transitional year, I didn't have to do any surgery

Finally M3

Senior Member
10+ Year Member
15+ Year Member
Jun 27, 2002
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Attending Physician
I did a prelim year, and I'm at a place with 'sicker' rehab folks....

And to be honest, I wish I did a TY. Granted, where I did my prelim year was VERY cush, but the TY allowed for more elective time, and less administrative stuff. Finally, we had continuity clinics in Prelim, but not TY.

I think I would have been as prepared doing a TY when compare to a Prelim; I mean, how many times will you have to do a GI bleed workup in a older patient before you learn how to manage it?
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