Prelim Surg --> Categorical Surg

[GuP]

Are there any top programs that traditionally take one of their own prelims to continue as a categorical i.e. to PGY-2, if the prelim wishes to stay with the program?

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[SocialistMD]

Are there any top programs that traditionally take one of their own prelims to continue as a categorical i.e. to PGY-2, if the prelim wishes to stay with the program?

Any top program that vacates one of its categorical spots will likely take one of its prelims. I know of several people who have obtained a categorical spot by being in the right place at the right time and working hard until that point. If this is the strategy you want, look to programs that have either a high number of residents/year or a program that is historically malignant that has a lot of turnover. Still, I think it is far better to be a categorical at any program than a prelim at a top program.

 

[doc02]

Any top program that vacates one of its categorical spots will likely take one of its prelims. I know of several people who have obtained a categorical spot by being in the right place at the right time and working hard until that point. If this is the strategy you want, look to programs that have either a high number of residents/year or a program that is historically malignant that has a lot of turnover. Still, I think it is far better to be a categorical at any program than a prelim at a top program.

Strictly speaking, that's true because if you are a categorical you are "guaranteed" to finish training. But I know a guy who is going out of his mind because he managed to jump tracks to categorical. Unless you happen to be extremely lucky that usually only happens at community programs. And while I want to stress that I agree that lots of community programs provide strong training, there are also lots of community programs that I have no idea how they remain accredited. From what he tells me, they meet their numbers but only in name because you don't get to do anything in many cases, even as a senior or chief. And they don't even have many inpatients, maybe just ten or fifteen pre service. I felt bad for the guy because we're close and I'm at a university program. And while we have a community hospital affiliate where we do the exact same thing (no operations, almost no patients) that's just one affiliate for one month, not our entire training. I told him to turn in the program because how can you be a surgeon with that training? But he can't because if he did then he'd be SOL. It's a tough situation for him.

 

[Winged Scapula]

Unless you happen to be extremely lucky that usually only happens at community programs.

Actually, conventional wisdom has it that its easier to do at a university program with acrive research labs. When you have people going in and out of the labs, it is much easier to finagle a categorical position for a desirable prelim than in the typical community program where you essentially have to wait for someone to quit, be fired or die to give up the spot.

And while I want to stress that I agree that lots of community programs provide strong training, there are also lots of community programs that I have no idea how they remain accredited. From what he tells me, they meet their numbers but only in name because you don't get to do anything in many cases, even as a senior or chief. And they don't even have many inpatients, maybe just ten or fifteen pre service.

This is not just a problem at community programs. There are many university programs which are top heavy, which have few cases that the juniors and even seniors do and low censuses (censi?). These factors have more to do with the design of the program, faculty interest and hospital dynamics than they do with whether or not a program is university or community based.

 

[doc02]

Actually, conventional wisdom has it that its easier to do at a university program with acrive research labs. When you have people going in and out of the labs, it is much easier to finagle a categorical position for a desirable prelim than in the typical community program where you essentially have to wait for someone to quit, be fired or die to give up the spot.

I respectfully disagree because in places where lots of people do research (university programs), they have a system for that. It happens so regularly that as people go into the lab, others are coming out to resume their years.

There are many university programs which are top heavy, which have few cases that the juniors and even seniors do and low censuses (censi?).

I hear people say that, but I don't know where that is. I feel bad too because he can't really complain to anyone but me. How would you like to tell people that you are being inadequately trained? I don't even know what to tell him sometimes.....I try to cheer him up but he's really depressed these days.

 

[Winged Scapula]

I respectfully disagree because in places where lots of people do research (university programs), they have a system for that. It happens so regularly that as people go into the lab, others are coming out to resume their years.

Perhaps and I didn't say it was easy, but IMHO there is more manueverability when you have active research labs, especially since not everyone spends the same amount of time in the lab.

hear people say that, but I don't know where that is.

I can name two that I have firsthand experience with: Penn State and UMDNJ-RWJ.

I feel bad too because he can't really complain to anyone but me. How would you like to tell people that you are being inadequately trained? I don't even know what to tell him sometimes.....I try to cheer him up but he's really depressed these days.

It is frightening to think that you may not be adequately trained and I have pondered aloud here many times that the increase in fellowship training may be a function of programs not producing people ready to go out and practice general surgery (there are other factors at work obviously but you can't help but wonder if this is not a significant one).

 

[Dr. V]

My program typically gives 1 spot a year to a deserving prelim from the year before.

Not because they have to because I know for a fact several people ranked them higher than the places they matched, but because they believe in rewarding good work.

Of course there are 4 prelims a year so there is usually at least 1 keeper among them, sometimes more.

It's a win win for both, the program gets to know them and know what they are like, and the prelim gets his/her spot as a categorical. Sure they repeat their intern year but they got a spot.

 

[Pilot Doc]

I respectfully disagree because in places where lots of people do research (university programs), they have a system for that.

In the two programs I have seen, that system is to hire prelims to fill the spots that open up when people do more or less than the standard lab time.

 

[Winged Scapula]

In the two programs I have seen, that system is to hire prelims to fill the spots that open up when people do more or less than the standard lab time.

That is what I've seen (also at two programs), so somewhat easier to do at a university program.

 

[GuP]

For the posters who have mentioned that take prelims, do you mind sharing which programs these are? You can either pm me or post here. Thanks!

 

[Winged Scapula]

For the posters who have mentioned that take prelims, do you mind sharing which programs these are? You can either pm me or post here. Thanks!

Penn State and UMDNJ-RWJ.

 

[GuP]

Penn State and UMDNJ-RWJ.

Thanks.

Does anyone know of any other programs which have a history of taking their prelims as categoricals?

 

[CattleprodSurg]

UTSW but it really really hard to get that prelim spot - you need an "in".

 

[GuP]

Bump...Any other programs where prelims have gone onto categorical w/o repeating the intern year again?

 

[DoctorMunchkin]

If you take a prelim spot, think of it as an audition. Work hard and you will get rewarded. If you have to repeat your intern year, it is a relatively small price to pay to get to do what you actually want.

Also, there are websites where openings are posted, for all levels. Check out www.apds.org.

As previously said, the more malignant programs may have more openings, just because of the nature of the beast. But, again, they are malignant. Also, places are more likely to take someone they know. If there is an opening at a higher level and someone is applying for it there is a reason they are leaving their program and looking for a new place. It may be nothing or it may be something. At least if the program takes a prelim, they know what they are getting.

 

[GuP]

Good advice...thanks.

 

[GuP]

bump

 

[adpsurg]

i'm sorry, i may be a little slow, but question:

can you do a prelim year in surgery, and then enter the match the next year for a categorical spot? i know you guys are talking about doing the categorical year again, but it sounds like only at the same institution (where the prelim year was done) that's possible. i read on another post (by dr. cox) that there is only 5 years of federal funding for a general surgery resident, so programs aren't likely to accept you for 6 total years.

need help soon, i have to scramble tomorrow!

thanks

 

[butterfly0660]

i'm sorry, i may be a little slow, but question:

can you do a prelim year in surgery, and then enter the match the next year for a categorical spot? i know you guys are talking about doing the categorical year again, but it sounds like only at the same institution (where the prelim year was done) that's possible.

need help soon, i have to scramble tomorrow!

thanks

Most prelims do enter the match again and try to land a spot as a categorical...this is far more common than the few that get lucky enough to land a spot at their own program.

 

[Winged Scapula]

i'm sorry, i may be a little slow, but question:

can you do a prelim year in surgery, and then enter the match the next year for a categorical spot?

Yes, you can. There are no restrictions against doing so and as a matter of fact, you would be well advised to do so to maximize your changes of getting a position.

i know you guys are talking about doing the categorical year again, but it sounds like only at the same institution (where the prelim year was done) that's possible.

We are talking about repeating your internship year if you get a categorical position as many programs would only offer you a PGY1 position and that is generally what is offered through the match. It is possible if you stay at the program where you did your Prelim year that you DON'T have to repeat internship but this varies frm program to program...no hard and fast rules.

i read on another post (by dr. cox) that there is only 5 years of federal funding for a general surgery resident, so programs aren't likely to accept you for 6 total years.

need help soon, i have to scramble tomorrow!

thanks

It depends on how much they want you. You are fully funded by CMS for 5 years; after that, programs get 50% of CMS funding for each year you are over the five. There are anecdotal reports of programs that won't accept people who do not have full funding but there are probably just as many that don't have a problem with it as long as you are a desirable applicant.

 

[RajMahal]

i heard that of Mayo (rochester) 11 prelims, they keep one as a pgy2. i'm not sure if this is true or not, it's just hearsay.

 

[Sweet Tea]

My program has a history of moving prelims into categorical spots as people drop out/take an extra lab year/take a year off/whatever. It's worked out well for my program, and I think is only possible because we have a built-in lab year. Then again, there are also a good number of prelims like me that come through our program who don't intend to stay in surgery.

 

[rox]

My program has a history of moving prelims into categorical spots

and your program would be....

 

[TheGrog]

There never are any guarantees on getting a spot.

My current program took one prelim last year on as a PGY-1 cat, but this year......way different. Not only did they not take on two of the prelims that wanted gen surg (and wanted to stay....both now unmatched), they fired one of the current PGY-1's (who is a very good resident) and brought in someone from a different program to fill the spot for next year (PGY-2).

I am not going to mention any program names yet as I am still there and looking for a spot for next year.

 

[DJ KT]

There never are any guarantees on getting a spot.

My current program took one prelim last year on as a PGY-1 cat, but this year......way different. Not only did they not take on two of the prelims that wanted gen surg (and wanted to stay....both now unmatched), they fired one of the current PGY-1's (who is a very good resident) and brought in someone from a different program to fill the spot for next year (PGY-2).

I am not going to mention any program names yet as I am still there and looking for a spot for next year.

Without mentioning names, why would they fire a very good categorical resident just to bring in someone from the outside? Is this the same resident who previously was a prelim? Just curious. Thanks

 

[TheGrog]

Without mentioning names, why would they fire a very good categorical resident just to bring in someone from the outside? Is this the same resident who previously was a prelim? Just curious. Thanks

No, it was not the same one.

As to why, it kind of has everyone scratching their heads. She had good test scores, was a very hard worker, very smart and everyone liked her.....except the program director.

 

[Leukocyte]

There never are any guarantees on getting a spot.

EXACTLY. And that is why I am doing a 3 year categorical residency in a non-surgical field (with ALL my free electives in surgery) with the hopes to do a second residency in surgery after graduating from my current residency.

I got lots of prelim spot offers, and had a VERY hard time deciding between doing prelim sx for one or two years, and doing a categorical residency in something else, then applying to GS. I decided to do a categorical in something else for now.

Reasons:

-I am an US-FMG (Average scores)
-Out of my 5 friends who were doing preliminary surgery, only 2 were able to get categorical surgery spots. They both had to repeat their intern year though. The other 3 were unable to get a cat. spot. Two of those who were unable to get a cat. spot gave up, and are appying for EM and FM. The remaining resiliant one is doing his third year of preliminary surgery at a new program.

I still love surgery though, despite my current specialty...and hope one day I will be able to be a surgeon. However I did not want to spend 3 years as a resident doing preliminary surgery with no prospect of being a board certified physician in anything! I do not have that kind of money or time. I have bills to pay, and have family to support, who are waiting for me to finish residency so that we can start living like "normal" people. However, if I was younger, I would not mind spending 1, 2 or even 3 years in a prelim surgery program.


Good Luck to all you prelims.