Prelim vs transitional year

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Jun 12, 2008
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Hi everyone, I am a med student interested in psychiatry (though I am still open to other fields), it will be a few years till I apply to internship/residency but I am a bit confused about a few terms I have heard thrown around, and was wondering if anyone would graciously help clear things up by answering these questions about transitional vs prelim year:

-What specialties do a prelim and which a transitional? Are there some that require one over the other? Is one only for people unsure of what specialty they want to go into?

-If you are a PG-1 are you always either doing a transitional or prelim year, instead of just being in residency?

-Does one look better than the other? Is one more strenuous than the other?

-When is one more useful than the other? Is there a benefit of one over the other?

-Do some specialties require you to do one or the other?

-To my understanding, you apply to either prelim or transitional AND PG2 at the same time. Is this always the case?

-I have heard that the transitional year buys some people time to decide what field they want to go into, but how is this possible if you must apply to both at the same time?

-Who would go into “medicine preliminary”?

-How come so many people do their intern year and PG-2 at the same institution? Does that mean they just happened to get into both programs, or is it because once you get into one program you get into the other (like intern year gets you into residency there or vice versa?)

Some of these questions probably seem silly, but I haven't been able to get a straight answer, I would really appreciate your help!

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This probably doesn't belong in the psych forum, but...
-Ophthalmology, radiology, dermatology, neurology, radiation oncology and some anesthesia programs require a prelim year. A prelim year can be a prelim medicine year, a prelim surgery year, or a transitional year (which usually just means that it has more electives than the other two).
-Most specialties require either a prelim medicine or transitional year. I'm not sure which ones will allow a prelim surgery year. Neither is "better", but transitional years are typically more "cush" because they allow for more elective time. Some say that programs "prefer" a prelim medicine spot b/c you'll get better training, but I don't know if that's really true.
-If you are applying to a specialty that requires a prelim year, then yes, you apply to both at the same time. If you are undecided and just want to do a prelim year before you make your final decision, then you apply to prelim programs only.
-If you decide to apply to a prelim program b/c you're undecided about specialty, then you will have to reapply to your chosen specialty the following year, however because you are no longer a US senior (ie, a 4th year medical student), you are not bound by the rules of the match and can prematch or, in some cases, take a PGY-2 position (depending upon what you're going into and if you fulfilled the requirements of a PGY-1 year for a given specialty). However, the specialties mentioned above, which require a prelim year, match for a PGY-2 position 2 years out, so you may have to take another year off and do research or something if you decide to match into one of those specialties.
-Most people do their prelim and categorical years at the same institution because it's easier than moving twice. I'm not sure exactly how it works, but I believe when you fill out your rank list you rank categorical programs linked with your prelim year. For example:
1. MGH + MGH medicine prelim
2. MGH + Brigham medicine prelim
3. MGH + BIDMC medicine prelim

Again, not sure. But I have a friend matching into rads and I think that's what she told me.
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