Preliminary Surgery Questions

[Dr.Curly]

Unfortunately I matched into a preliminary surgery year.... Now that the numbness is starting to fade, I'd like to get moving in the right direction for attaining a categorical position. Any help with the following questions would be much appreciated. Thanks in advance.

I read that to scoop a PGY2 categorical position you need to have your application ready with LORs in a PDF format, send your application to programs you are interested in, and monitor websites for residency vacancies...
- Are these supposed to be new LORs or am I supposed to ask my previous letter writers for copies?
- Are there any other websites I should be monitoring other than residencyswap.org, apds.org, and ama-assn.org?
- When should I send my application to programs for them to have on file? Now? July? January?

My program does not have PGY-2 prelims. I do not remember ERAS having PGY-2 prelim surgery positions listed. Are these attained in the similar manner as above?

My program is known for being benign and supportive. Even so, I assume the opportunity to interview will be limited this year. Can someone give me an idea of how programs typically handle interview season with prelims? How many interviews are you allowed to attend? Do you simply use vacation time when you have an interview? Are programs generally flexible?

Any other thoughts or advice is welcome... I'm truly devastated.

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[Winged Scapula]

I'm sorry things did not turn out as you had expected/hoped.

Unfortunately I matched into a preliminary surgery year.... Now that the numbness is starting to fade, I'd like to get moving in the right direction for attaining a categorical position. Any help with the following questions would be much appreciated. Thanks in advance.

I read that to scoop a PGY2 categorical position you need to have your application ready with LORs in a PDF format, send your application to programs you are interested in, and monitor websites for residency vacancies...

Ideally you will want to transfer into another program at the PGY-2 level. You'll want to look for open PGY-2 spots which will not be in the match at all. They tend to get advertised starting in January and pick up in March when contracts are not renewed. I've not heard of sending in uninvited applications.

- Are these supposed to be new LORs or am I supposed to ask my previous letter writers for copies?

You can use those from your prior application but it is expected to at least have some new letters from your Prelim program. Clearly you haven't much time to get those, but then again, in medical school you only knew your letter writers for a few weeks as well.

- Are there any other websites I should be monitoring other than residencyswap.org, apds.org, and ama-assn.org?

Those are the best sources. You'll also find that your program will get announcements from other programs about openings. Many positions are found by word of mouth even before they are advertised. You'll need to let EVERYONE know that you are looking and that you are flexible. Location is not an issue (hopefully).

- When should I send my application to programs for them to have on file? Now? July? January?

You don't send an application but you will also need to reapply for the match when it opens. This means you are willing to accept repeating your PGY-1 year. When programs interview you, you'll make it known that while you are willing to repeat intern year if they have an advanced position, you would be eligible for that.

My program does not have PGY-2 prelims. I do not remember ERAS having PGY-2 prelim surgery positions listed. Are these attained in the similar manner as above?

PGY-2 prelim positions are uncommon but they do exist. Your goal is a categorical position. Thus, you will apply through ERAS. PGY-2 positions would be listed as "R" positions (i.e., requiring prior GME).

My program is known for being benign and supportive. Even so, I assume the opportunity to interview will be limited this year. Can someone give me an idea of how programs typically handle interview season with prelims? How many interviews are you allowed to attend? Do you simply use vacation time when you have an interview? Are programs generally flexible?

That is going to be up to your program. Some will allow you easier rotations during interview season, but you should expect to use vacation time. Your program will have handled this before, so an open discussion with your PD early on will make the transition easier as long as everyone has the same expectations. YOUR BEST CHANCES WILL BE AT YOUR PRELIM PROGRAM SO YOU MUST HIT THE GROUND RUNNING AND BE THE BEST DAMN INTERN THEY'VE EVER SEEN.

 

[XCdude]

I'm sorry things did not turn out as you had expected/hoped.



Ideally you will want to transfer into another program at the PGY-2 level. You'll want to look for open PGY-2 spots which will not be in the match at all. They tend to get advertised starting in January and pick up in March when contracts are not renewed. I've not heard of sending in uninvited applications.



You can use those from your prior application but it is expected to at least have some new letters from your Prelim program. Clearly you haven't much time to get those, but then again, in medical school you only knew your letter writers for a few weeks as well.



Those are the best sources. You'll also find that your program will get announcements from other programs about openings. Many positions are found by word of mouth even before they are advertised. You'll need to let EVERYONE know that you are looking and that you are flexible. Location is not an issue (hopefully).



You don't send an application but you will also need to reapply for the match when it opens. This means you are willing to accept repeating your PGY-1 year. When programs interview you, you'll make it known that while you are willing to repeat intern year if they have an advanced position, you would be eligible for that.



PGY-2 prelim positions are uncommon but they do exist. Your goal is a categorical position. Thus, you will apply through ERAS. PGY-2 positions would be listed as "R" positions (i.e., requiring prior GME).



That is going to be up to your program. Some will allow you easier rotations during interview season, but you should expect to use vacation time. Your program will have handled this before, so an open discussion with your PD early on will make the transition easier as long as everyone has the same expectations. YOUR BEST CHANCES WILL BE AT YOUR PRELIM PROGRAM SO YOU MUST HIT THE GROUND RUNNING AND BE THE BEST DAMN INTERN THEY'VE EVER SEEN.

 

[XCdude]

As someone who did not match initially and did what you're attempting to do prelim to categorical I think I have so salient advice.

I asked the policy about interviews, rotations and if flexibility during interview season was possible and made my PD at the time know I needed this. Your program will likely have time available for interviews that doesn't count towards your vacation since there is an HR policy for all residents who are interviewing...ask to see policy in writing from HR so you can have it in hand before you ask for days off.

Apply super broadly. Go on every interview.

Practice interviewing. You do not realize how much this will help. Use your iPad and record yourself saying your interview answers outload. Watch the painful videos and change your body language and delivery accordingly.

You need to know why you didn't match and be prepared to talk about it. Any red flags in your app must be addressed and you need to be able to talk candidly about them...

I matched to my top choice program this year. I knew I didn't want to stay when my initial PD stepped down and i met my new one. I went on 14 interviews all over the country. I didn't waste my time interviewing where I did previously.

I disagree a prelim's best shot is at their program. They look for reasons NOT to keep people. Most people do not look for reasons to keep you. Keeping prelims is political. And the program may be a horrible fit for you. Keep your eyes open. Keep your head up, stay positive , smile and be helpful. If you want to stay at your program it will be imperitive to make friends with everyone so they have no doubt in their minds that your the one they want. It will be a long year. Play your cards close to the vest. Trust no one until you have a contract in hand or have matched.

Many have been in your shoes and matched or transferred successfully. The hardest part is the uncertainty. PM me if you have specific questions.

In the end, doing a prelim year and interviewing made my actual interviewa easier and the ranking process a breeze. I knew what I wanted. I knew where I was going to match after I interviewed at my new program. I also got to see what else is out there and it made choosing a program easy for me.

Good Luck!

 

[Winged Scapula]

As someone who did not match initially and did what you're attempting to do prelim to categorical I think I have so salient advice.

I asked the policy about interviews, rotations and if flexibility during interview season was possible and made my PD at the time know I needed this. Your program will likely have time available for interviews that doesn't count towards your vacation since there is an HR policy for all residents who are interviewing...ask to see policy in writing from HR so you can have it in hand before you ask for days off.

Apply super broadly. Go on every interview.

Practice interviewing. You do not realize how much this will help. Use your iPad and record yourself saying your interview answers outload. Watch the painful videos and change your body language and delivery accordingly.

You need to know why you didn't match and be prepared to talk about it. Any red flags in your app must be addressed and you need to be able to talk candidly about them...

I matched to my top choice program this year. I knew I didn't want to stay when my initial PD stepped down and i met my new one. I went on 14 interviews all over the country. I didn't waste my time interviewing where I did previously.

I disagree a prelim's best shot is at their program. They look for reasons NOT to keep people. Most people do not look for reasons to keep you. Keeping prelims is political. And the program may be a horrible fit for you. Keep your eyes open. Keep your head up, stay positive , smile and be helpful. If you want to stay at your program it will be imperitive to make friends with everyone so they have no doubt in their minds that your the one they want. It will be a long year. Play your cards close to the vest. Trust no one until you have a contract in hand or have matched.

Many have been in your shoes and matched or transferred successfully. The hardest part is the uncertainty. PM me if you have specific questions.

In the end, doing a prelim year and interviewing made my actual interviewa easier and the ranking process a breeze. I knew what I wanted. I knew where I was going to match after I interviewed at my new program. I also got to see what else is out there and it made choosing a program easy for me.

Good Luck!

I'm pleased that you were successful and the advice you've given is solid.

My comment about "your best shot is at your Prelim program" is not something I made up. While it may be true that some programs look to fire Prelims, many (including many that I have direct experience with) respond favorably to a good hardworking Prelim and will, if not offer them a position, help them find one elsewhere. Thus, I stand by my comment which has been conventional wisdom for years.

 

[Dr.Curly]

Thank you so much for the responses. I will certainly take all of your advice to heart over the next year.

Could you possibly comment on what you recommend including in my personal statement? Right now I'm a ball of emotion. Last year I attempted to write a very serious description of my key personality traits that will lend myself to being a surgeon. I'd now like to share about my devastation and determination, but I also don't want to sound desperate or unprofessional. Any thoughts would be greatly appreciated.

 

[sassilysweet]

I am finishing a prelim year now & matched into a program as a 1st year again. I agree with pretty much all the advice given here so far.
-keep in mind some programs (mostly academic ones) will not even consider an applicant whom has done a prelim year for financial purposes. I don't know if there is a list floating around anywhere, but your PD might know which ones they are. U of MN is one for sure.
-my PD strongly discouraged me from pursuing a prelim PG2 spot if I didn't match. She thought it would be better to either do a research year or SOAP into a different specialty, because it becomes astronomically more difficult to match into a PG3 spot after the 2 yr (and possibly even harder to get another PG1 spot)

 

[XCdude]

I am finishing a prelim year now & matched into a program as a 1st year again. I agree with pretty much all the advice given here so far.
-keep in mind some programs (mostly academic ones) will not even consider an applicant whom has done a prelim year for financial purposes. I don't know if there is a list floating around anywhere, but your PD might know which ones they are. U of MN is one for sure.
-my PD strongly discouraged me from pursuing a prelim PG2 spot if I didn't match. She thought it would be better to either do a research year or SOAP into a different specialty, because it becomes astronomically more difficult to match into a PG3 spot after the 2 yr (and possibly even harder to get another PG1 spot)

I interviewed at the "U of MN" this year and rush among several other academic programs. Getting interviews is all about boards, research, and your LORs.

Generally I agree with the sentiment that as a prelim you are in a sense tainted

You absolutely must apply broadly

 

[sassilysweet]

I interviewed at the "U of MN" this year and rush among several other academic programs. Getting interviews is all about boards, research, and your LORs.

Generally I agree with the sentiment that as a prelim you are in a sense tainted

You absolutely must apply broadly

I specifically mentioned the financial aspect - if you do a prelim year in surgery, you are using 1 yr of your allotted GME $ and therefore would be a year short of funding (this is per my current PD).

Some places don't care about this. Certain ones do. Specifically the U of MN did in the past, was my point. However, if you did interview there after a prelim year, they may have changed what they do this year

 

[TraumaLlamaMD]

I'm pretty sure prelim years don't use up your funding.

 

[doc05]

Thank you so much for the responses. I will certainly take all of your advice to heart over the next year.

Could you possibly comment on what you recommend including in my personal statement? Right now I'm a ball of emotion. Last year I attempted to write a very serious description of my key personality traits that will lend myself to being a surgeon. I'd now like to share about my devastation and determination, but I also don't want to sound desperate or unprofessional. Any thoughts would be greatly appreciated.

wait a few months before rewriting the PS. You're too emotional now. Your "devastation" is kind of depressing and you don't want that in a personal statement.