PSA to 4th years: If you can, do a sweet/cush TY next year

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I'm sure I'll catch a lot of flack from the more idealistic pie-in-the-sky med students, but hear me out.

If you're applying for a specialty that requires a separate intern year (Derm, Rads, RadOnc, PM&R, Ophtho, etc), give some serious, serious consideration to applying to and highly ranking some relaxing Transitional Year programs. I realize not everyone can snag one of these spots, but you owe it to yourself to try.

I'm 3 months into intern year and while it's been awesome for me, we're all at the point where my friends from medical school who chose the above fields but opted for a "serious preliminary medicine year" for whatever reason are currently kicking themselves and cursing my name. I don't think I have ever heard anyone say "boy I wish I would've picked a prelim medicine year over this cush TY I ended up in" but I can't even begin to count how many people (on here and in real life) say that if they had to do it all over again they would without a doubt apply to and try to match into a cush TY.

Seriously, I know many of you will be applying for residency with delusions of really owning the intern year experience as if you were John Dorian or Samuel Shem. Ready to slog through 52 80+ hour weeks rounding until your mind explodes, because goshdarnit that's what we doctors do! Hell, I almost picked a prelim medicine program (due to location) before wising up . . . even at the "cush" prelim medicine program I had my eye on the interns at that time were warning me to run as far away as I could from any prelim medicine program into the arms of a nice TY. Best advice I ever got, to be honest.

There is no reason to torture yourself if you don't have to. You can still learn a ton and have a (reasonably) fun time while doing it. You can immerse yourself in half a dozen months of electives, which will afford you the ability to simultaneously experience specialties you'll never get to do again and probably plan tons of vacations you otherwise would never have as an intern.

I know ERAS already opened, but it's not too late to add a few TYs to that list of yours. I know there are guys and gals on this forum who will back me up on this. If there are any current prelim medicine interns who disagree with me, I invite them to revisit this thread in another 3 months as well.
 
I'm sure I'll catch a lot of flack from the more idealistic pie-in-the-sky med students, but hear me out.

If you're applying for a specialty that requires a separate intern year (Derm, Rads, RadOnc, PM&R, Ophtho, etc), give some serious, serious consideration to applying to and highly ranking some relaxing Transitional Year programs. I realize not everyone can snag one of these spots, but you owe it to yourself to try.

I'm 3 months into intern year and while it's been awesome for me, we're all at the point where my friends from medical school who chose the above fields but opted for a "serious preliminary medicine year" for whatever reason are currently kicking themselves and cursing my name. I don't think I have ever heard anyone say "boy I wish I would've picked a prelim medicine year over this cush TY I ended up in" but I can't even begin to count how many people (on here and in real life) say that if they had to do it all over again they would without a doubt apply to and try to match into a cush TY.

Seriously, I know many of you will be applying for residency with delusions of really owning the intern year experience as if you were John Dorian or Samuel Shem. Ready to slog through 52 80+ hour weeks rounding until your mind explodes, because goshdarnit that's what we doctors do! Hell, I almost picked a prelim medicine program (due to location) before wising up . . . even at the "cush" prelim medicine program I had my eye on the interns at that time were warning me to run as far away as I could from any prelim medicine program into the arms of a nice TY. Best advice I ever got, to be honest.

There is no reason to torture yourself if you don't have to. You can still learn a ton and have a (reasonably) fun time while doing it. You can immerse yourself in half a dozen months of electives, which will afford you the ability to simultaneously experience specialties you'll never get to do again and probably plan tons of vacations you otherwise would never have as an intern.

I know ERAS already opened, but it's not too late to add a few TYs to that list of yours. I know there are guys and gals on this forum who will back me up on this. If there are any current prelim medicine interns who disagree with me, I invite them to revisit this thread in another 3 months as well.

100% agree. Beyond a doubt. I'm also 3 months into my TY and I have never had anything close to second thoughts about it. I had the option to go categorical or the prelim medicine route as well but really glad I didn't. Everything GWDS posted is spot on and I there's not much more to add. Just wanted to throw in my support to what he said.

I think the hours we've (well at least me) logged on SDN have exponentially increased since starting intern year.
 
MS3 noob here...would you mind explaining what this is? Thanks!
 
MS3 noob here...would you mind explaining what this is? Thanks!


MS3 here, ditto the post above me! 😉

If you apply for any of the specialties above (plus others like Anesthesiology), you have to apply separately for your intern year program (except for some programs in your given specialty which have an intern year linked to that given hospital). In other words, the majority of people applying to Rads/Derm/RadOnc/etc will end up with two match results listed on their piece of paper in the envelope on match day: Intern Year and Advanced Program (the specialty you chose).

That said, you have two choices for this intern year. Actually, you sort of have three.

1. Academic Prelim Medicine - this is a classic "Medicine intern year" and you will work alongside all the Internal Medicine interns (people who applied to and matched for a 3 year internal medicine residency), and sometimes even being scutted out more than them because the higher-ups know you're only there for one year, and if you're going on to those other competitive specialties you must've done well in med school and are pretty competent (cheap labor). I would list these as a last resort, if at all. The only benefit they have is if you happen not to match into your specialty, at least you're spending a solid year working hard in an academic program and you can either try to weasel yourself into the Internal Medicine residency or at least gain a little cred among specialty program directors when you re-apply for your specialty the following year.

2. Community Prelim Medicine - these programs are found at smaller hospitals that may or may not be "affiliated" with academic institutions/medical schools. They often contain less desirable internal medicine residencies (and you will often find a good number of FMGs there) but they usually have some good teaching and more importantly are usually focused on being more efficient than huge academic centers, so you hopefully don't get stuck rounding from 8am until 5pm deliberating about the 18th most likely cause that the patient's Magnesium dropped from 2.0 to 1.9. Can be hit or miss, but it's still a medicine year and you'll still end up with a ton of medicine months, ICU/CCU month(s), etc. Few electives (maybe a month, more if you're lucky).

3. Transitional Year - Many of these are really nice deals. But be careful, because some "Transitional Year" programs still kinda suck and are as bad as or worse than prelim medicine years. They're usually at small hospitals too, and often in places that aren't particularly high on the list of desirable places to live (often found away from big city areas). But they give you a much more diverse (and laid back) intern year than a year of medicine. You often get anywhere from 3-6 months of electives, maybe a month or two of ED, may or may not have ICU, and only a couple (2-4, often) months of floor medicine (the difficult months). The intensity of the floor medicine months also varies from program to program. Ultimately, these places are very competitive because of how "chill" they usually are, and how much lower stress they are.
 
I completely agree. It would be so, so nice to not have to get brutalized by the medicine program here for basically no reason. The learning is nowhere near proportional to the time spent. Take the "easy" way out if at all possible. You'll probably learn the same stuff and won't hate your life in the process.
 
from an initial review of different TY and community prelim programs there seems to be quite a variety of schedules. For example, a certain TY has 4 elective months while a prelim has 5. Or as another example, the same hospital has a TY and prelim program, the only difference is TY has 4 months of med floors and 1 month of surgery while the prelim program has 5 months of floors and no surgery month; # of electives being the same.
It seems generally TYs are cushier, but sometimes a prelim med could be a bit better...or am I missing something?
 
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