question about switching from prelim to categorical?

[stillhere]

Hello I interviewed at a program for preliminary medicine year b/c i also applied to ophthalmology. But if i dont match into ophthalmology (and i'll find out jan.18) i plan to do a categorical internal medicine residency.
So the program that i interviewed at for a preliminary year is a place that i would really like to go to if i end up doing categorical medicine. (i realize now that i should have applied as categorical but made the mistake by applying as prelim)

any advice on what to do? the program already knows that i applied to ophthalmology, so if i reapply on eras for a categorical position, wont it look bad?
I was thinking that i could just enter the program as a preliminary resident and then hope they let me continue in categorical as a PGY-2. but what if they dont have any spots open as a PGY-2????
i dont know what to do

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[Dr. ZZ]

usually prelim is harder to get...im sure they would love to keep you as a PGY2 so dont stress it

 

[mig26x]

If you do a good job as a prelim I think you have a good chance of staying for second and third year, but I think that the program that you do the prelim in is the only program that you can ask for a PG2 position, you cannot ask for a pg2 position in another program. I might be wrong.

 

[stillhere]

i just wasnt sure if i should talk to the program after i find out about the ophtho match and ask them if i can switch my application to categorical. i cant afford to go back and do a second interview. and i dont know if they'll even be interested in me since they know i applied to ophtho first.

and i guess i can just do a prelim year there and hope to continue on but i heard the prelim spots there are really competitive. i'm talking about the WashU im program.

 

[ljl1982]

I'm applying to radiology and applied to both preliminary internal medicine and transitional year for PGY-1. I asked the assistant PD at my medical school about the possibility of switching from prelim to categorical in the event that I don't match into radiology, and received the following answer:

<<
That's a good question.

Of course when you do a preliminary program it is only a spot for one
year, and there is no obligation by the program to offer you anything
else. However, it is not uncommon for prelim candidates to either
change their mind, or simply not match in their desired specialty. We
have taken several prelims into our categorical program, but only when
we have openings in our program. The RRC allows a program a certain
number of slots, and that cannot be changed on a short notice.

So, the short part of your question is that yes programs can take you
into the categorical program if they have openings. If I were you and
you have concern about your ability to match in radiology, make sure the
prelim programs you match are places you would like to do categorical
medicine as well.
>>

I guess you could ask the internal medicine dept at your medical school if any of the prelim residents in the past have been able to switch into categorical.

All the best 🙂

 

[ny skindoc]

i just wasnt sure if i should talk to the program after i find out about the ophtho match and ask them if i can switch my application to categorical. i cant afford to go back and do a second interview. and i dont know if they'll even be interested in me since they know i applied to ophtho first.

and i guess i can just do a prelim year there and hope to continue on but i heard the prelim spots there are really competitive. i'm talking about the WashU im program.

I agree that it should not be problem If you perform well as a prelim.There are invariably a few categoricals who drop out after 1 year to pursue other interests so a spot will open especially in a large program.
If it makes you feel better to speak the program after the match I dont see a problem but I would not panic and rush to do it.Think about what you really want to do if you dont match in optho,reapply? are you sure about IM?.You will always be able to get PGY2 in medicine(with your credentials from Wash U)at you home program or at another place.

 

[NotAProgDirector]

As a PD, I would seriously encourage you to contact the PD's after Ophthal match day should you not secure a spot there. It is true that you will "probably" be able to get a categorical spot due to someone leaving -- but it's not guaranteed and you might be competing with other prelims for it, which could make for an ugly early PGY-1. Also, most prelim years do not include a continuity clinic, which can be a curricular problem should you want to extend to three years.

What can happen if you contact the PD?

1) They understand that not everyone gets ophthal/rads/derm who applies, and those people who don't often make great IM residents. They rank you highly on their cat list, and you get a 3 year spot on match day and you don't need to worry any more. I feel this way, and I bet a bunch of other PD's do also.

The only danger (from the PD end) is that you apply again for ophthal in your PGY-1, hoping to secure a spot for the following year. Still, you end up completing your PGY-2, and being short a PGY-3 resident is usually no big deal. I have had a few residents try to do this -- the only one who was successful finished his whole medicine residency first and then got an ophthal spot.

2) They are not interested in you for a cat position, but keep you on their prelim list anyway. Why not? Some programs only accept those residents matching into their own home programs (or order their rank lists to prioritize this) -- you are not telling them anything they don't know already (i.e. they can figure out that you did not match in ophthal)

3) They remove you from their prelim list. I can't imagine why someone would do this, just because you didn;t match into ophthal (other than the home program issue above, which happens either way)

On your rank list, I think you can rank both prelim and cat programs, so you could rank Wash U cat #1 and Wash U prelim #2, and see what happens.

It is true that as a prelim from a top notch residency program, you are (virtually) guaranteed to get a PGY-2 spot somewhere. I agree with the above poster that it depends on what you want -- if you're sure that you would want an IM categorical spot if no ophthal spot happens, then I would try to get one outright in the match. If you're not sure, then a prelim year is the best way to go.

Hopefully it's all a moot point, and you'll get an ophthal spot!

 

[stillhere]

to aProgDirector: you said on my rank list i could rank washu categorical #1 and washu prelim #2. but i cant really rank Wash u categorical position on my rank list b/c i did not even apply there for a categorical spot yet. and i'm not sure if i can still do that at this point on ERAS b/c i may have missed the deadline (i have to check that).

so i guess what i'm still trying to decide is: since i would be interested in Wash u for a categorical spot, should i try to apply for that on ERAS now, or just put wash u prelim on my rank list and pray that i get a PGY-2 spot in the future??
and then even if i go on ERAS now and apply to Wash U for a categorical spot, will i even have a chance since they know that i applied for ophthal?
Thanks for all the advice!

oh btw, aProgDirector you answered another question that i had on another thread about my low step 2ck score and not wanting to release it. thanks so much for answering that. but i still have a question about that, in general do a lot of IM programs contact applicants asking for step2ck score before rank lists are in?? thank you

 

[xaelia]

I hope the OP did in fact match into Ophtho, and doesn't have to worry about this, but I did not....

I pretty much just interviewed at Prelim medicine and TY programs that weren't terribly stressful,and, after not matching in Ophtho, I ranked all my Prelim medicine programs ahead of the TY in the thought that I have a pretty decent chance of preferring to finish medicine rather than reapply to Ophtho. Of course, the prelim programs are all community hospital programs, not academic medical centers, so while I'm sure there is some possiblity to stick around at the same place for another two years, I'd probably likely rather switch into a different, academic program- maybe even into the ABIM research pathway.

I've seen people posting about Findaresident etc. for filling unexpected R2 and R3 vacancies, but are there any other ways to go about finding an R2 position? Is this something where, once I'm certain I want to do this, that I contact PDs directly to work something out?