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Questions about PGY1 required for Advanced Neurology Program

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danielchess_MD

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This is my first time applying to residency and I have so many questions, I will welcome your comments.

1) It appears that when applying to an Advanced Neurology Program, you need to simultaneously apply to a Preliminary Year PGY1, but I would like to know if you are allowed to enter in 2 different MATCH, one for Advanced Neurology and One for the required Preliminary Year (PGY1 Only)? Assuming that if you apply for the Full IM PGY1-PGY3 or 4 program will come with a binding contract or at minimum moral commitment to fulfill that IM program.

2) If independent MATCH is allowed for PGY1 Preliminary IM/Medicine Year or Transitional then, do the Personal Statement to those program need to highlight your main interest to Advanced Neurology Program? In other words, do I need to tell them that I need their program to move forward to other Residency as Neurology?

3) What Happen if you MATCH for the PGY1 preliminary medicine but not in the Advanced Neurology Program?

4) It appears that when entering your choices in NRMP site, it will allowed to choose Preliminary versus categorical IM programs, but this is my first time, is it correct?
alternatively, How I know all those Internal Medicine Programs will offer any position as Preliminary (only 1 year program)

5) IS it possible that those programs offering Preliminary Medicine PGY1 are reserving those position for their institution Advanced PGY2 programs slots? IN other words,, these PGY1 preliminary position may be more competitive because they need to serve or give priority to candidates also applying to their advanced programs. Is this a correct notion?
 

warchild

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1) yes you can apply to both categorical programs and prelim+advanced programs at the same time in the same match. There are 1 year preliminary medicine programs that are distinct from the categorical 3 year medicine programs. Your rank list might look like this:
#1) favorite neurology program is categorical
#2) next favorite neurology program is advanced, so there is a prelim rank list specific for this program:
#2A) favorite prelim #2B) next favorite prelim #2C) third fav prelim. #3) 3rd favorite neuro program is categorical #4)
 
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warchild

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#4) fourth favorite neuro program is advanced, but you may have a different prelim rank list since its in another state: #4A)prelim A #4B) prelim B ... etc ...#20)least favorite neuro program
Then at the end of your neurology program rank list, you can list your prelims #21) favorite prelim #22) next favorite prelim ... etc
This way if you don't match in neuro, maybe you'll still match in a prelim program and still get a job for at least a year (and then figure out how to get a 2nd year position via SOAP or whatever)
 
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warchild

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2) For your prelim personal statement, you don't need to go into depth about your neurology goals. You have limited space and they know you are going on to an advanced program, but they want to know why you want to do a medicine year at their program. Your personal statements may overlap quite a bit since your qualifications and motivations for treating patients remains the same whether they are neurology patients or medicine. But you should be specific about what you want to get out of your prelim year (skills you will need before you start neuro) and what type of program you are looking for
 
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warchild

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3) if you match prelim but not neuro, you can try to SOAP into a 2nd year slot. However, in my experience prelim positions are somewhat more competitive, and if you match prelim but not neuro, then you did not apply to enough neuro programs. But sometimes there are programs looking to fill a 2nd year slot and you can reapply during your intern year and interview etc, although I imagine this would be difficult given your time constraints

4) you can search for medicine programs that have prelim positions. I recommend reading all their eligibility criteria carefully, since prelim programs may have different requirements regarding medicine letters, chair letters, when to take step 2 etc.
 

warchild

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5) yes it is true that many programs do this. It may work in your favor if the neurology program has a deal with their prelim program to hold some spots.
 
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Gnocchi Monster

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So people write a separate PS for the prelim year and neurology programs? I guess that makes sense, I've just never thought about it. Would I need to get a few IM letters then? I really need to take a look at ERAS... darn step 2 studying.
 
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danielchess_MD

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Thanks so much. It makes more sense now.

Should I expect invitations for interviews at both Advanced NEURON and Linked Preliminary Medicine programs (no in same institution as the Advanced position)??

Should I search all the IM medicine in my state place calls to ask each program if they offer the Preliminary PGY1 and if they will invite preliminary candidates to interview?
 

warchild

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gnocchi - I wrote my neuro PS first, then edited it to get my prelim PS, so there was a lot of overlap. I have heard others say they used the same PS, but the prelim programs I wanted to match at were pretty competitive, so I put in the extra effort.

I imagine prelim programs are looking for hard workers who work well with others, have good patient rapport and are eager to learn. Also many prelim programs are County and might opt for applicants with more emphasis on community service, public health, global health, quality improvement etc. The county hospitals have more obstacles to providing quality care (fewer resources, more logistical scut and social work issues) while simultaneously trying to provide care for more people who can't afford it. As a result it takes a certain personality to want to deal with those obstacles, but the reward is that you see late presentations with multiple comorbidities and have more direct management and less specialists/fellows micromanaging your patients.

My instincts tell me that neuro programs put a large emphasis on selecting people who are truly passionate about neurology. Neuro programs might be more interested in your research endeavors and where you see yourself in 20 years.

I did not get IM letters because I had 4+ neurology letters that were way better than any IM letters I could get, and I devoted the first half of 4th year to neuro subIs and externships and didn't do a medicine subI until after interviews. However, I bet I would have gotten more prelim interviews with an IM letter (1 should be enough). Also I realized late that some (very few) prelim programs want a medicine chair letter, and some want step 2 scores.

danielchess - Many Neuro programs will grant you an interview with a representative of the prelim program on the same day, and some of these prelim programs will even rank you based on how the neuro program ranks you. However, some will not and you'll end up getting the neuro interview but not the prelim interview. And some advanced Neuro programs don't have prelim programs at their institution. Some categorical programs will even allow you to do your intern year at a different prelim program

You can search FREIDA to find out where the preliminary medicine programs are. The prelim programs are distinct from the categorical programs in the match, and a certain number of medicine intern spots are reserved for prelims. For the most part, prelim and categorical cointerns do the same job, but it seems like most programs have slightly different schedules for each, usually giving the categoricals a little more elective time in the first year than prelims.
 

Thama

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Thanks so much. It makes more sense now.

Should I expect invitations for interviews at both Advanced NEURON and Linked Preliminary Medicine programs (no in same institution as the Advanced position)??

Should I search all the IM medicine in my state place calls to ask each program if they offer the Preliminary PGY1 and if they will invite preliminary candidates to interview?

Many programs will not require a separate interview for their linked prelim program. Others will. You should send your application to both and if you get an interview with the neuro program, ask about the interview requirements for their prelim.
 

Gnocchi Monster

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Good info all around. I was tempted to not even apply to any advanced programs with all the extra hassle and interview costs, but I may as well apply to advanced programs + their own prelims in hopes of getting some joint interviews.
 

danielchess_MD

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So, for linked Preliminary Positions, I can customize my PS to make my applications more appealing to them, what about the LORs? Are you allowed to include different LORs or you can use the same as for Neurology Advanced Position? I will think you may want to add 1 or 2 LORs that may support your skills in IM instead of Neurology, is that a correct assumption?
 

warchild

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Yes you can customize your PS - you could send a different PS to every program if you wanted. And yes you can send different sets of letters to different programs. Also yes, I would recommend getting an IM letter or 2 to send to prelim programs. You can also use them for neuro programs. You're usually required to have 3 letters, but not allowed to have more than 4. If you have a medicine or neuro chair letter it would count as 1 of your 4. Your Dean's letter does not count as one of the 4.
 
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chickensoupdr

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If a neurology program is "advanced," could they still require you to take the first year of internal medicine at their institute?
 
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