So here is a scenario I can imagine coming up for me personally (and I'm sure many others): I like program A a lot but it is only advanced I like program B just a tiny bit less but it is completely categorical For me, doing the preliminary year at the same institution is very important, where if I did not match at program A for prelim medicine, I would rather match at program B. As I understand the ranking system, it seems I would have to choose one or the other. Is there any way to input something like this into the ranking system: 1. Program A with prelim at IM program A 2. Program B categorical 3. Program A with prelim at IM program x, y, z, etc. I can't imagine I am the only one in this situation. Anyone know what the deal on this is?