So I really should know this BUT...

[DonStracci]

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What exactly do the IM catergories mean?
"Categorical"
"Preliminary"
"Transitional"

I've never seen an exact definition of the categories, though I'm sure one exists.

Thanks!😳

 

[Apollyon]

Categorical training leads to eligibility for board certification.

Preliminary programs do not lead to eligibility for board certification, and do not count against the funding "clock" for Medicare reimbursement (which goes on the categorical track one follows). Most preliminary positions are in internal medicine and general surgery, but there are also peds and ob/gyn prelims, and a first year of family medicine can be counted as one.

Transitional programs are a specific type of preliminary program that have a set number of required rotations, including ICU time, and typically a lot of electives that are free for the person to take across all disciplines of medicine (provided one isn't repeated). For example, someone going into radiology and someone going into ophthalmology might be in the same transitional program, taking the same required core rotations, but the rads person may rotate on MSK, CT, MRI, neurorads, and interventional, whereas the optho person may rotate on cornea, retina, and ENT.

 

[DonStracci]

A very good answer, thanks...
So why would someone even do a prelim year? It doesn't sound advantageous at all.

 

[DOme2009]

let's say you apply for a competitive residency program, like neurosurgery, but fail to match . you can scramble for a prelim surg year and reapply the following year for a pgy2 slot in neurosurgery since you will have hopefully completed the requirement of a general surgery internship. that's just one scenario, there's probably lots more.

 

[Pinkertinkle]

A very good answer, thanks...
So why would someone even do a prelim year? It doesn't sound advantageous at all.

Not everyone can get a transitional year and so for those in specialties which require a pgy-1 year before starting prelim is their only choice.

 

[hippiedoc13]

A very good answer, thanks...
So why would someone even do a prelim year? It doesn't sound advantageous at all.

It's not about any sort of advantage at all.

There are still several specialties that begin their specialty-specific training at the PGY-2 level, and thus require completion of a more "general" PGY-1 year first. (Anesthesiology, dermatology, ophthalmology, radiology, neurology, PM&R, radiation oncology, and *some* emergency medicine programs.) For those applicants entering a field that starts at PGY-2, their options for completing the PGY-1 year include prelim medicine, prelim surgery, or transitional year.

Also, as someone noted above, if an applicant fails to match into a categorical program in their desired specialty, they may choose to scramble into an open prelim spot, so as not to "lose" that year of training while they figure out their next move, so to speak.