Some basic questions about residency and the match

[DrinkSKYY]

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I'll be starting med school next year, so the specifics of residencies and that match are still unknown to me. I've looked over a few match lists and have noticed some things that I knew I didn't quite understand.

1.) What is a preliminary residency (like prelim-general surgery, etc). Is this something like a program for people that aren't fortunate to get matched into a general surgery program right away, so they then do a prelim program first? How long do these last? What do you do after it's done?

2.) Some match lists mention things like PGY1 or PGY2 - I'm guessing this means "post graduate year 1 or 2" - what does that mean when it's placed beside a residency?

3.) I'm a little confused about the relationship betwen residencies and fellowships. My understanding is that a fellowship is additional, more advanced and specialized training that takes place *after* a residency. For example, a person could do their residency in orthopedic surgery, and could then do a fellowship to sub-specialize in hand surgery. But do some people also do two residencies? For example, if a person wanted to get into a competitive field like plastics or ortho, would he/she first do some general surgery (or something else?) and then attempt to match into these programs? I guess what I'm asking is, is the road to becoming, say, an orthopedic surgeon, the same for everyone, or do more sought-after doctors get the necessary training in fewer steps? If so, how does this happen.

4.) It seems like some residencies are at major academic centers (as most/all medical schools are) while others are at individual private hospitals. What are the drawbacks (and perhaps advantages) to matching into a residency at one of these private hospitals? What effect does it have on securing a fellowship?

thanks very much.

 

[sblau001]

1.) What is a preliminary residency (like prelim-general surgery, etc). Is this something like a program for people that aren't fortunate to get matched into a general surgery program right away, so they then do a prelim program first? How long do these last? What do you do after it's done?

Those that don't match can definitely do a preliminary year, but more commonly a prelim year is for someone who is going into a field like anesthesiology or urology, which require prelim years. Also, fields like neurology and dermatology require prelim years in internal medicine. So that's why there's always a lot more first year residents in medicine and surgery than 2 and 3rd years.

2.) Some match lists mention things like PGY1 or PGY2 - I'm guessing this means "post graduate year 1 or 2" - what does that mean when it's placed beside a residency?

PGY1 is a first year residency spot, PGY2 is 2nd year, etc. Basically, fields like the ones mentioned above only start as PGY2's or 3's. So for example, dermatology starts as a PGY2 spot.

3.) I'm a little confused about the relationship betwen residencies and fellowships. My understanding is that a fellowship is additional, more advanced and specialized training that takes place *after* a residency. For example, a person could do their residency in orthopedic surgery, and could then do a fellowship to sub-specialize in hand surgery. But do some people also do two residencies? For example, if a person wanted to get into a competitive field like plastics or ortho, would he/she first do some general surgery (or something else?) and then attempt to match into these programs? I guess what I'm asking is, is the road to becoming, say, an orthopedic surgeon, the same for everyone, or do more sought-after doctors get the necessary training in fewer steps? If so, how does this happen.

You've got the concept of fellowship. Basically, it's a way to specialize. So from medicine, you can do a fellowship in rheumatology, infectious disease, etc., etc. And yes, some people do 2 residencies. Usually it's because someone wants to switch fields (why else spend more time doing residency , which pays next to nothing?)


This is a question which is open to a lot of debate. There are a lot of private community programs with solid reputations whose residents have no problems securing fellowships, so the bottom line is, it depends on the place.

 

[DrinkSKYY]

Those that don't match can definitely do a preliminary year, but more commonly a prelim year is for someone who is going into a field like anesthesiology or urology, which require prelim years. Also, fields like neurology and dermatology require prelim years in internal medicine. So that's why there's always a lot more first year residents in medicine and surgery than 2 and 3rd years. PGY1 is a first year residency spot, PGY2 is 2nd year, etc. Basically, fields like the ones mentioned above only start as PGY2's or 3's. So for example, dermatology starts as a PGY2 spot.

So would a person have to match twice? (Once into a prelim spot, and then again into their chosen field?) Or, is the prelim program part of the main residency?

You've got the concept of fellowship. Basically, it's a way to specialize. So from medicine, you can do a fellowship in rheumatology, infectious disease, etc., etc. And yes, some people do 2 residencies. Usually it's because someone wants to switch fields (why else spend more time doing residency , which pays next to nothing?)

Do some people go through one residency just to make themselves to get into the one they really want? If, for example, I was interested in ortho but didn't match into it, could I go into general surgery, and then later do an ortho residency or fellowship?

 

[FlindersGrad]

So would a person have to match twice? (Once into a prelim spot, and then again into their chosen field?) Or, is the prelim program part of the main residency?

Both are correct. Some programs which require a prelim year will automatically place you into a PGY-1 position. In other programs you will need to apply to prelim positions, interview at prelim positions, and match to one. So yes...sometimes you will need to match to 2 different programs.


[QOUTE]Do some people go through one residency just to make themselves to get into the one they really want? If, for example, I was interested in ortho but didn't match into it, could I go into general surgery, and then later do an ortho residency or fellowship?[/QUOTE]

This would be unorthodox. There is no "ortho fellowship" for gen surg. The better option would be for you to apply to ortho and prelim surg positions. You would rank all the ortho spots above the prelims, and then wait to see what happens. If you match to a prelim spot you can then try to get an ortho spot "out of the match" for the next year or enter the match again.

 

[8744]

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[DrinkSKYY]

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