Jul 22, 2020
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Hi, I'm currently a 4th-year medical student about applying to residency. Recently, I've made some changes to my plans. I was originally going to apply for an IM residency but now am looking to apply to a Transition year or a preliminary year. the reason being so that I may wait a year to apply in the couples match with my wife who is currently a 3rd-year medical student. I don't know much about a transition year or a preliminary year so I wanted to ask you guys. I know a research year is an option, but I would like the experience in the hospital, and I would also like the confirmed source of income when the grace from my student loans ends.

First, what is the difference between Transition Year and a Preliminary Year?

Second, How competitive would you consider transition year programs/ preliminary programs?

Third, is it possible that they may count towards your residency year, for instance, if I go into IM after my TY would it count as my intern year? I know probably not but I figured I'd ask.

Fourth, my personal statement and all of my LOR's are set up as if I am applying to an IM residency. Do you believe I need to change this?

Also, do they look bad on your application to residency after you complete them, or would you consider them a plus?

Finally, please give any advice about TY or preliminary year that you can think of as I am truly lost.

Thank you guys for everything in advance. I know this is a lot of questions I just am lost at the moment and didn't know where to turn.


Just keeping cool in the pool...
5+ Year Member
Apr 28, 2015
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TY>>>>> prelim medicine. TYs are generally more competitive. The only benefit to a prelim medicine year is if you end up doing medicine— a TY counts for PMR, rads, derm, ophtho, anesthesia, and neurology. If you do a transitional year and decide you want to do medicine, you’d have to repeat your prelim year.


10+ Year Member
Apr 5, 2010
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I would highly recommend against applying to only preliminary/transitional year. You do not want the hassle of applying to residency twice, especially as you will be much busier as a resident. Also, if you want IM, you will most likely repeat first year as there are fewer PGY-2 spots and even if there is PGY2 spot, you might be missing some rotations in your transitional/prelim year that require repeating. I would suggest applying to residency program in larger cities where there are multiple programs available, e.g., NYC. Also, if you match categorical program, you can build good relationship with program director in the specialty your wife is interested in at the same hospital and let her/him know your situation.

Now to answer your other questions, transitional year and IM prelim years are different by flexibility. Whereas IM prelim years have a set number of required IM rotations with only a few blocks of electives, you can do a lot more non-IM rotations in transitional year. Some advanced residencies such as neurology require minimum 8 months of IM rotations as part of intern year, and others are not as strict. If you are interested in these advanced programs, you can potentially enter 2nd year without repeating intern year with transitional/prelim, provided that you meet all the requirements. Prelim/TY are very easy to match into in general and are usually what people ended up doing if they can't match categorical spots. This is especially the case with surgical prelim. To this end, no the LORs would not matter if it says you want IM.
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Sep 16, 2012
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To be clear, is IM your goal? And you're just trying to pass the year?

What is your SO applying to? That makes a big difference. If they're applying to competitive specialties like ophto, ortho, etc., then they're the limiting factor, and you'll need to base where you apply/interview off of them. IM is easy to match into--there are programs everywhere.

I agree with not only applying to TY/pre-lim programs. I think you're likely to be at a big disadvantage when it comes to applying for advanced/categorical programs. Many programs may look at you going to a TY/prelim IM without having matched to an advanced program as a red flag. Maybe they wont, but even then you're still trying to deal with scheduling interviews during intern year. I think it just sets you up for a lot of difficulties.

You could get credit from a TY towards an IM program--it could be partial (meaning you get more electives as a senior IM resident--they're not going to graduate you early), or if you structure your rotations right, you may be able to apply directly for a PGY2. This is most common if a PGY2 position opens up at the same institution. It's also possible you get full credit, but have to do substitute your PG2 and 3 electives for the core rotations you missed as an intern, if you didn't do enough. Basically, it varies.

I think if your ultimate goal is to match with your SO, and match well, I think a research year could be your best bet.
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Pastafarians Unite!
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Oct 11, 2006
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This is a bad idea. Either take a year off and match the following year (research, another degree, etc) or just apply to IM, your wife tries next year to match in the same area, if that fails then you consider trying to transfer as an IM PGY-2. But transfers don't always work out, and it's hard to do well in a new program you don't know.


15+ Year Member
Sep 20, 2004
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Just do a research year as a med student and then graduate the same time as your wife...then you can at least couples match.
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No Meat, No Treat
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Mar 6, 2005
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The plan you've outlined is basically the worst possible option in your case.

Do you want to go into IM? If so, you should match into IM. You can do it this year, or you can do a research year, or some other kind of extra year that a lot of schools have (both my med school and residency program, 3000 miles and multiple "tiers" apart, had a "pathology fellowship" pretty much designed to allow one partner to catch up with another in the graduation and residency application process) and then you should match together.

Otherwise, pick a big city with lots of surrounding "commutable" programs that will allow you both to be in the same general geographic area.

As mentioned above, a lot depends on what your partner wants to do. If it's a specialty that is 2 or more words, and the last word is "surgery" or includes the word "dermatology", you definitely need to wait and go where she goes.

Have this discussion NOW! It's OK (and expected) that she won't know what she wants to do going forward. But I'm sure she has an idea. If you're committed to IM, then you need to figure out what she's thinking about and make your plans based on that. If IM or similar/less competitive, either go for IM this year or wait it out as above. If she's an integrated plastics gunner, find something useful to do for a year and
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