Transitional year to 2-4 program?

[Red Beard]

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I am a 4th year who is still a little bit on the fence about what I want to do, although I've been planning on applying to internal medicine and becoming a hospitalist. There are a couple of other specialties that I haven't explored yet, including EM--I have my required EM rotation just before the end of interview season this year.

Given that November may find me still unsure, I am considering doing an unlinked transitional year internship to explore my options a little more.

If I end up discovering that EM is the right direction for me too late to make a go of it this match year, is it reasonable to plan on doing a TY as a back door? Are there pgy-2 positions out there for people coming out of a TY that you don't have to apply for in your 4th year of medical school? Or is an unlinked TY a major dead end if one decides they want to train in EM?

Thanks in advance for any input👍

 

[xaelia]

Going from a Transitional Year program into Emergency Medicine is typically a replication of an identical process as you would have if you were applying as a 4th year medical student, except you will be using your precious vacation to try to squeeze in interviews. There are no special PGY2-4 spots available for TY folks; there are very rare vacancies posted on the SAEM website for which a TY would be a candidate.

The good news is, applying as a TY, you can simply just attend a PGY1-3 program - yes, you're an intern all over again, but your overall GME years still totals four. Repeating intern year has many moments of annoyance, but the second intern year is a lot less stressful than the first. Some PGY1-3 programs may be willing to give you credit for up to six months of your first intern year, but I would not expect this.

Most EM residencies are PGY1-3 programs.

 

[Red Beard]

Thanks for the info. So it sounds like I would most likely have to enter the match a second time.

My second question: Would I have an advantage, a disadvantage, or be on on a level playing field relative to 4th year students as a TY applicant?

 

[bartleby]

If you did a transitional year, you would be virtually certain of having to enter the match next year.

Doing a transitional year would not necessarily hurt you. Particularly if you got good evals and a strong letter or two (especially if you could arrange for your ED rotation to be early enough that you could get a letter from the PD where you rotate if there's a residency there) it might even help.

Even though you'd start as an intern again if you matched in a PGY 1-3 program, some programs may give you "time served" for floor months depending on the requirements of the residency you'd match in.

 

[Saladin MD]

Thanks for asking this question. I also needed the answer to it.

I have a follow-up question though. So basically the TY year won't count, but what about prelim medicine or prelim surgery? In the four year EM programs, does the prelim year count as the first year, so you can then apply to a PGY2 pot?

 

[deleted109597]

Any PGY1 year counts for a 2-4 program. There are prelim OB and prelim peds spots out there if you look hard enough (now the question of why isn't answered). However, the 2-4 spots fill up in the same match year that you go for the prelim, so you are most likely, as mentioned before, going to have to go through the match again.
A few 2-4 programs have PGY2 spots open for the match, Mississippi being one of them. You would have to look. At least at one of those places you wouldn't have to be an intern again.

 

[Saladin MD]

Any PGY1 year counts for a 2-4 program.

Including a TY?

 

[Saladin MD]

Including a TY?

Bump. Anyone?

 

[lucky_deadman]

Bump. Anyone?

Any prelim year or a TY counts for your first year towards a 2-4 EM program.

None of the above count towards a 1-4 EM program unless special approval is given by RRC and/or Program Director. Still probably not getting out of a whole year, but might get a couple duplicated off-service rotations replaced by EM months.

 

[Saladin MD]

Any prelim year or a TY counts for your first year towards a 2-4 EM program.

None of the above count towards a 1-4 EM program unless special approval is given by RRC and/or Program Director. Still probably not getting out of a whole year, but might get a couple duplicated off-service rotations replaced by EM months.

Ahhh ok, thank you. Now I understand. I'm an IMG so I didn't quite understand how it works there. I thought that all 4 year programs have 1 year of Prelim/internship in med or surg, and then the rest of the 3 years are EM. So it seems that there are two types of 4 year programs: one where the first year is prelim, and the others with 4 years straight of EM. OK thanks!

Are very few programs 2-4 year ones?