Transitional year

[santa_claus]

Hi there,
I am an Australian med student, who is interested in US residency, and I'm aiming for surgery. Browsing through the previous posts, I read about someone who did a "transitional year" b/c he didn't match into the residency he wanted. Can someone please explain what a transitional year is? If I don't match into surgery, and I'm stubborn (or stupid ), is my best option to take a transitional year and try to match into surgery next year? Like, is the transitional year going to improve my chances? What can I do, as an international student, to maximize my chances of getting the specialty that I want in the first place?
Thanks guys!

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[Wizard of Oz]

A transitional residency, as I understand it, is sort of a mixed year in which several specialties are sampled. They vary widely as far as quality is concerned. Most if not all are very competative because they are usually saturated by people who are doing 1+3 or 1+4 programs such as derm, anesthesiology, and rads (which are quite competative residencies themselves). There are also a handful of folks out there who do only a 1-year transitional year, take their step 3, and go work as a doc-in-a-box or under some other doctor.

There are several other preliminary 1-year programs that are easier to match. The most common is medicine, but I've heard of others in ped's, surgery, and (rarely if it even exists) ob/gyn.

Best advice--go to the websites of some of the schools you'd consider going to. They usually have personal profiles of their students. See if you match the characteristics of the people they take.

 

[Wizard of Oz]

I didn't read the rest of your message, so I'll say something else. Take this with a grain of salt--I am only an MS1.

Dunno if a preliminary year will help or not. Some schools or programs go solely by USMLE step 1 because in their field, that is the greatest indicator of success in the specialty. One thing that people try to do to improve their application is to submit their step 2 score which may or may not help them. You can take that at the beginning of your fourth year if you want. You probably won't be ready for your step 3 until you've had some PGY experience, so the application deadlines will likely keep you from that step unless you want to take time off after your preliminary year. If you match somewhere, you have to go there unless you are comfortable going nowhere (at least in the US).

Best advice--be ready for USMLE step 1. Second best advice--be ready for USMLE step 1. After that--do well on USMLE step 1. All programs focus heavily on standards that are common among their applicant pool.

Oh yeah, other best advice--don't do general surgery. It's not worth the money anymore.

 

[SoCuteMD]

You are probably better off to forget the transitional year - they tend to be competitive as a previous poster pointed out and they won't do much to further your gen surg application. If you don't match in a categorical general surgery position it's pretty easy to snap up a prelim year in general surgery if you have more than one geographic location that you are willing to go to. Then you can apply to "categorical" gen surg again with some experience and some support from a residency director and hopefully earn a categorical spot. You could also possibly earn a spot at the place where you do a prelim if someone who has a categorical spot changes his/her mind about surgery as a career.

Terms:
prelim - basically means you have a one year non-renewable contract. Most commonly offered in medicine and surgery
categorical - a spot in a residency that will renew your contract yearly assuming you perform to standards, etc - meaning that you will finish the residency and be eligible to take that specialty's boards.

Hope this helps. Best of luck!!!

 

[njbmd]

Hi there,
I am an Australian med student, who is interested in US residency, and I'm aiming for surgery. Browsing through the previous posts, I read about someone who did a "transitional year" b/c he didn't match into the residency he wanted. Can someone please explain what a transitional year is? If I don't match into surgery, and I'm stubborn (or stupid ), is my best option to take a transitional year and try to match into surgery next year? Like, is the transitional year going to improve my chances? What can I do, as an international student, to maximize my chances of getting the specialty that I want in the first place?
Thanks guys!

Transitional year is the modern equivalent of the old "rotating" internship. It is a year of study where you rotation through various disciplines like Peds, Internal Medicine, Psych etc. It is a PGY-1 year only and very popular for people who are entering Anesthesia or Radiology who do not want to do a Prelim year of Surgery or Medicine.

Preliminary years are PGY-1 (and sometimes PGY-2) years that can be designated (meaning that you have a residency that starts at the PGY-2 level such as Anesthesia or Rads) or undesignated (you didn't match into a categorical residency and need a year of practice).

Preliminary years can be done in medicine or surgery most commonly. By doing a prelim year or year, means that you will seek a categorical position at some time in the future either at the same insititution or elsewhere.

Categorical positions mean that you are expected to finish the entire residency barring a poor clinical performance. For example, catergorical positions in General Surgery are far more competitive than Preliminary positions.

 

[BlondeCookie]

Preliminary years are PGY-1 (and sometimes PGY-2) years that can be designated (meaning that you have a residency that starts at the PGY-2 level such as Anesthesia or Rads) or undesignated (you didn't match into a categorical residency and need a year of practice).

Preliminary years can be done in medicine or surgery most commonly. By doing a prelim year or year, means that you will seek a categorical position at some time in the future either at the same insititution or elsewhere.

Good advice. Thanks.

Is an undesignated preliminary year the same as a transitional year? Do you do the same things (rotate through several specialties) in an undesignated preliminary year? And what is the purpose of a preliminary year? Is it for the residency program to try out residents before they decide to accept them to a categorical position later on?

 

[Bertelman]

Good advice. Thanks.

Is an undesignated preliminary year the same as a transitional year? Do you do the same things (rotate through several specialties) in an undesignated preliminary year? And what is the purpose of a preliminary year? Is it for the residency program to try out residents before they decide to accept them to a categorical position later on?

A few residencies (Anesthesia, Derm, Rads) do not begin until the PGY2 year at some institutions. Thus, you need to fill your PGY1 year with either a transitional or preliminary position.


Let's try again...
Transitional year= bits and pieces of several rotations (IM, Surg, Rads, Anesthesia, EM, etc.)

Preliminary year= one specialty, all year long. I know of Medicine, Surgery and Pediatrics. Thus, if you match to Prelim IM, you will be on a medicine service all year long. Surgery? You'll be scutted out for H&Ps and pus drainage in the ER while the upper levels cut in the OR- although you may have a chance to do a month of Anesthesia on Surgery.

Undesignated=has no influence on the activities of the actual program year. This only means that you, poor soul, did not match into the competitive Anes/Derm/Rads PGY2 spot you had hoped for. Otherwise, you will still be on the medicine service all year long AND you will be applying for a PGY2 spot.

If you want a better breakdown of things like categorical v. advance positions, I'd suggest searching the Residency forum, or maybe the ERAS thread.