Medical Understanding Match List Terms: Prelim vs Transitional Year vs Integrated

[Question]

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Hello!

I am an MS1 trying to better understand how to read match lists, specifically entries like surgery (preliminary), transitional year, and surgery (integrated).

- Does a preliminary surgery position mean the student will need to reapply through the Match after that year?
- Is a transitional year typically done by those who didn't match and will be interning for a year before reapplying?
- For integrated programs (thoracic, vascular, etc.), does that mean training is integrated with another specialty like gen surg?

I'd appreciate any clarification on how to interpret these. Thank you!

— Experts please respond to this post —

 

[GoSpursGo]

Challenging to understand in a vacuum. Prelims and TYs can be used for certain specialties that require a separate PGY-1 prior to starting the specialty (examples include anesthesia and radiology). But if someone just gets a prelim, they'll either need to reapply the next year or manage to find a PGY-2 position outside of the match. TYs are usually quite competitive so it is uncommon to "just" get a TY without an advanced position.

Integrated means you get to go straight to the "integrated" training, i.e. CT surgery, without having to do it as a fellowship after a categorical surgery residency

 

[Dral]

To make sure I'm understanding:

For specialties like anes/rad, some programs require applicants applying simultaneously to advanced positions and separate PGY-1 (prelim/TY)? What's the point of this if you aren't guaranteed a PGY-2 spot?

If someone matches only into a prelim year, could that also be because they didn't match into their intended specialty and this is a backup?

Is a TY essentially a non-specialty PGY-1 before starting an advanced program at PGY-2?

Are integrated surgical programs more competitive than categorical?

Listed as only:
Preliminary
Transitional year

The person either intentionally only applied to and/or ranked prelim programs, or they only matched prelim or TY and not to an advanced position.

Categorical: some programs that typically require intern year have it included in the program and not separate.

For specialties like anes/rad, some programs require applicants applying simultaneously to advanced positions and separate PGY-1 (prelim/TY)? What's the point of this if you aren't guaranteed a PGY-2 spot?
Yes. Good question. Ideally they would all be categorical.

If someone matches only into a prelim year, could that also be because they didn't match into their intended specialty and this is a backup?
If their advanced position requires an intern/TY year, then they likely just didn't match into their advanced position. Typically people wouldn't only try for an intern/TY year as a back up since they are sort of 'dead end' positions in a way.

Is a TY essentially a non-specialty PGY-1 before starting an advanced program at PGY-2?
Yes. TY and prelim years are similar.

Are integrated surgical programs more competitive than categorical?
I do not think there are many integrated programs. In general, most surgical programs will be categorical, but few are integrated. Thus, integrated is more competitive in general. So if someone wants to do vascular surgery, the integrated residency will be more competitive than the gen surg residency which someone would complete and then apply for vascular surgery fellowship in a more 'traditional' pathway.

 

[GoSpursGo]

I generally agree with @Dral . Someone listed as only matching to a prelim or TY likely either didn't match to an advanced position, or went completely unmatched and SOAP'd into whatever they could get.

 

[GoSpursGo]

This question really doesn't require confidentiality, and I'm not sure why you're so focused on this level of detail. For all intents and purposes, a prelim only position almost certainly means they failed to match to an advanced position or that they failed to match at all and SOAPed. Do not plan to apply to a prelim only position.

But to directly answer your questions

I saw a student matched Surgery-General and another Surgery-Preliminary at the same institution, so the one who got the prelim position would be applying again?

Yes, unless the prelim position can find a PGY-2 position outside of the matche

In what scenario would someone be intentionally applying/ ranking prelim/TY positions only?

They wouldn't, at least not a US MD/DO grad. There may be someone somewhere who decided to do a prelim or TY to "give themselves more time" to decide on a specialty, or who has some idea about going into industry after 1 year of training once they're eligible for a full license... but these are corner cases where someone is either making a mistake, or following a path that doesn't apply to >99% of people.

Also, are integrated surgical residencies generally shorter than the traditional categorical -> fellowship pathway?

Yes

 

[Dral]

Agree, we are getting into a lot of detail here. It's great that you're interested in this, but this is more than you need to know at this point probably. I'm not opposed to sharing the information I know though.

In addition to what GoSpursGo said above, I believe that a few residencies want you to apply during intern year. These are programs such as preventive, occ, and aerospace med (I think so at least). These are fairly niche specialties though. Someone who I graduated with went into preventive and irrc, they interviewed and matched intern year only, then during that year, applied to their preventive programs - and that's how the timeline is supposed to go for them. That could have changed by now though.