What are Preliminary Positions?

[Smashingdude]

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Okay this might seem like a dumb question, but every program that I apply has some sort of preliminary program as well. What are those exactly?

I am applying to Internal Medicine, and I see an entry for "Preliminary program" in addition to the "Internal Medicine" program.

 

[Raryn]

Okay this might seem like a dumb question, but every program that I apply has some sort of preliminary program as well. What are those exactly?

I am applying to Internal Medicine, and I see an entry for "Preliminary program" in addition to the "Internal Medicine" program.

Preliminary programs are 1 year programs that are meant for someone who is going on to a specialty that requires an intern year.

For example, (most) radiology programs require one to do 1 year of internal medicine, surgery, or "transitional year" before they start. Ditto with derm, pmr, ophtho, some anesthesia programs, etc.

Basically, if you're applying categorical (i.e. three year) IM, ignore the prelim options.

 

[Law2Doc]

...

Basically, if you're applying categorical (i.e. three year) IM, ignore the prelim options.

Except that if/since OP is presumably applying from abroad, a "dead end" prelim might in some cases be the only way for him to get his foot in the door. You might want to apply to a few of these if only to put at the end of your match list just in case. Some might still be available in SOAP, but you have more ability to target geographic locations if you jump on one of these at this stage.

 

[Raryn]

Except that if/since OP is presumably applying from abroad, a "dead end" prelim might in some cases be the only way for him to get his foot in the door. You might want to apply to a few of these if only to put at the end of your match list just in case. Some might still be available in SOAP, but you have more ability to target geographic locations if you jump on one of these at this stage.

IM programs are pretty different from surgery programs. It's very unusual for someone to apply IM prelim as a backup. If it were done so, the first assumption from any program where you dual applied would be that you're actually applying for some kind of ROAD specialty and lying that your primary intention is IM.

 

[Winged Scapula]

IM programs are pretty different from surgery programs. It's very unusual for someone to apply IM prelim as a backup. If it were done so, the first assumption from any program where you dual applied would be that you're actually applying for some kind of ROAD specialty and lying that your primary intention is IM.

Even for an IMG? I can't imagine anyone assuming anyone except the most exceptional IMG applying for a competitive "ROAD" specialty.

 

[Law2Doc]

Even for an IMG? I can't imagine anyone assuming anyone except the most exceptional IMG applying for a competitive "ROAD" specialty.

Yeah I don't buy this either. Also you can always apply to prelims at different places than categoricals

 

[Raryn]

Even for an IMG? I can't imagine anyone assuming anyone except the most exceptional IMG applying for a competitive "ROAD" specialty.

There's always the possible assumption of PMR or neuro for the less competitive candidates I suppose.

But yes, I don't know of many people who apply IM-prelim as a backup, and it would look strange. The different places strategy would be one way to go about it.

The other thing to take into account is that prelim programs are frequently (usually?) MORE competitive than their parent IM program. In some places, a LOT more competitive. Your competitors for categorical IM are your typical med school graduates with a wide distribution, while competitors for IM prelims are almost all people who are applying ROAD, Rad Onc with the PM&R and Neuro people thrown in.

There are plenty of community programs known as being on the "cush" side where the credentials of the prelims/transitionals are far and away superior to their categorical seniors. I can think of one I rotated at during medical school where the TYs were all AOA people going on to do ophtho at harvard (or equivalent) and the categoricals were 100% foreign grads, not even caribbean.

All-in-all, it's a very different reality than the surgery programs I'm aware of. The majority of people who do prelims actively try to avoid surgery programs, and there's a culture with a lot of people who couldn't otherwise match surgery doing prelims to try to get a spot through a back door. I can't say it never happens in medicine, but it is much more unusual.

 

[RangerBob]

There's always the possible assumption of PMR or neuro for the less competitive candidates I suppose.

But yes, I don't know of many people who apply IM-prelim as a backup, and it would look strange. The different places strategy would be one way to go about it.

The other thing to take into account is that prelim programs are frequently (usually?) MORE competitive than their parent IM program. In some places, a LOT more competitive. Your competitors for categorical IM are your typical med school graduates with a wide distribution, while competitors for IM prelims are almost all people who are applying ROAD, Rad Onc with the PM&R and Neuro people thrown in.

There are plenty of community programs known as being on the "cush" side where the credentials of the prelims/transitionals are far and away superior to their categorical seniors. I can think of one I rotated at during medical school where the TYs were all AOA people going on to do ophtho at harvard (or equivalent) and the categoricals were 100% foreign grads, not even caribbean.

All-in-all, it's a very different reality than the surgery programs I'm aware of. The majority of people who do prelims actively try to avoid surgery programs, and there's a culture with a lot of people who couldn't otherwise match surgery doing prelims to try to get a spot through a back door. I can't say it never happens in medicine, but it is much more unusual.

Ouch--physiatrists have feelings too 🙁

(not sure about neurologists though--they're pretty cerebral people 🙂

But you're absolutely right--I actually used that as a guide on where to apply for pre-lim and TY positions. If there were PM&R pre-lims it told me I had a decent shot, and if there were PM&R, neuro, and/or anesthesia residents, it hinted that maybe it was a decent program. I interviewed at a few programs that were all prelim-ROAD residents and while it'd certainly be nice to leave everyday around 3pm liked they bragged, I actually need to know some medicine--I don't want to be the rehab guy who's always consulting medicine for things like management of HTN and a cough.

I agree that the prelims are more competitive than the categorical program. In fact I can't think of a single program I interviewed (cush or non-cush) where the prelim year (TY or IM) wasn't far more competitive than the categorical program. I'm sure there are exceptions, I just didn't interview at any of them.

 

[DermViser]

There's always the possible assumption of PMR or neuro for the less competitive candidates I suppose.

😱 --