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15+ Year Member
Dec 7, 2001
Sebastian. said:
I don't know the exact numbers, but every year a whole lot of US grads and FMG's sign up for Non-designated prelim surgery positions. I guess they intend to slip into a catagorical position when a space opens up. That happens quite often but at a much lower rate than the yearly inflow of prelim applicants. What happens to the rest of them? Are the majority of them destined to be unceremoniously discarded or do most of them really get a catagorical spot in the next year's match with experience earned as a prelim. Does anyone have numbers for the chances of a non designated prelim actually becomming a surgeon? I'm just curious about this. It seems to be an unnecessarily wastfull and cruel process.
Many, many people start out in categorical surgery positions and then after a few months realize how hard surgery sucks. These people switch in to other specialties.

In other words, the attrition for residents at many surgery programs is tremenedous.

Before I get flamed, let me say that surgery is pretty cool but you have to love it, I mean absolutely love it to the exclusion of wife, family, God, and country or you will be miserable.

turtle md

Hardware Included
10+ Year Member
7+ Year Member
Jan 22, 2005
just over there
Attending Physician
Case in point: I have a friend that did a surgery prelim year at a program that is coming under investigation. He worked 120+ hours/week and realized surgery was not for him. He liked it, but did not eat, breathe, and $#!t it. So now he is doing OB/GYN (go figure :confused: ) and loving only having to work 80 hours/week.
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1K Member
10+ Year Member
5+ Year Member
Jan 30, 2005
There is a whole netherworld of people bouncing from prelim to prelim. At some point they either:
- land a gig in a rural ED (essentially as a GP)
- work at a 'doc in the box'
- earn a living on subsistence farming (aka insurance physicals)
- enter a family practice residency
- do another prelim in the hopes to become a surgeon

While there are some RRC limits on the number of non-designated prelims, there seem to be a good number of surgery residencies (ab)using them to maintain their pyramid scheme. Abolishing them alltogether would probably not be a big loss to medical education (it would however be a financial loss to the institutions participating in this game).
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