turquoiseblue

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Theoretically, it shouldn't be hard to get a PGY2 after completing a PGY1 right?
I was curious to know how likely is it to get a PGY2 position. (P.S.: this question is just a general question, not about my personal likelyhood).

Here are the numbers: 1165 prelim surgery spots and 1863 prelim IM spots, totalling to 3028 prelim positions offered. There are 2711 PGY2 spots (82 of which are neurology spots). so there are 317 more prelim spots than PGY2 spots, so those are the ones that have problems finding a spot afterward and maybe have to do a PGY1 or wait the next year. Not to mention, you would have to calculate in the number of PGY1's and beyond from categorical years who aren't renewed or want to switch programs (I don't have those statistics--anyone know them?)

are some PGY1 prelims completely fruitless afterwards or do most eventually get something? are there any stats on this?

Just curious. Thanks.
 

captaincrunch

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Okay, I'll humor you. According to the NRMP, there were the following number of prelim positions offered in 2010: IM-Prelim (1863), Surgery-Prelim (1165), and transitional (980). Grand total = 4008.

The number of PGY-2 positions offered in 2010 was 2711. As you can see, the number of prelims outweighs the number of PGY-2 positions offered through the NRMP. However, remember that a certain percentage will have PGY-2 positions via the SF/Early match. As well, some choose to continue in their prelim field (i.e., surgery, internal medicine) and will find spots.

For the PGY-2 positions offered in the match, 97% filled (73.2% by US grads). This only applies to positions that require a prelim (e.g., Anesthesiology, Radiology, certain Neurology programs, etc), and not vacant positions in medicine, surgery, etc.

Realistically, most people who want a PGY-2 position will get one. More often, a person may do so well in the prelim field (for example, medicine) that they may be offered a categorical position despite having a PGY-2 position elsewhere (e.g., Radiology). Of course, for any of this to apply, one has to actually complete a PGY-1 year. In your case, you would probably be looking for vacant spots in medicine, FP, path, whatever (which are often offered outside the match), rather than PGY-2 positions offered via the match, which are typically competitive fields.

The so-called "pyramid" residencies don't really exist anymore, if that's what you're wondering.

Cheers
 

aProgDirector

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You're looking at this somewhat backwards. Many students are matching for PGY-2 advanced positions -- be they derm, rads, anesthesia, neuro, etc. If they match into one of these programs, then they need to match into a PGY-1 also. So, the PGY-2 position "comes first", and then the PGY-1 position is just an afterthought, because it's required.

So, what you're really asking is, if someone does a PGY-1 position and doesn't have a PGY-2 position set up already, what are their chances of getting a PGY-2 position "on the fly". The answer is, it depends -- depends on the field they are looking at, the PGY-1 they are doing, and how well they have done.

If someone does a PGY-1 surgery spot and then is looking for a PGY-2 surgery, I don't know how often that happens but I'm certain that many people never make it beyond the prelim.

If a PGY-1 comes to my program and does well, and wants a PGY-2 in medicine, I am 100% certain I'll be able to get them one. Programs develop openings (people drop out, change fields, etc) and as long as they are flexible about where they go I'm certain they'd get a spot.

I get emails, every day, from IMG PGY-1's in prelim spots in NYC area programs, telling me that they are looking for PGY-2 spots in IM. I have no idea how successful they are.
 

turquoiseblue

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thanks for the clarifications..

if that's the case, i just wondered why nondesignated PGY1 prelim years even exist if a resident can't get beyond that. is it just extra labor the US needs?

of course the extra experience is great but sounds like a bummer to not get to complete a residency or even have that count toward something more substantial than a licence (although i still dont understand how to work with just a year of experience and how much money one can make with that or how difficult that may be).

i also noticed that nondesignated prelims don't really get preference in PGY1 positions in the match even with the extra experience (but i may be wrong). I guess if the PGY2 position is always matched each year that would be difficult to obtain anything with that either.

where do these poor nondesignated prelims go?
 
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thanks for the clarifications..

if that's the case, i just wondered why nondesignated PGY1 prelim years even exist if a resident can't get beyond that. is it just extra labor the US needs?

of course the extra experience is great but sounds like a bummer to not get to complete a residency or even have that count toward something more substantial than a licence (although i still dont understand how to work with just a year of experience and how much money one can make with that or how difficult that may be).

i also noticed that nondesignated prelims don't really get preference in PGY1 positions in the match even with the extra experience (but i may be wrong). I guess if the PGY2 position is always matched each year that would be difficult to obtain anything with that either.

where do these poor nondesignated prelims go?

i guess turquoiseblue is specifically asking for non-designated surgery prelim fate.i share his same question..."where do these poor nondesignated prelims go?"
 
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gutonc

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thanks for the clarifications..

if that's the case, i just wondered why nondesignated PGY1 prelim years even exist if a resident can't get beyond that. is it just extra labor the US needs?

where do these poor nondesignated prelims go?
A "designated" prelim spot just means that the position is intended for a person matching to a particular advanced program. So if a program has 10 prelim IM spots and 5 of them are designated, that means they are only for people going on to a specific advanced program at that institution while the other 5 are for anyone going into any advanced program anywhere.

Some institutions - like mine - only have designated prelim spots (only for Neuro and Gas at our hospital) while others (like 2 community programs in town) are only non-designated (they don't have advanced programs at their hospitals). Lots of places have a combination of the two.
 

Winged Scapula

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Surgical programs often have a mixture of Designated and Non-Designated Prelims. The designated prelims were those going on to advanced surgical training with residencies at the same hospital; the non-designated prelims were for those who needed a prelim year such as for Rads, Anesthesia or for those who didn't match into Categorical GS or subspecialty.

As to the fate of the NDP - that is highly variable and has been a subject of much derision on the past. People doing 3 or more years of Prelim without being offered a Categorical position were not uncommon and was a reason behind the ACS/ABS refusing to allow this practice to continue. Some get Categorical positions, some repeat their Intern year, others change field and a few others drop out of medicine altogether after being unable to secure a categorical residency position in any field.
 

dragonfly99

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Agree with APD and WingedScapula.
I personally know someone who did 2 surgery prelim years and could not get an upper level surgery position...and he wasn't a crappy resident. He was a US perm resident but did attend a foreign school, which I'm sure was part of the issue. I think that if you are IMG or FMG, then you should only do a surgical prelim spot if you realize that the likelihood of moving on to categorical surgery and/or a surgical subspecialty is likely pretty low. If you are a very good standardized test taker and can ace the ABSITE (their "in-service" exam for surgical residents) and are good @office politics/can make people like you, then you might have a shot. Otherwise, you should be planning your next move...such as to another specialty or to a research year after that.

If you're going to do a random prelim year, then IMHO it is better to do internal medicine. For one thing, it may be more educational for you. Also I think it is acceptable to more specialties (as a prelim/initial year). There end up being a lot more open upper level IM spots than surgical spots, and the competition (average applicant test scores, etc.) is not as stiff. There just aren't that many surgical spots, even in general surgery. There are a lot of surgical programs that will take people to do prelims, lure them in with the idea that they "may" be able to stay there if they do well. It's not a pyramid scheme per se like in the old days, but a lot of those programs will take 4-5 prelims and only keep one on as a categorical, so in a sense it is exploitative. On the other hand, it's a job and it may help you get a foot in the door to do something else later on down the line.