What's the purpose of Prelim years and TYs anyway?

[Shoushu]

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What's the purpose of Prelim years and TYs anyway?

I sort of know the difference of prelim and categorical residencies. Preliminary year(s) can only be done in IM or surgery, true? But they don't lead to graduation from programs correct? So what's the purpose of them? I read of people sometimes do 2 or even 3, 4 prelim years, at different hospitals... doesn't that decrease chances of ever matching into Cat. spots and graduating from any program?

What about Transitional Years? I kinda know they're like core rotations (IM, Surg, PED, OBGYN), so does one spend 2-3 months in each? What are TYs good for?

Does Categorical > Prelim > TY? If IMG, does Pre-Match Cat. trump everything? Pre-matching means 100% guaranteed job and set program-graduation.

Sorry for many questions. Please shed some light.

 

[core0]

What's the purpose of Prelim years and TYs anyway?

I sort of know the difference of prelim and categorical residencies. Preliminary year(s) can only be done in IM or surgery, true? But they don't lead to graduation from programs correct? So what's the purpose of them? I read of people sometimes do 2 or even 3, 4 prelim years, at different hospitals... doesn't that decrease chances of ever matching into Cat. spots and graduating from any program?

What about Transitional Years? I kinda know they're like core rotations (IM, Surg, PED, OBGYN), so does one spend 2-3 months in each? What are TYs good for?

Does Categorical > Prelim > TY? If IMG, does Pre-Match Cat. trump everything? Pre-matching means 100% guaranteed job and set program-graduation.

Sorry for many questions. Please shed some light.

Some categorical programs do not have prelim years attached to them. For example if you match into Anesthesia you will do three years of Anesthesia starting at your PGY-2 year. However the anesthesia is a four year residency so you have to do an intern year in either surgery or medicine. Many programs have extra prelim years so that the residents have some place to go. Others make you find a separate prelim year somewhere else.

A transitional year is a form of prelim year where you rotate through various areas of medicine. From my understanding they are considered more desirable since you avoid many of the more malignant rotations. At my institution they are usually filled by Derm, Opthamology and Rad Onc and are very competitive.

Finally in addition to having prelim programs for specialties without a designated internship, many programs have extra prelim years knowing that some people will quit the specialty they are in. This allows them a ready pool of known residents to fill that spot. Although there are no guarantees. Finally some of programs simply use them to fill manpower needs.

 

[Mattchiavelli]

The whole conceptual point of them is that you're going into an advanced field where you will need to know more medicine (or peds or surgery) than med school, but not so much as a full residency. Example- anesthesiologists need to know more about heart disease/ COPD/ endocrine abnormalities etc for what they do but not a ton since they're not the ones managing a patient's CHF long term.

In general, TYs are more desired because they have more flexibility of what you do clinically. I'm in a prelim medicine program and all my electives are IM specialty services, whereas my friend also doing neurology at a TY program in town is doing a month of neurosurgery.

As far as people doing multiple prelims, a lot of those people didn't match to a program and scrambled into an open prelim year with hopes of re-applying for an advanced program next cycle. If they don't get an advanced spot, sometimes they will do another prelim, but the more you do the less likely chance you have to get an advanced position.

 

[cowme]

The whole conceptual point of them is that you're going into an advanced field where you will need to know more medicine (or peds or surgery) than med school, but not so much as a full residency. Example- anesthesiologists need to know more about heart disease/ COPD/ endocrine abnormalities etc for what they do but not a ton since they're not the ones managing a patient's CHF long term.

In general, TYs are more desired because they have more flexibility of what you do clinically. I'm in a prelim medicine program and all my electives are IM specialty services, whereas my friend also doing neurology at a TY program in town is doing a month of neurosurgery.

As far as people doing multiple prelims, a lot of those people didn't match to a program and scrambled into an open prelim year with hopes of re-applying for an advanced program next cycle. If they don't get an advanced spot, sometimes they will do another prelim, but the more you do the less likely chance you have to get an advanced position.

I personally think it's mostly worthless for radiology. I think ED, ICU, and a couple medicine months are potentially valuable and helpful. The rest is a complete waste. I don't need a month of reading ekgs and managing decubitus ulcers. I don't need to learn to manage meds and social work issues to help me read an x ray.

 

[Mattchiavelli]

I personally think it's mostly worthless for radiology. I think ED, ICU, and a couple medicine months are potentially valuable and helpful. The rest is a complete waste. I don't need a month of reading ekgs and managing decubitus ulcers. I don't need to learn to manage meds and social work issues to help me read an x ray.

I completely agree with rads... from what I know the prelim year was a relatively recent requirement and the push to keep it going comes from a few influential people basing their argument on feedback from surveys mailed out after completing residency.

 

[cyneuron]

Is Prelim supposed to be more for medicine based advanced branches (like Neurology, Anesthesia) and TY for surgical based branches (like General Surgery, Optha etc.) ?

Whats the important difference to know in terms of competitiveness between the two ? I mean I am applying for Neurology, and all I have heard is Prelim. Not heard much about TY in Neurology.