Word of advice for those interviewing for prelim/TY spot

[waytogo1]

For those who are interviewing for prelim/TY programs, make sure you do full research on all programs you are interviewing at and reach out to residents from that program to ask workload, schedule, EMR and other details that you think would impact your happiness while at work.
I'm a prelim who ended up matching at a large academic medical center. I knew it was not going to be chill/easy as a TY in a community hospital but I still got a good vibe on the interview day. So I ranked it relatively high. On my first day at work, I realized that it was a huge mistake and everyday I regret not researching about the program more in depth. Interview impression was way way off, and I honestly want to go back in time and re-rank this program to the bottom of my list. I wish someone at the program, any prelims at the program told me how difficult work load was on the interview day-- but they did not. They told me they were satisfied with the program leading me to have a wrong perception.
As a prelim, we tend to put more time into ranking our advanced programs --that's going to be rest of our career so it does make sense to put more time into ranking those. But intern year is also important for your health/mental wellbeing - one year is quite long. You don't want to be miserable for a whole year and burn out even before starting your advanced program. I wish I took time and effort to reach out to at least one resident per program (ask for their personal email if they don't mind sharing it, not their work email) and ask for their honest opinion about the program. It's rare that a resident would bad mouth their own program on the interview day.
I guess it may be a different process for this year because of COVID, but I just wanted to share this so others don't have to suffer and "feel cheated" by the program.

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[Vandalia]

The advice I used to give residents was don't think anything until the first kickoff of the college football season.

If you don't think in August you are an idiot, that you made a huge mistake, and that you are the worst intern/resident in history in August, that you are in the worst residency in the country, then there is probably something wrong with you. Or wrong with your program.

I am willing to bet that in a few months you will be saying exactly the same things that the resident you spoke to at the interview said. You are comparing your experience in the first month of a residency (internship) with that of someone who is a number of months in. They are very different.

 

[waytogo1]

Its already september, I still feel the same way about this program. Please do your research on all prelim/ty programs you are applying to - it can be one miserable miserable year, and I don't want anyone else suffering as much as I am suffering right now. People telling you, "you need to go to a program that makes you work so you can learn more" is also BS. Alot of work can be scutwork that takes time away from you actually learning medicine. Go to a TY that gives you freedom to choose to study/put more time into learning.

 

[Dral]

I feel I lucked out here. My home program only had 2 or 3 prelim spots and I wasn't sure how likely I was to get one of them. I felt that the IM program at UPMC had the same 'atmosphere' so to speak as my home program (which was a good thing). I care less about work load, but more about how happy the residents seemed and how they interacted.

The main reason I'm posting this, is that I don't want people to generalize about large academic centers. I'm not trying to put in a plug for UPMC, but I liked my intern year. We worked hard on our floor months, but I got 5 or 6 months of elective time. I wasn't fond of ICU, but that was for a number of reasons outside of how the program worked (some of the residents during that rotation weren't my favorites and I really just am not the critical care type of person).

Overall, I agree though that you should really research it and not just think "oh, it's just a year, whatevs".

 

[Naruhodo]

I've gone back and forth on whether to apply for a prelim year. One of my concerns is that in a categorical residency they are at least somewhat invested in you not burning out your first year so that you can go on to be a senior resident in their program. I worry this might not apply in a prelim program where they just have you for a year? Feel free to share your thoughts.

 

[AvacadoToast]

I've gone back and forth on whether to apply for a prelim year. One of my concerns is that in a categorical residency they are at least somewhat invested in you not burning out your first year so that you can go on to be a senior resident in their program. I worry this might not apply in a prelim program where they just have you for a year? Feel free to share your thoughts.

Depends on the prelim. I'm at transitional year program and I am very, very happy. Lots of learning, normal-ish hours (with the exception of 4 months of inpatient IM). Lots of time for electives (6 months of them). Not all TYs are the same and not all prelim med/surg programs are the same. Apply broadly.

 

[waytogo1]

After going on interviews for my advanced programs and prelim/tys, I was pretty tired, and although i did research on the programs, in hindsight I could have done more. Just wanted to emphasize to those applying this year that where you do prelim/tys actually matter and can have a huge impact on burnout/your happiness. Choose wisely, rank wisely. @AvacadoToast So jealous! Wish I was at a TY program

 

[Laradd]

Such a great advice! Would really mean a lot

 

[magictouch]

Second this, also try to determine how much gen med you are really willing to tolerate and assume any prelim that tells you you’ll get 4-5 months of gen med and 2-4 weeks of night float always means you’ll get 5 months gen med and 4 weeks night float. the people who luck out are categoricals not prelims.

 

[bananabag2.0]

All valid points. To echo some of the themes, be warned if a program does not allow you to interact with current prelims. That should be a red flag. Also ask the program how well they manage resident work-life balance and duty hours violations. Some programs will imply that they never go over duty hours but in reality manipulate data entries to not violate GME requirements. Another tip I have come to realize, if a program has a Veterans department affiliation, they tend to stuff most prelims are those sites and you will overloaded with scut work/general medicine inpatient constantly. Point is you will be exhausted so please pick a place that values you as an individual and not one that just wants you to be a glorified secretary.

 

[AzBasRad]

Another tip I have come to realize, if a program has a Veterans department affiliation, they tend to stuff most prelims are those sites and you will overloaded with scut work/general medicine inpatient constantly. Point is you will be exhausted so please pick a place that values you as an individual and not one that just wants you to be a glorified secretary.

This!! At my medical school, the prelim interns get the most VA day and nightfloat shifts. The ancillary staff at my university hospital is good-great, but the same cannot be said about VA.

 

[docbsb2015]

Throwin a random plug in for St Vincent TY/prelim in Indianapolis if you want to match in the Midwest. As others have said, intern year is actually important. It was a good year.

 

[Naruhodo]

I really loved one of my prelim interviews. For me personally I think it makes more sense to go categorical (and avoid applying/moving again) but it was reassuring to me that there's "good" prelim spots out there.

 

[Moose A Moose]

It’s one year.
You will be fine.

 

[.Asterion]

I’m at a chill TY program. Best year of my life so far....
choose wisely!

 

[.Asterion]

Feel free to DM if you’re curious where I’m at