You guessed it! Another SOAP-related question/thread?

[Law2Doc]

...
P.S. I'm annoyed at Anesthesia people or RADS that take up Prelim-Med. I feel like it should be reserved for neuro because we actually need it and can't do anything else.

the ROAD specialties need either transitional or prelim years. There aren't enough transitional spots for everyone who wants one, so the cushiest of the prelim spots get the next bunch of these people. Not sure why this is annoying. It's not like the ROAD people who didn't get transitional spots have many other choices. Your real gripe should be with neurology for limiting your options to prelim med.

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[agranulocytosis]

They can take prelim surgery. Hence the discontent.

 

[deleted103644]

They can take prelim surgery. Hence the discontent.

You do not know the meaning of discontent until you've been through a prelim surgery year.


Seriously, if anyone you should be mad at your neuro program for not coordinating a prelim with their medicine department. Or yourself for being a weaker applicant for medicine prelims than those going into rads/anesthesia/etc.


And again, the person complaining admitted they didn't rank all of their prelim programs, so it really is their own fault. You can't blame anyone with an alternative for opting out of prelim surgery - for those not going into surgery it's usually a miserable and uneducational experience.

 

[LouisianaDoctor]

You do not know the meaning of discontent until you've been through a prelim surgery year.

What's the deal with prelim surgery programs? I was never interested in surgery so I never looked into it at all. As I understand, it's a 1 year position with no guarantee that you will get a PGY2 position. So why do it? What does it give you?

I talked to a resident on one of my interviews who did a prelim surgery year before going into a completely unrelated residency. He said at his program there were 3 other prelims, and that one of them quit within the first week, and the others gave up after several months, likely because they just realized it was pointless to finish. ??

 

[deleted103644]

What's the deal with prelim surgery programs? I was never interested in surgery so I never looked into it at all. As I understand, it's a 1 year position with no guarantee that you will get a PGY2 position. So why do it? What does it give you?

I talked to a resident on one of my interviews who did a prelim surgery year before going into a completely unrelated residency. He said at his program there were 3 other prelims, and that one of them quit within the first week, and the others gave up after several months, likely because they just realized it was pointless to finish. ??

Many IMGs go to prelim surgery without an advanced spot because it is all they can get and rightly or wrongly they think it makes them more competitive for subsequent matches.


People going into surgical specialties often need a prelim year, but they are generally treated better in prelim surgery than people going into unrelated fields or IMGs without an advanced slot.


Radiology people sometimes do a surgery prelim if they're really interested in IR, but I have yet to speak to someone who did that who didn't regret it. If you learned anything during the year it could make sense, but most prelim surgery spots are just exploitation of cheap labor with no education (and often no OR time) at all. Again, this is particularly true if you are not going into surgery and do a surgical prelim.

 

[gutonc]

What's the deal with prelim surgery programs? I was never interested in surgery so I never looked into it at all. As I understand, it's a 1 year position with no guarantee that you will get a PGY2 position. So why do it? What does it give you?

I talked to a resident on one of my interviews who did a prelim surgery year before going into a completely unrelated residency. He said at his program there were 3 other prelims, and that one of them quit within the first week, and the others gave up after several months, likely because they just realized it was pointless to finish. ??

There are a number of advanced specialties (Gas, Rads, PMR, Neuro, Derm, Rad Onc) that require a "general" preliminary (PGY1) year. You can get this with a prelim IM or Surg year or a Transitional year (and there are a few, rare prelim Peds and FP spots). With the exception of Neuro, you can fulfill the prelim requirement with any of those specialties (Neuro requires either IM or an IM heavy TY).

Because Prelim Surg spots suck (for the reasons already outlined, there are generally a lot of those spots available in the SOAP/Scramble. Some people who matched advanced positions may not have also matched a prelim, so doing prelim surg is better than losing an advanced spot.

But bottom line, prelim surg is something of a dead end (just like prelim IM is) unless you have an advanced spot lined up. But it's a very painful, miserable dead end.

 

[wannabeOBGYN]

There are a number of advanced specialties (Gas, Rads, PMR, Neuro, Derm, Rad Onc) that require a "general" preliminary (PGY1) year. You can get this with a prelim IM or Surg year or a Transitional year (and there are a few, rare prelim Peds and FP spots). With the exception of Neuro, you can fulfill the prelim requirement with any of those specialties (Neuro requires either IM or an IM heavy TY).

Because Prelim Surg spots suck (for the reasons already outlined, there are generally a lot of those spots available in the SOAP/Scramble. Some people who matched advanced positions may not have also matched a prelim, so doing prelim surg is better than losing an advanced spot.

But bottom line, prelim surg is something of a dead end (just like prelim IM is) unless you have an advanced spot lined up. But it's a very painful, miserable dead end.

There are also prelim OB/GYN spots, which I have also heard are pretty much dead ends.

 

[deleted103644]

There are also prelim OB/GYN spots, which I have also heard are pretty much dead ends.

For those who haven't secured an advanced spot and want OB those are probably better. The ratio of people dropping out of OB to OB prelim only spots is definitely better than for surgery, so PGY2 spots definitely open up.

 

[agranulocytosis]

You do not know the meaning of discontent until you've been through a prelim surgery year.


Seriously, if anyone you should be mad at your neuro program for not coordinating a prelim with their medicine department. Or yourself for being a weaker applicant for medicine prelims than those going into rads/anesthesia/etc.


And again, the person complaining admitted they didn't rank all of their prelim programs, so it really is their own fault. You can't blame anyone with an alternative for opting out of prelim surgery - for those not going into surgery it's usually a miserable and uneducational experience.

Well, seeing as I'm currently a prelim surgery intern, I think I have a bit more say on the matter than you do. Just a little.

Prelim surgery can be very educational for the ROAD specialities, and very useful, too. Anatomy can be more readily visualized for rads, physiology can be better understood for gas, and basic surgical technique perfected for ophtho and derm. Neuro REQUIRES prelim med, the ROAD specialties don't. That's it.

 

[drizzt3117]

Well, seeing as I'm currently a prelim surgery intern, I think I have a bit more say on the matter than you do. Just a little.

Prelim surgery can be very educational for the ROAD specialities, and very useful, too. Anatomy can be more readily visualized for rads, physiology can be better understood for gas, and basic surgical technique perfected for ophtho and derm. Neuro REQUIRES prelim med, the ROAD specialties don't. That's it.

I thought about doing prelim surg and actually initially applied to all prelim surg programs; applied to 3 TYs part way through and ended up matching to a nice TY that will allow me to finish up some research before starting rads. I feel like most ROAD ppl will take a TY if they can get one, and settle for prelim med if they can't, or are geographically limited. While PS might be useful for them, the simple fact is they they're competitive enough to have other options; if neuro ppl aren't competitive, whose fault is that? Don't hate the player, hate the game.

-going into rads and didn't apply to prelim med.

 

[deleted103644]

Well, seeing as I'm currently a prelim surgery intern, I think I have a bit more say on the matter than you do. Just a little.

Prelim surgery can be very educational for the ROAD specialities, and very useful, too. Anatomy can be more readily visualized for rads, physiology can be better understood for gas, and basic surgical technique perfected for ophtho and derm. Neuro REQUIRES prelim med, the ROAD specialties don't. That's it.

I'm being a bit hyperbolic, but what I've said stands. There are a few good preliminary surgery programs out there that provide some educational experience and don't discriminate against prelims.

These are the exception, not the rule. Kudos to you if you're in one.

I'm interested in IR so thought about preliminary surgery at first, but was quickly talked out of it by residents.

 

[Law2Doc]

I'm being a bit hyperbolic, but what I've said stands. There are a few good preliminary surgery programs out there that provide some educational experience and don't discriminate against prelims.

These are the exception, not the rule. Kudos to you if you're in one.

I'm interested in IR so thought about preliminary surgery at first, but was quickly talked out of it by residents.

I think the short answer is this. If you are going into a procedurally oriented advanced program, then yes, a prelim surgery program might be a good learning opportunity. You will put in lines, get very adept at suturing up oozing wounds, get comfortable with post procedural complications, and learn a lot of anatomy from the inside out. HOWEVER it tends to be a very tough year, where you will be working 80 hours a week almost every week, with minimal elective time, lots of ICU, and thus if you can snag a transitional year or cushy prelim medicine year, you do. Programs range from very benign to very malignant, with variable opportunity for prelims to see the OR, so you need to get the word of mouth. But if you ended up with an advanced program and no prelim, it's certainly a lot better than derailing your career.

Now for everyone else a prelim surgery spot is a bit dangerous, as it's often a dead end. I know a couple of people who turned prelim spots into categorical, but they worked exceptional hard, and several others in their years didn't have the same results, ended up wasting a year. For foreign IMGs with inadequate US clinical exposure, I would think a prelim surgery year should satisfy most critics, but haven't met many people who were successful on this route.

 

[Sarcoidosis]

But bottom line, prelim surg is something of a dead end (just like prelim IM is) unless you have an advanced spot lined up. But it's a very painful, miserable dead end.

Oh... so sadly true...

 

[NotAProgDirector]

Prelim IM is not necessarily a dead end. Many PGY-2 spots open up, and prelim IM people often fill them. The same is not as true with GS -- although some PGY-2 spots do open up, nowhere near as many.

 

[wersclubby]

does it mean they're looking to fill spots? are they just curious?

 

[deleted103644]

does it mean they're looking to fill spots? are they just curious?

ERAS != NRMP


Programs may be using it to fill spots outside of the Match and SOAP.

 

[NotAProgDirector]

They may also be downloading updated transcripts from their matched applicants. When I contact the ERAS post office, I get everything waiting for me -- even for applicants whom I've rejected.

 

[wersclubby]

ERAS != NRMP


Programs may be using it to fill spots outside of the Match and SOAP.

This would give some people hope

 

[wersclubby]

They may also be downloading updated transcripts from their matched applicants. When I contact the ERAS post office, I get everything waiting for me -- even for applicants whom I've rejected.

This is what I expected. So, just to clarify, if an applicant applied to a program, and she goes to ERAS to see if the program to which she's applied has been downloading her info recently, just because ERAS indicates that the program downloaded info on 3-22-12, that doesn't mean the program is still looking to fill a spot? But could it mean that?

 

[gutonc]

This is what I expected. So, just to clarify, if an applicant applied to a program, and she goes to ERAS to see if the program to which she's applied has been downloading her info recently, just because ERAS indicates that the program downloaded info on 3-22-12, that doesn't mean the program is still looking to fill a spot?

Correct

But could it mean that?

I suppose. Highly unlikely though.

 

[SouthernSurgeon]

I think the short answer is this. If you are going into a procedurally oriented advanced program, then yes, a prelim surgery program might be a good learning opportunity. You will put in lines, get very adept at suturing up oozing wounds, get comfortable with post procedural complications, and learn a lot of anatomy from the inside out. HOWEVER it tends to be a very tough year, where you will be working 80 hours a week almost every week, with minimal elective time, lots of ICU, and thus if you can snag a transitional year or cushy prelim medicine year, you do. Programs range from very benign to very malignant, with variable opportunity for prelims to see the OR, so you need to get the word of mouth. But if you ended up with an advanced program and no prelim, it's certainly a lot better than derailing your career.

Now for everyone else a prelim surgery spot is a bit dangerous, as it's often a dead end. I know a couple of people who turned prelim spots into categorical, but they worked exceptional hard, and several others in their years didn't have the same results, ended up wasting a year. For foreign IMGs with inadequate US clinical exposure, I would think a prelim surgery year should satisfy most critics, but haven't met many people who were successful on this route.

As a categorical surgery resident who has had colleagues/friends go through the prelim experience, I would say this is a very good summary of the range of experiences seen.