Matched prelim surgery, wanted categorical.

The secure live connection into the operating room
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
S

surgeryMD

New Member
5+ Year Member
Joined
Mar 13, 2017
Messages
2
Reaction score
0
About me: U.S. allopathic MD4, step 1 209, step 2 214.
Goal: categorical general surgery in California.
Situation: I matched into a prelim general surgery spot, likely not in California.

Question: When do I apply for PGY-2? Do I re-register for the match? Can I opt out of the match and apply using APDS?

Since I'd like to end up in California, would it be easier for me to end up there if I applied for a prelim year 2 in Cali? Would it be stupid to deny a categorical position at the program I'll be completing my PGY-1 if offered? or is the attrition rate in general surgery high enough for me to be able to comfortably take that risk?

Feel free to tell me if my thoughts are stupid, but if you take the liberty to do so, please explain your thought process. Thank you.
Members don't see this ad.
 
surgeryMD said:
About me: U.S. allopathic MD4, step 1 209, step 2 214.
Goal: categorical general surgery in California.
Situation: I matched into a prelim general surgery spot, likely not in California.

Question: When do I apply for PGY-2? Do I re-register for the match? Can I opt out of the match and apply using APDS?

Since I'd like to end up in California, would it be easier for me to end up there if I applied for a prelim year 2 in Cali? Would it be stupid to deny a categorical position at the program I'll be completing my PGY-1 if offered? or is the attrition rate in general surgery high enough for me to be able to comfortably take that risk?

Feel free to tell me if my thoughts are stupid, but if you take the liberty to do so, please explain your thought process. Thank you.
Click to expand...

If you are offered a categorical position and you want to be a surgeon, take it. You can always move to California later.
 
  • Like
Reactions: 12 users
surgeryMD said:
About me: U.S. allopathic MD4, step 1 209, step 2 214.
Goal: categorical general surgery in California.
Situation: I matched into a prelim general surgery spot, likely not in California.

Question: When do I apply for PGY-2? Do I re-register for the match? Can I opt out of the match and apply using APDS?

Since I'd like to end up in California, would it be easier for me to end up there if I applied for a prelim year 2 in Cali? Would it be stupid to deny a categorical position at the program I'll be completing my PGY-1 if offered? or is the attrition rate in general surgery high enough for me to be able to comfortably take that risk?

Feel free to tell me if my thoughts are stupid, but if you take the liberty to do so, please explain your thought process. Thank you.
Click to expand...


YES it would be stupid to pass up a categorical spot for the sake of geography in residency. getting a categorical spot as a prelim is not a cakewalk. I've been there myself. so if you are fortunate enough to be offered a spot in your home program (and thats a big IF) it would be foolish not to take it.
 
  • Like
Reactions: 3 users
Members don't see this ad :)
surgeryMD said:
About me: U.S. allopathic MD4, step 1 209, step 2 214.
Goal: categorical general surgery in California.
Situation: I matched into a prelim general surgery spot, likely not in California.

Question: When do I apply for PGY-2?
Click to expand...

Just like last year, in September when applications open.

Do I re-register for the match?
Click to expand...

Yes.

Can I opt out of the match and apply using APDS?
Click to expand...

You could but why would you? You apply for the match, and look for positions anywhere you can find them, including APDS. Of course, if you match you cannot take another position, or if you take a position outside of the match you must drop out of the match.

Since I'd like to end up in California, would it be easier for me to end up there if I applied for a prelim year 2 in Cali? Would it be stupid to deny a categorical position at the program I'll be completing my PGY-1 if offered? or is the attrition rate in general surgery high enough for me to be able to comfortably take that risk?

Feel free to tell me if my thoughts are stupid, but if you take the liberty to do so, please explain your thought process. Thank you.
Click to expand...

You are being stupid. Remember the oft quoted attrition rate is not 20% per class but across all years.

California's not going anywhere. Take any categorical position offered to you, regardless of location.
 
  • Like
Reactions: 2 users
Goal: categorical general surgery in California.

very unrealistic.

With your scores I would cast an extraordinarily wide net and take whatever you get.
Register for the match again, knowing its a PGY1 match, while looking for PGY2 posistions throughout next year.

good luck. lots of spots open up
 
  • Like
Reactions: 5 users
surgeryMD said:
About me: U.S. allopathic MD4, step 1 209, step 2 214.
Goal: categorical general surgery in California.
Situation: I matched into a prelim general surgery spot, likely not in California.

Question: When do I apply for PGY-2? Do I re-register for the match? Can I opt out of the match and apply using APDS?

Since I'd like to end up in California, would it be easier for me to end up there if I applied for a prelim year 2 in Cali? Would it be stupid to deny a categorical position at the program I'll be completing my PGY-1 if offered? or is the attrition rate in general surgery high enough for me to be able to comfortably take that risk?

Feel free to tell me if my thoughts are stupid, but if you take the liberty to do so, please explain your thought process. Thank you.
Click to expand...


Hi,
I have a silly question. I also applied to both categorical and prelim positions. How did you know that you matched into prelim and not categorical? Did they specify it for you? For me, it just says that 'you have matched'
Thanks.
 
  • Like
Reactions: 1 user
Unforgettable said:
Hi,
I have a silly question. I also applied to both categorical and prelim positions. How did you know that you matched into prelim and not categorical? Did they specify it for you? For me, it just says that 'you have matched'
Thanks.
Click to expand...
Then you have matched to a categorical spot.
 
  • Like
Reactions: 1 user
surgeryMD said:
About me: U.S. allopathic MD4, step 1 209, step 2 214.
Goal: categorical general surgery in California.
Situation: I matched into a prelim general surgery spot, likely not in California.

Question: When do I apply for PGY-2? Do I re-register for the match? Can I opt out of the match and apply using APDS?

Since I'd like to end up in California, would it be easier for me to end up there if I applied for a prelim year 2 in Cali? Would it be stupid to deny a categorical position at the program I'll be completing my PGY-1 if offered? or is the attrition rate in general surgery high enough for me to be able to comfortably take that risk?

Feel free to tell me if my thoughts are stupid, but if you take the liberty to do so, please explain your thought process. Thank you.
Click to expand...

I don't mean to be harsh, but you need to take geography right out of the equation with your stats (assuming you truly want to be a surgeon and aren't willing to apply to a less competitive field). You need to apply widely (both geographically and in terms of prestige) the second time around, and work HARD to be considered for a categorical spot at whatever program you matched. General surgery has gotten ridiculously competitive over the past decade.... I was reviewing applications for our program this year (and we are NOT a top 20 program by any stretch) and realizing that there is no way I would have matched were I applying this year.

I lived in many places I wouldn't have necessarily chosen during training, and not all were bad experiences (actually, one of the least geographically appealing places I lived, ended up influencing where I chose to practice). Don't limit yourself.
 
  • Like
Reactions: 4 users
I don't wanna make a new thread but im in a similar boat. 240+ step 1 and 2, 1st quartile, and I have to SOAP into a prelim spot tomorrow. A bunch of programs said one of my letters said I was interested in integrated plastics, and unfortunately, when I told the writer that I ended up switching last minute this fall, it didn't get translated well into that letter. My application didn't help as it was definitely geared towards plastics for the first 3 years. Even when talking to programs today, some PDs were like "your letters are good, but one of them was interesting", so I'm assuming that's what did me in.

What's the best way to get myself to land a categorical spot next cycle? I know I have to hit the ground running next year, be a team player, etc. but is there anything else? My home institution PD said he would take me for a prelim and then there are no guarantees after that but my working hard can help me potentially get a categorical here.

I know I'm gonna get looked at differently next cycle, and im wondering if my chances of landing a great fellowship/good career path are out the door because of this/having to go to a smaller community place for a categorical spot.
 
Last edited:
  • Like
Reactions: 1 user
just to clarify something mentioned above....APDS is not an application service but a website where programs post their open spots. you would then directly contact the program. keep in mind that PGY 2 categorical spots are super tough to come by in this manner. much more likely to find a pgy3-4 which won't help much coming out of a prelim year internship
 
What do people typically end up doing in these situations? Are PGY1 Prelims treated equivalently to US Seniors in the regular match for interviews? Basically, is Prelim surg a dead-end position or are there viable options for categorical GS after?
 
Hemorrage said:
What do people typically end up doing in these situations? Are PGY1 Prelims treated equivalently to US Seniors in the regular match for interviews? Basically, is Prelim surg a dead-end position or are there viable options for categorical GS after?
Click to expand...

So here's the routes from prelim 1 you could do - from most common to least common IMHO. I see all of this happen from time to time. #1 happens every year:

1. Apply to the match again for a PGY-1 and (rarely a PGY-2?) surgery spot
2. Arrange a PGY1, PGY2, or research resident spot outside of the match. Ie. new program back-fills, spot opens up b/c someone quits your home program takes you.
3. Swing a detour and match/SOAP into another discipline that accepts surgery prelim year (ie. radiology, anesthesia, etc)
4. Quit medicine and never match into anything ever again.
 
Members don't see this ad :)
caffeinemia said:
So here's the routes from prelim 1 you could do - from most common to least common IMHO. I see all of this happen from time to time. #1 happens every year:

1. Apply to the match again for a PGY-1 and (rarely a PGY-2?) surgery spot
2. Arrange a PGY1, PGY2, or research resident spot outside of the match. Ie. new program back-fills, spot opens up b/c someone quits your home program takes you.
3. Swing a detour and match/SOAP into another discipline that accepts surgery prelim year (ie. radiology, anesthesia, etc)
4. Quit medicine and never match into anything ever again.
Click to expand...

So its safe to say it's fairly difficult to get a PGY2 GS spot even through the regular match as a US graduate (PGY1 intern)?
 
Hemorrage said:
What do people typically end up doing in these situations? Are PGY1 Prelims treated equivalently to US Seniors in the regular match for interviews? Basically, is Prelim surg a dead-end position or are there viable options for categorical GS after?
Click to expand...
About 40% of non-designated preliminary general surgery residents obtain categorical general surgery positions (either after 1 or 2 Prelim years), 40% categorical positions in other fields and 20% failed to obtain a residency position right after finishing Prelim GS (but may have later - a certain percentage do after doing a fellowship or research, but I cannot remember the number; its not large).

PGY1 or physicians are not treated the same or equivalent in the match; your greatest success in matching is as a US Senior. Each year you fail to match decreases your chances that you will ever match.

Preliminary surgery is not always a dead end but it is certainly a difficult road to travel. The most successful NDP candidates who transition to a categorical GS position tend to be those who applied for surgical subspecialties but didn't match; they tend to be very hard working and bright. This is your competition in many cases. Its also difficult because essentially you are on audition for an entire year. A very difficult year with a steep learning curve.

Your options are:

1) apply for a PGY-1 position through the NRMP while you are an intern; this is the most common route to success. Yep, that means repeating your internship year. It will be difficult to take time off for interviews so you will need to talk with the administrative Chief about the vacation/rotation schedule to allow you to have time for interviews. They will not be as generous with your time off as your medical school and you will only have a couple of months of rotations to impress for new LORs.

2) get a PGY-2 Categorical position where you are a PGY-1 NDP. Holy grail (of course assuming you like it there).

3) get a PGY-1 Categorical position where you are a PGY-1 NDP. Yep, that means repeating your internship year.

4) find another PGY-1 or 2 categorical position outside the match; word of mouth, the APDS website, etc. People do quit - IMHO it tends to be the 2nd month, around December/January when the winter blahs hit and internship seems unending and of course, around April when contracts are not renewed

5) they offer you a Prelim PGY-2 position; this might translate into something, it means they like you enough to keep you around. Or it might mean they figure its easier to keep you for another year, an extra body on the call schedule, than it is to let you go and start with someone new. You have to go with the gut on this one.

Your best advice is that even if your prelim program tells you they will give you a Categorical position, you still enroll in the match and stay in the match until you see a contract from them.
 
  • Like
Reactions: 8 users
Thank you all so much for the great responses. This is going to be really helpful for me in the upcoming months.

I have another question. If I did 2 prelim years and failed to get a categorical spot, do I say goodbye to a surgical career? Do I re-enter the match and do another specialty? How would I go about getting letters of recommendation from other fields (e.g. family med) if I haven't done a rotation with them? Can I schedule a rotation after 2 years of general surgery?

Thank you!
 
surgeryMD said:
Thank you all so much for the great responses. This is going to be really helpful for me in the upcoming months.

I have another question. If I did 2 prelim years and failed to get a categorical spot, do I say goodbye to a surgical career?
Click to expand...

Yes most likely.


Do I re-enter the match and do another specialty?
Click to expand...
Yes, it's no different than in my response above. You either re-enter the match looking for an advanced position that will take your preliminary surgery years, reenter the match for a PGY 1 categorical program in another specialty or you look for a position outside of the match. Sometimes you will find open advanced positions where they matched candidate either change their mind or wasn't eligible to take that position.

How would I go about getting letters of recommendation from other fields (e.g. family med) if I haven't done a rotation with them? Can I schedule a rotation after 2 years of general surgery?
Click to expand...

Tuypically you don't/can't.

What happens is your surgical program director will write a letter saying that you're a great resident but you're just not cut out for a surgical career or you had a change of heart etc.

There is very little elective time built into a surgical residency. however, if near the end of your second year it becomes clear that they are not keeping you or you have no other options they may allow you to take some elective time.

There's no way to definitively answer these questiobs at this point in time because it's going to depend on so many unknown factors.
 
  • Like
Reactions: 6 users
surgeryMD said:
Feel free to tell me if my thoughts are stupid, but if you take the liberty to do so, please explain your thought process. Thank you.
Click to expand...
Your thoughts are insanely stupid. **** California, man, pull your head out of your rear end. If you get offered a Catty, you need to take it, whether its at UCLA or in Bumble****, Montana.

(Was only mean B/C OP said I could be)
 
  • Like
Reactions: 1 user
quickfeet said:
Your thoughts are insanely stupid. **** California, man, pull your head out of your rear end. If you get offered a Catty, you need to take it, whether its at UCLA or in Bumble****, Montana.

(Was only mean B/C OP said I could be)
Click to expand...
Jajajajaja i think you had some anger repressed inside you
 
Pompacil said:
In going to believe that you read that post you quoted back in March, and it took you eight months to come up with that sick burn until proven otherwise.
Click to expand...
i really dont care to much about what someone in a internet forum think. In any case i was just doing my research about the topic because i have had much more prelim interviews than advanced (mostly medicine prelims).
 
knosway14 said:
i really dont care to much about what someone in a internet forum think. In any case i was just doing my research about the topic because i have had much more prelim interviews than advanced (mostly medicine prelims).
Click to expand...

Why would a prehealth student worry about residency interviews?
 
ThoracicGuy said:
Why would a prehealth student worry about residency interviews?
Click to expand...
im a FMG... graduated on 2014 december... i dont remenber why a filled that category years ago when i sing up for SDN forum but thats also "mehhh"
 
knosway14 said:
i really dont care to much about what someone in a internet forum think. In any case i was just doing my research about the topic because i have had much more prelim interviews than advanced (mostly medicine prelims).
Click to expand...

I'm just giving you a hard time. This has been an inactive thread since match day.
 
knosway14 said:
im a FMG... graduated on 2014 december... i dont remenber why a filled that category years ago when i sing up for SDN forum but thats also "mehhh"
Click to expand...
Its not "mehh".

Surely you understand that surgeons are likely to pay attention to detail and small details sometimes matter. Such as here: when you present yourself as something you're not, it makes it hard to offer advice or evaluate the advice you offer. Its pretty easy to change your status so I (and others) are not sure why you wouldn't.
 
  • Like
Reactions: 1 user
knosway14 said:
im a FMG... graduated on 2014 december... i dont remenber why a filled that category years ago when i sing up for SDN forum but thats also "mehhh"
Click to expand...

It would be worthwhile to fix your status. I'll give different advice as it would pertain to a premed vs med student vs resident.
 
  • Like
Reactions: 1 user
You must log in or register to reply here.
Next unread thread

Similar threads

SoleScholar
General surgery vs podiatric surgery
Replies
3
Views
1K
RM38
R
M
Vascular Surgery Fellowship Match (5+2) 2024-2025 Thread
Replies
2
Views
1K
Helpful Troll
H
voodooheparinchild
Vascular Surgery Fellowship Match (5+2) 2023-2024
Replies
1
Views
4K
Coleworld16
C
R
FM PGY2 swap to GS
Replies
4
Views
830
Apollyon
A
H
MS4 applying CT surgery
Replies
9
Views
3K
harrdworrk
H
Top