Sep 14, 2014

What Does Being A Preliminary Resident Really Mean?

I am a researcher, probably to a degree that is sometimes unhealthy.   I have spent countless hours over the last 4+ years researching online anything and everything about medical school, board exams, residency applications, and residency in general.  There really is an endless amount of information out there on the web.  But, there is NOT very much information regarding being a preliminary resident.  Granted, this is something I had hoped we wouldn't have to deal with.  But now that it is, it's very disappointing to not find much in the way of guidance online for how to navigate this type of situation.

The main issue as a prelim is that it is only a 1 year guarantee.  At the end of this resident year (July-June), Josh will no longer have a job.  One year as a surgical resident does not allow you to practice on your own, become fully licensed, etc.  In short, it's not a situation anyone wants to be in.  At the same time, it is a slightly better situation than not matching at all and having no job for the past year, no new experience, and no income.

The biggest downside for us is the uncertainty that being a preliminary resident brings.  We still don't know where we will be living after this year.  We still don't know if Josh will get to continue on in his quest to become a surgeon.  We don't know if he will have to repeat his PGY1 year or if he can move forward as a PGY2. There are so many unknowns.

Here are a few of our options as "prelims."

1.  Take and hopefully excel on the ABSITE (American Board of Surgery In-Training Examination) and wait for any PGY2 categorical spots that come available across the nation.  Apply to these programs with the backing of his current PD (program director) and hope you can secure a second year spot meaning you have wasted no time. (This is our first choice.)

2.  Reapply to the 2015 Match in General Surgery (because it was oh so fun the first time around).   We are hopeful that with some new experience as a resident, brand new letters from current attendings, an updated CV and Personal Statement, and an ECFMG certification, Josh will be granted more interviews and hopefully match into a PGY1 categorical surgery spot.  He would be repeating his intern year but would have a full residency. (We are doing this.)

** The problem with the above options is that it is likely that many PGY2 open positions will not become available until after the ABSITE scores are in, which is after Rank Order Lists are due for the 2015 Match.  If you enter the Match and do in fact match to a PGY1 spot, that match is a binding contract.  You would then be unable to accept a PGY2 position if one were offered to you.  We plan to see how interview season goes.  If Josh interviews at some programs that seem like a good fit, we would likely move forward ranking programs for the Match and not put all of our eggs into the PGY2 basket.

3. Apply to and take a PGY2 preliminary surgery position.  This is a second year spot, but again is still preliminary leaving us in a similar situation next year as we are in this year.  After a PGY2 prelim year, Josh would be able to apply to PGY3 positions that are available and hopefully secure one.  But again, this is not a guarantee and therefore our last choice.  (We will consider doing this come the Spring if nothing else pans out.)

4.  Reapply to the 2015 Match for a spot in something other than Gen Surg.  For example, Family Medicine, Internal Medicine, or Anesthesia which he is more likely to get.  Match into one of these and be happy we have a job, even if it's not initially what Josh thinks he wants to do. (We are NOT doing this.)  At least not this year.

**Josh and I have discussed it a lot and together we have decided that we are not ready for him to give up on his dream of being a surgeon.  While he could likely match into one of these specialties, doing so would close the door on surgery and we both feel that there are too many other viable options, even with extra years, that would still allow him to pursue a successful surgical career.  IF after this year, he becomes a PGY2 prelim we would likely then decide to apply to some of these specialities for the 2016 Match.  We sure hope we don't get to that point.

As I'm sure you can tell, it is a stressful time with lots of possibilities hanging in the balance.  However, this atmosphere is almost becoming "normal" around here.  Applications are open to be submitted tomorrow for the 2015 Match.  We have been finalizing Josh's application all weekend and are maintaining faith that our outcome will be different this year.  We also wish so many of our friends who are doing this for the first and hopefully only time, a successful Match season.

May the Match be ever in your favor.


  1. Hi Stephanie, my name is Claire, a non-US IMG preparing for USMLE. I am a primary care physician in my home country. Working in the US as a doctor had been my dream since before I applied to medical school, however I could not afford to go to US medical school. I found your blog and was literally reading your blog about Dr Scurlock's matching process, with growing palpitations and nausea. I have known of course how tough it is for IMGs to get matched, and it has been getting worse each year. Needless to say, his credentials looked really good and having read that despite all of that he still had a hard time, made my stomach lurch. I want to apply to primary care, IM or FM, not because I settle, but because I simply love primary care medicine. I admit, now I feel pretty discouraged, but I will try my best and leave God the rest. All in all, what is important is being able to practice medicine, and that is what I am going to do. I wish you and your husband best of luck for your following plans. Looking forward for the next update!

    1. Thanks so much Claire! I appreciate you reading my blog. Yes, It is a bit hard to read a story like ours in your position I'm sure, but I hope the fact that up until this point, we have had success gives you some sort of encouragement. Good luck to you in your future career ventures!

  2. I believe you cannot repeat gen, surgery PGY-1, so if applying to gen. surg, it will be either as a categorical or a prelim PGY-2. Good luck

    1. Yes he is applying as PGY-1 Categorical for the 2015 Match. He had interviews and hopes to match. It is possible to repeat your PGY1 year.

  3. Hi ! Your story is very inspiring and i wish your husband,all the very best for his future.I just have a quick question,and would be extremely grateful if you could answer that.I wanted to know,what did your husband mention as a reason to choose the preliminary program, in the personal statements ?

  4. So what happened this Match day? Was he able to secure a PGY1 categorical or PGY2 prelim? Really hope it worked out!

    1. He Matched! Into a categorical gen surg program. :)

  5. Hi Stephanie ...
    this blog is AWESOME .
    I'm like ur husband an IMG who wants to pursue a career in surgery in the US , grad 2013 , did my steps , and planing on applying next September.
    I've some Qs for u ...
    - after matching prelim , from what I understand , u went with ur second option and applied for the next year match , in that process , to how many programs did u apply , what was the split in ur application ( cat PGY 1 , cat PGY 2 , prelim PGY 2 ... ) , and is it possible after doing a year of prelim to reapply the next year for a cat PGY 1 ?


  6. This all a resident student be clear with. Every residency student should know this how their whole journey is going to be. Thanks for sharing it.

  7. The medical school personal statement is just one part of your entire medical school application. Your GPA, MCAT, extracurricular activities, letters of recommendation and interview make up the rest. family medicine residency personal statement

  8. These days, the decision to attend graduate school is becoming more and more of a necessity to differentiate yourself within the career marketplace. However, many prospective applicants underestimate the importance of the personal statement in the graduate admissions process. personal statement internal medicine

  9. Hello again Stephanie ...

    As I said before your husband story has been an inspiration.
    Do you think he can help me in securing an interview at his program ?
    I am a coalfield IMG applicant with scores in the 250s in both steps, with research and surgical experience.
    I applied to his distinguished program, if you want I can send you my AAMC ID number and a brief CV.

    Thank you in advance

  10. Stephanie -

    Thank you so much for posting this. My fiancee and I have found ourselves in the exact same situation this year and have waded through all of the confusion and disappointment to arrive at the same options, with the same hope for the future. Thank you for sharing, and proving that it is, in fact, possible to make it through this prelim year and match next year. Hopefully I'll be able to sleep for the first time since the dreaded "You didn't match" email!


  11. It’s a great post, thank you so much! Such an inspiring story! Applying for a school is always a stressful process. Not only do you need to come up with an original and compelling prelim surgery personal statement, but also prepare all other essential application documents. Besides, your GTA, MCAT, activities outside school, and so on really matter. Getting entered on such a program is rewarding and perspective, so candidates should do whatever it takes to make their dreams come true. Application equals stress, headaches, sometimes even tears. But it’s a chance to get a great career and do what you’re passionate about. Best of the luck to all applicants!