If you are applying to residency in the US through the NRMP match program, you may be confused about the different types of programs offered. This may be especially confusing for international medical graduates (known as IMGs), who may not be familiar with the US training pathways for physicians.
Categorical vs Preliminary (vs Transitional Year programs)
Most U.S. medical students are looking to match into what is known as a categorical position for residency training in a given specialty during their final year in medical school. A “categorical” position is one which offers full residency training required for board certification in a particular specialty.
That is different than a “preliminary” position, which usually is one year of training prior to entry into advanced specialty programs. Many internal medicine and surgery training programs offer preliminary positions in addition to categorical positions.
What is a transitional year program?
Transitional programs can be thought of as a sampling of many disciplines. Trainees rotate through medical and surgical rotations, including oncology, pulmonology, anesthesiology, dermatology, radiology, rheumatology, neurology, infectious diseases, obstetrics/gynecology, and ophthalmology. Transitional years are for specialties where a thorough understanding of basic pathophysiology and procedures is needed.
Transitional year programs are also considered preliminary year training programs, which are a stepping stone to categorical positions.
Are some advanced programs coupled with preliminary year programs?
Trainees can complete their intern year and residency at the same institution in some situations. These programs may be applied to together. Consequently, applicants don’t have to secure an intern year separately from their residency. Instead, their program offers the full training necessary to acquire board certification in that particular discipline. Popular residencies with many categorical programs include internal medicine, psychiatry, pediatrics, emergency medicine, family medicine, anesthesiology, and OB/GYN.
Related: A Guide to Residency Program Signaling (Should You Use Them?)
What is an advanced (PGY-2) residency?
Advanced residencies are the residencies in non-categorical programs after completing an intern year. Applicants apply for both their intern year and advanced residency simultaneously but separately. As a result, the application fees and interview trail costs can double! Advanced (PGY-2) positions are often for the most competitive fields, such as dermatology, ophthalmology, radiology, radiation oncology, etc.
What if I don’t match into an advanced program?
When a student is applying to an advanced program and doesn’t match, they may still be able to match into a prelim year program. They can impress people there and stay in a categorical program after! A great intern might even improve their chances to match at the same institution for an advanced residency spot, but there needs to be a spot open for them.
How do I apply to preliminary, categorical or advanced year residency positions?
Most applications for residency positions are transmitted by using the AAMC’s Electronic Residency Application Service (ERAS®). Visit the ERAS website for information about the application process. (nrmp.org)
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