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 Preliminary Surgery, is it worth it?  

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i would like to know your opinions guys about this. I applied to surgery to categ and prelim positions but so far, i only have 2 ivs for preliminary. Categ would be perfect, of course but life is simply like this.

If i get a spot in prelim surgery in the match, what are my chances to get a PGY2 the next year?
is it easy or difficult to get a PGY2? in that case, now do they offer a categ position from PGY2 to PGY5?
is there a chance to not get a PGY2 ? what happen s with those people?
i'm talking about IMGs only. AMGs is always a different story.

i hope you understand my point.

another related question could be: what are the advantages and DISADVANTAGES of a prelim surg position?

THANK YOU ALL OF YOU GUYS WHO WILL ANSWER AND SHARE YOUR OPINIONS. I know this question has been made a couple of times but i don't have a very clear idea about it and i need to have it as soon as possible.


hi chem,

i'm in the same boat man. the way i see it. if you have applied to anything other than surgery and wouldn't mind doing that specialty, choose that instead!
now...if you're really dedicated to be a surgeon, its a whole different story.
despite being a u.s. img, graduating and working in europe for 3yrs in surgery, its still not enough to get enough categorical invites.
which american programs...'there's no training other than u.s. training'.
let's say if you don't take prelim, and reapply next year, do you realistically think you'll have a better chance at obtaining categorical interviews (keeping in mind the increasing competitiveness. and all UK graduates who are jobless).
1 year of prelim will give you 1 year of USCE, as a resident! (as compared to student clerkship or observership). So, even if you have to reapply for the match, the odds are much better.
Getting PGY2 depends on if anyone drops out. but you should also know there will be other non-designated prelims in the program with you who are competing for the same. Unfortunately, this will be an unhealthy environment to work in. You can also reapply to PGY2 programs in other insititutions. I personally feel obtaining a PGY2 position elsewhere depends on you working your ass off in the first year (twice as hard as the categoricals), and furthermore getting a recommendation from an influential person. I think this would be optimized if you obtain a prelim at a very competitive program, or well respected program, with well known and well-published attending surgeons.
If, you are unable to even obtain that, the program sometimes provides a pgy2 prelim year at their program or a pgy2 prelim in another place. If you still cannot do that, you maybe be able to do 1 or 2 years of surgical research (paid hopefully, which is easier if you are a U.S. citizen or greencard holder).
After 1 year of prelim surg, and 1 or 2 yrs of research that is unpaid (the worst case scenario, which hopefully shall never happen to any of us), if you don't get a categorical PGY2 its a sign from higher powers to leave surgery and you are destined for something better!
Keep the hope high my friend. We're all in the same boat. Surgeons love dedication and love for surgery. All you need is one shot. Take the prelim and work as you have never worked before. Be first person to preround, know your patients better than anyone else, be a 'yes' person, first person who willingly does all scutwork to pick up slack. Be the prelim who doesn' t mind missing cases in theatre, but just gets all the work done happily. They are testing your patience, character, and persevance. Hard work goes far in surgery, and this my friend is universal.


I guess a million posts could nt ve said what surg has done here in 1 .......
When the going gets tough , the tough get going . keep up the spirits guys!!!!


i appreciate your detailed answer surg. if you're able to get a PGY2, is it usually a categ from 2nd to 5th year?

any other opinions/further discussion is welcome

i understand surg, i don't think i'll have a better chance next year, i need a visa too, so it's not easy. I'm ready to work hard, i'm eager to do it but i just don't want to end my 1st year and then, dont have anything again, like now, and again apply to the match and maybe not get a spot, that was/is my fear with this kind of position. But thank you again. it's pretty useful info.


csdude X2 nod


Well guys, this is exactly the question that has been in my mind last moths...

and... as surg has said, there are different escenarios after prelim PGY1, which the best one seems to be obtaining a Cat spot after 1 prelim year.

However, my question in this regard would be:
Is it possible to repeat PGY1 after the prel PGY1 on a J1/H1 VISA status?

Thanks in advancecool


i think you can't repeat Pgy1 in the same speciality, you aren't allowed to. That's what i know. Let's wait for more opinions.


yeah.. this is what i thought...

Anyway... lets see if we get a cat spot.

Wish you a Nice Weekend!!!grin


you too.
keep in touch master


hi guys,
i'm not sure about the visa issues. my best advice, arranged marriage to a desi girl with green card or u.s. citizenship...haha. i'm assuming we're all desi here.
on a more serious note, i wasn't aware that one couldn't reapply to same specialty, that's strange! why should it matter what specialty you apply too?! your best bet would be to contact the programs you have prelim interviews at.
furthermore, we should ask our interviewers the outcome of most of their prelims.
i can't speak for everyone, but I know for a fact that all the graduates from my med school who took prelim at big places eventually stayed on a categorical at the same or a different program.
theoretically speaking, a prelim at a medium ranking place isn't a bad idea either. i would expect a higher amg dropout rate at those programs. We shouldn't deflate our ego if we end up as prelims.
During one of my student clerkships at a big program (4 yrs ago), one of the prelim pgy1's was a guy who dropped out after 2 years of internal medicine at the same hospital! despite 2 years of IM at the same hospital, they still didn't give him categorical surgery. I think in a super competitive surgical environment that we face nowadays, we should be thankful if we get a chance to do prelim surg. We tend to forget that there's a huge difference between a surgeon and a physician. I've been working as a surgical resident in a foreign country, but, the responsibility we take as surgeons is unsurpassed by any other specialty. period.
Its understandable why the U.S. program directors prefer to give us a test run, if you know what I mean. They need to see that we are hard working and trustworthy in their system, where litigation and lawsuits are rampant!


good point surg.


hey everyone...
really informatiive posts..spec by surg...
i too..would like to know about the visa issue..
isnt it tru that prelim surg only offer ji...and that u cant repeat pgy1 in th same spec ..?? which puts fellowship oppurtunities(assuming u want to stay on) pretty much at zero..??


i don't know that about the visa, anyone?
prelim surg =J1 always???


"you can't repeat PGY1 in the same speciality". about this: that's what i've heard from many people, so, in consequence, that's what i know BUT i don't have any official information.


thanx chem...
i think someone mentioned it a while bac..some rule from the ecfmg or something..but i tried looking it up and couldnt find it...
anyone....plz...tell about the prelim surg= j1 ? issue...


If you go on J-visa, you shoud go for J-visa again.

After one year Prelim, there is more chance to get a spot in sugery, but it could be a prelim again, coz some prgrams don't accept prelim from another progam.


bottom line: it's possible but you have to work hard and even harder and harder, and that could last a couple of years.

Once you've tasted the joys and passion for surgery, you'd like to continue doing it...


folks, i had come up with the issue thats been discussed early this month and had post it in the mega thread forum but the discussion didnt catch up much and my search ended up with same note as its here.

just to summarise my questions and the answers that i got (as it iwll answer some here too)

1- chances of cat after prelim? 20% (as quoted from a 3rd cat IMG resident currently on j1 visa) this guy took prelim j1, then the same prog offered him prelim pgy2 and luckily the 3rd year that program took him into categorical the best part being directly into 3rd yr categorical position, he didnt have to repeat 1 and 2 again...i asked him what was his backup, he said nothing, he was prepared to go back...on one hand very commendable dedication but on other hand very veyr risky...

2 so whtas the risk...the risk is if you take prelim on j1, and dont get cat/prelim/seat in any other field, you need to go back due to J1 visa 2yr HRR (not with H1 where you can probably change to student visa) so its very very risky to take prelim on a j1 visa (as if we have a choice!!!)...i would really appreciate if someone can find whether its possible to change from j1 to f1 (student visa) without completing 2yr hrr...a prelim j1 surg resident said to me its possible however i doubt as j1 is non transferrable without finishing 2yr hrr...

3 you can change from prelim j1 to research j1 if you dont get cat/pgy2 prelim/any other program seat however thts a one-way path, (as heard from someone who is currently working on her j1 waiver job, she has been thru all this with lawyer and knows thats its one way path) meaning once you go from clinical J1 to research j1, you cannot come back to clinical...i would really appreciate if someone can confirm on this too.

4 as surg suggested, marrying citizen and getting green card ofcourse is helpful but now its probably too late to start finding one......haha..this point was funny but i m putting all possibilities out in the quest for the "surg resident" title

5 taking prelim is ofcourse advantageous compared to spending a year doing observserships said earlier, it will give USCE.

6 now the most imp question- whether we can repeat PGY1 prelim or not? guys i have tried to find answer to this thru whatever sources i had and got mixed response...2 prelim j1 residents told me you cannot repeat, the rule says residency cannot have repettion....however a friend (who is also applying for surg this year llike us all) told his friend's friend is repeating prelim surg PGY1 again so its possible...someone told me its possible ifyou show that the rotations are different.......i wonder how thats possible, you obviously do gen surg, trauma etc rotation no matter what prog you join again...I spoke with NRMP and also have their emails which said we can reapply for Prelim PGY1 and repeat it, basically its all to the discretion of the program, however after doing pgy1 prelim twice often the prog mightbe reluctant to offer categorical as their funding is at stake, for each seat they get funding from US govt would reduce the percentage of funding for a seat if its for someone who is already trained for that progs are reluctant to hire someoen who is already trained in USA...however in the end if the progs wants to, it can always hire you, no rule stops it from doing so...

good luck to everybody.


chemamr wrote:
i don't know that about the visa, anyone?
prelim surg =J1 always???

no prelim surg is not always j1, you can get h1 too..


if u marry someone with GC or citizen and u r on j1, u still have to go back for 2 years unless u show extreme hardship which is rare.

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