IU School of Medicine Preliminary Match Primer

Which advanced residency training pathways require a preliminary training year?

The following training pathways require completion of a preliminary training year prior to starting advanced residency training: Anesthesiology, Dermatology, Diagnostic Radiology, Interventional Radiology, Neurology, Ophthalmology, Physical Medicine & Rehabilitation, and Radiation Oncology.

What is the difference between preliminary, advanced, and categorical residency positions?

  • A preliminary position is a PGY-1 position that is unattached to an advanced residency program.
  • An advanced position is a PGY-2 position that is unattached to a preliminary position.
  • A categorical position is a PGY-2 advanced position that includes a PGY-1 preliminaryposition (one categorical position matches for both the preliminary and the advanced residency training years).
  • To matriculate into an advanced position, one must complete a preliminary year, whether that is a separate preliminary position or as a combined categorical position.
  • Many advanced residencies offer both advanced and categorical positions.

What preliminary position training pathways exist?

Graduates must choose to train in one of the following approved preliminary training pathways (though some advanced residencies may prefer a given pathway): Medicine-Preliminary, OB/GYN-Preliminary, Surgery-Preliminary, Transitional Year.

How competitive is the match for preliminary positions?

Very competitive! A high demand for PGY-1 preliminary positions exists in the US. While most are aware of the highly competitive nature of advanced residency positions, such as Diagnostic Radiology and Ophthalmology, many fail to recognize the competition inherent in the match for preliminary positions. Potential trainees for all advanced residency disciplines are vying for the same preliminary training positions! Add in non-US graduates and graduates who are applying for a second match cycle, and one can start to appreciate the vast competition for preliminary positions. Even applicants who successfully match into advanced residency positions cannot begin training without completing a preliminary training year – prioritizing the preliminary match is important! As an example, for Transitional Year positions alone, the average applicant matching into a Transitional Year position in 2017 ranked an average of 6.4 programs according to NRMP data.

I’m an Ophthalmology applicant using the San Francisco Match – do I also need to apply for a preliminary training year through the NRMP Main Match?

Yes! Ophthalmology applicants must separately apply for and learn to navigate the NRMP match, as well as the San Francisco Match.

What preliminary positions are available through the NRMP Main Match?

In the 2017 NRMP Main Match, 4,171 preliminary residency positions were offered. However, not all preliminary residency positions are offered through the NRMP Main Match (see the following paragraph). Using data published by both the National Residency Matching Program (NRMP) and the San Francisco Match (SFM), Table 1 below depicts 2017 preliminary position data for both the US and Indiana. The total number of PGY-2 positions published does not distinguish between advanced and categorical positions. Indiana has an above-average number of Transitional Year positions and a below-average number of other preliminary year positions in the Match.

Table 1. 2017 preliminary year position data.

2017 preliminary match info
2017 preliminary match info

 

These numbers can be misleading – they only tell part of the story. First, categorical positions are not typically included in the reported total number of preliminary positions. This is because categorical positions are filled as an extension of the advanced position with which it is integrated (rather than as a separate preliminary position). For example, there are a number of preliminary medicine positions at IUSM associated with varying numbers of anesthesiology, dermatology, neurology, and radiology categorical positions. Because these are a part of these categorical positions, they are not available or identified in the NRMP as an independent preliminary position. Second, some preliminary positions are “held” for advanced match applicants in some situations and are, consequently, not included in the Match or published NRMP data. Be sure to learn which advanced programs offer categorical positions in the Match!

How does the rank order list process work for preliminary programs?

To be able to enter into and rank programs in the Match, you must register with the NRMP (http://www.nrmp.org/intro-to-main-residency-match/). Note that this is separate from ERAS, where you submit your residency application.

As an applicant to advanced programs, you will create a primary rank order list (ROL) of your advanced (including categorical) programs. In addition to this, you will create one or multiple supplemental ROLs with your desired preliminary programs. Each advanced program (with the exception of categorical programs) must have an attached supplemental ROL of preliminary programs.

You may create one supplemental ROL and attach it to each of your advanced programs, or you may create multiple supplemental ROLs and attach different preliminary program preferences to each advanced program. Why would you consider making multiple different supplemental ROLs? One example might be if you want to pair your preliminary preferences with advanced programs based on location, such as a supplemental ROL with all Indiana transitional programs ranked highest to attach to the advanced programs in the Midwest and a separate supplemental ROL with Wyoming preliminary programs ranked highest to attach to advanced programs located in the Northwest US. More information regarding supplemental ROLs can be found on the NRMP website (http://www.nrmp.org/supplemental-rols/).

Best of luck in the Match season, and contact your advisor with any questions!

References

  1. Advance Data Tables for the 2017 Main Residency Match. http://www.nrmp.org/wp-content/uploads/2017/03/Advance-Data-Tables-2017.pdf. Accessed March 24, 2017.
  2. Ophthalmology Residency Match Summary Report 2017.https://www.sfmatch.org/PDFFilesDisplay/Ophthalmology_Residency_Stats_2017.pdf. Accessed March 27, 2017.