Thread by @ShelbySweat

Hey rising 4th year #physiatry hopefuls! I’m an incoming PGY-1 at @auugamp who will be starting an advanced program at @UofLPMR next summer. I have some hot tips for you to help navigate the prelim vs TY conundrum and share some of my experience in the process

You will apply to categorical (PGY1 - PGY4) and advanced (PGY2-PGY4) positions. More programs are advanced than categorical, so you will apply to transitional years (“TY”) and prelim medicine years (“prelim”) for your supplemental rank list.

“TY or prelim?” - your preference. Many TYs have surgical floor experience and other electives. Some TYs are known to be chill. Prelim medicine will be lots of floors and ICU. Talk to residents to find out about culture bc this was less clear on my prelim/TY interviews.

I chose prelim>TY because I want to do inpatient rehab. My interests lie heavily in TBI/SCI/neurorehab, and my prelim has ample neuro exposure and a rehab floor I get to work on (rare for a prelim!). I also did not want the surgical rotations that come with a TY.

“Where do I apply?” - Evaluate your present living situation then choose some programs close to where you’re currently living/your home program, programs close to home if you want more time with family during the hardest year of your life, and programs near your PM&R top choices

I attend school in Philly and knew ideally I wanted to be near my family in GA for intern year. I applied to both prelims and TYs in my home state, in Philly, and in cities my pre-interview top advanced programs were located in.

In general, you have a better chance of matching prelims and TYs near your medical school bc they know you from rotations. For me - for programs outside of the NE, I talked extensively about family ties in my PS and ended up w a comfortable amount of invites in the SE

Full disclosure: I got 0 invites from programs in the cities I targeted for adv programs but was happy with my options in the SE. I encourage you to reach out to programs you haven’t heard from if you get a PM&R invite in their city so they reconsider you. I just didn’t do that.

“How do I order my supplemental rank list if I end up interviewing all over?” - you can make multiple supplemental lists, and I highly recommend ranking them with your happiness and location preferences in mind.

Some programs allow you to rank their home medicine program and the PM&R interview counts as your prelim interview. This is really convenient so make sure to ask when you get your interview invitation. They will usually tell you because it is a selling point of a program.

For me, I completed M4 near home and ranked prelim>TY + SE>NE for List1, NE>SE + prelim>TY for List2, and had List3/List4 with the partner home prelim + location>all. I wanted to be in the SE, but ultimately tailored my lists to the location of the adv program bc moving is a pain

“ANOTHER personal statement?!” - yes. You should already be tailoring your PS to your PM&R programs, but your intern statement should reflect how a good intern year will prepare you for your advanced position. Use the paragraph you’re using for “why [x] program” for this

I used my PM&R statement for my intern year statement base then altered the last paragraph to talk about how a good medicine foundation would make me a better rehab doc and how I wanted to train in the area I grew up.

This process is stressful. It forces you to figure out your values then takes your preferences into an algorithm that relies on who liked you the most in a 15-20min convo. Take this time to prioritize YOUR needs so you can be confident in your choices and happy wherever you go

Also, use this time to set yourself up for a successful match if you end up loving an advanced program and want to minimize your moving stressors. Categorical sounds nice bc you only move once, but you shouldn’t be so stressed that you rank based on that alone

If you have any specific questions or want 1 on 1 mentoring through interview season, DM me. I wouldn’t be here without the residents I relied on during this time, so I say this with my whole chest: I am here for you.