# Preliminary and Transitional Year Programs

## Contacts

| Your Career Advisor  |
| -------------------- |
| Steve Paik           |
| Alex Posner          |
| Vannita Simma-Chiang |

## What are Preliminary Positions?

Preliminary positions are one-year positions that occur in PGY1, prior to entry into advanced specialty programs.  

## What are the Preliminary Position Options?

Students can apply to preliminary positions in internal medicine, general surgery, ob-gyn (rare) and pediatrics (rare) and transitional years.  

A Transitional Year (TY) position, is a type of preliminary position where residents have required rotations in medicine, surgery, and other specialties in that first year to give residents a foundation prior to starting an advanced position.  

Preliminary positions in medicine, general surgery and ob-gyn and pediatrics focus on just those specialties. 

Almost all specialties that have programs with advanced positions also have programs with categorical positions. Students should be researching each program they are planning on applying into to understand if they need to apply for preliminary positions or not. 

## Specialties that may require a preliminary position: 

| **Specialty**                                                                                                                                                                                     | **Types of Positions**                                                                                                                                                                                                                                                                 |
| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Anesthesiology**                                                                                                                                                                                | many programs offer both categorical and advanced tracks                                                                                                                                                                                                                               |
| **Dermatology​**                                                                                                                                                                                  | historically are only advanced but some programs are now offering categorical tracks (for example- Cleveland Clinic)                                                                                                                                                                   |
| **Diagnostic Radiology**                                                                                                                                                                          | some programs offer categorical and advanced tracks                                                                                                                                                                                                                                    |
| [**Interventional Radiology​**](https://www.sirweb.org/in-training/pathways/integrated-ir-residency/?utm_source=chatgpt.com)                                                                      | Commonly offers advanced tracks by some programs are categorical                                                                                                                                                                                                                       |
| **Neurology**                                                                                                                                                                                     | <p>many programs offer both categorical and advanced tracks </p><p> </p>                                                                                                                                                                                                               |
| **Ophthalmology**                                                                                                                                                                                 | Match is through SF match, not NRMP, and programs have shifted toward an integrated/categorical 4 year program which includes a PGY-1 position. Students may have to register for NRMP and submit a rank list with that PGY-1 position separately, in addition to the SF Ophtho match. |
| [**Physical Medicine & Rehabilitation**](https://www.aapmr.org/career-support/medical-student-resources/a-medical-students-guide-to-pm-r/what-is-a-residency-in-pm-r-like?utm_source=chatgpt.com) | some programs offer categorical and advanced tracks                                                                                                                                                                                                                                    |
| **Radiation-Oncology​**                                                                                                                                                                           | often advanced but some programs offer categorical and advanced tracks (for example- Mayo Clinic)                                                                                                                                                                                      |

## Questions to ask yourself

When students are deciding which prelim specialty (IM, Gen Surg, Peds, TY) they should apply to, they should take into consideration the following:&#x20;

* What specialty are you entering?&#x20;
  * Certain prelims may be better for certain advanced specialties- think about your goals and what you want to get out of your PGY-1 year and how the preliminary position can help you in your specialty.&#x20;
* What are the requirements of the advanced program?&#x20;
  * Specialties/ACGME have “clinical base year” requirements (ICU time, inpatient v outpatient time, etc) so your prelim year should follow these guidelines&#x20;
  * If this information is not on the program’s website you may need to interview there/ask questions regarding the schedule to find out.&#x20;

## Considerations when deciding what kind of program to apply to.

### Transitional Year &#x20;

* Pros: broad exposure, lots of electives, generally lighter call schedule&#x20;
* Cons: often more competitive, some programs are outpatient heavy, may or may not fulfill your base year requirements&#x20;
* Best for: Anesthesiology, Diagnostic Radiology, PM\&R, Dermatology, Radiation-Oncology, Interventional Radiology, Ophthalmology&#x20;

{% embed url="<https://cmss.org/wp-content/uploads/2025/07/OPDA-PD-Guide_2025-2026_Transitional_Year.pdf>" %}

### Preliminary Medicine&#x20;

* Pros: strong inpatient + ICU experience, excellent prep for managing sick adults, many positions available&#x20;
* Cons: Heavier workload, fewer electives at some programs&#x20;
* Best for: Neuro, Anesthesiology, Diagnostic Radiology, PM\&R, Dermatology, Ophthalmology, Radiation-Oncology&#x20;

### Preliminary Surgery&#x20;

* Pros: high acuity, procedures, comfort in the OR, good for surgery-adjacent fields&#x20;
* Cons: most intense, can be “service heavy”&#x20;
* Best for: Interventional Radiology, Ophthalmology, Diagnostic Radiology, Surgical Subspecialties&#x20;

## Competitiveness

Source: [2025 Match Advanced Data Tables](https://www.nrmp.org/wp-content/uploads/2025/03/Advance_Data_Tables_2025.pdf)

In the 2025 Match there were 1,600 Internal Medicine preliminary positions in 329 programs, 69.3% of positions were filled by U.S. MD Seniors.&#x20;

In the 2025 Match there were 1,194 General Surgery preliminary positions in 261 programs, 22.4% of positions were filled by U.S. MD Seniors.&#x20;

In the 2025 Match there were 1,860 Transitional preliminary positions in 236 programs, 56.7% of positions were filled by U.S. MD Seniors.&#x20;

***

## ISMMS Match Data 2021-2026

<table><thead><tr><th width="121">Specialty</th><th width="215">Institution Name</th><th width="56">2021</th><th width="57">2022</th><th width="57">2023</th><th width="59">2024</th><th width="57">2025</th><th width="56">2026</th><th width="51">Total</th></tr></thead><tbody><tr><td>Medicine-Preliminary</td><td>B I Deaconess Med Ctr-MA</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>Brigham &#x26; Womens Hosp-MA</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>CA Pacific Med Center</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>Flushing Hospital Med Ctr-NY</td><td>0</td><td>0</td><td>1</td><td>0</td><td>1</td><td>0</td><td>2</td></tr><tr><td>Medicine-Preliminary</td><td>Greenwich Hospital-CT</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>ISMMS Mount Sinai Beth Israel-NY</td><td>3</td><td>2</td><td>4</td><td>0</td><td>0</td><td>0</td><td>9</td></tr><tr><td>Medicine-Preliminary</td><td>ISMMS Mount Sinai Morningside-West-NY</td><td>0</td><td>2</td><td>5</td><td>3</td><td>6</td><td>3</td><td>19</td></tr><tr><td>Medicine-Preliminary</td><td>ISMMS NYC Health+Hospitals/Elmhurst-NY</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>2</td><td>3</td></tr><tr><td>Medicine-Preliminary</td><td>Johns Hopkins/Bayview-MD</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>Kaiser Permanente-Oakland-CA</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>MGB-Massachusetts Gen Hosp</td><td>0</td><td>0</td><td>0</td><td>2</td><td>0</td><td>0</td><td>2</td></tr><tr><td>Medicine-Preliminary</td><td>Montefiore Med Ctr/Einstein-NY</td><td>1</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>2</td></tr><tr><td>Medicine-Preliminary</td><td>NYMC-Landmark Med Ctr-RI</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>NYP Brooklyn Methodist Hosp-NY</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>New York-Presbyterian/Queens-NY</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>NYU Grossman School Of Medicine-NY</td><td>0</td><td>1</td><td>0</td><td>1</td><td>0</td><td>0</td><td>2</td></tr><tr><td>Medicine-Preliminary</td><td>Olive View-UCLA Med Ctr-CA</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>Pennsylvania Hospital</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>Rutgers-New Jersey Medical School</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>U Maryland Mercy Med Ctr</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>U Miami/Jackson Health System-FL</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>U Michigan Hosps-Ann Arbor</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>U North Carolina Hospitals</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>Yale-New Haven Hosp-CT</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>Zucker SOM-Northwell Forest Hills Hosp-NY</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>1</td></tr><tr><td>Medicine-Preliminary</td><td>Zucker SOM-Northwell Staten Island Univ-NY</td><td>1</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>2</td></tr><tr><td>Surgery-Preliminary</td><td>ISMMS Mount Sinai Hospital-NY</td><td>0</td><td>0</td><td>4</td><td>2</td><td>2</td><td>2</td><td>10</td></tr><tr><td>Surgery-Preliminary </td><td>Stanford Health Care-CA</td><td>0</td><td>0</td><td>1</td><td>2</td><td>0</td><td>0</td><td>3</td></tr><tr><td>Surgery-Preliminary</td><td>UC San Francisco-CA</td><td>0</td><td>1</td><td>0</td><td>1</td><td>1</td><td>0</td><td>3</td></tr><tr><td>Surgery-Preliminary</td><td>Brigham &#x26; Womens Hosp-MAÂ </td><td>2</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>2</td></tr><tr><td>Surgery-Preliminary </td><td>NYU Grossman School Of Medicine-NY</td><td>0</td><td>0</td><td>1</td><td>1</td><td>0</td><td>0</td><td>2</td></tr><tr><td>Surgery-Preliminary </td><td>Johns Hopkins Hosp-MD</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Surgery-Preliminary </td><td>MedStar Georgetown Univ Hosp-DC</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Surgery-Preliminary </td><td>MedStar Union Memorial Hosp-MD </td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Surgery-Preliminary </td><td>NYP Hosp-Columbia Univ Med Ctr-NY</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Surgery-Preliminary</td><td>Swedish Med Ctr-WA</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>1</td></tr><tr><td>Surgery-Preliminary</td><td>U Washington Affil Hosps </td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Surgery-Preliminary</td><td>UMass Chan Medical School-MA</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Surgery-Preliminary</td><td>Vanderbilt Univ Med Ctr-TN</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Surgery-Preliminary</td><td>Zucker SOM-Northwell NS/LIJ-NY</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Crozer-Chester Med Ctr-PA</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Doylestown Hospital-PA</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>1</td></tr><tr><td>Transitional</td><td>Emory Univ SOM-GA</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Garnet Health Med Ctr-NY</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Lincoln Med Ctr-NY</td><td>0</td><td>1</td><td>1</td><td>0</td><td>0</td><td>0</td><td>2</td></tr><tr><td>Transitional</td><td>Memorial Sloan-Kettering-NY</td><td>0</td><td>2</td><td>3</td><td>1</td><td>1</td><td>0</td><td>7</td></tr><tr><td>Transitional</td><td>Mount Carmel Health System-OH</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>San Juan City Hospital</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Santa Clara Valley Med Ctr-CA</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Scripps Mercy Hosp-San Diego-CA</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Sunrise Health GME Consortium-NV </td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Tripler Army Medical Center Hawaii</td><td>0</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>Tucson Hospitals Med Ed-AZ</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>1</td></tr><tr><td>Transitional</td><td>WellStar Kennestone Reg Med Ctr-GA</td><td>1</td><td>1</td><td>0</td><td>0</td><td>0</td><td>0</td><td>2</td></tr><tr><td>Transitional</td><td>Zucker SOM-Northwell South Shore-NY</td><td>0</td><td>0</td><td>0</td><td>0</td><td>1</td><td>0</td><td>1</td></tr></tbody></table>


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