Figuring Out the Transitional, Preliminary, and Categorical Year for Residency Application

Figuring it outThe first year of post-graduate training following medical school is called "internship." Medical school graduates in the first year of post-graduate training are called an "interns" regardless of what that first year of training consists.  Your initial year could be one of the following: a Categorical Year, Transitional Year, or Preliminary Year.

In many specialties, graduates can go right into specialty training, but several require an intern year of more generalized training before specialty training; hence the Transitional and Preliminary Programs. When this occurs, students must apply and interview at both their specialty programs and their intern year programs, even though they will not begin their specialty training a year after their intern year. This has also made Preliminary and Transitional Programs highly competitive, as many of the very competitive specialties require these types of intern years before specialty training.

Some of the fields that require a basic training year before beginning residency include:

Radiation Oncology

A Transitional Year is an intern experience that many fields require or prefer where the student experiences a global training before beginning residency training. In this training, the graduate would experience both surgical and internal medicine rotations and be well prepared to enter a specialty where a thorough understanding of pathology, physiology, and surgical procedures are necessary.

The alternative to the Transitional year for some is the Preliminary Year. Preliminary Programs are further divided into Internal Medicine or Surgery. Surgical specialties will obviously require a Surgical Preliminary Year, but other specialties, such as anesthesiology will accept either a Preliminary Year in Surgery or Internal Medicine.

Students that are accepted straight into the program without going through a separate intern year are entering a Categorical Position. Often students that must match into a Transitional Year or Preliminary Year prior to entering their Residency Year, must do so in another location requiring that they move twice in two years. Matching straight into a Categorical Position allows the graduate to move only one time. However, there are many programs where students match into Transitional or Prelim Years at the same location as their residency training.

Often students will use a Preliminary year or Transitional year as a backup plan in case they do not immediately match into the specialty of her/his choice.  The applicant then takes a preliminary or transitional year to improve her/his chances and qualifications for the next year's residency match. This is especially important if you do well in your intern year and intend to apply to the residency program at the same institution where you just did your prelim or transitional year. However, you will be matching into the program for 1 year following the match year unless you manage to arrange a job outside of the match. This will be more difficult to manage if the NRMP is successful in its lobby to change to the “All-in” match where institutions must commit to all of its residency positions going through the NRMP match with no pre-match offers beginning in the 2013 match; however, it may still be a viable and useful plan rather than going a year without an internship.

Things to know:

1. You can find Transitional Programs on FREIDA and list them separately it their “Specialty” section under the “Program Search” tab.

2. To find Preliminary Internal Medicine and Preliminary Surgery Programs in FREIDA, you search “Internal Medicine” or “Surgery” as a Specialty, then check off “Preliminary Programs” Under “Optional Criteria Selection.”

Go the FREIDA page to search for residency and fellowship programs with FREIDA Online, the AMA Residency & Fellowship Database.

It’s important to have a strategy for what and when you will study. Many students find the structure of the Doctors In Training USMLE Step 1 Review Course, the Doctors In Training USMLE Step 2 Review Course and the Doctors In Training USMLE Step 3 Review Course beneficial to their exam preparations. Our courses present the high yield information you need to know and are updated annually to reflect student feedback.

4 Responses to “Figuring Out the Transitional, Preliminary, and Categorical Year for Residency Application”

  1. andresperez04 says:

    Hello, I'm currently on a surgery pre-elimn. I will like to apply for radio but I'm not sure if I should apply advance plus a transitional/pre-elim or just advance because I already have my transitional year?

    • DIT Advising says:

      Thank you for your question. You improve your chances of getting interviews slightly by applying to both programs, but if you are a strong applicant there is no need to apply to programs that require you to repeat your internship year.


  1. Happy Outcomes | Married... with Med School -

    [...] our other friends didn’t match into their decided specialties and had to do The Scramble to get a prelim year somewhere.  They have, and each day feel a bit better about the road [...]

  2. Categorical vs Preliminary -

    [...] you’re looking for more information on this subject Wash U explains the basics pretty well. So do Doctors in Training (DIT). But my favorite post on this subject is from RK MD- a tech savvy anesthesia [...]

Leave a Reply