Categorical vs. preliminary residents

Residency Program Insider, January 28, 2020

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The following is an excerpt from The Residency Coordinator’s Handbook, Fourth Edition. To learn more or order your copy, click here.

The ACGME uses the terms “categorical” and “preliminary” to identify the type of training commitment that the program has to the resident. A categorical resident enters a training program with the intent of completing training and graduating from the program. This applies both to a PGY1 resident who just matched to a program and to an upper-level resident who transfers into the program with the intent of completing training. In contrast, a preliminary resident has a one- or two-year commitment to train in the program, with no intention of completing training in that specific program. There are differences within the preliminary resident designation as well, especially within the general surgery specialty. For example:

  • Designated preliminary residents match into another specialty that requires residents to complete a year in general surgery as a prerequisite for their training. For example, urology requires residents to complete one year of general surgery training before entering their urology residency program, and anesthesia requires one year of prerequisite training in either surgery or internal medicine.
  • Non-designated preliminary residents are those who did not match into the training programs of their choice. They generally continue to interview during the PGY1 year and try to either match as categorical residents the following year or find positions as PGY2 categorical residents. This designation gives medical students who do not match into a program an opportunity to stay in the medical field and reapply to residency programs the following year.

Depending upon whether vacancies occur, some training programs may also offer an open PGY2 categorical position or another preliminary year to a preliminary resident.


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