Outcomes of non-designated preliminary general surgery interns: A 25-year Mayo Clinic experience

Non-designated preliminary, general surgery interns have no job security after year 1. Understanding how such non-designated preliminary, general surgery interns fare at any single institution might help future prelim applicants make better ranking decisions. We aimed to analyze the outcomes of residents pursuing a non-designated preliminary year in general surgery at a single institution.

A retrospective cohort analysis of non-designated preliminary interns, who completed a preliminary year at our institution from 1993 to 2017, was conducted to understand their career path after the preliminary general surgery year.

Three hundred and fifteen non-designated preliminary interns (232 international medical graduates and 83 American medical graduates) were identified. Two hundred and thirty-five (75%) matched into categorical residency spots (115 [49%] in general surgery, 18 [8%] each in orthopedic surgery and anesthesiology) after their preliminary year, 58 (18%) matched into a second year preliminary spot, and 22 (7%) left graduate medical education. American medical graduates (90%) more commonly matched into categorical spots than international medical graduates (69%; P < .0001). One hundred and fifty-four (49%) of our total nondesignated, preliminary resident cohort eventually garnered categorical general surgery residency positions. Importantly, 33 (65%) of our non-designated, preliminary residents who pursued a postgraduate year 2 preliminary surgery position subsequently obtained a categorical general surgery position. Twenty-nine nondesignated, preliminary interns joined our general surgery training program to fill open postgraduate year 2 slots. Of our nondesignated, preliminary residents (n = 300), 95% are currently practicing in the United States.

Most nondesignated, preliminary residents at our institution secured categorical spots for continuing graduate medical education. A preliminary internship year seems a useful endeavor for most trainees and even a second prelim year produces a categorical position for most of these driven and hard-working individuals.