Christiana Care has been a top-rated academic medical center for more than a century. Our Preliminary Year and Transitional Year programs give residents the broad experience they need to go on to pursue further specialties.
At Christiana Care, Preliminary and Transitional Year rotations are very similar.
For students who are not sure whether to consider a Preliminary Year or Transitional Year program, we offer a few guidelines.
Preliminary Medicine Year or Transitional Year?
Preliminary Medicine Year
- Typically for students and residents going into residencies that require more knowledge of internal medicine (e.g., anesthesiology, dermatology, preventive medicine and rehabilitation).
- A good choice for students who are leaning toward internal medicine as a career but are uncertain. Preliminary Year meets all of the requirements for a categorical PGY 1 Year should that student elect to seek a PGY 2 spot thereafter.
- Typically for students and residents going into specialties that require a breadth of exposure during internship (e.g., radiology).
- A good choice for students who are uncertain about their career choice should choose the transitional program for a chance to sample all specialties.
However, there is a tremendous amount of overlap and no hard and fast rule.
Preliminary residents take the following four-week block rotations:
- Inpatient medicine (three).
- Coronary intensive care unit (one).
- Medical intensive care (one).
- Emergency medicine (one).
- Medicine night float (one).
Sample Schedule for Preliminary Medicine Year
The transitional year curriculum provides for significant flexibility. The curriculum consists of 6-7 months of fundamental clinical skills rotations. Three of the months are spent on a combination of inpatient internal medicine and inpatient family medicine rotations. Residents have the choice of how to complete the other 3-4 months of inpatient rotations and may choose from additional time on internal medicine, family medicine, or any combination of inpatient pediatrics, OB-GYN, or general surgery. All residents also spend a month on emergency medicine and a month on ambulatory medicine caring for adults or children. The remaining time is dedicated to electives.
Transitional Year residents have the same responsibilities as categorical program interns when they rotate through inpatient services. Transitional Year residents are colleague-trainees who receive full support from upper-year residents and faculty during all rotations.
Sample Schedule for Transitional Year
Electives for the preliminary and transitional year program are very similar. Residents may choose from electives in internal medicine subspecialties (e.g. cardiology, pulmonary, endocrinology, nephrology, infectious diseases, gastroenterology, rheumatology, hematology, and oncology) as well as many non-medicine specialties (e.g. radiology, radiation oncology, pathology, neurology, anesthesiology, dermatology, ophthalmology, ENT, physical medicine & rehabilitation)
We try to accommodate a resident’s request for an elective, including developing rotations in other non-traditional electives, whenever possible.
Preliminary interns usually do two, two-week blocks of night float.
When they are on inpatient floor rotations, they share short call (4p-7p) with their co-interns on a rotating schedule. In the MICU and CICU, call is approximately every fourth night.
For Transitional Year residents, the call schedule varies from department to department. On Family Medicine and Internal Medicine floor rotations and inpatient general internal medicine floors, there is a night float system. On General Surgery, OB/GYN, Pediatrics, MICU, and CICU call is approximately every fourth night.
Feedback is important to the growth of all physicians. Residents receive informal feedback every day and more formal feedback at mid-rotation and at the end of each rotation. Additionally, residents meet with either the Program Director or an Associate Program Director twice a year to review all of the evaluations and reflect on the resident’s performance over the previous six months.
Preliminary residents are fully integrated into the Department of Medicine and attend Medicine journal clubs and all social activities, including the annual holiday party and the end-of-the-year party for departing house staff. In this way, they have ample opportunities to get to know the other residents.
The Department of Medicine serves as the academic and administrative home for the transitional year residency program. Similar to the preliminary and categorical internal medicine residents, transitional year residents are integrated into the Department of Medicine orientation and are invited to attend Medicine journal clubs and all social activities, including the annual holiday party and the end-of-year party for departing house staff.