1. Selection, mentorship, and subsequent placement of preliminary residents in an academic general surgery residency program University of Colorado School of Medicine Department of Surgery University of Colorado Anschutz Medical Campus

2. We have no disclosures. University of Colorado School of Medicine Department of Surgery University of Colorado Anschutz Medical Campus

3. Background Goals for Academic Medical Centers ACGME work-hour restrictions Hospital Workforce Needs – Physician extenders – Categorical residents – Preliminary residents

4. Background Why non-designated preliminary residents (NDPR)? – Increasing medical school enrollment – Relatively unchanged amount of categorical resident positions – Potential for a symbiotic relationship

5. Methods University of Colorado General Surgery Residency Program 2002-2012 Reviewed 64 non-designated preliminary residents – Selection Process – Original Goals – Mentoring Process – Ultimate Fate

6. FIGURE 2: Medical schools of origin for UC Denver preliminary residents

7. Selection of NDPRs No prelim interviews Target unmatched general surgery, orthopedics, and urology applicants USMLE scores > 200 Avoid Favors Scramble & Telephone Interviews SOAP ( supplemental offer and acceptance program )

8. USMLE Scores

9. Mentoring NDPRs Introductory Meeting with Program Director (July) – Debrief match failure – Discuss individual issues (debt, family) – Analyze portfolio – Discuss realistic plans – Re-enter match?

11. Mentoring NDPRs Outside Match – Frequent PD meetings – If Surgery… ABSITE APDS Website – If non-surgical… Cold calls/e-mails Contact outside PDs Re-entering the Match – Letters of Reference – Meet relevant PDs – Target less competitive programs – Be prepared if unmatched again

12. RESULTS NDPRs completing first prelim year- 95% NDPRs obtaining categorical position immediately after 1 st year - 75% NDPRs ultimately obtaining categorical position- 84% How did they get there?

13. Preliminary Residents n=64 Finished Year/transferred to categorical program n=61 Obtained Categorical Training n=48 Remained at UC Denver n=14 Categorical Training Elsewhere n=34 Did Not Obtain Categorical Training n=13 Preliminary R2 Year n=4 Research Year n=5 Other Employment n=2 Lost to Follow Up n=2 Did Not Finish Year n=3 Categorical Training n=1 Other Employment n=2 Categorical Training n=2 Still Looking n=2 Categorical Training n=3 Still Looking n=2 First Year Second Year

14. Categorical Positions General Surgery n=7 (15%) Surgical subspecialties n=31 (65%) – Anesthesia – Orthopedics – Urology – ENT Non surgical specialties n=10 (20%) – EM – Medicine – ObGyn – Radiology

15. Original specialty interests of preliminary residents at UC Denver

16. Conclusions Non-designated preliminary residents are a valuable group of physicians in need of work and opportunity Academic training centers can benefit from the support of NDPRs Mentorship by surgery program directors builds a rewarding relationship with NDPRs Successful Placement of NDPRs is possible with a well organized and executed plan for the preliminary year

17. Thank You! Special Thanks Drs. Mark Nehler & Paul Montero Claire Travis University of Colorado School of Medicine Department of Surgery University of Colorado Anschutz Medical Campus