Key facts
- A categorical position gives the full training needed for board certification in a specialty; a preliminary position is a one-year first year that does not.
- Advanced positions start the year after the Match and require one or more years of preliminary training first, so those applicants need a separate first-year position.
- In 2026, Surgery-Preliminary offered 1,207 positions but only 55.0 percent filled, while Transitional Year offered 1,937 and 90.1 percent filled (NRMP).
- A preliminary year does not guarantee a categorical position afterwards, and you may need to match again.
A categorical position is a residency that takes you to board eligibility in one specialty. A preliminary position is a single year that does not. The difference decides whether you finish a program or need to match again after year one, so confirm the type before you apply to or rank any program.
The position types NRMP uses #
NRMP's definitions, as of its current help pages:
| Type | What it means (NRMP) |
|---|---|
| Categorical (C) | A PGY-1 position that provides the full training required for board certification in a specialty |
| Primary (M) | A PGY-1 position in Internal Medicine or Pediatrics with a training emphasis on primary care |
| Preliminary (P) | A one-year position, such as Medicine, Surgery, a Transitional Year or a specialty program, that provides prerequisite training for advanced positions |
| Advanced (A) | A specialty position that starts the year after the Match, after one or more years of required preliminary training |
| Reserved (R) | A PGY-2 specialty position that starts in the Match year, limited to physicians with prior graduate medical education |
NRMP also describes a "Joint A/P" feature in its R3 system that lets an institution link an advanced program with a preliminary program. Applicants who match to the advanced program are the only ones who can match to the linked preliminary program. NRMP's pages do not say how to rank unlinked programs, so ask each advanced program whether it provides a first year, links one, or expects you to find your own.
Why both exist: two kinds of specialties #
Some specialties start with PGY-1 categorical positions that include the first year (for example, Internal Medicine, Pediatrics, General Surgery and, for many positions, Anesthesiology and Neurology). Others offer advanced PGY-2 positions that need a separate first year. In the 2026 Match, Anesthesiology offered 306 PGY-2 positions and Neurology 233 alongside their PGY-1 positions (NRMP). See Anesthesiology and Neurology.
An advanced applicant therefore competes in two ranks: the advanced program and a first-year position. Preliminary and transitional years can be done in medicine, surgery or a transitional program. For the full application side, see preliminary and transitional years.
2026 numbers for preliminary-type positions #
| Position type (PGY-1 only) | Positions offered (2026) | Filled in the algorithm | Share filled by non-U.S. citizen IMGs | Share filled by U.S. citizen IMGs |
|---|---|---|---|---|
| Medicine-Preliminary | 1,565 | 91.4% | 8.2% | 3.1% |
| Surgery-Preliminary | 1,207 | 55.0% | 18.1% | 6.0% |
| Transitional | 1,937 | 90.1% | 5.7% | 4.7% |
| Pediatrics-Preliminary | 25 | 100.0% | 8.0% | 12.0% |
| OB/GYN-Preliminary | 21 | 47.6% | 0.0% | 4.8% |
Source: NRMP Results and Data: 2026 Main Residency Match, Tables 1E and 1F. The share columns are the percent of positions offered that were filled by each group. Transitional Year participates in AAMC's program signaling for 2027 with 12 signals, so it is one of the few one-year pathways where signals apply.
The Surgery-Preliminary row shows a high IMG share alongside 543 unfilled positions. That describes who filled positions in 2026; it does not mean those positions lead to categorical training. The same table also shows how much larger the categorical General Surgery market is (see General Surgery for IMGs).
The risks of relying on a preliminary year #
- No guarantee of a next position. A preliminary year does not carry a promise of a categorical position at the same hospital. You apply again for PGY-2 or advanced positions in the Match.
- You apply while working. You are completing a demanding intern year while applying and interviewing. Plan your leave and your letters (reapplicant strategy).
- Short visa and contract horizon. A one-year position is a one-year appointment. Visa sponsorship and the dates of your status depend on program and visa type, so confirm what happens at the end of the year (visa timeline after the Match).
- Mismatch in specialty. A medicine preliminary year does not make you a stronger applicant in an unrelated specialty by itself. Letters from your preliminary attendings help most when they come from the specialty you want.
- Program quality varies. Ask current residents about workload and teaching, and ask where recent graduates went next.
- Opportunity cost. Spending a year in a one-year position can delay a better-prepared reapplication. Compare it with research or additional USCE.
How it is listed and applied for #
Applicants apply through ERAS (or ResidencyCAS for EM and OB-GYN) and register for the Match separately with NRMP. In NRMP's IMG newsletter the process is: register in R3, certify your rank order list by the deadline of March 3, 2027 for the 2027 Match, and meet ECFMG requirements by then. NRMP reports Surgery-Preliminary, Medicine-Preliminary and Transitional positions separately from categorical ones in its tables.
A practical decision guide #
- You want categorical in your specialty: apply to categorical programs first. Use a preliminary or transitional year only as a deliberate second tier (backup specialties).
- Your specialty starts at PGY-2: plan both ranks from the start, and check each advanced program's expectations for the first year.
- You are unmatched: a preliminary position through SOAP may be possible, but read the risks above before accepting (SOAP explained).
- Visa required: confirm sponsorship for the preliminary year and for the following year separately.
Frequently asked questions
What is the difference between categorical and preliminary?
Per NRMP, a categorical position provides the full training required for board certification, while a preliminary position is a one-year position that provides prerequisite training for advanced positions or other specialties.
Will a preliminary year lead to a categorical position?
Not automatically. NRMP does not describe a path from preliminary to categorical, so assume you will need to match into a categorical or advanced position separately unless a program says otherwise in writing.
What is an advanced position?
A specialty position that starts the year after the Match, after one or more years of required preliminary training, according to NRMP. Examples in the 2026 Match include Anesthesiology and Neurology PGY-2 positions.
Are preliminary positions easier for IMGs to get?
NRMP's 2026 data shows non-U.S. citizen IMGs filled a larger share of Surgery-Preliminary (18.1 percent) and Medicine-Preliminary (8.2 percent) positions than of several categorical specialties, but those numbers do not give an individual chance and the positions lead nowhere by themselves.
Sources
- NRMP, What are the types of program positions in the Main Residency Match?
- NRMP, The Match Terms and Topics
- NRMP Results and Data, 2026 Main Residency Match
- AAMC Program Signaling for the 2027 MyERAS Application Season
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