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While residency training in Canada is a direct entry (you stay in the same discipline and program from start to finish), the same is not necessarily the case in the US. There are several different residency position types:

• Categorical (C) – These positions start in post-graduate year 1 (PGY-1) and include all of the years of training required to be certified in the specialty.
• Preliminary (P) – These positions start in PGY-1 and usually last for one year, providing prerequisite training for many advanced programs. These positions are in Internal Medicine or General Surgery. A special type of preliminary position is a Transitional Year, a PGY-1 position of one-year duration that includes rotations through many different disciplines (much like Core Clerkship).
• Advanced (A) – These positions generally start in PGY-2 after completion of a preliminary program and offer the remaining years of training for certification in the discipline. Disciplines that require a preliminary year and advanced training include Radiology, Anesthesiology, Dermatology, and Ophthalmology, among others.

Students applying to advanced programs must apply to both preliminary positions and advanced positions, interview for both, and submit two rank order lists (one for a preliminary position and one for an advanced position) during the same match cycle. Some programs offer a guaranteed preliminary position at the same institution if you match to their advanced program, but you still have to apply to and rank their preliminary position separately.