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Transitional Year and Prelim Year Interview Guide
Transitional year and prelim year interviews: what TY and prelim programs ask, what six programs say, signals, and how to fit them around advanced interviews.
A transitional year or prelim year interview is a shorter, more clinical version of a residency interview. Expect why this year, why your advanced specialty and why this program, plus questions on clinical judgment and adapting to new teams. Many hospitals fold the TY interview into your advanced interview, so check each program's page before you schedule.
Transitional year vs prelim year
The ACGME defines a transitional year program as “A one-year educational experience in graduate medical education (GME), which is structured to provide a program of multiple clinical disciplines designed to facilitate the choice of and/or preparation for a specialty.” It adds that “it does not comprise a complete program in GME”.
A prelim year is one year inside an internal medicine or surgery program. NRMP defines a preliminary position as a “One-year position in an Internal Medicine, Surgery, Transitional Year, or specialty program that provides prerequisite training for entering advanced positions.” The advanced position it leads to is a “Position in a specialty program that begins the year after the Match and after one or more years of required preliminary training.” Advanced programs at Emory, for example, include “dermatology, neurology, radiology, radiation oncology, ophthalmology, or PM&R”. Practice for your advanced interviews too: dermatology, radiology, neurology and anesthesiology.
How they match with your advanced program
You rank advanced programs on your primary rank order list, then attach supplemental lists of TY and prelim programs to them. NRMP says “The matching algorithm will attempt to place an applicant in a preliminary position on a supplemental ROL only if the applicant first matches to the linked advanced program on the primary ROL.” It also notes “Supplemental ROLs often are based on geographic location.” Henry Ford, for example, asks that its TY code “should be placed on the supplemental list attached to the advanced program of your choice”.
If you match an advanced program but none of its linked prelim programs, “the applicant still is committed to the advanced position and must seek a qualifying first-year position”, usually through SOAP. You can also rank prelim programs on your primary list, but “do so with the knowledge that you may match to a program with only one year of training”. And “Program directors will inform applicants during the interview process if a program has a Joint A/P arrangement.” The rank list guide covers the rest.
Signals, letters and format for 2026-27
Transitional year has its own signals: 12 for the 2027 ERAS season, and you may signal your home program and programs where you rotated. The TY program director guide says “Applicants should signal the programs they are most interested in so that all participating programs receive consistent information about their level of interest.” Prelim programs set their own policies. SSM Health/SLU internal medicine lists “program signals (strongly encouraged)”, and Mayo Clinic's surgery FAQ says “Applicants should signal their most interested programs regardless of whether they are home or away rotations.” See ERAS signals by specialty.
On letters: “One letter should be written by a faculty preceptor from an inpatient core rotation that can speak to the candidate's clinical acumen.” And “minimally one letter should be targeting their advanced program specialties”. The internal medicine guide asks prelim applicants for one clinical letter from an IM faculty member and one from any specialty. The TY guide lists virtual as its interview format. TY guide
What six programs say about interviews
Four transitional year and two prelim programs, from their own pages, read October 23, 2026. Policies change each season, so check again before you book.
Emory
Transitional year. If an Emory advanced program interviews you, there is no separate TY interview, and the TY director gets your advanced interview scores. Others interview virtually in December and January. Source
UPMC
Transitional year. No separate TY interview if a UPMC advanced program interviews you, and it typically does not consider applicants without one. Virtual information sessions run in late January. Source
Henry Ford
Transitional year. The TY is a separate program you must apply to. If the TY and an advanced program both invite you, it tries to coordinate one virtual day. Invites start after mid-October. Source
ThedaCare
Transitional year. Virtual interviews from October 7 through December. Applicants who signal get preference for invitations, and interviewers are trained to score everyone in a structured way. Source
Mayo Clinic (Minnesota)
Prelim surgery. Nine nondesignated prelim positions for 2026-27. Prelim interviews are virtual, on January 11 or 12, 2027, after the in-person categorical days in December. Source
SSM Health/SLU
Prelim medicine. Six to seven prelim positions, four filled by newly matched ophthalmology residents. Interviews are virtual and low-key, scored by two faculty members and two residents. Source
What TY and prelim programs ask
The questions overlap with any residency interview, with more weight on the clinical year ahead. The TY guide says “the Transitional Year Residency training prioritizes development of clinical acumen, professionalism, interpersonal communication skills, adaptability to the complex healthcare delivery systems and readiness for advanced training across different specialties”. Here is what to prepare, why they ask, and what a strong answer does.
Why a transitional year (or a prelim year)?
They want to know the year is a choice, not just a box to tick before your advanced program.
A strong answer names what you want from the year for your specialty, such as broad inpatient medicine before radiology.
Why your advanced specialty?
Your letters point there, and the program wants a resident who knows where they are headed.
A strong answer gives one moment that made the specialty real, then how this year feeds it.
Tell me about a patient you managed on an inpatient rotation.
The TY program director guide asks for a letter from an inpatient core rotation that speaks to your clinical acumen.
A strong answer walks through your own reasoning and what you did next, not the diagnosis alone.
Tell me about a time you adapted to a new team or system.
A TY rotates you through several disciplines, and the program director guide names adaptability as a priority.
A strong answer shows how you learned the unwritten rules fast and what you changed in yourself.
How will you stay engaged on rotations outside your field?
Most months of a TY or prelim year are outside the specialty you are heading to.
A strong answer links one off-specialty rotation to a skill your advanced specialty will need.
Tell me about a quality improvement or service project.
The TY guide counts QI, advocacy, community service and leadership projects equally.
A strong answer names your part, the change it made and what you would do differently.
Why our program?
Even for one year, they want to know you chose them for a reason.
The next section shows how to answer it for a one-year program.
On projects, the guide says “Transitional Year Residency Programs consider involvement in QIPS projects, advocacy in healthcare policies, community service initiatives, leadership capstone projects equally valuable.” Pick the one you can talk about in the most detail.
Practice it and see model answers in the app
Why this program, for one year
One year is still a choice, and programs say what they value. ThedaCare writes: “Our mission is to train compassionate, clinically excellent physicians capable of delivering high-value, equitable care for our community.” Build your answer from facts like that, in three short parts.
- The year itself. Name one part of the curriculum that fits your advanced specialty, such as the ICU, the electives or the inpatient months, from the program's own pages.
- The place. Say why this location works with your advanced program. NRMP notes that supplemental lists are often built by geography, and programs know it.
- What you bring. Give one thing you add to an intern class you will leave after a year, such as teaching, QI or steady work on busy services.
Keep it to about a minute. The full method, with what six programs say they look for, is in why this residency program.
Fitting them around advanced interviews
TY and prelim interviews land in the same months as your advanced ones. Some programs make booking easy. St. Luke's Bethlehem says “The entire interview schedule is available for you to select the date and session (am/pm) that works best for your schedule.” “You may change that date up to seven days prior to the interview.” Emory says “Virtual interviews will be held December 2026 and January 2027 to allow most applicants time to interview with Advanced Programs.”
Check whether an advanced interview covers the TY
At Emory and UPMC, an interview with one of their advanced programs replaces the TY interview. At Henry Ford you still apply to the TY separately. Read each program's page before you book anything.
Book your advanced interviews first
Some TY and prelim programs interview later, like Mayo Clinic's January prelim days. Emory times its TY interviews to leave room for advanced programs.
Ask for one combined day where it is offered
When both a TY and an advanced program at the same hospital invite you, ask whether they can share a day. Henry Ford says it will try.
Keep a note on every linked pair
For each advanced program, list the TY or prelim programs you will link to it and where they are. That note becomes your supplemental rank lists in February.
Watch for joint arrangements
Some advanced programs have a joint advanced and preliminary arrangement. The program director tells you during the interview, and only applicants who rank the advanced program can rank that prelim program.
For the dates every applicant shares this season, see residency interview season.
Sources: ACGME Glossary of Terms. NRMP, Program Positions in the Main Residency Match and About Supplemental Rank Order Lists. Program Director Associations Guides 2026-2027, Transitional Year and Internal Medicine. Program pages of Emory, UPMC, Henry Ford, ThedaCare, St. Luke's Bethlehem, Mayo Clinic (Minnesota) and SSM Health/SLU. All checked October 23, 2026.
Frequently asked questions
What is the difference between a transitional year and a prelim year?
A transitional year rotates you through several specialties in one PGY-1 year. A prelim year is one year inside an internal medicine or surgery program. Both are one-year positions that come before an advanced program, and neither is a complete residency on its own.
Do I need a separate interview for the TY or prelim program?
It depends on the hospital. At Emory and UPMC, an interview with one of their advanced programs replaces the TY interview. At Henry Ford the TY is a separate program you apply to, and it tries to coordinate one virtual day when both invite you.
How many program signals do transitional year programs get?
12 for the 2027 ERAS season, and you may signal your home program and programs where you rotated. The program director guide asks you to signal the programs you are most interested in. Prelim programs set their own policies, so check each one's page. ERAS program signals by specialty.
What if I match my advanced program but no prelim year?
NRMP says you are still committed to the advanced position and must find a first-year position in SOAP or after it. Linking enough TY and prelim programs to each advanced program on your supplemental lists lowers that risk. How SOAP works.
Are transitional year interviews virtual?
Mostly. The 2026-27 transitional year program director guide lists virtual as its interview format, and Emory and ThedaCare interview TY applicants virtually. Mayo Clinic's prelim surgery interviews are virtual too.