An Overview of the Type of Program Positions Available in the Main Residency Match What’s the Difference Between Preliminary and Categorical Residency Positions?

April 25, 2023


Preliminary vs. Categorical Residency-Type of Program Positions in Residency Match

What’s the Difference Between Preliminary and Categorical Residency Positions?

The Main Residency Match is a crucial event for medical students and residency programs. Understanding the different types of program positions can significantly impact your application strategy. This article explores the various program positions available in the Match, particularly focusing on the differences between preliminary and categorical residency positions, as well as other types.

Types of Program Positions

  1. Categorical Position (“C”)
    • A Categorical Position is a post-graduate year one (PGY-1) position that provides full training required for board certification in a specific specialty.
  2. Primary Position (“M”)
    • This is a PGY-1 position in Medicine or Pediatrics with a focus on training in primary care.
  3. Preliminary Position (“P”)
    • A Preliminary Position is a one-year position in a Transitional Year or specialty program. It provides foundational training, often required before entering advanced specialty training.
  4. Advanced Position (“A”)
    • An Advanced Position begins after the PGY-1 year and requires one or more years of preliminary training. This type of position typically starts at the PGY-2 level.
  5. Reserved Positions (“R”)
    • These are PGY-2 positions in specialty programs reserved for physicians with prior graduate medical education, also known as “Physician Positions”.

Key Differences

  • Preliminary vs. Categorical Residency:
    • Preliminary Residency Positions are one-year programs that do not lead directly to board certification but are often prerequisites for advanced specialty training. Preliminary Residency positions provide essential training that prepares residents for more specialized fields.
    • Categorical Residency Positions provide a complete training program from PGY-1 through to board certification in a particular specialty. Categorical Residency positions are designed to offer comprehensive education and training, leading to full certification in a specific medical field.
  • Advanced vs. Reserved:
    • Advanced Positions require completion of a preliminary year and typically start at PGY-2. They are for specialties that require initial general training before specialized training.
    • Reserved Positions are similar to Advanced Positions but are specifically reserved for those who have already completed some graduate medical education and are entering directly into PGY-2 or higher.

Participation and Accreditation

The Match primarily includes residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME). These programs are found in various settings, such as academic medical centers, community hospitals, and Veterans Affairs (VA) hospitals.

Most residency programs in the United States participate in the Match. However, certain programs, like military residencies, have their own application and matching processes. Additionally, specialties such as ophthalmology and urology have their own matching systems and do not participate in the Main Residency Match.


Understanding the differences between various program positions, especially preliminary vs. categorical residency positions, as well as advanced and reserved positions, is crucial for making informed decisions during the residency application process. Knowing these distinctions can help you target the programs that best fit your career goals and qualifications.

For more detailed guidance and personalized assistance with your residency application process, explore the resources and services offered by IMGPrep to increase your chances of a successful match.

IMGPrep is a leading educational consulting firm dedicated to assisting IMGs in reaching their goals, dreams, and potential. Check out our other Articles and learn more about IMGPrep services at:

IMGprep is not associated with the NRMP® or the MATCH® ECFMG®