The Prelim Playbook: Tips, Tricks, and Unspoken Rules for Success

Behind The Knife: The Surgery Podcast

Education, Science, Health & Fitness, Medicine

4.8 • 1.4K Ratings

🗓️ 26 March 2026

⏱️ 54 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

In this episode, we explore the grueling realities of the general surgery preliminary year—a high-stakes, one-year audition for surgical trainees operating without a safety net. We sit down with a program director, a former IMG prelim turned attending, and a recently successful SOAP applicant to uncover exactly what it takes to survive the scramble and excel clinically. Listen in to learn actionable strategies for navigating hospital expectations, securing vital mentorship, and ultimately turning your preliminary position into a secured categorical spot.

Hosts:

Ayman Ali, MD
Dr. Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital.

Kevin Naresh Shah, MD
Dr. Kevin Shah is an Assistant Professor of Hepatobiliary Surgery at the Duke University School of Medicine and Program Director of General Surgery.

Katharine Louise Jackson, MBBS
Dr. Louise Jackson is an Assistant Professor of Colon and Rectal Surgery at the Duke University School of Medicine and the Medical Student Clerkship Director.

Rafael Felix Tiongco, MD
Dr. Rafael Tiongco is a first-year resident at Penn State College of Medicine.

Sponsor Disclaimer: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content. Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only

***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6

Transcript

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0:00.0	Behind the Night, The Surgery Podcast, Relevant and Engaging Content to help you dominate the day. We want you want you, yes, you, to join the Behind the Knife team as a surgical education fellow.
0:39.9	We're looking for enterprising surgical residents to take the bull by the horns and build something new and exciting.
0:46.6	Fellows will benefit from ample support from the Behind the Knife team, including the use of our digital education platform,
0:52.8	and access to all of our resources like
0:54.8	illustrators, video editing, AI tools, social media, and more.
0:59.7	Get your name out there and build your CV by being part of the number one surgery education
1:04.2	platform in the world. We're offering a two-year fellowship starting July 26 and ending in June 28.
1:12.4	Only residents beginning their two-year academic development time will be considered.
1:16.9	Check out the show notes for more information, including the application link.
1:20.4	All applications are due on April 20th.
1:23.7	Again, all applications are due by April 20th.
1:27.2	Welcome back to Behind the Knife. I'm Iman O'I, a general surgery resident. Again, all applications are due by April 20th.
1:29.0	Welcome back to Behind the Knife.
1:33.8	I'm Iman Owey, a general surgery resident at Duke Hospital and a Behind the Knife fellow.
1:39.0	Today, we're going to talk about a unique, grueling, and often misunderstood pathway and surgical training, the preliminary year.
1:42.1	Before we start, I want to acknowledge that there are many perspectives we
1:45.4	won't cover today, and some that we plan to cover in the future. So please let us know any
1:49.9	feedback or requests. Also, for international medical graduates looking to apply into a residency,
1:56.9	I encourage you to listen to our prior podcasts, dominate the match episode 6 and 7, where we go
2:02.5	through that in detail.
2:04.7	Now, back to the discussion for today.
2:07.3	The preliminary year is complicated.
	...

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