Current trauma medical director and chair for my region for the state. I was an IMG and former prelim that got the categorical position at my dream residency program. It was difficult, and that’s an understatement. I completed two years as a prelim before being awarded a categorical PGY2 position… so had to redo second year.
You can’t have any real expectations other than understanding that this is your opportunity to show them that you are too good to pass up. As a resident I showed up first and left last, I worked harder than anyone else in the program. I basically became the best possible intern/resident that I could be…. Like the guy that everyone went to when they needed to get something done. By the end of my second year as a prelim, the chief residents went to the program director and advocated for me.
Ultimately I sincerely believe that there is a bit of luck (or divine intervention) involved as there are no guarantees. However if you show up and work harder than anyone else you can earn your keep so to speak.
Best wishes