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The rest is up to you. The drawback of this is having to pick up and move two times. Many institutions offer more preliminary internships than residency spots (cheap labor), so interns who have not been accepted to residency can work hard and hope for acceptance (or at least a good letter of recommendation) the following year.
Doctors of a certain age tend to fetishize the physicalexam. I think this is because learning the physicalexam is an important part of the socialization of the doctor. Though with every passing day I feel more and more like part of the old guard, I can only give the exam a tepid defense.
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