Advice to match into top IM Residency

SDN Members don't see this ad. (About Ads)

..

There isn't a cook book recipe. Do well in med school, bust your ass during your clinical years, study as hard as you can for your boards. Research helps a lot so fit that in where you can.

Away rotations often help but I don't think it plays a major role at UCSF or Columbia.

While there is no guarantee of a residency at UCSF even if you do well in medical school, internal med is way less competitive than a lot of other residencies, and if you are at an ivy school and end up in the top 1/3 of your class, then you would have a very, very good shot at getting in. You say you are top 10-20% of your class, but you don't really know how things will end up. Much will depend on your 3rd year grades. Even if not in the top 20-30% of your class, if you are at a high reputation med school, you'd still have a good shot at IM residency at a lot of the top places if you aced the medicine clerkship and subI, have good LOR's, and have at least one publication, good USMLE scores (like 230 or more) and can make a case for why you'd be a good resident for them. Just don't totally set your heart on just UCSF and you should be just fine...though it sounds like you'll have a good shot at going there anyway.

I don't know which of the Harvard hospitals is supposed to have the best cards fellowship...Mass General and Brigham both have good ones I think. UCSF is a pretty basic science type place...they'll probably try to make you do at least 1, if not more than 1, research year(s) if you choose to do cardiology fellowship there. I'm sure you can find out more about this later on in your med school career, and/or during IM residency interviews, so I wouldn't stress out too much about who has the "best" cards fellowship right now.

Step one isn't nearly as important as your clinical grades and what school you currently go to. I went to med school at UCSF and at the IM career meeting they told us that they look at step 1 only as a cutoff (probably around 220). Your clerkship grade in medicine and your subI grade in medicine is much more important, and no one can deny that the school you go to has strong influence. If you go to an ivy league school (penn, cornell, columbia, harvard, yale and less so with brown and dartmouth) then ucsf has pretty good experience with those programs. Meaning, if you do well and your program director writes a letter (or calls) and recommends you it can go a long way. Doing research will make it all the more obvious that you are interested in academic medicine, which is much more important for fellowship than it is for residency.

Bottom line: do well on step 1 but don't obsess about it; honor your 3rd year clerkship; honor your sub-I; and get letters of recommendation from prominent faculty who know you well. AOA is icing on the cake.

.

Hi I am starting med school this fall and have a choice to make. I will most likely having to choose between howard and nymc. I am interested in Cards and will like to try to get a good IM residency spot. What do I have to do coming from a lower tier school and not an Ivy to get into a top notch IM residency. If anyone can give me some advice on choosing between those two schools it will be very helpful. Thanks in advance.

Clerkships:
I think this is the most important. If youre coming from Brown or Dartmouth, I'd say that you need an honors in your basic medicine clerkship, medicine sub-I, and in all your other medicine related advanced clerkships (consults, MICU, etc). Even my friend from Columbia (265 step I) who got a HP in medicine was advised that he probably would not get interviews at Hopkins or Harvard, which turned out to be true for him. I'm sure a lot of publications would make up for it or something, but you need to do well in those core clerkships.

Letters/General support and enthusiasm of your department for you:
Intangible but extremely important. I think the two are interrelated. Even as an MS1-2, you will be viewed for your potential as a house officer by the faculty. Don't blow off classes and small groups. On the wards, the residents become the faculty/PD's eyes and ears. You WILL be compared to others so don't stand out in a bad way. I think 4 letters, 1 of which is departmental, with a mix of big name people versus people who actually know you well. The more letters that fit both criteria, the better. The more your department and your PD (or whoever coordinates things for your med students) likes you, the more they will go to bat for you and pick up that phone. If they don't, they certainly won't risk their reputation for you. Phone calls become VERY important later.

Research, or whatever else you like:
Work on research if you can this summer. Publications help if you're actually interested in research. If not, people can spot a fake, whether it's the PI you work with or your interviewer across the table. Along the way, a first authorship on a clinical research paper could help to show youre serious.

If you dont like research, do something else you like! This isn't about getting into the next step anymore. You're laying the foundation for your career, and developing the skill sets you need to succeed. Whatever you do, excel in it.

A year off:
Absolutely unnecessary, but if you happen to do it, and if your year was productive, you will shine on the trail.

Preclinical:
Do your best in MS1-2. MS2>1. It won't be a dealbreaker, but some Honors along the way should show that you're smart.

Step1:
Others are right in that Step1 is a cutoff. Do above 220-230 to be safe. It'll never get you in.

Personal statement:
Write about something youd like interviewers to bring up during your interview as discussion fodder. This is all its for...

AOA:
Great if you can get it.

Step II:
I dont even think this matters. I haven't even taken mine yet and Im a 4th yr, but its the norm at my school to take it late. I guess you shouldn't embarass yourself.

************

To be honest, the harder hurdle will be landing a cardiology fellowship. Might as well start on that now too!

P.S. All programs are 80 hrs. A lot of the top tier programs aren't front loaded.

Front loaded first year:
Hopkins, MGH, Duke, Columbia

Evenly loaded, from what I could tell:
UCSF, Mich, UW

First year not as hard, harder in the second year:
Brigham, WashU, Penn

Originally Posted by rackd8ball

First year not as hard, harder in the second year:
Brigham, WashU, Penn

I disagree about Penn. It is definitely harder during the intern year. Like all programs, the resident years carry more responsibility and, at times, can feel more tiring - but the intern year is definitely more difficult than the JAR year.

I think that most of the top IM programs have more demanding schedules than some of the lower tier IM programs, or the community programs, from what I saw on the interview trail. One community program where I interviewed had interns who were NOT busy, barely had any patients on their list, and said they screened out all patients with mental health issues out of the resident clinic. I'm sure there are some malignant and/or busy city hospital programs that work the interns very hard too, however.

Originally Posted by souljah1

I disagree about Penn. It is definitely harder during the intern year. Like all programs, the resident years carry more responsibility and, at times, can feel more tiring - but the intern year is definitely more difficult than the JAR year.

Sorry! I was basing my opinion on what I saw on the interview day. I never meant it to substitute for actual experience with a program.

Hey all, I am starting medical school in the fall and I have a choice between Morehouse and University of South Carolina. I would like to get into a really good IM university residency program because I am interested in cards. Which school do you all think will be a batter choice for me? I know Morehouse has Dr. Gibbons as the director for card research over there. I've done some research on him and he seems to be a top notch cardiologist. Would it be to my advantage to go to Morehouse and try to get some research done in cardiology? How about USC? Would doing well there make me any more competitive than doing well at Mourehouse? Thoughts, suggestions, and opinions are greatly appreciated. Thanks!

Just do your best at whichever place will allow you to focus on studying while remaining sane - so take proximity to family and social life into account.

Agree with Choirboy, at the stage you and a poster above are at - choosing medical schools - just pick the one where you will be most comfortable, have support, and enjoy life - there is plenty of time to worry about the rest when the time comes

Also, I think at any of the schools mentioned in your posts, if you do well, good step scores, research etc, there will certainly be a very solid university program out there for you, which will allow you to reach you goal of cardiology or whatever, so don't worry.

IF on the other hand, which is difficult to tell from the posts, you are set on training at one of the elite IM residency programs that have been mentioned on this thread, I'll be the bearer of bad news and tell you that you probably need to somehow get accepted into a "better" medical school. Nothing against those programs (and I was not in an elite medical school either), but you would have to be a fairly absurdly amazing IM candidate out of those programs to get noticed by the UCSFs, Havards, Hopkins etc, whose match lists are littered with very good students from the top medical schools

Choirboy, thanks for your advice, I really appreciate it. That's definitely something to consider anda deal breaker. UofM527, thanks for the advice. I would like to get into an elite IM residency ( I am sure almost everyone would) but I am completely satisfied with getting into a solid univeristy IM residency were I can learn the most to further develop my skills as a practioner and help me get into a good cardiology fellowship. It would be awesome to get into a top tier IM residency, but is it necessary to get into a GOOD (dare I even say great?) card fellowship?

Originally Posted by Trutodafield07

Choirboy, thanks for your advice, I really appreciate it. That's definitely something to consider anda deal breaker. UofM527, thanks for the advice. I would like to get into an elite IM residency ( I am sure almost everyone would) but I am completely satisfied with getting into a solid univeristy IM residency were I can learn the most to further develop my skills as a practioner and help me get into a good cardiology fellowship. It would be awesome to get into a top tier IM residency, but is it necessary to get into a GOOD (dare I even say great?) card fellowship?

First, what's the deal with resurecting threads that are years old lately?

Most of the "top tier" cardiology fellowships are very, very research heavy at the expense of clinical time with the exception of possibly Cleveland Clinic, Duke and a few others. To get into one of these top tier programs you pretty much have to come from a very strong residency program. That said, if you want a strong clinical training, you will be in good shape coming from a strong university program.