My impression:
-if you go to a top school, you can write your own ticket
I just went through the match from a top school for transitional year and competitive specialty, and I think this is absolute nonsense. I had what I thought was a very competitive application and I got beat out on my rank list by numerous people from lower tier schools.
In the first place, I think regional bias matters more than school rep. I didn't want to stay in my home region, did aways outside of here, did research outside of here, and it didn't matter. I couldn't get off the east coast. At least I went from northeast to southeast. I could have probably moved to the midwest if I really wanted to... But almost nobody does, and hence it's not competitive.
I think the reasons why our school has so many people going into competitive sub-specialties is because:
1) We get a lot of early exposure to sub-specialties. It's hard to ignore the brand new cancer center and massive proton facility that constantly makes news.
2) The subspecialty departments are very strong. So you have a lot of access to advisors, letter writers, and research opportunities in those specialties.
3) Research is strongly promoted at this school. Well over half the class takes at least a year out or attains some other advanced degree.
dantt said:
No offense but their match list is more consistent with lifestyle specialties than physician-scientists / leading academicians. There's nothing wrong with that. Just saying.
I found that post very astute.
4) And to say what everyone knows but nobody actually wants to say... The students here really get grilled by the top medicine and peds residency programs when they rotate through. When you do the rotations and sub-Is in those departments most nurses/residents/attendings are unhappy, and as a med student they often make you feel like an unknowing, unhelpful burden. Then you go do a rotation in derm, rad onc, or some other "cushy" specialty, and all of a sudden here's a big group of friendly attendings and residents who actually seem like they enjoy life and want to teach you. The decision to go into a subspecialty becomes a no-brainer. As for FP, yes there is a subspecialty bias at the top research medical schools. If you talk to faculty here, they'll generally try to push you more towards IM, peds, med-peds, EM, etc... It's hard to subspecialize and have big research careers out of FP. Further, the big name med schools have weak or non-existent FP departments, as opposed to the large, flashy subspecialty departments. People know this coming in, and if they had a strong interest in FP/primary care, they probably wouldn't have come to this big name, expensive private school anyway that so highly values all that undergrad research.
I find it all interesting, because when I talk to my buddies at not so big name schools who go into medicine, most of their class loves their medicine rotations. Their attendings and residents tend to be happy people. This is not so at MASSIVE, BIG NAME PROGRAM where everyone is under high pressure, high stress, low pay, and the residents are probably hiding their actual work hours.
I mean sure, it probably does help a lot that our average step 1 score is about 240. But I don't think school rep really matters much at all.
As for why we end up matching at so many "big name" residencies... We're a big name northeastern medical school, so the location bias comes back in again. There's a lot of big name programs in the northeast.
If you go to MCG, you probably have a lot more incentive to stay in the southeast, and there's not nearly as many big name sounding programs in the area. Though that being said, pre-meds have no idea what programs are "big name" in any given residency field. It does not correlate well with the medical school.
In the end, I'm sure I have swayed nobody. I've been on these forums near 10 years and everyone is convinced school rep means everything all the time. I've lived it (from no name undergrad to big name med school to competitive subspecialty), and I still think this "prestige" factor means little to nothing.