Anti-elitism ?

[deleted631385]

Does any one think that SDN is anti-top medical schools ? I was really shocked that large quantity of readers actually dissuade premed or med student for pursuit of elite schools with the excuse of student debts or no differences after medical school. However, the name recognition is one of the important factor for residency and practices, and top schools actually give generous assistance to poor students. How do you think?

---

Members don't see this ad.

 

[raiderette]

I don't see this at all. Applicants apply to all schools from Harvard to Caribbean. SDN is great about being realistic about chances, comparing cost versus benefit and explaining the process. SDN doesn't need to blow smoke up your butt and tell you that you can get into a top school, or that paying full price to attend a top 25 school is better than a full ride to a state school.

 

[PS2020]

I don't think SDN is anti-top schools. If SDN is anti anything, then it is anti Carib schools/IMGs. Over the years I also came across a ton of threads that say pedigree absolutely matters. Everyone echoes the sentiment that an allopathic MD = all doors remain open (just a matter of how much you hustle), but no one denies the fact that pedigree makes some doors more accessible.

 

[Winged Scapula]

Does any one think that SDN is anti-top medical schools ? I was really shocked that large quantity of readers actually dissuade premed or med student for pursuit of elite schools with the excuse of student debts or no differences after medical school. However, the name recognition is one of the important factor for residency and practices, and top schools actually give generous assistance to poor students. How do you think?

I think it's actually the opposite: it seems to me there is more elitism (i.e., if you can't go to a Top whatever or US MD school you might as well give up), than anti elitism

 

[sliceofbread136]

I think it's actually the opposite: it seems to me there is more elitism (i.e., if you can't go to a Top whatever or US MD school you might as well give up), than anti elitism

Agreed for medical school.

I have encountered the opposite attitude for residency, with some people saying that in a lot of cases a community residency is better than a top one (I don't agree with this statement either)

 

[IsWhat]

I think the general concescous is go to the best school you can AFFORD. Your top 5 MD degree is going to mean nothing to you when you graduate from residency and see your lowly state school graduate colleagues pay off their entire medical school debt with 1 or 2 paychecks. They'll be buying nice homes/cars and building wealth on their way to an early retirement - all while you are still living like a resident well into your late 30's, because that $300,000 degree was worth it, right?

 

[Mad Jack]

Does any one think that SDN is anti-top medical schools ? I was really shocked that large quantity of readers actually dissuade premed or med student for pursuit of elite schools with the excuse of student debts or no differences after medical school. However, the name recognition is one of the important factor for residency and practices, and top schools actually give generous assistance to poor students. How do you think?

SDN is actually pretty elitist. Go to a top 10 school if able, but outside of the top 10 or so schools it becomes a cost-benefit analysis that varies highly based on debt load and school.

 

[sinombre]

Agreed for medical school.

I have encountered the opposite attitude for residency, with some people saying that in a lot of cases a community residency is better than a top one (I don't agree with this statement either)

I'm assuming you're referring to gen surg? The generalization I've heard is that going to a program with fewer fellows can be advantageous because in theory there are fewer people 'above' you to take up certain cases. How true this is or how much it really matters, I'm not sure. There is enough volume where I am that I don't think it matters.

 

[hello1234!]

Is anti-elitism a bad thing?

I don't think the decision to go to a top school is elitist.

 

[sliceofbread136]

I'm assuming you're referring to gen surg? The generalization I've heard is that going to a program with fewer fellows can be advantageous because in theory there are fewer people 'above' you to take up certain cases. How true this is or how much it really matters, I'm not sure. There is enough volume where I am that I don't think it matters.

Referring to peds and im actually, but ya I've seen for surgery too. I don't really the experience with that to comment on the accuracy of the statement (nor do I want it, surgery is yucky)

 

[Goro]

Does any one think that SDN is anti-top medical schools ? I was really shocked that large quantity of readers actually dissuade premed or med student for pursuit of elite schools with the excuse of student debts or no differences after medical school. However, the name recognition is one of the important factor for residency and practices, and top schools actually give generous assistance to poor students. How do you think?

No. Next question

 

[BorntobeDO?]

G0ing to a free school over a top 25 school (as long as both are USMD) is not anti elitist, its just smart money. I mean, I would splurge maybe for a Harvard, Yale, Hopkins, UWash, Stanford, etc. But if the name is just respected (say UC Davis, for instance), and I had the opportunity to go to a lower ranked school for free? I would be completely on board with the lower ranked school, as long as it met your desired goals area. Harvard will open doors just cause of the name even if board scores are below average for specialty. UC Davis not so much, you still need to actually be good.

 

[elitehacker1337]

Couldn't any average joe do really well on step and match derm from a mid/low MD?

 

[Mad Jack]

Couldn't any average joe do really well on step and match derm from a mid/low MD?

The better your pedigree the easier it will be though. Particularly in a field like dermatology, where prestigious degrees tend to be overrepresented.

 

[neoevolution]

Couldn't any average joe do really well on step and match derm from a mid/low MD?

If you look at charting outcomes, even crazy high Step percentiles still have a large percentage not matching. Top tier schools have the name and research support that can make the difference

 

[VA Hopeful Dr]

Referring to peds and im actually, but ya I've seen for surgery too. I don't really the experience with that to comment on the accuracy of the statement (nor do I want it, surgery is yucky)

I think much of that depends on what you want to do. If you want to do basic outpatient general X (be it peds, IM, surgery, whatever), sometimes community programs can be advantageous. Fewer fellows taking procedures/complex patients which is good, but you do lose some of the super rare, complicated patients. The question is: are those patients that important in a general practice? I can't answer that for peds, but I can for my field (FM) - the answer is generally no. You're better off getting more of the usual pathology and less of the super rare stuff than the other way around. When I was in residency, we ran the OB floor - no OB residents, it was entirely us (with OB attendings available for C-sections as needed). We ran the peds floor, no pediatrician residents. Same with medicine, ICU, Level 1/2 nursery. Had our program been at an academic center, I would have gotten less overall experience in most of those areas but would have likely seen more rare diseases. For a guy doing outpatient FM, I think its the right trade off.

 

[deleted631385]

Do you have other physicians from top school get more patients than you? Compared to my supervisor whose beds are always occupied, others seem always available. In fact , patients choose physicians based on experiences and where he/she complete education and residency, right? Moreover, top medical schools' match lists are monstrous as if every their students got above 250. Probably school were not important twenty years ago, but it's incontrovertible that top schools are given huge advantages nowadays.

 

[wholeheartedly]

Do you have other physicians from top school get more patients than you? Compared to my supervisor whose beds are always occupied, others seem always available. In fact , patients choose physicians based on experiences and where he/she complete education and residency, right? Moreover, top medical schools' match lists are monstrous as if every their students got above 250. Probably school were not important twenty years ago, but it's incontrovertible that top schools are given huge advantages nowadays.

Patients can barely differentiate nurses from doctors from phlebotomists half the time. Most aren't going to know where their doc went to med school. Maybe where they did residency.

 

[sliceofbread136]

I think much of that depends on what you want to do. If you want to do basic outpatient general X (be it peds, IM, surgery, whatever), sometimes community programs can be advantageous. Fewer fellows taking procedures/complex patients which is good, but you do lose some of the super rare, complicated patients. The question is: are those patients that important in a general practice? I can't answer that for peds, but I can for my field (FM) - the answer is generally no. You're better off getting more of the usual pathology and less of the super rare stuff than the other way around. When I was in residency, we ran the OB floor - no OB residents, it was entirely us (with OB attendings available for C-sections as needed). We ran the peds floor, no pediatrician residents. Same with medicine, ICU, Level 1/2 nursery. Had our program been at an academic center, I would have gotten less overall experience in most of those areas but would have likely seen more rare diseases. For a guy doing outpatient FM, I think its the right trade off.

To each their own, but I don't really agree. A lot of these diseases aren't actually super rare in the scheme of seeing thousands of patients, and actually having experience with the disease allows you to more effectively keep it in your differential for your more common symptoms. We get tons of transfers where the diagnosis was simply not even considered at an outside hospital. Of course hindsight is 20/20, but I can't help but feel that if the attending had more experience with said disease it could have been caught sooner and likely had a better outcome. To me this is more valuable than seeing those extra couple of asthma exacerbations (also personally significantly more entertaining, I love trying to figure these things out)

I do also think there is the opposite extreme where there is not enough bread and butter. I sought out a residency with a good mix

 

[Donald Juan]

I always thought SDN was elitist as hell...

 

[B_52]

Does any one think that SDN is anti-top medical schools ? I was really shocked that large quantity of readers actually dissuade premed or med student for pursuit of elite schools with the excuse of student debts or no differences after medical school. However, the name recognition is one of the important factor for residency and practices, and top schools actually give generous assistance to poor students. How do you think?

honestly I see the opposite. People here tend to see say arbitrarily the top 30% of US schools in the same breadth, while they tend to excessively bash the less competitive options and especially Caribbean schools (warranted to a degree but I still hold a certain respect for someone who is so set on medicine that they are willing to face 50/50 odds to still have a shot at it).

 

[ChordaEpiphany]

.

 

[Psai]

I would argue it's the opposite. People on here tend to revere those who come from top schools while not giving time of day to those at other schools. There are about 20,000 new med students each year, which were picked from a group of 50,000 applicants, which was composed of the very few college students who actually kept up a GPA high enough to even keep that dream alive. Of all of those students, about 3000 go to schools that currently have their name on the first page of USNWR, and even of those schools, many on SDN probably would exclude plenty of those students on the grounds of benefiting from a highly ranked state school. There are something like 175 US med schools, each of them able to be very picky with admissions. Most students at a top 50 med school who applied to other graduate schooling (e.g. Law, PhD, PharmD, MBA) with the same stats/resume proportionally (and tailored to that field) would have an acceptance to a top 25 school in any of those fields. Yet you know that most people, even those who know the process well, would have a gut reaction to think of a Cornell law student as more impressive than someone at BU for med school, even though the med school admission is still statistically more difficult.

If anything, SDN suffers from a serious problem with adhering to name-brand value far too much. There are more than a few posters on here who have indicated that they would not have gone to med school had they had to go to a school without name-brand value. Others have indicated that they would try for a different specialty rather than go to a community program or fall out of the elite programs. Then there are the even more ridiculous people who seem to think that going to Brown/Dartmouth is better than say... UVA, just because they have the Ivy undergrad name.

I think I've said this here before, but I do believe that a not insignificant portion of SDN lives and works tirelessly entirely for recognition, whether that be from within their family, their friend group, or the general public. SDN is definitely not anti-elitism. This forum is actually probably one of the primary drivers of institution-based elitism in the US medical world today.

State school?

 

[Ismet]

I think much of that depends on what you want to do. If you want to do basic outpatient general X (be it peds, IM, surgery, whatever), sometimes community programs can be advantageous. Fewer fellows taking procedures/complex patients which is good, but you do lose some of the super rare, complicated patients. The question is: are those patients that important in a general practice? I can't answer that for peds, but I can for my field (FM) - the answer is generally no. You're better off getting more of the usual pathology and less of the super rare stuff than the other way around. When I was in residency, we ran the OB floor - no OB residents, it was entirely us (with OB attendings available for C-sections as needed). We ran the peds floor, no pediatrician residents. Same with medicine, ICU, Level 1/2 nursery. Had our program been at an academic center, I would have gotten less overall experience in most of those areas but would have likely seen more rare diseases. For a guy doing outpatient FM, I think its the right trade off.

I agree with this, it ultimately depends on your career goals. A community program is not for everybody, but there are many who seek out and benefit from one. I did my med school FM rotation at a rural community hospital with an unopposed FM residency, and I saw the same things you described - FM residents ran the peds floor, the inpatient medicine units, the nursery, OB, in addition to the very busy clinic. I got so much more out of my rotation than the people who stayed in the city and just did 4 weeks of outpatient FM clinic. For someone planning on working in that setting, it makes sense to train in that setting. Contrast to the FM residents at my academic program and I think they do like 3 months of peds in their entire residency. There are pros and cons to each setting and ultimately you have to weigh those for yourself against your career goals.

 

[darklabel]

I agree with this, it ultimately depends on your career goals. A community program is not for everybody, but there are many who seek out and benefit from one. I did my med school FM rotation at a rural community hospital with an unopposed FM residency, and I saw the same things you described - FM residents ran the peds floor, the inpatient medicine units, the nursery, OB, in addition to the very busy clinic. I got so much more out of my rotation than the people who stayed in the city and just did 4 weeks of outpatient FM clinic. For someone planning on working in that setting, it makes sense to train in that setting. Contrast to the FM residents at my academic program and I think they do like 3 months of peds in their entire residency. There are pros and cons to each setting and ultimately you have to weigh those for yourself against your career goals.

Just to add to this, for IM I did an away at a place that is fellowship heavy and one that is not. The difference was night and day on how things are run. Instead of relying on consults you were pretty much on your own. Of course if you want a fellowship then go to an academic center or a community program with a lot of fellowships, but I definitely could see the draw of a community program for someone that may not want to subspecialize.

 

[Entadus]

I didn't realize pre-med students were allowed to create threads in Allo now

 

[ChordaEpiphany]

.

 

[North meets South]

I go to a top 20. Just saw way too many of my smartest and most talented friends get shafted in favor of some serious asskissers who knew how to play the game (or hired someone to teach them/write their essays, more common than anyone is willing to admit).

It's always someone's "friend." If you had received an acceptance to a top 20 medical school, then presumably you'd think they did a great job in selecting you, but the process is fatally flawed since they didn't. Given your seemingly constant focus on prestige, and I hope this doesn't come across as overly harsh, but it's like you've become the prestige equivalent to failedatlife for Step 1.

Remember, the cream always rises to the top. Application success at all levels isn't simply about some sort of game and is more meritocratic than you'd otherwise prefer to believe. The people who "lucked out" with medical school admissions normally fall off and vice versa for those who were truly great. In the end, I'm sure you'll do well in the residency application process if you deserve it, but your fate hasn't already been predetermined simply by your current school.

 

[ChordaEpiphany]

.

 

[North meets South]

Ultimately I applied to 20 schools and got 3 IIs, one from a top 5 school, on high-mid tier, and one low ranked state school safety. I squeaked by and got into the lower two and matriculated at the high-mid tier (USNWR ~30) school. I was MD/PhD so it's a YMMV situation, but this whole process is a crapshoot.

I mean... I'm not lying lol. If I was the sort of person who would let my own acceptance guide my opinions about the application process (which is essentially a test that is supposed to, with accuracy, predict future success as a physician), I'd be a pretty terrible scientist. The truth is, I'm a student at a top 20 MD/PhD program. I believe in objectivity and believe most of the admissions process is hand-wavy nonsense set in place to allow admissions committees to select candidates that make them feel better about themselves, make themselves appear more competitive (residencies mostly), and to appease donating alumni as well as the LCME...

9 months ago it was ~30 (which is really code for 31-34), today it's top 20, but perhaps next year it'll be top 10? The general tenor of your posts, when I've come across them, have been of one who felt he wasn't appropriately rewarded for his accomplishments. It's interesting that on one hand you are essentially lamenting that the medical school application process did not adequately take into account the reputation of your undergrad and the reputation of the rigor of engineering degrees at your school, yet you complain that the current application system only looks at the name of the school.

I think it's very dangerous to presume you know the quality of someone's application and character, the good and the bad, from fairly limited interactions. Perhaps your intellectually lazy classmates are incredibly passionate about inspiring projects you wouldn't normally waste two minutes on. Who's the lazy one then? With that caveat, your n=1 has been the complete opposite of my n=1. The large, large majority of my amazing classmates have done remarkably well in medical school/residency while the ones I was less impressed with, either not so much or have fallen off for residency.

While obviously nowhere close to perfect, the process is also far from some "hand-wavy nonsense," but hey, at least there's a built-in excuse in case things don't go well for residency.

 

[ChordaEpiphany]

.

 

[PhysMatMan]

Agree with Chorda here. And for those saying the undeserving will reveal themselves, keep in mind that higher ranked schools have "gentleman's B" policies that mask variation in their student population. I can say this from experience.

At the end of the day, medicine is an art and our evaluations are largely subjective. There is even variability in Step I scores, and I have no faith in third year evaluations whatsoever. Connections and schmoozing and personalities are at least 80% of the system.