Better med school = better residency?

[Str8Baller]

If two candidates are applying to the same residency, all else being equal, does the candidate that attends the more competitive medical school have a significant advantage?

Now, assuming that a person will likely perform more poorly against a curve at an elite medical school as opposed to a lesser school, is it worth going to an elite medical school if getting into a competitive residency is the only consideration?

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[Ruhroh]

I know the prevailing wisdom on SDN is that it doesn't matter that much, but I think it's something we shouldn't completely discount. It probably becomes more important as the specialty or the hospital becomes more desirable.

 

[Sidereum]

I know the prevailing wisdom on SDN is that it doesn't matter that much, but I think it's something we shouldn't completely discount. It probably becomes more important as the specialty or the hospital becomes more desirable.

Although Step 1 scores are definitely the most important factor, it always helps to have that boost to make you stand out. Obviously, if you're trying to match into a less competitive specialty, I highly doubt it matters.

 

[flaviviral]

School does matter in certain residency programs. Certain specialties and certain places may use medical school prestige as a criteria, but other places are looking for the best students in every medical school.

It's better to go to a top tier school or a middle tier school well-respected in the state/region, if you can afford it. If you go to a lower tier school or a middle tier school in a region filled with top schools, then you have to do more extra things to gain a competitive edge, especially if you want interviews in other parts of the country.

 

[Law2Doc]

If two candidates are applying to the same residency, all else being equal, does the candidate that attends the more competitive medical school have a significant advantage?

Now, assuming that a person will likely perform more poorly against a curve at an elite medical school as opposed to a lesser school, is it worth going to an elite medical school if getting into a competitive residency is the only consideration?

All else is never equal, so your question is flawed. PDs have made clear that this isn't a top factor they use, but at some point sure, it could come into play. I'd still rather go where I'd be happy and do well, because the numbers, and whether attendings will bust their hump calling colleagues to get you through doors is going to matter more than the name on your tuition bill.

 

[NotAsking4Much]

If two candidates are applying to the same residency, all else being equal, does the candidate that attends the more competitive medical school have a significant advantage?

Now, assuming that a person will likely perform more poorly against a curve at an elite medical school as opposed to a lesser school, is it worth going to an elite medical school if getting into a competitive residency is the only consideration?

It makes a difference. Obv if you are doing horrible, then it doesn't matter. I do think coming from a good school can patch up an average part of your application.

Top PDs know other PDs at well established programs and will substantially help you on your networking / push for you. This aspect is often overlooked. There is a guy who matched several years ago to MGH who scored barely passed step 1 (~190). It did take a few phone calls to push him in, but hey...he's in.

 

[Law2Doc]

It makes a difference. Obv if you are doing horrible, then it doesn't matter. I do think coming from a good school can patch up an average part of your application.

Top PDs know other PDs at well established programs and will substantially help you on your networking / push for you. This aspect is often overlooked. There is a guy who matched several years ago to MGH who scored barely passed step 1 (~190). It did take a few phone calls to push him in, but hey...he's in.

Actually from my own experience, I've seen it work more often in reverse, where some of the grads of top named places actually get a lot less consideration because (1) some program directors feel there is too much of a sense of entitlement at certain programs, and (2) there is a reputation (true or not) of a lack of hands on skills at certain of these big name places, (3) the prior grads of big name places burn lots of bridges labeling places "safety" programs and not ranking them too many years in a row, and (4) the Nobel prize winning attending isn't about to make a phone call for a mere med student, while at a smaller school the attendings work the phones. So I'd be a bit careful about this -- you are better off going wherever you would be happiest, because trying to fame the system simply doesn't work as well as setting yourself up in a situation where you can thrive and do well.

 

[FrkyBgStok]

People could say yes but the fact is that all else being equal, the PD may take someone from his school or a friends school over a competitive school, or they may have dumped by a Jane and are subconsciously taking it out on Jane named applicants. There are just too many variables to say "all else being equal" and since PDs say it doesn't matter, that is really the only thing people can go with.

 

[Lollygag]

Actually from my own experience, I've seen it work more often in reverse, where some of the grads of top named places actually get a lot less consideration because (1) some program directors feel there is too much of a sense of entitlement at certain programs, and (2) there is a reputation (true or not) of a lack of hands on skills at certain of these big name places, (3) the prior grads of big name places burn lots of bridges labeling places "safety" programs and not ranking them too many years in a row, and (4) the Nobel prize winning attending isn't about to make a phone call for a mere med student, while at a smaller school the attendings work the phones. So I'd be a bit careful about this -- you are better off going where ER you would be happiest, because trying to fame the system simply doesn't work as well as setting yourself up in a situation where you can thrive and do well.

I have heard of all this as well, especially #2 but perhaps people from top schools are more research oriented?

 

[Law2Doc]

I have heard of all this as well, especially #2 but perhaps people from top schools are more research oriented?

That may be, but the PD, first and foremost, wants to avoid the headache of having to deal with a resident who isn't up to snuff. That's the kind of thing that results in the annoying late night calls from frustrated attendings. A PD would rather have the guy he knows will be good because the last three guys they took from that school were solid, than the guy with great pedigree but a questionable skillset. There's a reason programs tend to go back to the same finite number of wells year after year. It's because in the middle of the night on the wards, nobody gives a darn about your research acumen.

 

[Law2Doc]

I have heard of all this as well, especially #2 but perhaps people from top schools are more research oriented?

That may be, but the PD, first and foremost, wants to avoid the headache of having to deal with a resident who isn't up to snuff. That's the kind of thing that results in the annoying late night calls from frustrated attendings. A PD would rather have the guy he knows will be good because the last three guys they took from that school were solid, than the guy with great pedigree but a questionable skillset. There's a reason programs tend to go back to the same finite number of wells year after year. It's because in the middle of the night on the wards, nobody gives a darn about your research acumen.

So I still say, do what you need to to put yourself in a situation where you can thrive. Your Step score is going to matter a lot. What the attendings think of you will matter a lot. The rest is just an attempt at gaming the system, and can backfire as often as work in your favor.

 

[FSU2013]

It depends. I interviewed at a big name program recently where the PD said he didn't want students from a certain brand name school because they have been so clinically inept in the past. I've also had a couple PDs say they love people from my school because the residents they have in their program from my school are very strong residents.

On the other hand, I was told that one program's rejection email listed "med school attended" as a factor considered highly. I also heard that one residency program won't consider people from my school because they one resident they took sucked.

I suspect it's highly field dependent and even moreso very program dependent.

Bottom line: go where you'll be happy.

 

[Str8Baller]

Thanks guys, very helpful

 

[LovelyBRass]

That may be, but the PD, first and foremost, wants to avoid the headache of having to deal with a resident who isn't up to snuff. That's the kind of thing that results in the annoying late night calls from frustrated attendings. A PD would rather have the guy he knows will be good because the last three guys they took from that school were solid, than the guy with great pedigree but a questionable skillset. There's a reason programs tend to go back to the same finite number of wells year after year. It's because in the middle of the night on the wards, nobody gives a darn about your research acumen.

So I still say, do what you need to to put yourself in a situation where you can thrive. Your Step score is going to matter a lot. What the attendings think of you will matter a lot. The rest is just an attempt at gaming the system, and can backfire as often as work in your favor.

This is a situation where one program director doesn't like students from one school. But overall this just isn't the case. A better school will always help. I'm focused on Medicine and the bottom of the Medicine match list from any Ivy is comparable to the middle of a state school at best.

OP, everyone always tells you to go where you'll be happiest, but you have no idea where you'll be happiest until you get there. So try to be "happy" at the best name you can get into.

 

[clutch100]

Most surgeons I have talked to suggest going to a cheap (but respectable) medical school, finishing top 10-20% in your class, and then going to an elite medical school for residency.

 

[Law2Doc]

This is a situation where one program director doesn't like students from one school. But overall this just isn't the case. A better school will always help. I'm focused on Medicine and the bottom of the Medicine match list from any Ivy is comparable to the middle of a state school at best.

OP, everyone always tells you to go where you'll be happiest, but you have no idea where you'll be happiest until you get there. So try to be "happy" at the best name you can get into.

Every other year PDs complete a survey of factors they consider important. School name has never cracked the top three factors for any specialty. It's simply not deemed that importnt. So Step 1, your clinical year evaluations, for some fields research, and of course networking/away rotations drives this train. All the lesser factors, such as program name are not primary factors and can cut either way -- I've certainly seen certain biases at work at multiple places. Get yourself into a good situation and you will do great. But don't dwell on the name because the PDs ave made clear that they put other things much higher on their wish list.

 

[Law2Doc]

Most surgeons I have talked to suggest going to a cheap (but respectable) medical school, finishing top 10-20% in your class, and then going to an elite medical school for residency.

The top med school grads with good Step scores at each school tend to get looked at by everyplace. Whether or not the training is better at certain residencies is a Program by program evaluation you have to make with the help of mentors in the field because there is no useful US News ranking for residencies, the hierarchy is different in each specialty based a lot on faculty, and a place you may never have heard of might be the top program in a particular specialty. So that's an analysis you probably need to make during your third year of med school at the earliest. Until that point, go somewhere you n thrive and put up the numbers you need to make these decisions. If you go somewhere and scrape the bottom of the urge, it's all moot.

 

[FSU2013]

The top med school grads with good Step scores at each school tend to get looked at by everyplace. Whether or not the training is better at certain residencies is a Program by program evaluation you have to make with the help of mentors in the field because there is no useful US News ranking for residencies, the hierarchy is different in each specialty based a lot on faculty, and a place you may never have heard of might be the top program in a particular specialty. So that's an analysis you probably need to make during your third year of med school at the earliest. Until that point, go somewhere you n thrive and put up the numbers you need to make these decisions. If you go somewhere and scrape the bottom of the urge, it's all moot.

This is pretty important. I was woefully unprepared to evaluate medical schools. I only applied to a couple and I skimmed their match lists. I knew the big names only insofar as when they correlated with top med schools. I'm going into EM and would have assumed as an undergrad that the best programs were Hopkins, Yale, etc. I had never heard of Carolinas Medical Center and I wouldn't have impressed if someone told me matched EM at Denver, Cinci, Indy, etc. Don't get me wrong, a lot of traditional big name places have stellar programs, but a lot of places you wouldn't have heard about are major players in various specialties.

 

[quiltlady]

Don't discount personality. I know a guy who graduated from a top 5 medschool, had extraordinary step scores, but was unable to match anywhere. His home school found a transitional year for him, but he was never able to match ortho. Why? because he had a terrible personality, and once he interviewed, no one wanted to rank him highly. He eventually matched in some other field.

 

[Lollygag]

This is a situation where one program director doesn't like students from one school. But overall this just isn't the case. A better school will always help. I'm focused on Medicine and the bottom of the Medicine match list from any Ivy is comparable to the middle of a state school at best.

OP, everyone always tells you to go where you'll be happiest, but you have no idea where you'll be happiest until you get there. So try to be "happy" at the best name you can get into.

Lol that last paragraph made me laugh out loud but it's so true

 

[LovelyBRass]

Every other year PDs complete a survey of factors they consider important. School name has never cracked the top three factors for any specialty. It's simply not deemed that importnt. So Step 1, your clinical year evaluations, for some fields research, and of course networking/away rotations drives this train. All the lesser factors, such as program name are not primary factors and can cut either way -- I've certainly seen certain biases at work at multiple places. Get yourself into a good situation and you will do great. But don't dwell on the name because the PDs ave made clear that they put other things much higher on their wish list.

The flaw in this is that when you look at something like Medicine, which is what I referred to, there is so much heterogeneity in the quality of program. Sure basically anyone can match into Medicine, probably, but they're not matching into the good quality university programs that are full of AMGs. When it comes to good programs, the med school just matters.

 

[Caesar]

All of the stats collected from PDs says no, but on the Internet you'll always find an anecdote. If you pick a school for this reason alone you're making a huge mistake that you will regret. Just sayin.

 

[Caesar]

All of the stats collected from PDs says no, but on the Internet you'll always find an anecdote. If you pick a school for this reason alone you're making a huge mistake that you will regret. Just sayin.

http://www.nrmp.org/data/programresultsbyspecialty2010v3.pdf

Relevant link. Not sure if you need a log in. It's a very unimportant part.

 

[Caesar]

Elite medical schools don't always equal best place to become a surgeon. They might have the nicest toys with telemedicine with laser beams operating someone in Timbuktu in real time right in front of your office and great research opportunities... buuuuuuuut..

Oh BTW, we don't let first year residents to even get near a patient, you're not yet qualified, you need to be a resident here for at least 7 years before you can actually touch them, but when you graduate you will graduate with the copyrighted brand name hospital attached!

I personally would prefer to go to a residency program where I am zipping Swan Ganz lines with my eyes closed in under 3 minutes because I do the procedure 50 times every day and seeing a huge variety of a bit of everything with a good and friend PD and attendings that are actually interested in teaching me, and friendly resident coworkers than a place where I am miserable, they don't let me do anything, don't let me go on vacations ever or sick leave, the PD isn't friendly, the attendings are too interested drinking coffee to teach me and my resident coworkers are too busy stabbing my back.

...aren't you doing residency outside the US?

 

[235009]

All of the stats collected from PDs says no, but on the Internet you'll always find an anecdote. If you pick a school for this reason alone you're making a huge mistake that you will regret. Just sayin.

http://www.nrmp.org/data/programresultsbyspecialty2010v3.pdf

Relevant link. Not sure if you need a log in. It's a very unimportant part.

As stated above the PD survey is essentially irrelevant for a specialty as huge and heterogeneous as IM. answers from PDs of lower tier programs and community programs that are IMG mills will easily outnumber those of PDs from middle and top tier programs that are exclusively AMGs and therefore the responses of the latter will be diluted out. it's not anecdote it's common sense.

 

[LovelyBRass]

All of the stats collected from PDs says no, but on the Internet you'll always find an anecdote. If you pick a school for this reason alone you're making a huge mistake that you will regret. Just sayin.

I am familiar with the paper everyone is clinging to and have already responded. All you have to do is compare match lists, as I stated above, and compare stats over in the medicine forum and see where people are interviewing to start scratching the surface on this discrepancy.

 

[LovelyBRass]

Elite medical schools don't always equal best place to become a surgeon. They might have the nicest toys with telemedicine with laser beams operating someone in Timbuktu in real time right in front of your office and great research opportunities... buuuuuuuut..

Oh BTW, we don't let first year residents to even get near a patient, you're not yet qualified, you need to be a resident here for at least 7 years before you can actually touch them, but when you graduate you will graduate with the copyrighted brand name hospital attached!

I personally would prefer to go to a residency program where I am zipping Swan Ganz lines with my eyes closed in under 3 minutes because I do the procedure 50 times every day and seeing a huge variety of a bit of everything with a good and friend PD and attendings that are actually interested in teaching me, and friendly resident coworkers than a place where I am miserable, they don't let me do anything, don't let me go on vacations ever or sick leave, the PD isn't friendly, the attendings are too interested drinking coffee to teach me and my resident coworkers are too busy stabbing my back.

This is such a near-sighted response. You act as if the only dichotomy is that between no-name do-everything place or touch-nothing great-name hospital. These just aren't the only options and it's irresponsible to present hospitals as such.

 

[Caesar]

I accept what you are saying in a sense but I think it is completely inappropriate to assume that the match list is due to school you graduated from alone, or is even a large part of the consideration. Folks that go to Ivys had to get into Ivys. They were more competitive residency applicants from the get go. You'd likely find the same correlation of MCAT score and match list perceived prestige. This is all highly highly residency and program specific and I think it is irresponsible to pick a medical school based on what PDs will think of it. These kids have no idea what specialty they are going into even.

 

[LovelyBRass]

I accept what you are saying in a sense but I think it is completely inappropriate to assume that the match list is due to school you graduated from alone, or is even a large part of the consideration. Folks that go to Ivys had to get into Ivys. They were more competitive residency applicants from the get go. You'd likely find the same correlation of MCAT score and match list perceived prestige. This is all highly highly residency and program specific and I think it is irresponsible to pick a medical school based on what PDs will think of it. These kids have no idea what specialty they are going into even.

Are we going to medical school to plant flowers and sing Kumbaya or are we going to start a career?

 

[circulus vitios]

The majority of physicians aren't academic physicians. Training at a "better" residency program is largely irrelevant.

 

[Caesar]

I'm going to medical school to have a fulfilling career that makes me happy. The name of the place I train means far less than the quality of the training. But I am not and have never been interested in overly competitive specialties or certain programs because of their names. If you have, that's fine for you, but to pick a medical school based soley on that schools reputation for matching in _______ at ________ program is laughable to me. But what do I know, like you, I am n=1

 

[235009]

I accept what you are saying in a sense but I think it is completely inappropriate to assume that the match list is due to school you graduated from alone, or is even a large part of the consideration. Folks that go to Ivys had to get into Ivys. They were more competitive residency applicants from the get go. You'd likely find the same correlation of MCAT score and match list perceived prestige. This is all highly highly residency and program specific and I think it is irresponsible to pick a medical school based on what PDs will think of it. These kids have no idea what specialty they are going into even.

if you look at the match lists of top med schools for IM you see that the majority go to top residencies which means that even an average candidate can land a solid residency whereas the rank list at a lower ranked school is noticeably different.

doesn't matter which specialty you want to go into, going to a more prestigious or more well respected school will keep more doors open

 

[Caesar]

My argument is going to a different one where you are happy and do well wont shut any. I think it's honestly a wash. That said I am limited by my experience which is mostly one of indifference to where one trains.

 

[487806]

If two candidates are applying to the same residency, all else being equal, does the candidate that attends the more competitive medical school have a significant advantage?

Now, assuming that a person will likely perform more poorly against a curve at an elite medical school as opposed to a lesser school, is it worth going to an elite medical school if getting into a competitive residency is the only consideration?

Law2Doc points out that "all else equal" isn't true. Anyhow, I would say that school name does have an impact for residency, but that's only true if you're aiming for top residency (i.e. top residencies would prefer students from top schools).

 

[LovelyBRass]

I'm going to medical school to have a fulfilling career that makes me happy. The name of the place I train means far less than the quality of the training. But I am not and have never been interested in overly competitive specialties or certain programs because of their names. If you have, that's fine for you, but to pick a medical school based soley on that schools reputation for matching in _______ at ________ program is laughable to me. But what do I know, like you, I am n=1

That couldn't be what you read because I didn't write that.

But yeah, overall, to get the most and your best options, better names are going to help you. None of you guys should limit yourselves because you "just want to do non-competitive specialty X" at "lame community hospital anyway." And it's even more important to go to better places when you don't know what you want to do, not less.

 

[Caesar]

bolded was directed at the topic, not you. I'm just offering my opinon to OP's question. I'm not here to change hearts or minds. Everyone needs to do what they feel is best for them. This is what's worked for me.

 

[Law2Doc]

if you look at the match lists of top med schools for IM you see that the majority go to top residencies which means that even an average candidate can land a solid residency whereas the rank list at a lower ranked school is noticeably different.

doesn't matter which specialty you want to go into, going to a more prestigious or more well respected school will keep more doors open

First, I'm suggesting that folks younger than 3rd year of med school are ill equipped to gauge what are the "top residencies" in any field. It's not the same as US News. A place with a big name can be outright malignant and most people's lower choice. So match lists are misleading. Until you go through the process it's hard to appreciate that.

Second, though you dismiss it, the PD survey of factors they consider important isn't meaningless. They do put more stock in your step scores than your alma mater, no matter what you choose to believe.

Third, from personal experience, pretty much all the people I know who did well, from a wide range of US allo med schools, ended up at what most would consider prestigious residencies. They didn't end up at the IMG populated community medicine programs. Doing well on the Step opened doors, and where they went to med school sure didn't close them.

Fourth, I know folks from "lesser programs" who had mentors who pulled out all the stops in working the phones with their colleagues to help them get a good residency. Totally anecdotal, but something to watch for -- this would be a bigger selling point than school name IMHO.

Fifth, I have seen PDs prefer or dislike taking residents from certain schools for reasons totally unrelated to or inversely related to rank. So as a med student or premed you really won't know how this is going to cut. Each action opens some doors, closes others. it's hard to know which way the biases run, particularly if you find yourself wanting to end up in a particular geographic region that doesn't respect the big name (based on past experiences) as much as elsewhere in the country.

So I'm not going to be convinced that putting yourself in a setting where you can thrive and do well isn't more important. The US grads with high step scores and good evaluations end up where they want, period. Again, this isn't advocating to go to a lesser name school, per se, or saying that if you go to any med school and do poorly you are still golden. I'm just saying that getting into residency is going to depend more on other factors than school name, and more often your step score and networking will drive this train. If you think you will do better and get more networking help elsewhere, then that's probably more important. But if you can get all that at a top school, then sure, maybe that's the way to go. Just don't get hung up on the name because most PDs won't.

 

[Geebeejay]

Are we going to medical school to plant flowers and sing Kumbaya or are we going to start a career?

we're going to medical school to gain the training necessary to start a career.

+1 to whoever mentioned this earlier - pick a school that you are confident will adequately train you for residency, and where you believe you'd be happy, and beyond that I don't really think it matters. I have, however, encountered countless residents who come from "top" schools who are absolutely clueless once they get on the floor.

 

[235009]

First, I'm suggesting that folks younger than 3rd year of med school are ill equipped to gauge what are the "top residencies" in any field. It's not the same as US News. A place with a big name can be outright malignant and most people's lower choice. So match lists are misleading. Until you go through the process it's hard to appreciate that.

for some specialties you're correct. for instance the good EM residencies do not correspond with top med schools. however top IM residencies generally do. i'm not sure what this has to do with anything though. i'm stating a fact that top schools send more people to top residencies not suggesting that a pre-med should try to interpret a match list.

also i'm really beginning to hate the term "malignant" seems like a term that's thrown around in a way that renders it meaningless.

They do put more stock in your step scores than your alma mater, no matter what you choose to believe.

no one is arguing that it is more important than your step score however the same step score will probably carry you further at a more well-regarded school

Fourth, I know folks from "lesser programs" who had mentors who pulled out all the stops in working the phones with their colleagues to help them get a good residency. Totally anecdotal, but something to watch for -- this would be a bigger selling point than school name IMHO.

no argument there...connections are extremely important. i will contend though that at more well known places you will find better known faculty who will be better connections to have

So I'm not going to be convinced that putting yourself in a setting where you can thrive and do well isn't more important. The US grads with high step scores and good evaluations end up where they want, period. Again, this isn't advocating to go to a lesser name school, per se, or saying that if you go to any med school and do poorly you are still golden. I'm just saying that getting into residency is going to depend more on other factors than school name, and more often your step score and networking will drive this train. If you think you will do better and get more networking help elsewhere, then that's probably more important. But if you can get all that at a top school, then sure, maybe that's the way to go. Just don't get hung up on the name because most PDs won't.

it's pretty ridiculous to suggest that your gut feeling from spending 3 hours somewhere should be the most important thing you base the trajectory of your career on.

i went to a top school for undergrad and a barely-ranked school for med school and my opinion hasn't changed. having experienced both sides i can pretty confidently say that for college and med school where you go matters! this is particularly true if you are an average or slightly above average student.