Couldn't lower ranked schools going True P/F with no AOA actually hurt their students match outcomes?

[NegativeMargin]

This thread is partly for me, but also for people in other T30s who are P/F. And like most threads I make here, it's because I feel there are things I am missing. My school is P/F with no internal rankings for pre-clinical, AOA is determined by STEP performance and clerkships. So I have an idea of where I'll need to focus, but how about for others?

Do people at these True P/F schools feel they have more freedom to do other things because they didn't have to spend as much time on their studies?

Looking at ( match data for last year ) the biggest difference between matched and unmatched applicants is STEP scores and AOA membership. Everything else is the same: research experiences, abstracts, presentations, publications, work experiences, volunteer experiences.

There are a lot of people talking about the Pro's of P/F schools and STEP 1 changes all over the internet and in student Q&A's, but what I'm seeing isn't really as rose tinted. I'm going to a T30, but it's not Mayo. If my entire curriculum was P/F the only way I'd have to stand out is through ECs and STEP 2 scores, or through the schools own prestige.. at that works if you're at Mayo, but not really for me. Beyond that I've been told STEP 1 was a bigger determining factor than STEP 2 for a reason.. AOA, STEP 1, STEP 2, all big factors, but if you are in one of those schools, you don't get to take part in 2 of those 3 now that STEP 1 is P/F.

As for me, I don't really know what I want to do yet.. I have some ideas, but if I wanted to do a competitive specialty this AOA membership seems to mean even more. For Derm it's 47% of matched people, and it's over 40% for plastic surgery, ENT, and Ortho as well if I remember correctly. The obvious answer seems to be "focus on STEP 2" or pump up those research experiences, but again I've seen an overall trend that the higher ranked schools do tend to have more research opportunities for students, which further pushes lower ranked schools into this weird position where I see people discussing how happy they are about the curriculum going P/F which I can certainly understand from a students perspective.. but looking forward it seems like it could actually be a detriment.

Perhaps last years data isn't as important for what I am getting at so much as the next few years data will be in showing how these trends change? Is anyone already seeing trends change from the inside?

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[voxveritatisetlucis]

There are really 30 T20 schools. If you’re going to a school in the USNEWS top 30, I doubt that you’ll be held back for any residency (assuming other elements are good)

 

[deleted1114112]

There are really 30 T20 schools. If you’re going to a school in the USNEWS top 30, I doubt that you’ll be held back for any residency (assuming other elements are good)

Question is still relatively applicable for any school. I've talked to some students at my undergrad med school (T10) and some say that a lot of people get 'weeded out' of competitive specialties and that you still have to be at the top of your class post M1 M2 but I have no idea how this works and most people just give some weak excuse like "yeah ___ was too hard and I just wanted to pursue something more chill." This is something I've been trying to learn more about but most people just give weird answers or dodge the question lol. In some groups/chats with admitted students at some schools I have gotten A's at, unironically 9 out of 10 people will say they want to go into derm/ortho yet even at these schools less than 10 match.

 

[spidermedic]

Do people at these True P/F schools feel they have more freedom to do other things because they didn't have to spend as much time on their studies?

Yes. Freaking love my school (low-tier MD). I study at my own pace and have so much free time. Going for semi-comp specialty and being average (and without research) is more than good enough to match my desired programs (not looking to work at ivory towers or the coasts). At the same time, I have 0 desire for fame/prestige/titles and my priorities are to support my family (my parents and my own future wife/kids) and provide good patient care.

My peers that are going for FM (especially rural FM) have it even easier. They don't bother with Anki and mainly learn with B&B and doing a few practice Qs here and there. Always at the gym, weekend getaways (local or go to miami/etc).

 

[voxveritatisetlucis]

Question is still relatively applicable for any school. I've talked to some students at my undergrad med school (T10) and some say that a lot of people get 'weeded out' of competitive specialties and that you still have to be at the top of your class post M1 M2 but I have no idea how this works and most people just give some weak excuse like "yeah ___ was too hard and I just wanted to pursue something more chill." This is something I've been trying to learn more about but most people just give weird answers or dodge the question lol. In some groups/chats with admitted students at some schools I have gotten A's at, unironically 9 out of 10 people will say they want to go into derm/ortho yet even at these schools less than 10 match.

I thought it used to be boards (especially at schools that don’t rank) that weeded people out.

I actually don’t really know if the people matching “less” competitive specialities at top schools actually want to match those or they feel like they have to. I guess a good question/thought experiment would be, assuming HMS matriculates a class in which everybody wants to match Ortho/derm/plastics/NS/ENT, how many would end up in those residencies vs. FM/IM/psych (apparently the third is becoming more competitive so even that may not be a good metric)? I can’t answer this. Maybe some of the faculty at schools know how many at Harvard Yale jhu etc. could match competitive specialties

 

[spidermedic]

I thought it used to be boards (especially at schools that don’t rank) that weeded people out.

I actually don’t really know if the people matching “less” competitive specialities at top schools actually want to match those or they feel like they have to. I guess a good question/thought experiment would be, assuming HMS matriculates a class in which everybody wants to match Ortho/derm/plastics/NS/ENT, how many would end up in those residencies vs. FM/IM/psych (apparently the third is becoming more competitive so even that may not be a good metric)? I can’t answer this. Maybe some of the faculty at schools know how many at Harvard Yale jhu etc. could match competitive specialties

Yes. https://meded.hms.harvard.edu/files...cted_match_list_by_specialty.pdf?m=1617299792

I remember reading a statistic that Yale has graduated something like 100 primary doctors in the last 50 years COMBINED. Compare this with some of the lower-performing DO schools that match 85%+ into primary care EACH year

Students at top schools have their pic. I did my SMP at a respectable research school and I got to know the professors very well (many were MD/PhD and from Yale, Harvard, Cornell, etc). Some greatly talked down on lower-ranked schools and one even gave me a weird look when I told him I was prioritizing DO because my stats were not impressive (ended up MD thankfully).

 

[deleted1114112]

I thought it used to be boards (especially at schools that don’t rank) that weeded people out.

I actually don’t really know if the people matching “less” competitive specialities at top schools actually want to match those or they feel like they have to. I guess a good question/thought experiment would be, assuming HMS matriculates a class in which everybody wants to match Ortho/derm/plastics/NS/ENT, how many would end up in those residencies vs. FM/IM/psych (apparently the third is becoming more competitive so even that may not be a good metric)? I can’t answer this. Maybe some of the faculty at schools know how many at Harvard Yale jhu etc. could match competitive specialties

Yeah, agreed. This is totally a personal experience and small sample but I literally have met zero people who have said they want to match anything non surgical. Obviously they exist but like, I've talked to A LOT of people accepted into great schools and nothing reflects the match outcomes. Adding onto what you said, like ~50% of each class matches non-surgical and a fair amount match psych/FM/etc. even out of HMS. I'm not in medical school so can't really speak to how specialty interest changes (and it does, obviously) but still a interesting question nonetheless.

 

[spidermedic]

Yeah, agreed. This is totally a personal experience and small sample but I literally have met zero people who have said they want to match anything non surgical. Obviously they exist but like, I've talked to A LOT of people accepted into great schools and nothing reflects the match outcomes. Adding onto what you said, like ~50% of each class matches non-surgical and a fair amount match psych/FM/etc. even out of HMS. I'm not in medical school so can't really speak to how specialty interest changes (and it does, obviously) but still a interesting question nonetheless.

Read my comment above. Anyone matching FM out of harvard is doing it because of passion. They can most likely walk into anesthesia/radiology if they wished to do so (even my low-tier MD can help someone below-average do that with a little bit of work). Harvard doesn't even have a FM home residency

 

[voxveritatisetlucis]

From my experience in life, there are always elite performers at one level who can’t crack it at the next level ( this can be a result of luck , inability to translate aptitude into performance, extreme competition)

Every year there are many people who

-Went to Hotchkiss, Exeter, Deerfield, Thacher who can’t get into an Ivy/ Ivy equivalent
-Majored in economics at HYP who end up in corporate banking after getting no IBD offers
-Played football at LSU, Bama, Georgia but can’t sign to an NFL practice squad
-Goldman analysts who can’t get into a T7 MBA or private equity position


I would assume that similar situations occur at top med schools but I’m not sure since I don’t think the step up from med school to residency is as high as the above examples (see match rates of AMG)

 

[Med Ed]

I remember reading a statistic that Yale has graduated something like 100 primary doctors in the last 50 years COMBINED.

So this statistic claims that in the last 50 years Yale has sent 100 graduates into the fields of internal medicine, pediatrics, and family medicine.

Yeah no.

 

[KnightDoc]

So this statistic claims that in the last 50 years Yale has sent 100 graduates into the fields of internal medicine, pediatrics, and family medicine.

Yeah no.

Isn't ob/gyn considered primary as well?

 

[Med Ed]

Isn't ob/gyn considered primary as well?

There are somewhat variable definitions of primary care, but the three I listed are consistently included.

 

[voxveritatisetlucis]

I can’t find anything on Yale’s match for some reason but 70 from HMS matched primary care in 2021. So it’s doubtful that HMS produced more primary care in one year than Yale has in 50

“Of the 159 graduating MD students at HMS in 2021, 151 matched to clinical training, internship or residency programs at hospitals; two are graduating in Oral and Maxillofacial Surgery and six will pursue non-clinical positions.

Seventy students, or 46 percent, matched at an HMS-affiliated program for some part of their training.

HMS graduating students matched at residency programs in 20 different states across the country including 73 in Massachusetts, 25 in California, 10 in New York and the states of North Carolina, Pennsylvania, Maryland, Illinois, Michigan, Ohio, Connecticut, Florida, Missouri, Oregon, Texas, Washington, Georgia, Maine, Minnesota, Tennessee and Utah.

This year, 70 students, or 46 percent of the class, were accepted into fields related to these primary care categories: 6 in Family Medicine, 45 in Internal Medicine, 10 in Pediatrics and 7 in Obstetrics/Gynecology. Those training in Internal Medicine could eventually go into Primary Care or Specialty Care.”

The state that really stands out is the percentage staying at an HMS affiliated residency. I mean aside Mayo and Cleveland Clinic, do any hospitals beat out MGH affiliates? I would guess that these residents can get any fellowship they want.

 

[spidermedic]

So this statistic claims that in the last 50 years Yale has sent 100 graduates into the fields of internal medicine, pediatrics, and family medicine.

Yeah no.

I can't find yale's match list but even at a less prestigious school like uconn https://medicine.uconn.edu/wp-content/uploads/sites/1392/2021/03/Deidentified-Match-Day-2021.pdf only 14% of the class is FM/peds. One can assume a good portion of those doing IM will do GI/Cards/Heme-onc/PCCM.

Contrast this with many of the lower-tier MD schools like mine where 20-30% are usually FM/peds, and at least of those doing IM will just do general IM. Go even lower to the newer/lower-tier DO schools it becomes 70-90% FM/peds/General IM. So it makes sense the higher up you go the less desire there is to do FM

6 in Family Medicine, 45 in Internal Medicine, 10 in Pediatrics and 7 in Obstetrics/Gynecology.
I'll bet of those 45 in IM most will do GI/Cards

Just do a quick search for "Family doctors near 02115 (harvard med zipcode) or in most major cities or even near you). Then look up their school (healthgrades, sharecare, vitals, etc). You'll find the vast majority of FM docs are either IMG/FMG, DO and very seldom you'll find them graduates of ivory towers

 

[voxveritatisetlucis]

I can't find yale's match list but even at a less prestigious school like uconn https://medicine.uconn.edu/wp-content/uploads/sites/1392/2021/03/Deidentified-Match-Day-2021.pdf only 14% of the class is FM/peds. One can assume a good portion of those doing IM will do GI/Cards/Heme-onc/PCCM.

Contrast this with many of the lower-tier MD schools like mine where 20-30% are usually FM/peds, and at least of those doing IM will just do general IM. Go even lower to the newer/lower-tier DO schools it becomes 70-90% FM/peds/General IM. So it makes sense the higher up you go the less desire there is to do FM

Do you find that psych/neurology/anesthesia /EM (not primary care but also not Uber competitive) are tough to match from your school?

 

[spidermedic]

Do you find that psych/neurology/anesthesia /EM (not primary care but also not Uber competitive) are tough to match from your school?

Not at all but I think that's also partially due to the fact that not many people want to live in my state. In many nearby cities, the quality of the program/residents varies within a small radius. You'll find one IM program primarily made up of DOs, IMGs (even non "top 4" caribb), and FMGs, and a mile down the road a more prestigious IM program that's primarily USMD (and T50 at that)

That's one of the advantages of living in the south/midwest. The coastal med students are not trying to match here (generally speaking) so there is reduced competition (many of my OOS classmates want to go back to Cali/NYC, and even some native ones want to match the coasts). We also interact with PDs/attendings of every specialty as early as M1 (meetings, seminars, shadowing, hospital tours, etc) so we're very well known by the time we start rotations and eventually apply

 

[srirachamayonnaise]

I can’t find anything on Yale’s match for some reason but 70 from HMS matched primary care in 2021. So it’s doubtful that HMS produced more primary care in one year than Yale has in 50

“Of the 159 graduating MD students at HMS in 2021, 151 matched to clinical training, internship or residency programs at hospitals; two are graduating in Oral and Maxillofacial Surgery and six will pursue non-clinical positions.

Seventy students, or 46 percent, matched at an HMS-affiliated program for some part of their training.

HMS graduating students matched at residency programs in 20 different states across the country including 73 in Massachusetts, 25 in California, 10 in New York and the states of North Carolina, Pennsylvania, Maryland, Illinois, Michigan, Ohio, Connecticut, Florida, Missouri, Oregon, Texas, Washington, Georgia, Maine, Minnesota, Tennessee and Utah.

This year, 70 students, or 46 percent of the class, were accepted into fields related to these primary care categories: 6 in Family Medicine, 45 in Internal Medicine, 10 in Pediatrics and 7 in Obstetrics/Gynecology. Those training in Internal Medicine could eventually go into Primary Care or Specialty Care.”

The state that really stands out is the percentage staying at an HMS affiliated residency. I mean aside Mayo and Cleveland Clinic, do any hospitals beat out MGH affiliates? I would guess that these residents can get any fellowship they want.

Not sure Cleveland clinic or Mayo are really considered that top when it comes to residency and fellowship.

 

[Med Ed]

I can't find yale's match list but even at a less prestigious school like uconn https://medicine.uconn.edu/wp-content/uploads/sites/1392/2021/03/Deidentified-Match-Day-2021.pdf only 14% of the class is FM/peds. One can assume a good portion of those doing IM will do GI/Cards/Heme-onc/PCCM.

Contrast this with many of the lower-tier MD schools like mine where 20-30% are usually FM/peds, and at least of those doing IM will just do general IM. Go even lower to the newer/lower-tier DO schools it becomes 70-90% FM/peds/General IM. So it makes sense the higher up you go the less desire there is to do FM

6 in Family Medicine, 45 in Internal Medicine, 10 in Pediatrics and 7 in Obstetrics/Gynecology.
I'll bet of those 45 in IM most will do GI/Cards

Just do a quick search for "Family doctors near 02115 (harvard med zipcode) or in most major cities or even near you). Then look up their school (healthgrades, sharecare, vitals, etc). You'll find the vast majority of FM docs are either IMG/FMG, DO and very seldom you'll find them graduates of ivory towers

The fact remains.

 

[Goro]

Question is still relatively applicable for any school. I've talked to some students at my undergrad med school (T10) and some say that a lot of people get 'weeded out' of competitive specialties and that you still have to be at the top of your class post M1 M2 but I have no idea how this works and most people just give some weak excuse like "yeah ___ was too hard and I just wanted to pursue something more chill." This is something I've been trying to learn more about but most people just give weird answers or dodge the question lol. In some groups/chats with admitted students at some schools I have gotten A's at, unironically 9 out of 10 people will say they want to go into derm/ortho yet even at these schools less than 10 match.

*sigh*
This has bern discussed to death already.

Step 2 will still be scored.
There will still be audition rotations
Networking
MSPEs

God forbid you can't get that residency at Mass Gen.

Then again, matching is more about where students want to go, as in be close to family and enjoy life, not publish in Lancet. Not everyone wants to go to JHU or Yale.