Getting an Out of State Residency

[Spritsker]

I have done a lot of searching on this site but I was not able to find any threads specifically aimed at answering this question. My question, is it difficult to obtain an out of state residency after medical school if you have no connection to that state? I have heard from many that without family and/or roots in a different state, program directors will rarely look at you, even with a spectacular resume. I am wondering because I am a Michigan resident currently applying to MD schools, but I would like to eventually practice in a different area (Chicago, NY, Florida, Mass, etc), so I was wondering if I should perhaps apply to more MD schools in those areas if I wish to eventually practice there (I have no connection to those states). My stats are solid (3.9/37) so I feel like I could snag a few OOS interviews, I am just wondering if I should put in the extra effort, time, and, if accepted, the extra tuition/cost of attending an OOS place when my IS schools will be much cheaper and more convenient.

I understand that I am not even in medical school yet, so it is too early to inquire about these things. But if I am putting myself at a huge disadvantage for out of state residencies by going to an IS MD school, I would like to know.

Thanks

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[Winged Scapula]

There are lots of threads about this topic and the advice hasn't changed.

Residencies do not generally place the same emphasis on in-state vs OOS that medical schools do. You'll find that at many residencies, few of the residents are actually from that state, especially in larger programs.

You SHOULD go to the cheapest and best medical school you can get in to. Do not choose an OOS program and spend more money in the misguided attempt to increase your chances for a residency in that state.

 

[sobored]

There are lots of threads about this topic and the advice hasn't changed.

Residencies do not generally place the same emphasis on in-state vs OOS that medical schools do. You'll find that at many residencies, few of the residents are actually from that state, especially in larger programs.

You SHOULD go to the cheapest and best medical school you can get in to. Do not choose an OOS program and spend more money in the misguided attempt to increase your chances for a residency in that state.

With all due respect, I don't feel like this is good advice. Sure people can go anywhere for residency if they do well enough, but people vastly underestimate how much school name helps the application. A 220 step 1 from a top 10 is certainly viewed differently than a 220 from low ranked state school. Is it fair? Probably not. But that's the way it is. I have heard this from several departments at my own school, as well as from friends who've talked to their field of interest departments at different schools.

OP, IMO going to a better ranked school will help you to match out of state. Having said that, you can still match OOS from your state school if you do well, show interest in the region you want to go to (by doing away rotations your 4th year) and networking. I think you should go to the best school possible, without regard to expense - UNLESS the difference is in price is too large to pass up (>100k or so). Some people think money is more important, and they might be right. But as I have progressed through med school, I have personally realized that residency location and program quality matter more to me than some more debt. To each his/her own...

 

[DermViser]

With all due respect, I don't feel like this is good advice. Sure people can go anywhere for residency if they do well enough, but people vastly underestimate how much school name helps the application. A 220 step 1 from a top 10 is certainly viewed differently than a 220 from low ranked state school. Is it fair? Probably not. But that's the way it is. I have heard this from several departments at my own school, as well as from friends who've talked to their field of interest departments at different schools.

OP, IMO going to a better ranked school will help you to match out of state. Having said that, you can still match OOS from your state school if you do well, show interest in the region you want to go to (by doing away rotations your 4th year) and networking. I think you should go to the best school possible, without regard to expense - UNLESS the difference is in price is too large to pass up (>100k or so). Some people think money is more important, and they might be right. But as I have progressed through med school, I have personally realized that residency location and program quality matter more to me than some more debt. To each his/her own...

You missed the part where she said, "You SHOULD go to the cheapest and best medical school you can get in to. Do not choose an OOS program and spend more money in the misguided attempt to increase your chances for a residency in that state."

 

[sobored]

You missed the part where she said, "You SHOULD go to the cheapest and best medical school you can get in to. Do not choose an OOS program and spend more money in the misguided attempt to increase your chances for a residency in that state."

I didn't miss any of that. "And" means both. I said go for best over cheaper. Furthermore, I don't think it's a misguided attempt to spend more to go to an out of state school if someone thinks they want to be in that region post med school. Would it not be easier for someone from Michigan to obtain residency in California if they went to a UC school rather than Michigan State? I just have a different opinion than what is commonly shared on this forum.

 

[mehc012]

I didn't miss any of that. "And" means both. I said go for best over cheaper. Furthermore, I don't think it's a misguided attempt to spend more to go to an out of state school if someone thinks they want to be in that region post med school. Would it not be easier for someone from Michigan to obtain residency in California if they went to a UC school rather than Michigan State? I just have a different opinion than what is commonly shared on this forum.

When there's an 'and', clearly there must be a balance. Would you pick one top 1o over another if it gave a full ride and the other would give you $200k in debt? Then you, too, would advise going to the 'cheapest and best' school....emphasis on best, sure, but nonetheless both factor in.

The real point of WS's post was that you shouldn't pick a med school based on the state you want to do residency in.

 

[Winged Scapula]

I must have missed the part where the OP is choosing Michigan bottom of the barrel school over California Top 10 ranked program. Last time I checked, Michigan has a very highly regarded medical school which would be well regarded anywhere in the US. Check the medical schools of UC residency programs; unless the OP is going to an UC or Ivy League medical school, his chances of matching there are quite low. There is clearly a preference.

However, he mentions nothing about California as an option for practice or residency and does not give us any inkling that he would even be able to get into a top ranked program. He lists a wide variety of places with tons of residency programs (NY, Boston, Chicago), both highly regarded and less so.

You've made some assumptions about my advice based on your own beliefs and experiences. Nowhere did I say that a name brand reputation wouldn't open doors. I said choose the best and cheapest; if that's in state, then so be it. If he can get into U of Michigan medical school, as long as he does well, he will be a competitive applicant for most any residency program. But if the choice really is (and it never is) between Top 10 OOS school and bottom of the barrel but cheap in state school, I'd advise the former as well.

 

[sobored]

When there's an 'and', clearly there must be a balance. Would you pick one top 1o over another if it gave a full ride and the other would give you $200k in debt? Then you, too, would advise going to the 'cheapest and best' school....emphasis on best, sure, but nonetheless both factor in.

The real point of WS's post was that you shouldn't pick a med school based on the state you want to do residency in.

Please don't try to school me on semantics. You are completely misconstruing what I said. With any bit of common sense someone can figure out that choosing between 2 top 10s won't be limiting, and choosing the cheaper between the two is reasonable. What I said was that I thought it was not sound advice to tell someone who thinks they might be interested in a different region for residency to not factor that in the decision making - and as a secondary point, but equally important, going to a more expensive but higher ranked school will open the door to out of state residencies. So thank you very much but I fully understood the "real point" of WS's post. My opinion happens to differ with other people on this issue. And I am not pulling this opinion out of thin air, my interaction with PDs has shaped these beliefs. You are free to believe differently.

 

[sobored]

I must have missed the part where the OP is choosing Michigan bottom of the barrel school over California Top 10 ranked program. Last time I checked, Michigan has a very highly regarded medical school which would be well regarded anywhere in the US. Check the medical schools of UC residency programs; unless the OP is going to an UC or Ivy League medical school, his chances of matching there are quite low. There is clearly a preference.

However, he mentions nothing about California as an option for practice or residency and does not give us any inkling that he would even be able to get into a top ranked program. He lists a wide variety of places with tons of residency programs (NY, Boston, Chicago), both highly regarded and less so.

You've made some assumptions about my advice based on your own beliefs and experiences. Nowhere did I say that a name brand reputation wouldn't open doors. I said choose the best and cheapest; if that's in state, then so be it. If he can get into U of Michigan medical school, as long as he does well, he will be a competitive applicant for most any residency program. But if the choice really is (and it never is) between Top 10 OOS school and bottom of the barrel but cheap in state school, I'd advise the former as well.

The California bit was an example, you know what I meant. And what assumptions did I make about what you said? You clearly said it is "misguided" to choose a school based on location in order to increase the chance of matching in that region. I said I disagreed with that, and used the California example to illustrate what I meant. I could've just as easily said New York, Boston, whatever. Look, you offered an opinion, I offered mine - if anything now the OP has 2 sides to view this from.

 

[Winged Scapula]

Please don't try to school me on semantics. You are completely misconstruing what I said. With any bit of common sense someone can figure out that choosing between 2 top 10s won't be limiting, and choosing the cheaper between the two is reasonable. What I said was that I thought it was not sound advice to tell someone who thinks they might be interested in a different region for residency to not factor that in the decision making - and as a secondary point, but equally important, going to a more expensive but higher ranked school will open the door to out of state residencies. So thank you very much but I fully understood the "real point" of WS's post. My opinion happens to differ with other people on this issue. And I am not pulling this opinion out of thin air, my interaction with PDs has shaped these beliefs. You are free to believe differently.

No you didn't.

 

[sobored]

No you didn't.

You are a huge baby. I guess since you're a surgeon in real life you must be used to people kissing your ass all day. Since when is it not allowed to disagree with someone? I understood you just fine, but now you're being annoying. I'm done talking about this.

 

[Winged Scapula]

The California bit was an example, you know what I meant. And what assumptions did I make about what you said? You clearly said it is "misguided" to choose a school based on location in order to increase the chance of matching in that region. I said I disagreed with that, and used the California example to illustrate what I meant. I could've just as easily said New York, Boston, whatever. Look, you offered an opinion, I offered mine - if anything now the OP has 2 sides to view this from.

You assumed that location was the only factor.

The OP didn't even ask about reputation.

His question was "can I get a job if I didn't go to medical school/residency in that state?"

The answer is "yes". My response was that it is misguided to choose a medical school based on the assumption that it will significantly increase his chances of getting a residency or post-residency job in that state and that location shouldn't be chosen over cost. He should choose the best program which will also save him money because in the long run, location of medical school has little impact on employment as a physician.

Nothing was mentioned about school reputation etc. until you brought it up.

Everyone knows that such decisions are multifactorial and aren't easily boiled down to just one factor.

NB: there's nothing wrong with disagreeing and offering other opinions. Its what these forums are made of. I did not mean to imply that we couldn't disagree. My chosen profession has nothing to do with my response here so tiresome specialty slurs are not warranted.

 

[DermViser]

Please don't try to school me on semantics. You are completely misconstruing what I said. With any bit of common sense someone can figure out that choosing between 2 top 10s won't be limiting, and choosing the cheaper between the two is reasonable. What I said was that I thought it was not sound advice to tell someone who thinks they might be interested in a different region for residency to not factor that in the decision making - and as a secondary point, but equally important, going to a more expensive but higher ranked school will open the door to out of state residencies. So thank you very much but I fully understood the "real point" of WS's post. My opinion happens to differ with other people on this issue. And I am not pulling this opinion out of thin air, my interaction with PDs has shaped these beliefs. You are free to believe differently.

Are you accusing Winged Scapula's advice of relying on semantics? Her advice was quite clear - you emphasized the wrong thing, as if she was recommending someone to choose a bottom tier school bc cost should supercede everything. She said NOWHERE CLOSE to that as your initial post implied.

 

[DermViser]

You are a huge baby. I guess since you're a surgeon in real life you must be used to people kissing your ass all day. Since when is it not allowed to disagree with someone? I understood you just fine, but now you're being annoying. I'm done talking about this.

You seriously have got to be kidding. You must be a reincarnated user who was banned recently. You really can't be serious. You completely misconstrued the meaning what WingedScapula said and twisted it 180 degrees.

 

[DermViser]

With all due respect, I don't feel like this is good advice. Sure people can go anywhere for residency if they do well enough, but people vastly underestimate how much school name helps the application.

Let's address this. Please read Winged Scapula's post again. This is not at all what she said or meant. For your convenience I will paste it again here:

There are lots of threads about this topic and the advice hasn't changed.

Residencies do not generally place the same emphasis on in-state vs OOS that medical schools do. You'll find that at many residencies, few of the residents are actually from that state, especially in larger programs.

You SHOULD go to the cheapest and best medical school you can get in to. Do not choose an OOS program and spend more money in the misguided attempt to increase your chances for a residency in that state.

A 220 step 1 from a top 10 is certainly viewed differently than a 220 from low ranked state school. Is it fair? Probably not. But that's the way it is. I have heard this from several departments at my own school, as well as from friends who've talked to their field of interest departments at different schools.

Again not at all the point that WingedScapula was making which you've unjustly attributed to her.

OP, IMO going to a better ranked school will help you to match out of state. Having said that, you can still match OOS from your state school if you do well, show interest in the region you want to go to (by doing away rotations your 4th year) and networking. I think you should go to the best school possible, without regard to expense - UNLESS the difference is in price is too large to pass up (>100k or so). Some people think money is more important, and they might be right. But as I have progressed through med school, I have personally realized that residency location and program quality matter more to me than some more debt. To each his/her own...

What you say is true. But again, that's not at all what Winged Scapula said, which she further clarified for you. I will paste her post for your convenience with bolded:

I must have missed the part where the OP is choosing Michigan bottom of the barrel school over California Top 10 ranked program. Last time I checked, Michigan has a very highly regarded medical school which would be well regarded anywhere in the US. Check the medical schools of UC residency programs; unless the OP is going to an UC or Ivy League medical school, his chances of matching there are quite low. There is clearly a preference.

However, he mentions nothing about California as an option for practice or residency and does not give us any inkling that he would even be able to get into a top ranked program. He lists a wide variety of places with tons of residency programs (NY, Boston, Chicago), both highly regarded and less so.

You've made some assumptions about my advice based on your own beliefs and experiences. Nowhere did I say that a name brand reputation wouldn't open doors. I said choose the best and cheapest; if that's in state, then so be it. If he can get into U of Michigan medical school, as long as he does well, he will be a competitive applicant for most any residency program. But if the choice really is (and it never is) between Top 10 OOS school and bottom of the barrel but cheap in state school, I'd advise the former as well.

 

[mehc012]

Please don't try to school me on semantics. You are completely misconstruing what I said. With any bit of common sense someone can figure out that choosing between 2 top 10s won't be limiting, and choosing the cheaper between the two is reasonable. What I said was that I thought it was not sound advice to tell someone who thinks they might be interested in a different region for residency to not factor that in the decision making - and as a secondary point, but equally important, going to a more expensive but higher ranked school will open the door to out of state residencies. So thank you very much but I fully understood the "real point" of WS's post. My opinion happens to differ with other people on this issue. And I am not pulling this opinion out of thin air, my interaction with PDs has shaped these beliefs. You are free to believe differently.

I'm not trying to school you on semantics. I'm trying to point out that you are discussing something completely random and unrelated to the original question OR WS's response. You may have understood the "real point" of WS's post, but if so you chose to ignore it and start some irrelevant debate. I'm not ignoring your opinions on this because they're not well-backed, I'm ignoring them because they're utterly inconsequential to the thread, so telling me about all of your PD interactions is fairly pointless. I'm also not arguing against you or 'believing differently', though thanks for telling me I'm free to...I'm ignoring your point because it is 100% tangential.

Take your agenda somewhere else and start a thread on cost vs reputation...judging by similar posts in the past it will get tons of vehement responses. In this thread, however, the issue is irrelevant and your posts are unnecessarily rude.

 

[Spritsker]

I did not mean to stir a debate about this. As WS noted, my question was whether I would be able to get a residency in a state that I did not go to med school in.

However, since the prospect of school prestige has been brought into play, I'll specify my question a little more. If I wanted to practice in Chicago, and I was accepted to both Wayne State and Rush (both very similar ranking), would it severely disadvantage me to the take the instate, cheaper option?

 

[DermViser]

I did not mean to stir a debate about this. As WS noted, my question was whether I would be able to get a residency in a state that I did not go to med school in.

However, since the prospect of school prestige has been brought into play, I'll specify my question a little more. If I wanted to practice in Chicago, and I was accepted to both Wayne State and Rush (both very similar ranking), would it severely disadvantage me to the take the instate, cheaper option?

Which one is in-state for you?

 

[mehc012]

I did not mean to stir a debate about this. As WS noted, my question was whether I would be able to get a residency in a state that I did not go to med school in.

However, since the prospect of school prestige has been brought into play, I'll specify my question a little more. If I wanted to practice in Chicago, and I was accepted to both Wayne State and Rush (both very similar ranking), would it severely disadvantage me to the take the instate, cheaper option?

WS's initial answer and followup would indicate a definite 'No'. (this is assuming those are actually similar rankings, I'll trust you on that since I have no clue.)

 

[Spritsker]

Yes I am a Michigan resident, so Wayne State would be in-state for me. The only rankings I am basing it off of are the USNRW rankings, in which Wayne is 64 and Rush is 68.

Wayne would be significantly cheaper, about 50-60% of the price. But again, if I wish to practice to Chicago, would it be unwise to take Wayne for the price?

What slightly concerns me however, is the fact that Wayne is not extremely prestigious (not a top 10, as WS and others have been referencing in the debate), so it may not allow for out-of-state residency placement

 

[mehc012]

Yes I am a Michigan resident, so Wayne State would be in-state for me. The only rankings I am basing it off of are the USNRW rankings, in which Wayne is 64 and Rush is 68.

Wayne would be significantly cheaper, about 50-60% of the price. But again, if I wish to practice to Chicago, would it be unwise to take Wayne for the price?

What slightly concerns me however, is the fact that Wayne is not extremely prestigious (not a top 10, as WS and others have been referencing in the debate), so it may not allow for out-of-state residency placement

And what people have been stating throughout this thread is that, while some particularly prestigious schools may open the most elusive doors (which is a sidenote, not the point here), in general, residencies dgaf about instate or out-of-state. Go to a med school, do well, make your decision on something other than the specific state you hope to end up in.

I mean, come on...did you read the posts you are referencing? NOWHERE did WS say that only top 10 schools could get students into out of state residencies. She said the opposite, in fact.

 

[DermViser]

What slightly concerns me however, is the fact that Wayne is not extremely prestigious (not a top 10, as WS and others have been referencing in the debate), so it may not allow for out-of-state residency placement

Seriously, that is NOT what Winged Scapula said.

 

[WillburCobb]

Welp, if state residency matters that much for getting OOS residency spots I'm destined for FP, IM, Psych, or general surgery, or I'll be part of ~2/3 of my class that won't match; guess I should give up my spot and not take the risk.

 

[Spritsker]

And what people have been stating throughout this thread is that, while some particularly prestigious schools may open the most elusive doors (which is a sidenote, not the point here), in general, residencies dgaf about instate or out-of-state. Go to a med school, do well, make your decision on something other than the specific state you hope to end up in.

I mean, come on...did you read the posts you are referencing? NOWHERE did WS say that only top 10 schools could get students into out of state residencies. She said the opposite, in fact.

Sorry, I must have gotten lost in the debate here. What I meant by the top 10 quote was whether it would be difficult to secure a spot in an out-of-state residency from a non-top 10/20 MD school. After re-reading it, yes I do understand. Thank you all