How big of an advantage is having a home program?

[ERDOC555]

I've heard that many spots each year are really pre-filled even before the interview as the Med student at program X and the PD at program X have a mutual understanding after having gotten to know each other over the years. How do you go about having this talk with the PD at your school? Does it happen organically over the course of the years through research and rotations, or is it something you talk about from day 1?

I'm assuming the PD knows well before the match if you want to match at home program or elsewhere since they are making calls and writing letters for you. How common is it for PDs to be unwilling to take their home students? What may be potential reasons, (besides just disliking their personality/character)?

Also how much pull does the relationship hold? Let's say you do research years 1 and 2 and the department really likes you, but you get a sub-optimal Step 1. Would they still be willing to take you? Does this change for top programs compared to lesser ranked ones?

Any insights broad or specific about how this works would be greatly appreciated! Thanks!

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[asmallchild]

I've heard that many spots each year are really pre-filled even before the interview as the Med student at program X and the PD at program X have a mutual understanding after having gotten to know each other over the years. How do you go about having this talk with the PD at your school? Does it happen organically over the course of the years through research and rotations, or is it something you talk about from day 1?

I'm assuming the PD knows well before the match if you want to match at home program or elsewhere since they are making calls and writing letters for you. How common is it for PDs to be unwilling to take their home students? What may be potential reasons, (besides just disliking their personality/character)?

Also how much pull does the relationship hold? Let's say you do research years 1 and 2 and the department really likes you, but you get a sub-optimal Step 1. Would they still be willing to take you? Does this change for top programs compared to lesser ranked ones?

Any insights broad or specific about how this works would be greatly appreciated! Thanks!

It can be a huge advantage depending on your relationship to those within the home department.

Having enjoyed this advantage, I would assume others have as well. I was without question the worst student academically the year I applied for dermatology amongst all the applicants in my class. But often it's who you know and not what you know, and while I didn't know it at the time, I was already ranked to match by my home program (it would have been nice to know before spending thousands of dollars on the application/interview trail.....)

You can make those connections via research (as I did), shadowing, rotating, etc...

Different programs have different views on this. Some programs provide a huge advantage to students of their own medical school. Others will go out of their way to take outside medical students.

Getting along with the higher ups in the department (and this is also not generalizable advice. Some programs want more outspoken residents. Some want quieter residents who will keep their mouth shut and get the job done) is obviously a big step in getting this "home field" advantage with your home program.

 

[dermie1985]

That is excellent information!!!

I have the opportunity to go to a school with what is typically considered a top 10 residency program, top 20 at worst, (although we know these are completely subjective and hard to order).

I'm waitlisted at 1 school and waiting for decision at another with a much lower cost of attendance (~100k over 4 years) both with Derm programs but ones that aren't quite as well known/prestigious, but still good. Both schools have a healthy feed of Med students straight to their own residency program as does the school with the top program. I'd like to go with the significantly cheaper school, but to turn down a school with a top program is super hard.

Do you think a top program would be less likely to take their own, especially with borderline stats, as it might want the highest caliber of student? I'm worried if I go to the better school and don't live up to their standards I may get ruled out from my home program, whereas if I went to a school with an average program they may be more lenient in taking their own.

All 3 schools do have a heavy rate of home institution retention, maybe 20-40% depending.

P.S.
I'm also way over-thinking this. My goal is to get 250+ on Step 1 (which based on my GPA/MCAT/Work ethic should be reasonable), but my poor mind is running through all the scenarios where I get a 230 and would really struggle to match derm.

As a pre-med this is probably way too early to start thinking about (you shouldn't even necessarily be set on one specialty at this point...), but...

Going to a school with a top derm program will give you advantages in the match process (i.e. research opportunities, publications, letters of rec from well-known people, networking opportunities, etc.). A lot of derm isn't about your scores (yes these are "requirements") but rather who you know. After going through the interview/match process I can tell you this is definitely true.

Also, while your home program is always your best bet (statistically), do realize that some of the "top" programs might still be hard to match as an internal. For instance...not sure how things turned out this year, but when I applied there were something like 16 (?) Harvard applicants- many didn't even get interviews at their internal program, and some even went unmatched altogether. Sometimes going to a top program means it's more difficult to be the "big fish" if you catch my drift. Just something to keep in mind.

 

[ERDOC555]

As a pre-med this is probably way too early to start thinking about (you shouldn't even necessarily be set on one specialty at this point...), but...

Going to a school with a top derm program will give you advantages in the match process (i.e. research opportunities, publications, letters of rec from well-known people, networking opportunities, etc.). A lot of derm isn't about your scores (yes these are "requirements") but rather who you know. After going through the interview/match process I can tell you this is definitely true.

Also, while your home program is always your best bet (statistically), do realize that some of the "top" programs might still be hard to match as an internal. For instance...not sure how things turned out this year, but when I applied there were something like 16 (?) Harvard applicants- many didn't even get interviews at their internal program, and some even went unmatched altogether. Sometimes going to a top program means it's more difficult to be the "big fish" if you catch my drift. Just something to keep in mind.

Thanks for the information! That's crazy to think that not even all the Harvard graduates would at least interview at the home program.

 

[deltamed]

That is excellent information!!!

I have the opportunity to go to a school with what is typically considered a top 10 residency program, top 20 at worst, (although we know these are completely subjective and hard to order).

I'm waitlisted at 1 school and waiting for decision at another with a much lower cost of attendance (~100k over 4 years) both with Derm programs but ones that aren't quite as well known/prestigious, but still good. Both schools have a healthy feed of Med students straight to their own residency program as does the school with the top program. I'd like to go with the significantly cheaper school, but to turn down a school with a top program is super hard.

Do you think a top program would be less likely to take their own, especially with borderline stats, as it might want the highest caliber of student? I'm worried if I go to the better school and don't live up to their standards I may get ruled out from my home program, whereas if I went to a school with an average program they may be more lenient in taking their own.

All 3 schools do have a heavy rate of home institution retention, maybe 20-40% depending.

P.S.
I'm also way over-thinking this. My goal is to get 250+ on Step 1 (which based on my GPA/MCAT/Work ethic should be reasonable), but my poor mind is running through all the scenarios where I get a 230 and would really struggle to match derm.

Yes, in my experience smaller or lower tier programs tend to be promote nepotism more. This is not necessarily a good thing (for improving the program) but for most people a spot is a spot so using any insider track connections available is common.

Higher-tier programs are not immune to this, but do tend to be more of a meritocracy (which is probably part of why they are higher tier) so "knowing" people or having one faculty member "like" you for working on their pet-project is probably not going to be worth as much.


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[deltamed]

Thanks for the information! That's crazy to think that not even all the Harvard graduates would at least interview at the home program.

Why would they? Harvard would be silly to interview their own weakest applicants - they would be just wasting time of both the applicant and faculty.


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