How to play the game in medical school?

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chillaxbro

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I didn't know the importance of all the volunteering, extracurricular activities, altruism, "being unique", etc etc pre-med bs for medical schools and it really ****ed me over. I'm not going to make the same mistake for residencies. What's the game like for getting into a good residency during med school? I know good USMLE scores, clinical grades, LORs, and connections are important. I hear research in the field you're interested in is important. A lot of people seem to do volunteer work - is this also a "requirement" for a good residency? What other extracurriculars are important?

Don't hate me for being so blunt :cool:

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It's good to be blunt. Life's too full of BS and fluff. Even language has become inflated these days.

I was in your shoes about a year ago. From my experience, volunteering and other extracurriculars should reflect what you truly have a passion for, not what you think you need to do. But don't let it get in the way of the far more important things you listed.
 
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Volunteering isn't important for residency apps, and the only important EC is research.

If you like getting involved, volunteering, etc...go for it. But don't do it just for residency apps because that would be a waste of time.
 
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It varies per specialty, but as a general rule:

step 1, clinical grades, LORs (connections), school reputation, step 2, AOA (class rank), research, and leadership/community service matter most.

Some of the more competitive specialties place more emphasis on AOA and research.

The NRMP surveys PDs every year (however the response rate is pretty low).

http://www.siumed.edu/oec/Year4/References/NRMP PDSurvey 2012.pdf
 
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It varies per specialty, but as a general rule:

step 1, clinical grades, LORs (connections), school reputation, step 2, AOA (class rank), research, and leadership/community service matter most.

Some of the more competitive specialties place more emphasis on AOA and research.

The NRMP surveys PDs every year (however the response rate is pretty low).

http://www.siumed.edu/oec/Year4/References/NRMP PDSurvey 2012.pdf

"Volunteer/extracurricular experiences" are pretty low on the list. And while school reputation is important, it's a fixed variable at this point for any med student.

And AOA is universally a great thing to have on your application. It helps for all specialties, and some competitive places almost require it.
 
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TBH anything you do your M1 year will most likely mean very little. Everyone is going to be scrambling for positions and volunteering from day 1, but that's pretty stupid IMO. As others said, I'd only do what you want to do.
 
TBH anything you do your M1 year will most likely mean very little. Everyone is going to be scrambling for positions and volunteering from day 1, but that's pretty stupid IMO. As others said, I'd only do what you want to do.

Definitely agree with this.

The best thing you can do during first year is learn how to do well (most people have to change the way they study, I definitely did).
 
It varies per specialty, but as a general rule:

step 1, clinical grades, LORs (connections), school reputation, step 2, AOA (class rank), research, and leadership/community service matter most.

Some of the more competitive specialties place more emphasis on AOA and research.

The NRMP surveys PDs every year (however the response rate is pretty low).

http://www.siumed.edu/oec/Year4/References/NRMP PDSurvey 2012.pdf
Ouch.

on page 105, 70% (or a super majority) of ortho programs do not interview and rank do applicants.
 
Ouch.

on page 105, 70% (or a super majority) of ortho programs do not interview and rank do applicants.

Don't believe the Pre-Allo/Osteo PC Police who chant "MD=DO! MD=DO!" because for allopathic residency admissions, the two are not the same. It's a steep road for DOs to match highly sought-after spots. Lots of competitive programs don't even look at DOs, as evidenced here.
 
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Don't believe the Pre-Allo/Osteo PC Police who chant "MD=DO! MD=DO!" because for allopathic residency admissions, the two are not the same. It's a steep road for DOs to match highly sought-after spots. Lots of competitive programs don't even look at DOs, as evidenced here.

Agreed, but just to play devil's advocate: 1) the surveys have a low response rate, and 2) they have their own residency programs, at least until 'the merge.'
 
I didn't know the importance of all the volunteering, extracurricular activities, altruism, "being unique", etc etc pre-med bs for medical schools and it really ****** me over. I'm not going to make the same mistake for residencies. What's the game like for getting into a good residency during med school? I know good USMLE scores, clinical grades, LORs, and connections are important. I hear research in the field you're interested in is important. A lot of people seem to do volunteer work - is this also a "requirement" for a good residency? What other extracurriculars are important?

Don't hate me for being so blunt :cool:
Don't apologize for being blunt. A lot of medicine would be better if people were more blunt.
 
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Agreed, but just to play devil's advocate: 1) the surveys have a low response rate, and 2) they have their own residency programs, at least until 'the merge.'
Even with the merger, PDs are not going to suddenly change their minds. The merger only says that DO residencies must now fit ACGME rules, or risk closing down. They'll just have more applications to shave off which the computer automatically does for them. If anything it will hurt DOs, bc they've now lost any protectionism that their own residencies afforded them.
 
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Volunteering isn't important for residency apps, and the only important EC is research.

If you like getting involved, volunteering, etc...go for it. But don't do it just for residency apps because that would be a waste of time.
I think this depends on the specialty. That being said, yes, research means more than volunteering. However, volunteering does show that you're a "well-rounded" person.
 
Agreed, but just to play devil's advocate: 1) the surveys have a low response rate, and 2) they have their own residency programs, at least until 'the merge.'

Yeah the surveys have a low response rate, but that's not even where you need to look to see that DOs and MDs are not equal when applying to competitive residencies. Just ask anybody who interviewed at top residencies in moderately or highly competitive fields.

My personal experience in radiology -- interviewed at roughly half of the top 20-ish programs (mostly in the South and Midwest, which are less competitive than the West coast or NE) and didn't meet a single DO resident or applicant at any of those programs. Anecdote, I freely admit.

Or how about my home IM program, which is a solid mid tier who occasionally takes a DO, FMG, or two...except they only let US MDs apply to be chiefs. MD =/= DO. Wish it did, as virtually every DO I've met is just as good as the average MD I've met.

The merger will be interesting. Will it end up screwing DOs out of their previously protected derm, ENT, ortho slots?
 
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Even with the merger, PDs are not going to suddenly change their minds. The merger only says that DO residencies must now fit ACGME rules, or risk closing down. They'll just have more applications to shave off which the computer automatically does for them. If anything it will hurt DOs, bc they've now lost any protectionism that their own residencies afforded them.
There will be some sort of extra coursework/short fellowship type deal that MD applicants will have to go through either before or during the residency to get up to speed on OMM.

It will be interesting to see how many MD applicants will be willing to do that.

But, the reason I've been in allo is because the osteo board is nothing but discussion about this. I guess it was inevitable that it would find it's way over here at some point.
 
The merger will be interesting. Will it end up screwing DOs out of their previously protected derm, ENT, ortho slots?

Maybe some. But like with ACGME PD's, I don't foresee AOA PD's instantly dropping all their biases either.

My opinion is that there will be some short-term turbulence (5-10 years maybe), but things will even out after.
 
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Don't believe the Pre-Allo/Osteo PC Police who chant "MD=DO! MD=DO!" because for allopathic residency admissions, the two are not the same. It's a steep road for DOs to match highly sought-after spots. Lots of competitive programs don't even look at DOs, as evidenced here.

What did you expect? Pedigree matters.

And this is surprising?
To the three posters above: I never for a second believed that. I always knew that it was true, but I didn't have solid evidence/proof/statistics until now. I think a lot of do's who advocate md=do will be in for a rude awakening come match time. They beat their chest, stop their feet, and start insulting people when people talk about this real do bias. They insist that hard work can trump any and all roadblocks, but that clearly just isn't the case with 70% of the ortho programs.
Agreed, but just to play devil's advocate: 1) the surveys have a low response rate, and 2) they have their own residency programs, at least until 'the merge.'
N = 83, so that is not a small sample size. With the merger, anything can happen. But I am of the opinion that not much will change in terms of these pd's attitudes of do's. But that is just talking to the pds/faculty that I know (n=1, which isn't significant).
 
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The only two things I'd worry about first year: Getting good grades and finding a good research contact. Maybe a little dabbling into the resources people use for step 1 (notice I said dabbling, as in discovering and becoming familiar with what is recommended, not actually using them).
 
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There will be some sort of extra coursework/short fellowship type deal that MD applicants will have to go through either before or during the residency to get up to speed on OMM.

It will be interesting to see how many MD applicants will be willing to do that.

But, the reason I've been in allo is because the osteo board is nothing but discussion about this. I guess it was inevitable that it would find it's way over here at some point.
Depending on the specialty, OMM may not at all be necessary (i.e. D.O. derm residencies, for example). This is nothing but a DO poison pill to hold relevance.

I think it speaks volumes when the DO profession who holds OMM as some type of gospel, believe that DO students should have to undergo extensive coursework during medical school (at the expense of studying something else) and this level of proficiency can easily be gotten by an OMM crash course before starting residency for MD residents.
 
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To the three posters above: I never for a second believed that. I always knew that it was true, but I didn't have solid evidence/proof/statistics until now. I think a lot of do's who advocate md=do will be in for a rude awakening come match time. They beat their chest, stop their feet, and start insulting people when people talk about this real do bias. They insist that hard work can trump any and all roadblocks, but that clearly just isn't the case with 70% of the ortho programs. These people almost sound delusional. Glad I trusted my gut and ignored them.

N = 83, so that is not a small sample size. With the merger, anything can happen. But I am of the opinion that not much will change in terms of these pd's attitudes of do's. But that is just talking to the pds/faculty that I know (n=1, which isn't significant).
The DOs who advocate MD=DO are faculty that have already matched and gone on in their careers and have an interest in only your loan dollars for their school - which their school is dependent on.

These are the same ones that have been expanding DO schools like crazy, unlike the LCME which up until this point were quite conservative in approving new schools.
 
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The DOs who advocate MD=DO are faculty that have already matched and gone on in their careers and have an interest in only your loan dollars for their school - which their school is dependent on.
These are the same ones that have been expanding DO schools like crazy, unlike the LCME which up until this point were quite conservative in approving new schools.

Depending on the specialty, OMM may not at all be necessary (i.e. D.O. derm residencies, for example). This is nothing but a DO poison pill to hold relevance.

I think it speaks volumes when the DO profession who holds OMM as some type of gospel, believe that DO students should have to undergo extensive coursework during medical school (at the expense of studying something else) and this level of proficiency can easily be gotten by an OMM crash course before starting residency for MD residents.
It is like you are reading my mind, esp the bolded part.
 
Depending on the specialty, OMM may not at all be necessary (i.e. D.O. derm residencies, for example). This is nothing but a DO poison pill to hold relevance.
No real argument here. Personally I'm happy for the merger, but it won't help me at all even though it's set to get started the year I graduate. A unified match, on the other hand, would be tremendously helpful.

DermViser said:
I think it speaks volumes when the DO profession who holds OMM as some type of gospel, believe that DO students should have to undergo extensive coursework during medical school (at the expense of studying something else) and this level of proficiency can easily be gotten by an OMM crash course before starting residency for MD residents.
There is a large variation in time commitment for OMM between schools, not all of them end up costing you lots of time. How well it's integrated into the curriculum probably has a lot to do with it. I do think it's valuable depending on your specialty. Maybe the merger will be a small impetus for some schools to reevaluate how they handle their OMM, but that's probably asking a bit much.
 
The merger will be interesting. Will it end up screwing DOs out of their previously protected derm, ENT, ortho slots?
You bet it will. Unless you have older D.O.s (who may have not been able to obtain licensing due to MD/DO fights at the state level) on staff who feel an obligation to taking D.O.s.
 
I think a lot of do's who advocate md=do will be in for a rude awakening come match time. They beat their chest, stop their feet, and start insulting people when people talk about this real do bias. They insist that hard work can trump any and all roadblocks, but that clearly just isn't the case with 70% of the ortho programs.

If DO students are arguing that in general, they are legitimately out of their ****ing minds. In my experience, the students that think that way are so out to lunch that they aren't students getting the class rank, board scores, research, or connections to match anything competitive anyways (ACGME or AOA).

To be more fair, DO students that actually know what they are talking about could use the phrase DO=MD when referring to something such as the possibility to end up in most specialties. For example, it's pretty reasonable to say you could work as an IM physician, earn a normal IM salary, and have a normal career. When it's used in reference to ortho, I think people (the reasonable ones) are saying that you can do ortho as a DO are implying it's via the AOA route. It likely those people aren't specifying ACGME ortho, which would make their claims ridiculous - it just means ortho at all.

In reality, the number is actually probably higher than 70% and instead of explicitly stating it, it's just implied and apps aren't considered with any strong weight. The actual number is probably in the 90s.

With the merger, anything can happen. But I am of the opinion that not much will change in terms of these pd's attitudes of do's.

Agreed - it's fantastical to think the minds of a bunch middle aged academic physicians are going to be changed by the stroke of a pen.

However, I again don't see any reasonable DO students saying this will lead to immediate elimination of bias. The benefit for DOs, aside from the obvious ability to pursue fellowships without the "special applicant clause" if coming from an AOA residency, is the potential for a combined match down the road. In that case, the most competitive DO students could apply to ACGME programs without taking the gamble of skipping the AOA match. This would likely increase matches into competitive fields (but at lower-tier programs) simply because the most competitive DOs (and a higher number of them) will apply. In reality, this only pertains to ortho, uro, ENT, GS, NS, (and I guess theoretically derm and plastics :nono:). I don't think anyone with an opinion worth considering is saying there's going to be DO matching ortho at HSS in a couple years. As of now, the merger only benefits in terms of fellowship and maybe hospital hiring preferences down the road.

You bet it will. Unless you have older D.O.s (who may have not been able to obtain licensing due to MD/DO fights at the state level) on staff who feel an obligation to taking D.O.s.

I don't have a formulated opinion on this - I am not sure if it will hurt DOs looking for competitive specialties or not. Until there is a unified match, wouldn't MDs have to pass on the ACGME match to shoot for a low-tier community program via the AOA match first? I don't know how much that will happen, especially with a mandatory OMM component. If DOs can't outcompete the lowest-tier MD applicants for historically AOA programs with DO PDs, they probably shouldn't be matching anyways. Furthermore, I do suspect there would be some favoring of the DO degree within these programs. One problem would be if there was a loss of of AOA programs during the transition - that would be an obvious way to decrease odds. It will be interesting to see what the adjustment period is like, what the flexibility is like, if there are amendments to the ACGME requirements, and what happens with DO PDs.
 
I don't have a formulated opinion on this - I am not sure if it will hurt DOs looking for competitive specialties or not. Until there is a unified match, wouldn't MDs have to pass on the ACGME match to shoot for a low-tier community program via the AOA match first? I don't know how much that will happen, especially with a mandatory OMM component. If DOs can't outcompete the lowest-tier MD applicants for historically AOA programs with DO PDs, they probably shouldn't be matching anyways. Furthermore, I do suspect there would be some favoring of the DO degree within these programs. One problem would be if there was a loss of of AOA programs during the transition - that would be an obvious way to decrease odds. It will be interesting to see what the adjustment period is like, what the flexibility is like, if there are amendments to the ACGME requirements, and what happens with DO PDs.
My understanding is that a merger implies a unified match.
 
I didn't know the importance of all the volunteering, extracurricular activities, altruism, "being unique", etc etc pre-med bs for medical schools and it really ****** me over. I'm not going to make the same mistake for residencies. What's the game like for getting into a good residency during med school? I know good USMLE scores, clinical grades, LORs, and connections are important. I hear research in the field you're interested in is important. A lot of people seem to do volunteer work - is this also a "requirement" for a good residency? What other extracurriculars are important?

Don't hate me for being so blunt :cool:

I hate the game. But you have to play it... trust me. There are so many things you have to do during third year that are so ass-backwards and ******ed it will make you think if you're actually an adult or if the school really thinks you're an adult. You'll finally find out that the way you are as a person will have consequences at times.

Attendings that don't care what you do/say; you'll always get a 7/10 on evaluations even if you save their life. Or Attendings that will give you a 0/10 because you didn't do a good job as fluffer. Residents who will treat you like a child and punish you if you do anything outside of shadow (like answering the phone - ask me how I know). Faculty that will just hate you because you're a medical student.
Then comes the assignments - yes, the thing that makes absolutely no sense except to waste your precious time. Essays you have to write. Online quizzes you have to do. Modules/PBLs/classes... First and second year will seem like a blessing because you didn't have to go to class. Also note - patient comes second to ALL the above. Never once kid yourself that because you're taking care of a patient that it's excusable in the eyes of administration. Even if you're in an emergency surgery for brain trauma - if you stay, you're dead meat to admins.

If you want to play the game - I recommend going to your local neuro surgeon and asking them to remove all common sense and doubt. Just memory and regurg. The second you realize how much bull**** there is in medicine - you're in trouble.

And yes - there's bias in what I said. But no - it's not 100% bias. But yes - I hate medicine and people and don't care about patients anymore. I just want to get my job done and make the money for the hospitals so they're happy. Because... that's all we are now. We're becoming the "professional" version of a Jester. The only difference is the Jester knows he's a joke. Sorry, not he. They know. Cause; there are probably female jesters.


/rant
 
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I didn't know the importance of all the volunteering, extracurricular activities, altruism, "being unique", etc etc pre-med bs for medical schools and it really ****** me over. I'm not going to make the same mistake for residencies. What's the game like for getting into a good residency during med school? I know good USMLE scores, clinical grades, LORs, and connections are important. I hear research in the field you're interested in is important. A lot of people seem to do volunteer work - is this also a "requirement" for a good residency? What other extracurriculars are important?

Don't hate me for being so blunt :cool:

A couple of things to note about volunteering. One, if it's something that you're shooting for, you should check how your school assigns AOA. Many schools have a volunteering/leadership component to it, but of course it's still secondary to class rank. Two, if you do choose to spend some of your time volunteering, make it longitudinal and not just racking up volunteering hours by doing various odds and ends.
 
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Also note - patient comes second to ALL the above. Never once kid yourself that because you're taking care of a patient that it's excusable in the eyes of administration. Even if you're in an emergency surgery for brain trauma - if you stay, you're dead meat to admins.

It's so wonderful to hear someone else experienced this extra special WTF during third year. Why do we have to have required didactics on a surgical rotation at 12:00 noon? Or why must we have continuity clinic a 45 minute drive away from the VA so I must leave rounds early to make it on time, only to have the interns bitch me out in front of the attending the next morning for having left before finishing notes.
 
My understanding is that a merger implies a unified match.

From what I've read, the NRMP was not part of the merger discussions, but this indeed is the next logical step. Then, match statistics for MDs vs DOs won't be muddied by the fact that the AOA match is earlier than the NRMP match.
 
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From what I've read, the NRMP was not part of the merger discussions, but this indeed is the next logical step. Then, match statistics for MDs vs DOs won't be muddied by the fact that the AOA match is earlier than the NRMP match.

This is my understanding too. A unified match is a logical eventual conclusion, but hasn't been stated anywhere as of yet. I don't see it impacting any current med students, or soon to be incoming students.

Someone please correct me if I am wrong.
 
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This is my understanding too. A unified match is a logical eventual conclusion, but hasn't been stated anywhere as of yet. I don't see it impacting any current med students, or soon to be incoming students.

Someone please correct me if I am wrong.

Well, that depends on if a unified match is established. For DO students, they no longer have to forgo the AOA match to compete in the NRMP match- but on the other hand, they lose the benefit of two match cycles. When you look at NRMP data and see that, for example, 3 DOs matched into ACGME neurosurgery, you ask yourself if that number is low because most DO applicants competed in the AOA match first for good measure, matched and then never entered the NRMP match.

Those 3 students have balls of steel - they were confident enough to skip the AOA match (I'm sure it's not that they didn't match into any AOA programs)
 
I didn't know the importance of all the volunteering, extracurricular activities, altruism, "being unique", etc etc pre-med bs for medical schools and it really ****** me over. I'm not going to make the same mistake for residencies. What's the game like for getting into a good residency during med school? I know good USMLE scores, clinical grades, LORs, and connections are important. I hear research in the field you're interested in is important. A lot of people seem to do volunteer work - is this also a "requirement" for a good residency? What other extracurriculars are important?

Don't hate me for being so blunt :cool:

For volunteer work, no, it's not. I never spent one second doing volunteer work, free clinics, etc during the time I was in med school. If you don't want to do it, and it doesn't interest you, don't do it. Residencies PDs want to know if you'll be competent and good to work with. The other residents want to know if you'll be good to work with and not bring the drama(since in certain programs residents DO play a role in how people get ranked too!)

Trust me, I hate that BS too. Do what you like and interests you, and everything will fall in place. I never made a big deal about it, I only pursued things I liked, and stayed away from things I hated(research, certain ECs/academic clubs). This might be shocking to those in the pre-allo section(and maybe even here), but the only ECs I really did were the hobbies/interests I *gasp* actually enjoyed. Which were all the same ones talked about during interviews, which brings out more enthusiasm and interesting conversations.

What you mentioned is already "the game": Grades, tests scores, 3rd year stuff, etc. Which, is just normal med school stuff. Don't think of it like a game, cause games are supposed to be fun. :p
 
It's so wonderful to hear someone else experienced this extra special WTF during third year. Why do we have to have required didactics on a surgical rotation at 12:00 noon? Or why must we have continuity clinic a 45 minute drive away from the VA so I must leave rounds early to make it on time, only to have the interns bitch me out in front of the attending the next morning for having left before finishing notes.

Ironically, didactics were where I had the least amount of learning during certain rotations. Especially the ones that are in the afternoon and are SO boring. I guess I'm the opposite of some of my classmates who thought wards teaches you nothing and we needed more lectures.
 
Depending on the specialty, OMM may not at all be necessary (i.e. D.O. derm residencies, for example). This is nothing but a DO poison pill to hold relevance.

I think it speaks volumes when the DO profession who holds OMM as some type of gospel, believe that DO students should have to undergo extensive coursework during medical school (at the expense of studying something else) and this level of proficiency can easily be gotten by an OMM crash course before starting residency for MD residents.
I think that if you lose the OMM component during residency then it will be lost during the undergraduate portion (eventually) and PDs, school faculty and the AOA/AACOM know this. This is why you will see OMM requirements for MD students wishing to pursue formally AOA residencies pop up.
 
I think that if you lose the OMM component during residency then it will be lost during the undergraduate portion (eventually) and PDs, school faculty and the AOA/AACOM know this. This is why you will see OMM requirements for MD students wishing to pursue formally AOA residencies pop up.
I agree. They know it's the BS. It's only to establish an osteopathic "identity".
 
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