While specialties such as Derm, Plastics, and Optho are no doubt difficult to place into, it doesn't necessarily command a positive impression. Also, UNC is not renowned for its orthopedic program, neither is UT for opthalmology. Vanderbilt does have particular strengths in OB/Gyn, so even for a specialty that is not very competitive to match into, matching to Vanderbilt for OB/Gyn is pretty great. I'm sorry if anyone is upset that I don't think it is a particularly strong match list, but it's not like it's loaded with Surgical Matches to MGH, UTSW, and UPitt, or IM Matches to Vanderbilt, Emory, and UCSF, or Optho matches at B-P and Mayo. It's not just a matter of the specialty - it's also a matter of if your program is particularly known for that specialty. If you want to go into academic medicine, this comes up often. Even if you don't want to go into academic medicine, American's are concerned with 'the best', and you can be certain that patients will seek out a specialist with the best training in their area.
Please see my response above. I keep meticulous tabs on what hospitals are considered 'the top' for a number of fields each year - because of match list self-selctivity and location bias, my analyses aren't adequate to say "good school or bad school" but they do give a sense for what the reputation of a given medical school is outside of it's region in the U.S., based on total out of region match as well as the proportion of matches to top hospitals for a given specialty.
Also, the idea of a 'top EM' program is debatable. EM is a unique specialty when it comes to rankings and reputation, because it is not as if someone with a blast wound in a mining town will arrange to fly to Baltimore Shock & Trauma for their treatment - you just go to the closest trauma-level center appropriate for your injury/condition. Sure, there tend to be several EM programs that are usually boasted for their high volumes, but these are usually in cities that are known to have some pretty violent areas (baltimore, brooklyn, detroit, oakland, LA, cleveland, for example.)
I honestly did not expect to get grilled over this. Yes, there is a certain degree of self-selectivity and perhaps location bias when it comes to match lists - but a decent number of people leave the state of S.C. in this match list, and it's not for residency programs at institutions that are particularly reputed for that field
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Also, regarding USMLE: SUNY downstate gives students 7 weeks off to prepare for USMLE I. It is not unreasonable to suspect that the school does this in recognition that their basic sciences curriculum may not have adequately prepared the students for the USMLE. Likewise, NYMC gives
students 2 full months off to prepare for the USMLE. Same thing applies. Most programs give 4-5 weeks off to prepare for the USMLE - I'm not sure what the schedule at USC is. What I can say confidently, however, is that a mere handful of students that probably have an impressive USMLE score (according to their match) should not by and large tell you that the school is doing a good job in preparing students for the USMLE. When you see a litany of community programs though and very few top academic programs for a given field, it does raise that question.
