Matching from top IM programs

[amazin_grace]

I am an M4, interested in going into IM and eventually cards, GI, or H/O. Can anyone comment on how hard it is to get top cards spots from a top IM program?

I have good stats from a Top 10 med school (step 1 270s/all honors in 3rd year/very strong LORs/basic science pub). My mentors and friends here are telling me that I am crazy to apply IM rather than "cashing out" my good stats from med school into derm/rad onc/rads/anesthesia, since there is no guarantee that even if I go into a top IM program (MGH/BWH/JHU/UCSF) I will be able to get into a good cards/GI/Onc fellowship. But I fell in love with IM and its subspecialties so would really like to do IM if the road to a fellowship will not be too hard. I have spoken to the PD at my home institution (big 8 program) who said I will definitely get a spot there, and I spoke to a PD from a top 4 program after an away rotation last month who implied that I will be one of their top ranks, so I feel relatively confident that I will be able to get into a pretty good IM residency.

I am assuming there is very little time for research in residency, and I am not sure how else you can differentiate yourself (i.e. the equivalents of step 1 and 3rd year grades)... this makes me think that the reputation of your IM program weighs more heavily than the reputation of your med school does for residency matching. Also, how well does med school performance correlate to residency performance? I have frankly been pretty surprised by most of my scores and grades, which makes me insecure about my ability to continue doing well in residency to the point that I will "wow" top cards programs.

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[Instatewaiter]

I am an M4, interested in going into IM and eventually cards, GI, or H/O. Can anyone comment on how hard it is to get top cards spots from a top IM program?

I have good stats from a Top 10 med school (step 1 270s/all honors in 3rd year/very strong LORs/basic science pub). My mentors and friends here are telling me that I am crazy to apply IM rather than "cashing out" my good stats from med school into derm/rad onc/rads/anesthesia, since there is no guarantee that even if I go into a top IM program (MGH/BWH/JHU/UCSF) I will be able to get into a good cards/GI/Onc fellowship. But I fell in love with IM and its subspecialties so would really like to do IM if the road to a fellowship will not be too hard. I have spoken to the PD at my home institution (big 8 program) who said I will definitely get a spot there, and I spoke to a PD from a top 4 program after an away rotation last month who implied that I will be one of their top ranks, so I feel relatively confident that I will be able to get into a pretty good IM residency.

I am assuming there is very little time for research in residency, and I am not sure how else you can differentiate yourself (i.e. the equivalents of step 1 and 3rd year grades)... this makes me think that the reputation of your IM program weighs more heavily than the reputation of your med school does for residency matching. Also, how well does med school performance correlate to residency performance? I have frankly been pretty surprised by most of my scores and grades, which makes me insecure about my ability to continue doing well in residency to the point that I will "wow" top cards programs.

If you want to do IM, do IM. Just because you have good stats, you don't have to do something just because it is competitive. If you want to do cards, doing research is a necessary evil. Other things that distinguish you include your clinical performance and your LORs. But you are right, the IM program you come from plays a higher role for cards than med school does for IM.

Yes there is no guarantee that you will match to a top tier cards spot, but there is a high likelihood that you will coming from a top program

 

[DermViser]

I have good stats from a Top 10 med school (step 1 270s/all honors in 3rd year/very strong LORs/basic science pub). My mentors and friends here are telling me that I am crazy to apply IM rather than "cashing out" my good stats from med school into derm/rad onc/rads/anesthesia, since there is no guarantee that even if I go into a top IM program (MGH/BWH/JHU/UCSF) I will be able to get into a good cards/GI/Onc fellowship. But I fell in love with IM and its subspecialties so would really like to do IM if the road to a fellowship will not be too hard. I have spoken to the PD at my home institution (big 8 program) who said I will definitely get a spot there, and I spoke to a PD from a top 4 program after an away rotation last month who implied that I will be one of their top ranks, so I feel relatively confident that I will be able to get into a pretty good IM residency.

The road to fellowship is hard - GI, Cards, Heme/Onc are one of the most competitive specialties.

 

[amazin_grace]

The road to fellowship is hard - GI, Cards, Heme/Onc are one of the most competitive specialties.

This does not answer my question at all. Yes i know Cards is "hard" to get into, but it is also "hard" to get into a top 4 IM residency program. My question was specifically about how hard it is to get into a good cards program from a top IM program, and I am looking for answers from people who have gone through the cards match (or GI or H/O) and can speak to the relative importance of IM residency location versus other factors (like research during residency or how well you subjectively do during residency--I am not sure how this second point is even measured).

 

[DermViser]

This does not answer my question at all. Yes i know Cards is "hard" to get into, but it is also "hard" to get into a top 4 IM residency program. My question was specifically about how hard it is to get into a good cards program from a top IM program, and I am looking for answers from people who have gone through the cards match (or GI or H/O) and can speak to the relative importance of IM residency location versus other factors (like research during residency or how well you subjectively do during residency--I am not sure how this second point is even measured).

My point is you have absolutely NO assurance that you will get GI, Cards, or Heme-Onc, even from a top 4 IM residency program. With your stats, I'd definitely be on the side of your mentors/friends who are wondering why you're not applying for derm/rad onc/rads/ophtho, etc. Your MS-3 clerkship is quite different from IM residency. You are ranked in residency based on your evaluations and In-Training Exam score.

 

[TheNextLevel]

x

 

[hotshotdoc]

Just getting into a top IM program would not guarantee you a spot in a top cardiology program. There are examples of graduates from top IM programs having to go to mediocre cardiology fellowship programs and vice versa. During your IM residency you will need to publish, be active in research and be strong clinically to get into a good cardiology program. Its impossible for anyone (including yourself) to predict how you will do during your residency. If you are a sincere, hardworking chap in general then chances are you will work hard in residency too.

 

[amazin_grace]

Just getting into a top IM program would not guarantee you a spot in a top cardiology program. There are examples of graduates from top IM programs having to go to mediocre cardiology fellowship programs and vice versa. During your IM residency you will need to publish, be active in research and be strong clinically to get into a good cardiology program. Its impossible for anyone (including yourself) to predict how you will do during your residency. If you are a sincere, hardworking chap in general then chances are you will work hard in residency too.

But does it at least guarantee getting into a mediocre fellowship (i.e. I will not be stuck in general internal medicine)? That itself is a pretty important thing to consider before applying into a "stepping-stone" residency.

 

[P Diddy]

But does it at least guarantee getting into a mediocre fellowship (i.e. I will not be stuck in general internal medicine)? That itself is a pretty important thing to consider before applying into a "stepping-stone" residency.

yes, as long as you apply intelligently based on your stats.

p diddy

 

[Medstart108]

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[IM2GI]

This does not answer my question at all. Yes i know Cards is "hard" to get into, but it is also "hard" to get into a top 4 IM residency program. My question was specifically about how hard it is to get into a good cards program from a top IM program, and I am looking for answers from people who have gone through the cards match (or GI or H/O) and can speak to the relative importance of IM residency location versus other factors (like research during residency or how well you subjectively do during residency--I am not sure how this second point is even measured).

If you go to a "top 4" internal med residency, unless you are a huge tool and everyone hates you, you will match cards somewhere. In fact, even if you are a douche, you probably still will match cards somewhere. There are twice the number of cards spots than GI spots BTW.

FYI: Your posts make you seem like a tool, you should work on that. If you project this whole "stepping stone" nonsense, people will pick up on it. You do 3 years of IM to be a great internist first, worry about the cards later. Nobody likes the guy who is cards from day 1 and doesn't care about anything else.

 

[cardiology1979]

If you go to a "top 4" internal med residency, unless you are a huge tool and everyone hates you, you will match cards somewhere. In fact, even if you are a douche, you probably still will match cards somewhere. There are twice the number of cards spots than GI spots BTW.

FYI: Your posts make you seem like a tool, you should work on that. If you project this whole "stepping stone" nonsense, people will pick up on it. You do 3 years of IM to be a great internist first, worry about the cards later. Nobody likes the guy who is cards from day 1 and doesn't care about anything else.

 

[whodatMD]

Ah yes, the ol' "look at my stats and tell me how good I am" post... I've seen this a zillion times.

Here's the real truth. No one is going to take you just for your stats and place you did IM training. Does it help you stand out and make getting a top notch program easier? Come on dude... use some common sense. OF COURSE it does.

But there is definitely the people-factor in medicine, and especially in fellowships with only a handful or so of fellows each year. People don't want to work with people with serious personality flaws, and if those flaws limit your ability to actually care for patients, that makes you a crappy physician no matter what your Step scores were when you were a niave med student.

If you are a douche in your residency or need confirmation from rando's on some thread to feed your ego because you're insecure, that will 1) make life difficult during residency 2) be reflected in your LORs 3) hurt your chances of matching in anything.

Cardiology is an awesome field and you shouldn't have any problems getting into a good program pending no major personality flaws.

 

[Instatewaiter]

This does not answer my question at all. Yes i know Cards is "hard" to get into, but it is also "hard" to get into a top 4 IM residency program. My question was specifically about how hard it is to get into a good cards program from a top IM program, and I am looking for answers from people who have gone through the cards match (or GI or H/O) and can speak to the relative importance of IM residency location versus other factors (like research during residency or how well you subjectively do during residency--I am not sure how this second point is even measured).

It is incredibly rare for someone coming from a top program to not get into a top tier cards program. Personally I think it's kind of stupid but PD's panties drop if you have a big name on your application. Yes LORs are important as is research and not being a psychopath during your interview but even with the most mediocre application, you will match, and likely to a very strong program. The only time I have heard of people not matching was a few years ago there was a couple who did couples match cards coming from JHH. They didn't match (applied to like 6 of the most competitive programs couples match and refused to match separately which was really stupid). The next year, despite having the stigma of not matching, matched to JHH and Cornell.

Last year's card's match at JHH:
Hopkins, CCF, Mayo, The Brigham Duke, Cornell, Texas Heart UCSF,Emory,Chicago,Washington hospital program

Year before
JHH x 2, Wash U, UCSF, The Brigham, BIDMC, Cornell, BU, CCF, Duke, Mt Sinai, Maryland

I think what I'm saying is that if you can match to a strong IM program, you have an incredibly high likelihood of matching to a very strong cards program.

 

[HarryGary]

Yep. And every friday, each of these dbags wears an ugly tie with Hopkins logo on it. Jk

It is incredibly rare for someone coming from a top program to not get into a top tier cards program. Personally I think it's kind of stupid but PD's panties drop if you have a big name on your application. Yes LORs are important as is research and not being a psychopath during your interview but even with the most mediocre application, you will match, and likely to a very strong program. The only time I have heard of people not matching was a few years ago there was a couple who did couples match cards coming from JHH. They didn't match (applied to like 6 of the most competitive programs couples match and refused to match separately which was really stupid). The next year, despite having the stigma of not matching, matched to JHH and Cornell.

Last year's card's match at JHH:
Hopkins, CCF, Mayo, The Brigham Duke, Cornell, Texas Heart UCSF,Emory,Chicago,Washington hospital program

Year before
JHH x 2, Wash U, UCSF, The Brigham, BIDMC, Cornell, BU, CCF, Duke, Mt Sinai, Maryland

I think what I'm saying is that if you can match to a strong IM program, you have an incredibly high likelihood of matching to a very strong cards program.

 

[nervousivy]

I just wanted to add a caveat...I graduated from a top IM program and in our class, I would say less than five people (out of like 20+ combined) actually matched at their number 1 choice for Cards or GI fellowship. Going to a top program makes it easier to match well in a competitive specialty like Cards or GI, BUT it doesn't assure you, your first, second, or even third choices. Based on where people even get interviews, they may drastically change their expectations/ideal rank lists. For example, I've heard of East coast born and raised people landing out in Minnesota for Mayo or Ohio for CCF...not b/c they were clamoring to go to Mayo, but because of the interviews received that was their best option and/or they felt compelled to rank them highly due to their name/academic cache. Most people won't admit to you "Hey, this was my fourth/fifth/sixth choice" but it's not that uncommon to come from a top IM program and land at your fourth or fifth choice in some of the really competitive specialties.

All of this to say, while where you go helps, it is just one of many things needed for a successful Cards match. HTH.