The argument to go to a more expensive, prestigious med school

[FIREitUP]

It's been a while since I posted on this board, but I felt the need to post this, since I was always the guy who said "go to the cheaper school"...until I learned more about the realities of applying to residency. I currently go to a state school and I just wanted to tell you guys about the advantages of going to a more expensive school with a name.

1) Name recognition makes a difference to get into the top residency programs, and for competitive fields such as urology, dermatology, ENT, etc. An ENT resident who went to my school and had extensive research at an IVY league, would later interview at said program where they basically said they wouldn't consider her because of the fact that she went to a state school. keep in mind this was a student who was at the top of the class. In the end she matched at her school, but bear in mind for many of these competitive fields spots are very limited, so if many people in your class are concurrently applying, your chances diminish greatly. Also bear in mind a big name usually nets more interviews.

2) Name recognition helps with getting grants for research. You will see more and more residencies requiring research, and some people even will have to take a year off for research in order to get into a competitive specialty. If you are at a school who has money, chances are there is research going on that you can get involved in. This may prevent you from having to take a dreaded year off when applying to certain specialties.

3) Letters of recommendations from big names matter. A big name vouching for you can net more interviews at better programs. Chances are, these big names are at big places.

I hope you guys take into consideration my experiences. I feel so foolish now, having struggled so much at my school with poor advising and basically no research. Now I'm forced to take a year off because of my lack of connections/research. In the end, this decision will end up costing me in opportunity cost and substantial stress. Had I known, maybe I would have been more cognizant about the places I applied and maybe looked into more reaches. If you have the choice, definitely weigh the pros and cons of attending a school with a decent name.

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[DifferentialDiagnosis]

I go to a large state school and as an undergrad there have been countless opportunities to get involved in research if you put in the effort.

Edit: Realized OP was talking med school. Whoops. Maybe it's different? Idk.

 

[whoadude]

-

 

[infinitessimal]

Thanks for posting this in the pre-allo thread! I've always been against the MD=MD argument, and I've seen discussions like these in the allopathic boards but many premeds don't see them. This is not to say one side is right and the other is wrong, but at least now more people have more to consider when deciding between med schools.

 

[FIREitUP]

I go to a large state school and as an undergrad there have been countless opportunities to get involved in research if you put in the effort.

Edit: Realized OP was talking med school. Whoops. Maybe it's different? Idk.

Go to the undergrad that will net you the best grades while still being able to have fun. Try to enjoy your time. Undergrad prestige does not mean nearly as much, though it can also help because of opportunities.

 

[kk123]

1) Name recognition makes a difference to get into the top residency programs, and for competitive fields such as urology, dermatology, ENT, etc. An ENT resident who went to my school and had extensive research at an IVY league, would later interview at said program where they basically said they wouldn't consider her because of the fact that she went to a state school. keep in mind this was a student who was at the top of the class. In the end she matched at her school, but bear in mind for many of these competitive fields spots are very limited, so if many people in your class are concurrently applying, your chances diminish greatly. Also bear in mind a big name usually nets more interviews.

Thank you for posting this. I had wondered how much of an impact the prestige of a med school had on getting into residencies. If someone goes to a public school with a residency program for a competitive specialty, do they have a better chance of matching to that program than someone who did not go to that school? Or do schools prefer to accept students from different schools into their residency programs?

 

[FIREitUP]

Thank you for posting this. I had wondered how much of an impact the prestige of a med school had on getting into residencies. If someone goes to a public school with a residency program for a competitive specialty, do they have a better chance of matching to that program than someone who did not go to that school? Or do schools prefer to accept students from different schools into their residency programs?

my school preferentially takes its own for competitive specialties.

 

[darkjedi]

Thank you for posting this. I had wondered how much of an impact the prestige of a med school had on getting into residencies. If someone goes to a public school with a residency program for a competitive specialty, do they have a better chance of matching to that program than someone who did not go to that school? Or do schools prefer to accept students from different schools into their residency programs?

my school preferentially takes its own for competitive specialties.

I think this is true for the majority of schools. It's natural that the residency directors would get to know their own medical students very well. This is why doing away/audition rotations at places you wish to match is so important.

 

[Goro]

Fire, I'm still learning the ropes of getting people OUT of medical school (into and through I'm OK at). May I ask what your Board scores were? My understanding that these are among the top criteria for PDs/RDs.


This is a revelation...I can just imagine some of these people hanging signs out" "DO and State grads need not apply"

An ENT resident who went to my school and had extensive research at an IVY league, would later interview at said program where they basically said they wouldn't consider her because of the fact that she went to a state school. keep in mind this was a student who was at the top of the class. In the end she matched at her school, but bear in mind for many of these competitive fields spots are very limited, so if many people in your class are concurrently applying, your chances diminish greatly. Also bear in mind a big name usually nets more interviews.


Other residents and practicing clinicians, what say you? @gyngyn? @Dermvisor? @Catalystic? @Law2Doc?

 

[FIREitUP]

Fire, I'm still learning the ropes of getting people OUT of medical school (into and through I'm OK at). May I ask what your Board scores were? My understanding that these are among the top criteria for PDs/RDs.


This is a revelation...I can just imagine some of these people hanging signs out" "DO and State grads need not apply"

An ENT resident who went to my school and had extensive research at an IVY league, would later interview at said program where they basically said they wouldn't consider her because of the fact that she went to a state school. keep in mind this was a student who was at the top of the class. In the end she matched at her school, but bear in mind for many of these competitive fields spots are very limited, so if many people in your class are concurrently applying, your chances diminish greatly. Also bear in mind a big name usually nets more interviews.


Other residents and practicing clinicians, what say you? @gyngyn? @Dermvisor? @Catalystic? @Law2Doc?

>250

 

[Cyberdyne 101]

I think this is true for the majority of schools. It's natural that the residency directors would get to know their own medical students very well. This is why doing away/audition rotations at places you wish to match is so important.

So can a combination of glowing LOR's from away rotations, a high step 1, and a year of research, help the non-Yale applicant land a competitive residency?

 

[Holmwood]

I feel like an underachiever. All my specialty interests are noncompetitive. : D

 

[darkjedi]

So can a combination of glowing LOR's from away rotations, a high step 1, and a year of research, help the non-Yale applicant land a competitive residency?

Of course. Some programs may be snobbier than others, but if you look at the residents for many competitive residencies, you'll see they'll come from pretty much anywhere.

 

[FIREitUP]

I feel like an underachiever. All my specialty interests are noncompetitive. : D

you might surprise yourself!

 

[cs24]

I go to a large state school and as an undergrad there have been countless opportunities to get involved in research if you put in the effort.

Edit: Realized OP was talking med school. Whoops. Maybe it's different? Idk.

I go to a state (medical) school with plenty of research opportunities. This is going to be school dependent, so definitely something to think about when choosing a program (just want to point out that there are plenty of state schools with great research). Of course, the other advantages of being at a more prestigious institution are still going to give someone from Harvard an advantage over someone from my school.

 

[gyngyn]

Other residents and practicing clinicians, what say you? @gyngyn? @Dermvisor? @Catalystic? @Law2Doc?

In California, the medical schools are excellent and PD's know it. Most of the CA students want residencies in CA but realize that they will need to apply and interview broadly (OOS) if they are applying in the surgical subspecialties (or derm). The majority of students who left CA (for medical school) all want to return, so the competition for residency spots in just about every specialty here is fierce. If everything else is equal (high step scores, AOA, clerkship grades, LOR's, research, sub-I evals...) the medical school attended will be a factor. Despite the hype that a "year of research" can have a significant effect on the outcome, I have yet to see a modest applicant transformed into a strong one yet by a research year (with the possible exception of ophthalmology)..

 

[SlowCodeToChina]

I go to a state medical school which heavily favors in state students. Granted we are a top 50 institution, but I've never felt this way about the residency process. Step 1 and Step 2 truly are equalizers when it comes to applying to residency programs. I suspect that at lower ranked programs research might in fact be an issue, but it certainly is not at my institution. I suspect the reasons that applicants from top medical schools have a better shot at the match are the same reasons that they are at a higher ranked medical school than you--better test taking skills, better interviewing skills, richer ($$ = attend more interviews, better opportunities), and (believe it or not) better looking than you are.

 

[Ace Khalifa]

No amount of prestige is worth the higher amount of money that I would have to pay for going to an expensive but "prestigious" OOS medical school instead of one of my much cheaper state schools. Granted, NC only has 2 public schools, and the only "top 20" medical school I applied to was my alma mater Wash U, but whatever. I'm going into medicine so that I can take care of patients and bring about positive change on the small-scale level (individualized patient care). I have absolutely no interest in research or academic medicine, but if I have to do some research during medical school to become competitive for residency applications, then fine, I'll do it, but that would be the only reason I would. Personally, I'd rather spend my free time during medical school volunteering and staying engaged in community service activities.

 

[235009]

Pedigree ALWAYS gives you a leg up. Residency applications are no different. If you are coming from a less prestigious school you bet you're going to need better stats to have the same opportunities as a student at a top school. Same goes for undergrad school. I've been on both sides of this. There is no way I would've gotten into a US MD school if I wasn't an Ivy League graduate. On the flip side I think I would've gotten more opportunities come residency application time had I not been a state med school graduate. But to compete with the average top 20 school graduate you had to be the top of the class AOA type coming from my school.

Fire, I'm still learning the ropes of getting people OUT of medical school (into and through I'm OK at). May I ask what your Board scores were? My understanding that these are among the top criteria for PDs/RDs.


This is a revelation...I can just imagine some of these people hanging signs out" "DO and State grads need not apply"

I'm glad you are admitting your ignorance regarding the residency application process. Also coming from a state MD school is extraordinarily more advantageous than going to any DO school. The point we are trying to make is that generally you have to work harder to reach the same endpoint (though yea sometimes like on OP's example you are shut out) whereas being a DO is a disadvantage that many times no amount of hard work can overcome.

 

[Law2Doc]

Re number 1, If a program is telling someone they wouldn't consider her because of her state school pedigree, it means they had a much less defensible or more insulting reason they really don't want her. Usually you never have to tell someone why you won't take them for residency (the beauty of a match with no do overs) but if you are somehow put on the spot, you scrounge for something defensible and not insulting. State school sounds as good as any soft let down. It's a whole "it's not you, it me" song and dance. If you hear that, "it's you". Ive been in that position where someone we didn't rank highly asked if I knew why and you really just give them whatever comes into your head that won't crush them. Telling someone that their state school held them back is a lot nicer than saying interviewer X thought you were a total tool, or all the residents that met you didn't really feel like you'd mesh well, so we didn't rank you.

Truth of the matter is the top people at state schools can be found in all the most competitive specialties, even at some of the best places. I know MANY state school grads in the three specialties the OP listed, so take what he's saying with a tub of salt. Many state schools have strong departments in one or all of these and not infrequently cherry pick from their own med schools for residency.

(Also I cringe whenever anyone uses "Ivy league" when talking about med school or beyond. Ivy is 8 colleges, and IV was their designation for football division purposes. One of these 8 doesn't have a med school. Several are not really in the upper echelon of med schools. And once you get to residency many of these parent schools are subdivided into multiple hospitals, some better regarded than others. So that term Ivy league is pointless when you are not talking about college, and for residency discussions your college pedigree is pretty meaningless. Makes me think a poster has no clue.)

Regarding #2 and 3, there are actually quite a lot of big names at pretty much all of the state schools, and all state schools by definition have a built in brand name people know (assuming they have heard of all fifty of the states). And most do research, particularly if affiliated with a big state school undergrad. The real question is whether they are doing adequate research in the field you ultimately decide on. A state school might have a lot of big name neurologists and be doing tons of research in neurobiology but that doesn't really help you when you decide you want to do ortho. So I think you have to realize that pedigree doesn't always flow from the "brand name" but from the players in each specialty.

Look at it like baseball. Every team has it's hall of famers over the years. you might see more playing at the same time on a high payroll team like the Yankees, but just because you go to Yankee stadium doesn't mean they will give you the time of day. You are often better off going to the small market team where they only have a few stars, but they all spend the time to sign autographs.

Like it or not connections are huge, and being on the same campus as a big shot doesn't mean they will deign to be your mentor or write you a nice letter or pick up the phone for you. You are often better off trying to shoot a medium fish in a barrel than a big fish in a lake.

 

[ems2doc]

Plenty of people from state schools match in programs like neurosurgery, dermatology, and orthopedics. It's very rare that you will be discriminated against by residency programs.

There's a problem with your post... you have n=1. This is not representative of all of medicine.

 

[DermViser]

And the impenetrable bubble between SDN Allopathic and Pre-Allopathic has finally been broken.

 

[DermViser]

I hope you guys take into consideration my experiences. I feel so foolish now, having struggled so much at my school with poor advising and basically no research. Now I'm forced to take a year off because of my lack of connections/research. In the end, this decision will end up costing me in opportunity cost and substantial stress. Had I known, maybe I would have been more cognizant about the places I applied and maybe looked into more reaches. If you have the choice, definitely weigh the pros and cons of attending a school with a decent name.

To be fair, there are public state medical schools that have all the competitive specialties as well as research going on as well (and allow medical students to take part) -- highly dependent on the state in question. Also, premeds have no clairvoyance to be able to predict their class performance or board scores ahead of time so it's difficult to predict what specialties are still open to them.

It's not at all surprising that an Ivy League program would only want to recruit those from elite med schools. That being said, usually when you do research with them and prove your mettle, so to speak, they're more willing to take you, but that's not always the case. I can almost one hundred percent bet the ENT resident who was told it was bc of her school was an easy way of letting her down rather than tell her the truth - her work ethic, her grating personality, etc.

 

[DermViser]

Thanks for posting this in the pre-allo thread! I've always been against the MD=MD argument, and I've seen discussions like these in the allopathic boards but many premeds don't see them. This is not to say one side is right and the other is wrong, but at least now more people have more to consider when deciding between med schools.

There's a reason it's posted in Allo. Bc people figure it out too late, and Pre-Allo never believes Allo when they're told.

 

[DermViser]

Go to the undergrad that will net you the best grades while still being able to have fun. Try to enjoy your time. Undergrad prestige does not mean nearly as much, though it can also help because of opportunities.

Where do you think elite med schools recruit from?

 

[DermViser]

I go to a state medical school which heavily favors in state students. Granted we are a top 50 institution, but I've never felt this way about the residency process. Step 1 and Step 2 truly are equalizers when it comes to applying to residency programs. I suspect that at lower ranked programs research might in fact be an issue, but it certainly is not at my institution. I suspect the reasons that applicants from top medical schools have a better shot at the match are the same reasons that they are at a higher ranked medical school than you--better test taking skills, better interviewing skills, richer ($$ = attend more interviews, better opportunities), and (believe it or not) better looking than you are.

I truly hope you're joking.

 

[FIREitUP]

my school in particular is known for not having a good research endowment, so not all state schools are equal.

 

[ems2doc]

My state school has an incredible amount of research funding. Also, it's unwritten, but one of our affiliated hospitals is pretty "prestigious" and I think there's unofficial preference for our state school grads for residency. We have a few neurosurgery spots at the hospital. All 3 matched from our state school. I think it's part coincidence, part preference.

 

[DermViser]

my school in particular is known for not having a good research endowment, so not all state schools are equal.

Hence why it's very school specific - which you don't really know until long after you matriculate. Even then in some cases, like @snowy435's case, the more cost-effective deal is much better in the long run, even though it may not seem like it at the time. Student loan debt is a huge burden, and unless you're born affluent, it's nothing to scoff at.

We don't know what your class rank is, even though you scored >250s, but you had no way of knowing this before you entered med school. It could just as easily have gone the other way and then your school might have been a great deal. That being said - 1 year off is NO BIG DEAL at all.

 

[TooMuchResearch]

Fire, I'm still learning the ropes of getting people OUT of medical school (into and through I'm OK at). May I ask what your Board scores were? My understanding that these are among the top criteria for PDs/RDs.


This is a revelation...I can just imagine some of these people hanging signs out" "DO and State grads need not apply"

An ENT resident who went to my school and had extensive research at an IVY league, would later interview at said program where they basically said they wouldn't consider her because of the fact that she went to a state school. keep in mind this was a student who was at the top of the class. In the end she matched at her school, but bear in mind for many of these competitive fields spots are very limited, so if many people in your class are concurrently applying, your chances diminish greatly. Also bear in mind a big name usually nets more interviews.


Other residents and practicing clinicians, what say you? @gyngyn? @Dermvisor? @Catalystic? @Law2Doc?

Go to the cheapest medical school that will take you. Study hard. Crush your board exams and rotations. Do research if you want. Be an interesting person. Be personable in interviews. If some "big name" school finds your pedigree too lowly, bite your thumb in their general direction and realize you just narrowly avoided becoming a "big name" snob.

 

[ems2doc]

I wouldn't want to do a residency where they reject people for petty reasons like that.

 

[FIREitUP]

Go to the cheapest medical school that will take you. Study hard. Crush your board exams and rotations. Do research if you want. Be an interesting person. Be personable in interviews. If some "big name" school finds your pedigree too lowly, bite your thumb in their general direction and realize you just narrowly avoided becoming a "big name" snob.

Easier said than done. This is coming from someone who did well on Step 1 and honored almost all clerkships save OBGYN. Shelf exams can be tough and evals can be subjective. Take any leg up you can possibly get!

Again, this is just my personal opinion from what I have experienced. I feel like it would be a disservice to not mention this to people who do not have the same insight.

 

[DermViser]

Easier said than done. This is coming from someone who did well on Step 1 and honored almost all clerkships save OBGYN. Shelf exams can be tough and evals can be subjective. Take any leg up you can possibly get!

Again, this is just my personal opinion from what I have experienced. I feel like it would be a disservice to not mention this to people who do not have the same insight.

By your logic you could have gone to a more elite med school and not necessarily have gotten "Honors" on your MS-3 clerkships due to harder grading.

 

[Law2Doc]

I wouldn't want to do a residency where they reject people for petty reasons like that.

Oh please. Residency is a means to an end - a vehicle to your destination. I'd ride in a limo full of A-holes if it were the only vehicle that was going my way. (Fortunately I've not had to do that.)

 

[mimelim]

Fire, I'm still learning the ropes of getting people OUT of medical school (into and through I'm OK at). May I ask what your Board scores were? My understanding that these are among the top criteria for PDs/RDs.


This is a revelation...I can just imagine some of these people hanging signs out" "DO and State grads need not apply"

An ENT resident who went to my school and had extensive research at an IVY league, would later interview at said program where they basically said they wouldn't consider her because of the fact that she went to a state school. keep in mind this was a student who was at the top of the class. In the end she matched at her school, but bear in mind for many of these competitive fields spots are very limited, so if many people in your class are concurrently applying, your chances diminish greatly. Also bear in mind a big name usually nets more interviews.


Other residents and practicing clinicians, what say you? @gyngyn? @Dermvisor? @Catalystic? @Law2Doc?

Re number 1, If a program is telling someone they wouldn't consider her because of her state school pedigree, it means they had a much less defensible or more insulting reason they really don't want her. Usually you never have to tell someone why you won't take them for residency (the beauty of a match with no do overs) but if you are somehow put on the spot, you scrounge for something defensible and not insulting. State school sounds as good as any soft let down. It's a whole "it's not you, it me" song and dance. If you hear that, "it's you". Ive been in that position where someone we didn't rank highly asked if I knew why and you really just give them whatever comes into your head that won't crush them. Telling someone that their state school held them back is a lot nicer than saying interviewer X thought you were a total tool, or all the residents that met you didn't really feel like you'd mesh well, so we didn't rank you.

Truth of the matter is the top people at state schools can be found in all the most competitive specialties, even at some of the best places. I know MANY state school grads in the three specialties the OP listed, so take what he's saying with a tub of salt. Many state schools have strong departments in one or all of these and not infrequently cherry pick from their own med schools for residency.

(Also I cringe whenever anyone uses "Ivy league" when talking about med school or beyond. Ivy is 8 colleges, and IV was their designation for football division purposes. One of these 8 doesn't have a med school. Several are not really in the upper echelon of med schools. And once you get to residency many of these parent schools are subdivided into multiple hospitals, some better regarded than others. So that term Ivy league is pointless when you are not talking about college, and for residency discussions your college pedigree is pretty meaningless. Makes me think a poster has no clue.)

Regarding #2 and 3, there are actually quite a lot of big names at pretty much all of the state schools, and all state schools by definition have a built in brand name people know (assuming they have heard of all fifty of the states). And most do research, particularly if affiliated with a big state school undergrad. The real question is whether they are doing adequate research in the field you ultimately decide on. A state school might have a lot of big name neurologists and be doing tons of research in neurobiology but that doesn't really help you when you decide you want to do ortho. So I think you have to realize that pedigree doesn't always flow from the "brand name" but from the players in each specialty.

Look at it like baseball. Every team has it's hall of famers over the years. you might see more playing at the same time on a high payroll team like the Yankees, but just because you go to Yankee stadium doesn't mean they will give you the time of day. You are often better off going to the small market team where they only have a few stars, but they all spend the time to sign autographs.

Like it or not connections are huge, and being on the same campus as a big shot doesn't mean they will deign to be your mentor or write you a nice letter or pick up the phone for you. You are often better off trying to shoot a medium fish in a barrel than a big fish in a lake.

@Law2Doc knocked it out of the park.

Short: Name matters. It always matters, from HS to getting a job as an attending, it matters. It just matters very little and only in a small handful of cases a year does it make any difference at all.

 

[TooMuchResearch]

Oh please. Residency is a means to an end - a vehicle to your destination. I'd ride in a limo full of A-holes if it were the only vehicle that was going my way. (Fortunately I've not had to do that.)

I wouldn't. I like going to work. If I was working with snobs, I would hate work. My rank list was largely affected by the "good vibes" I got from residents and faculty on the interview trail.

 

[TooMuchResearch]

Easier said than done. This is coming from someone who did well on Step 1 and honored almost all clerkships save OBGYN. Shelf exams can be tough and evals can be subjective. Take any leg up you can possibly get!

Again, this is just my personal opinion from what I have experienced. I feel like it would be a disservice to not mention this to people who do not have the same insight.

You have insight into your anecdote; I have insight into mine.

No one cared where I went to school or rotated except for a few age >65 faculty who asked how their old friends from my medical school were doing.

 

[DermViser]

@Law2Doc knocked it out of the park.

Short: Name matters. It always matters, from HS to getting a job as an attending, it matters. It just matters very little and only in a small handful of cases a year does it make any difference at all.

That goes against the SDN pre-Allopathic credo that all MD schools, in the end, are somehow the same and the only thing that should matter is cost and that all programs should give all qualified applicants (based on Step scores and clinical grades only) an interview.

 

[IlDestriero]

That goes against the SDN pre-Allopathic credo that all MD schools, in the end, are somehow the same and the only thing that should matter is cost and that all programs should give all qualified applicants (based on Step scores and clinical grades only) an interview.

I don't think they actually believe that, they just want to believe that.
Most of the fellows at my shop come from the same handful of premiere residency programs. The fellowship match mixed it up a bit, but not dramatically.
How does one score a spot at a premiere residency? Scores, attitude, research and connections. Connections come into play with LORs.
What does one of these stand out residency programs offer? Name recognition in the field, a dense national network of grads to ping for job leads, superior research opportunities and higher quality training. In my field, anesthesia, you want regular exposure to high acuity challenging cases. They make you a better anesthesiologist. Any dunce can do a hernia or a lap chole.

 

[DermViser]

I don't think they actually believe that, they just want to believe that.
Most of the fellows at my shop come from the same handful of premiere residency programs. The fellowship match mixed it up a bit, but not dramatically.
How does one score a spot at a premiere residency? Scores, attitude, research and connections. Connections come into play with LORs.
What does one of these stand out residency programs offer? Name recognition in the field, a dense national network of grads to ping for job leads, superior research opportunities and higher quality training. In my field, anesthesia, you want regular exposure to high acuity challenging cases. They make you a better anesthesiologist. Any dunce can do a hernia or a lap chole.

So then I'm guessing the premiere Anesthesiology programs work you to the bone - the ones that have name recognition?

 

[IlDestriero]

So then I'm guessing the premiere Anesthesiology programs work you to the bone - the ones that have name recognition?

No. Not necessarily. It's not about doing more cases, it's about regular exposure to very challenging cases. Major referral centers offering full service is what you want. Community programs that refer out to major medical centers are a great place to learn how to be very average. And them sending the residents for a trauma month, etc. to the big house isn't the same at all. Though they will tell you how great it is to be "partnered" with MGH, Hopkins, UCSF, Stanford, etc.

 

[FIREitUP]

By your logic you could have gone to a more elite med school and not necessarily have gotten "Honors" on your MS-3 clerkships due to harder grading.

if indeed it is the case that it is harder to get honors in other schools. especially considering we all take the same shelf exams and evals are still based mostly on likeability.

 

[DermViser]

if indeed it is the case that it is harder to get honors in other schools. especially considering we all take the same shelf exams and evals are still based mostly on likeability.

Likeability is always important, however, clinical judgement and knowledge is also assessed based on your presentations and ability to answer pimp questions.

 

[Law2Doc]

That goes against the SDN pre-Allopathic credo that all MD schools, in the end, are somehow the same and the only thing that should matter is cost and that all programs should give all qualified applicants (based on Step scores and clinical grades only) an interview.

You need to reread that post. It says it matters "very little" and to a pretty insignificant number of cases each year. so 99.9% of the time, the "SDN pre-Allopathic credo" is spot on. To most broad brush people, 99.9% is about 100%. To a couple of borderline derm and rad onc hopefuls each year maybe not. In my experience, we are talking about a couple of dozen people out of 17000 in tge match each year where MAYBE it come into play. MAAyBE. That's so insignificant most if us are comfortable rounding it down to zero. So to almost everyone reading this, yes you might as well save your money and do the state school thing. Every school is a pretty good launching pad for what you want to do, and if you are tops in your rotations, do well on the steps and jump through the various expected hoops in terms of research and getting strong letters, the derm, ENT, etc doors will still be open.

 

[Law2Doc]

No. Not necessarily. It's not about doing more cases, it's about regular exposure to very challenging cases. Major referral centers offering full service is what you want. Community programs that refer out to major medical centers are a great place to learn how to be very average. And them sending the residents for a trauma month, etc. to the big house isn't the same at all. Though they will tell you how great it is to be "partnered" with MGH, Hopkins, UCSF, Stanford, etc.

I think you guys are trying to lump prestigious residency in with prestigious med school and it weakens the discussion. You can do well at a state school and then go to a great residency. Thats the point of this thread. A big state university isn't a funnel to a community hospital. There are TONS of state school med school grads at well regarded academic institutions.

I think Also maybe you are trying to extrapolate anesthesia onto other fields and it's falling flat. Perhaps in anesthesia working on challenging cases is a bigger deal. in most fields though, when you get to the academic institution vs community decision it turns on--. How cerebral is the practice? In neuro for example, you might be better off at a big place that sees lots of zebras. It's harder to diagnose something you've only seen in books. In a more procedural practice, like ortho, it's really all about volume -- nobody in practice really cares that you've seen the rare 1 in a million connective tissue disorder, it's how many hips, knees etc you've done. So some of the community residency grads actually have an easier time landing jobs because the guy who has been in on ten times as many procedures is more valuable to an employer than the guy with more untapped potential.

Often having "learned how to be average" is better to employers than being the world expert in a zebra that you'll never see again in your career. In the hands on skill fields, technical proficiency kind of matters more than having seen all the complicated things, because honestly your ultimate employers are going to refer away the disasters much faster than the community hospitals would. You want some exposure to complicated things, so the trauma month is useful, but it's not going to be your bread and butter so a month or two is plenty. In this day of reimbursements where you get paid the same whether a case is simple or a total train wreck, the private practice employers try to toss those train wrecks over to the university programs as often as they can. It's not that they aren't competent to handle them, and that the trauma month they had long the road wasn't enough, it's that they will lose money on these cases. So the universities pat themselves on the back and say "look at all the complicated cases we are doing" while the private practice employers are chuckling and saying "suckers".

 

[235009]

You need to reread that post. It says it matters "very little" and to a pretty insignificant number of cases each year. so 99.9% of the time, the "SDN pre-Allopathic credo" is spot on. To most broad brush people, 99.9% is about 100%. To a couple of borderline derm and rad onc hopefuls each year maybe not. In my experience, we are talking about a couple of dozen people out of 17000 in tge match each year where MAYBE it come into play. MAAyBE. That's so insignificant most if us are comfortable rounding it down to zero. So to almost everyone reading this, yes you might as well save your money and do the state school thing. Every school is a pretty good launching pad for what you want to do, and if you are tops in your rotations, do well on the steps and jump through the various expected hoops in terms of research and getting strong letters, the derm, ENT, etc doors will still be open.

I think you are only looking at it from the perspective of matching vs not matching in which case yes that's probably only a few dozen people but you are ignoring the disparity in where applicants match and how much of a superstar you need to be to achieve certain things. Of course this isn't nearly as big of a deal. OP could probably match SOMEWHERE in his chosen field with his current stats but the point is he has to take a year off to have a chance at matching where he wants whereas someone at a more prestigious school would not have had to do that.

 

[DermViser]

I think you guys are trying to lump prestigious residency in with prestigious med school and it weakens the discussion. You can do well at a state school and then go to a great residency. Thats the point of this thread. A big state university isn't a funnel to a community hospital. There are TONS of state school med school grads at well regarded academic institutions.

I think Also maybe you are trying to extrapolate anesthesia onto other fields and it's falling flat. Perhaps in anesthesia working on challenging cases is a bigger deal. in most fields though, when you get to the academic institution vs community decision it turns on--. How cerebral is the practice? In neuro for example, you might be better off at a big place that sees lots of zebras. It's harder to diagnose something you've only seen in books. In a more procedural practice, like ortho, it's really all about volume -- nobody in practice really cares that you've seen the rare 1 in a million connective tissue disorder, it's how many hips, knees etc you've done. So some of the community residency grads actually have an easier time landing jobs because the guy who has been in on ten times as many procedures is more valuable to an employer than the guy with more untapped potential.

Often having "learned how to be average" is better to employers than being the world expert in a zebra that you'll never see again in your career. In the hands on skill fields, technical proficiency kind of matters more than having seen all the complicated things, because honestly your ultimate employers are going to refer away the disasters much faster than the community hospitals would. You want some exposure to complicated things, so the trauma month is useful, but it's not going to be your bread and butter so a month or two is plenty. In this day of reimbursements where you get paid the same whether a case is simple or a total train wreck, the private practice employers try to toss those train wrecks over to the university programs as often as they can. It's not that they aren't competent to handle them, and that the trauma month they had long the road wasn't enough, it's that they will lose money on these cases. So the universities pat themselves on the back and say "look at all the complicated cases we are doing" while the private practice employers are chuckling and saying "suckers".

Well it might have something to do with that academic medical centers can charge facility fees, and private practices can't.

 

[mcloaf]

I think you are only looking at it from the perspective of matching vs not matching in which case yes that's probably only a few dozen people but you are ignoring the disparity in where applicants match and how much of a superstar you need to be to achieve certain things. Of course this isn't nearly as big of a deal. OP could probably match SOMEWHERE in his chosen field with his current stats but the point is he has to take a year off to have a chance at matching where he wants whereas someone at a more prestigious school would not have had to do that.

^^^

Even from a highly ranked school I'm strongly considering taking a year out for research to help with my geographic preferences in the match. Not all of us have family/relationship situations that make it as simple as just matching anywhere in the US as long is it's in the field.

 

[DermViser]

^^^

Even from a highly ranked school I'm strongly considering taking a year out for research to help with my geographic preferences in the match. Not all of us have family/relationship situations that make it as simple as just matching anywhere in the US as long is it's in the field.

In medicine your family/relationships is secondary to medicine. Just ask William Osler.

 

[TooMuchResearch]

In medicine your family/relationships is secondary to medicine. Just ask William Osler.

I'm pretty sure he's dead.