Top vs. Mid vs. Lower tier IM programs

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nykka3

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When ppl. use these terms are they referring to an actual list available to everyone (i.e. NIH funding) or is it all more subjective? I would like to apply to programs that will teach me well (i.e. evidence based medicine), encourage autonomy, and have a good record of residents attaining good fellowships. Do you end up finding all of this out during interview time or can you figure it out before?
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No, Yes, Yes, No in that order.

The tiering thing is completely subective and what you consider top-tier may differ dramatically from what I consider top-tier and the conditions for ranking them as such are completely subjective. NIH funding is one measure but that will have very little impact on the training you get as an IM resident. In general, when people talk about top-tier places, they are referring to competitiveness (is that even a word?) which may not have any real impact on the real quality of the program.
 
No, Yes, Yes, No in that order.

The tiering thing is completely subective and what you consider top-tier may differ dramatically from what I consider top-tier and the conditions for ranking them as such are completely subjective. NIH funding is one measure but that will have very little impact on the training you get as an IM resident. In general, when people talk about top-tier places, they are referring to competitiveness (is that even a word?) which may not have any real impact on the real quality of the program.

I agree that the entire tier debate doesn't hold much substance other than perceived reputation amongst colleagues and friends. From the places I've interviewed at, it seems you get fairly comprable clinical training despite differences in prestige. With that in mind, you find the program which is centered around something you value, or hope to get out of your training- whether it be research, helping the underserved, international exposure, exceptional clinicians etc etc. While most good programs try to be spectacular in everything, you definitely get a feel that there is one area which they focus on when you visit there.

As for NIH funding, which usually goes hand in hand with reputation/tier. I think it does make a slight impact in terms of your residency and subsequent fellowship placement. Places which have the highest NIH funding probably have top notch researchers in various disciplines conducting very prominent projects. To work and get a paper published under one of these guys, or get affiliated with one of these projects, I'd think, would bolster your fellowship app a lot more than working with the "average" physician scientist.
 
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