Thanks UK. I’ll follow your lead. Oddly enough my stats look similar to yours.
About me: US MD, 230s Step 1, higher Step 2, 1st pass CS. Not certain of quintile.
PM&R aways / letters: message me if you want details.
Nice mix of pass / honors on 3rd year clerkships.
Applied to 55 programs, 30 invites, went on 15 interviews and ranked 14.
Applied to many prelims / TYs, went on 10 interviews, and ranked all. Feel very strongly about training at one community hospital program.
Invited, but did not attend: Penn, Marianjoy, SUNYs, UC Davis, UC Irvine, UT Houston, UT Baylor, UT San Antonio, UT Southwestern, BU, NYU, Minnesota, MCW, Wisconsin, South Florida, Charlotte, East Virginia, Rochester.
Interested in MSK / US Training / Sports. Strong preference for large class size, established program history / reputation within institution and area, and beautiful geography (I’m a sucker). No geographic ties, significant other has portable job.
Also huge preference for not being “second fiddle” in a city. I’d prefer either being at the only program that serves a large geography or a program that is the heavy hitter in the city (Boston, Chicago, Houston, New York City). Maybe I have an inferiority complex.
I’m hesitant to give actual rank order until after Match.
Personal Top Tier (alphabetical order)
Mayo
RIC
Utah
Washington
Personal 2nd Tier (alphabetical order)
Colorado
Emory
Michigan
Ohio State
Personal 3rd Tier (alphabetical order)
Cleveland Clinic
Cornell-Columbia
Indiana
Missouri
UT-Austin
Rush
Not ranked
Vanderbilt
Concerning tiers: I'd be happy almost anywhere. That being said, some places seem to either have a few learning components missing or personality trait that clashes with mine. Both issues could be easily remedied and still make for a great learning experience. I feel that I could fall between my 1st and 4th spot and feel like I hit the lottery. Falling to 5th through 8th: no worries about learning deficiencies, no worries about personality clash. Will probably leave the program thinking that it belongs in a top 6 discussion. Falling 8th to end of ROL: make sure to identify what I'm trying to get out the program and make sure to actively seek it out if I'm afraid I can't find it there. Or maybe it's purely a geography issue. In that case, get over it
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Concerning Vanderbilt: I love Nashville, have family in the area, would have loved the PGY-1 training in one of the top IM programs, loved the faculty, loved the facility, and loved the residents. That being said, an interviewer in a prominent position made it very apparent that the program was not looking for what I offer. It wasn’t malicious and I appreciate the honesty. Also I hit my NRMP limit and Vanderbilt would have cost me an extra $30.
Things for future applicants to think about:
Class size: Small programs will fill quickly, making them as tricky to match as some big name large programs. Utah and Colorado come to mind: small class size + desirable geography = as tough to match at as any program.
Categorical Programs: At first I just ranked programs to increase my chance of getting where I wanted (stacking advanced and categorical next to each other). Later, mentors told me that some PGY-1 programs are a bear and other are excellent integrated experiences. Based on this, I reworked my system to drop “bad” Categorical matches lower and raise “good” Categorical matches higher. I don’t want to say which program has “good” or “bad” PGY-1 years, but ask the residents on interview day. They’ll use code like “I mean…you’ll learn a lot” to soft sell a hellish PGY-1 year.
Don’t miss programs: I knew about the big names and if you get an interview at one: go. These are programs that are not traditional top 6, but interviews that I was thankful I attended: RIM (Detroit Medical Center), Ohio State, Emory, Utah.
California, you fickle state: Received interview invites from 3 programs. Did not get interview invite from two programs I was interested in. Did not attend any.
Gender: I don’t know if this is a real or perceived truth but the top programs looked to have normal (50-50) gender distribution. Some of the male-only programs turned me off.
Ultrasound: That's where all of medicine is going. MSK diagnostic ultrasound is how physiatrists can continue to differentiate themselves from every other specialty. Neurologists won't be interested in the MSK component, Orthopedic Surgeons won't have the time to learn it in residency, and radiologists seem disinterested in it. If you are interested in a program that doesn't have it, figure out how quickly they are working to remedy it. It is a sharp learning curve and older physiatrists are spending $20,000 to attend courses to learn it. You can learn it yourself, but do you want to do it that way? A place that touts its EMG training and has little to say about it's US training would be a huge red flag to me.
Random (positive) thoughts on programs (if you are concerned about negatives of a specific program, you are welcome to message me).
Cleveland Clinic: Interesting risk here. The program is small, new, and un-established. That being said, world-class institution, amazing fellowships, big-time money, and great PM&R faculty. I think someone with a little faith could go here, get good training, and know that in 10 years this place will be perceived as a second Mayo.
Cornell-Columbia: I didn’t want to be in NYC. If I had any tolerance for NYC, this would have been a top tier ranking for me. The housing package and salary package make it seem more livable than I’d thought.
RIC: Wasn’t sure I’d connected with faculty enough to know the program. They kept it pretty sterile. Then funny and unplanned experience during interview day exposed me to the “true” side of the faculty and I saw how great they were. New building will be great.
Washington: Cancer rehabilitation shined through here (and Ohio State). By far the “coolest” residents. These people were comfortable in their own skin, proud but modest, smart but understated, and had so much pride for their program and city. I called a number of faculty after just to ask for career advice unrelated to their program and they wholly obliged
Mayo: Full disclosure that the “Mayo Way” freaks me a out a little. Their “Way” is what makes the institution great, I’m just a little nervous that I can comply. It isn’t a negative, it’s just that I know if I match there, I need to be ready to re-learn a few things. MSK ultrasound: every AMSSM ultrasound curriculum video is broadcast from Mayo. This place is the place to learn it.
Utah: Those who haven’t visited will wonder why it’s in my top tier with other traditional powerhouse programs. Those who have visited understand. I’m not Mormon, have no affiliation to the area, and really want to do my intern year at a specific TY program (which is impossible if I match Utah as it is Categorical only). With all of this working against it, there is too much good to miss. I’ll keep this love letter short: Huge catchment area, top sports fellowship, young / excited faculty, sharp and decorated PD. Osteo-integration actively happening, hospital built into the mountain, landscape / geography is beautiful and accessible, new rehabilitation building being erected, addresses all shortcomings quickly (lacked US, now has full US curriculum. VA rotation issues, quickly resolved and now a favorite rotation). Residents are smart, happy, fun, and close.
Emory: Just go. Shepard will blow your mind.
Colorado: The most fun I had at a resident dinner. Aurora is a + / -?
Michigan: Most personable faculty.
Indiana: Gorgeous new facility. Appreciated identify of program.
UT-Austin: PD went above and beyond.
RIM: Shadiest AirBnB had me chopping wood out back to supplement my “reduced rate.” I thought I was in for a Detroit doozy. Then I show up at RIM and it’s gorgeous, the residents are sharp, and the director established. Stroke patients were walking around in Exos like it was no big deal. I also got a sense that Detroit is on the up.
