You're pulling old numbers as your only source, but can you comment on the amount of publications, strength of writing, strength of ECs, strength of recs from people at different tiers of school? The fact is people like to feel better about themselves and will say "they only matched there because they're at a T10" when in reality the student from the T10 was just a better applicant than them. I agree with the above poster that people from T10s will have the strongest applications on average, simply because it is people obsessed with achievement. How do you think they got into a T10 in the first place? Also, the percentage of people taking research years at these schools can be HUGE. Someone told me Harvard was like 40% of the class or more? (not verified)
The only real data we have is PD surveys which rank school prestige as one of the lowest matters of importance if I remember correctly.
It's difficult to evaluate specific program matches because we don't know the structure of the applicant rank lists, but there are a few where it's easy to infer. For example, Mass General Radiology is top 3 program in the country, whereas BIDMC radiology is considered a fringe t20 (not bashing at all, it is still a great program). However, it is safe to assume everyone that matched at BIDMC would have rather matched at MGH if they had the chance. So let's look how their match lists compare!
MGH: 2 IMGS, UCLA, Dartmouth, Temple, UPenn, 2 Harvard
BIDMC: 2 Duke, 2 Yale, 1 Columbia, 2 Brown, 1 Georgetown, 1 Ohio State, 1 UVM
If prestige was that important why exactly did MGH pass on FIVE students from T10s and instead take IMGs, dartmouth, temple. Oh I know! it's because they had better applications and PDs don't actually care about prestige.
Perhaps in an absolute tiebreaker prestige makes up the difference, but it does not make up for weak points in applications.
This is a little disingenuous. While I agree that school prestige isn't everything, it makes a massive difference. Saying the students are all just "cracked" really disregards the talent of students who go to other schools, who may not have gotten into a top school for any number of reasons including socioeconomic status, poor mentorship in undergrad, late decisions to apply to medical school, etc...
This is coming from someone at a T20, btw.
You're pulling old numbers as your only source
Those numbers are step 1 scores from 2021. I don't think anything has changed dramatically since then, and I absolutely believe scores overlap. I have plenty of friends who scored 220 or lower on step 1. They all stressed
a lot, but most matched at T20 residencies (fwiw).
The fact is people like to feel better about themselves and will say "they only matched there because they're at a T10" when in reality the student from the T10 was just a better applicant than them. I agree with the above poster that people from T10s will have the strongest applications on average, simply because it is people obsessed with achievement. How do you think they got into a T10 in the first place? Also, the percentage of people taking research years at these schools can be HUGE. Someone told me Harvard was like 40% of the class or more? (not verified)
I think it's a little of both. Muddy waters for sure. T20 students are remarkably adept at curating an attractive application. That said, we get a lot of people here who get to med school and find they have lost their advantage. Some picked easy majors or continually gamed the system in college to get a 4.0 (personally I saw a ton of people at my university who left engineering because they were on track for an atrocious GPA, went to public health or a liberal arts major, and then got into top schools). Others got here by grinding, but you lose that advantage in med school when
everyone is grinding. Definitely had a lot of friends who entered as extraordinarily type A students and found they simply couldn't outgrind the competition any longer.
As for research years, I imagine it also scales with the increased number of students pursuing surgical subs + derm.
The only real data we have is PD surveys which rank school prestige as one of the lowest matters of importance if I remember correctly.
First, that's a survey of all PDs. Top program PDs are completely washed out statistically. They also list clinical grades as their #1 criteria, yet top schools feel comfortable eliminating that entirely. I think it's safe to say that top PDs feel differently. Certainly the PDs at my school do. They completely put up with the fact that top schools have no clinical grades because they want to match students from top schools. Frankly, filling your class with top grads is an easy way to get kudos from the dean, who is hyper-focused on maintaining strong relationships with other top schools. PDs are very aware of this.
It's difficult to evaluate specific program matches because we don't know the structure of the applicant rank lists, but there are a few where it's easy to infer. For example, Mass General Radiology is top 3 program in the country, whereas BIDMC radiology is considered a fringe t20 (not bashing at all, it is still a great program). However, it is safe to assume everyone that matched at BIDMC would have rather matched at MGH if they had the chance. So let's look how their match lists compare!
MGH: 2 IMGS, UCLA, Dartmouth, Temple, UPenn, 2 Harvard
BIDMC: 2 Duke, 2 Yale, 1 Columbia, 2 Brown, 1 Georgetown, 1 Ohio State, 1 UVM
If prestige was that important why exactly did MGH pass on FIVE students from T10s and instead take IMGs, dartmouth, temple. Oh I know! it's because they had better applications and PDs don't actually care about prestige.
This is definitely a stretch and a weak argument. I don't think anyone is saying school prestige trumps
all. However, if you consider the total applicant pool, T20 schools are overrepresented by a large margin, and this holds for most top residencies. This is basically saying that MGH will take 4 students from a pool of 20 schools vs. 2 students from a pool of 100 schools. Which pool would you rather be in?
I guess overall I'm reluctant to just accept the argument that T20 students are inherently better than T50 students. They are a little better on average, but that doesn't account for the discrepancy in match lists. It's not even really close. I have friends from undergrad who, for some reason, had great but not amazing apps to med school and went to mid-tier USMDs. Maybe it was a single bad year in undergrad because of a personal tragedy. Maybe it was deciding on med school late and thus having a few lackluster semesters on the record. Maybe it was a lack of mentorship or role models on entering college. Maybe it was sticking with engineering and pulling a 3.6 in the top 10% of the class instead of transferring to something easy where the average student was pulling a 3.7. Maybe it was needing to stay in a certain area for family or personal reasons.
My classmates are awesome. Some are truly rockstars with incredible tenacity destined to succeed in any environment. Most put on their pants one leg at a time like the rest of the world. Many of them had struggles in med school. It's hard to ignore that if those struggles had happened 2-3 years earlier, they likely wouldn't have put together a T20-caliber application. It's also hard to ignore that other incredibly talented friends of mine from college, who went to unranked USMD schools, struggled to match
anywhere for competitive specialties with clinical grades in the top 10%, step 1 scores > 260, and solid publication records. Students at my school with very average clinical grades, step 1 ~240, and the same 2-3 low impact pubs/case reports as everyone else were only stressing about whether it would be Stanford or UCSD. A lot of it is political. A lot of it is behind the scenes. The powers that be at top schools have relationships with physicians from other top schools that need to be maintained. Because of this, going to a top school confers a huge advantage.
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