Attending a "lower-tier" Med School Affecting Residency placement?

[mariambaby3]

I am a Canadian international looking to attend Med school in the US. I am aware of the higher standards for internationals and the smaller selection of med school that even interview internationals.

As such, I am aiming primarily for lower-tier schools, which I won't name at the risk of offending anyone. However, how much impact does the med school I attend have on my residency placement in the future, especially competitive residencies such as dermatology, radiology, plastic, etc...? Thanks.

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[StoicJosher]

Residency placements depends a lot of step 1 scores, what you did in medical school in terms of research etc, your clinical years grades, LORs etc. Just like going to a low tier school for UG has little to no effect on attending medical schools, attending a low-tier medical school will have little to no effect on residencies.

 

[BarcaBest23]

Residency placements depends a lot of step 1 scores, what you did in medical school in terms of research etc, your clinical years grades, LORs etc. Just like going to a low tier school for UG has little to no effect on attending medical schools, attending a low-tier medical school will have little to no effect on residencies.

You sound very naive in saying this. Of course it mattered where you went to UG for medical school and it will matter where you went to med school for residency. Pedigrees are there for a reason and institutions like them because it makes them feel fuzzy. Now will going to certain med school keep you out of a residency? no. But you do have to realize it is a sliding scale. Someone from a top 10 could score 10 pts. lower than you in Step 1 yet still be viewed as equal because of "pedigree points".... its just the way the world works ...

To OP, you do realize that only 1-2% of medical students go into derm right? You will need to knock the Step 1 out of the park.

 

[Nymphicus]

You sound very naive in saying this. Of course it mattered where you went to UG for medical school and it will matter where you went to med school for residency. Pedigrees are there for a reason and institutions like them because it makes them feel fuzzy. Now will going to certain med school keep you out of a residency? no. But you do have to realize it is a sliding scale. Someone from a top 10 could score 10 pts. lower than you in Step 1 yet still be viewed as equal because of "pedigree points".... its just the way the world works ...

To OP, you do realize that only 1-2% of medical students go into derm right? You will need to knock the Step 1 out of the park.

👍

 

[Gut Shot]

I am a Canadian international looking to attend Med school in the US. I am aware of the higher standards for internationals and the smaller selection of med school that even interview internationals.

As such, I am aiming primarily for lower-tier schools, which I won't name at the risk of offending anyone. However, how much impact does the med school I attend have on my residency placement in the future, especially competitive residencies such as dermatology, radiology, plastic, etc...? Thanks.

"Lower tier" schools routinely place graduates in highly competitive fields, including derm, rads, rad-onc, etc. If your goal is simply to practice in one of these fields, any allopathic medical school in the country will be an adequate springboard, assuming you can get the grades, Step 1 score, LORs, and ECs necessary to match.

If, on the other hand, you have a very specific and high level career trajectory in mind, such as being the chair of ortho at UPenn, or the head of urology at Hopkins, a pedigree will be extremely helpful.

Clarify your goals and you will have your answer.

 

[DO Anes]

Many/most Canadian schools are looked at as nearly equivalent or better than some US MD. So someone from McGill is likely seen as having a better pedigree than someone from Eastern Virginia, for example.

 

[Moebius]

If you are the top of your class, high scores, etc will take you far. MD schools are equal in the sense that if you are the best (bests) among a "lower tier" (whatever that means), you have a shot at the most competitive hospitals, maybe not the most competitive residency at the most competitive hospitals though.

 

[candav]

Residency placements depends a lot of step 1 scores, what you did in medical school in terms of research etc, your clinical years grades, LORs etc. Just like going to a low tier school for UG has little to no effect on attending medical schools, attending a low-tier medical school will have little to no effect on residencies.

This may be true for US citizens, but international students are bound to face greater barriers in residency placement. OP, as far as I know, if you are interested in practicing in the US in the future, it is imperative that you obtain the H1B work visa for residency. A limited number of residency programs are willing to go through the expensive and convoluted H1B visa application process. I haven't looked into it too much, but Canadian citizens may not be eligible for the similar J1 work visa, which is offered by a far greater number of institutions.

Given these challenges, and particularly if you are interested in competitive residency programs, it would behoove you to gain every advantage possible in your medical education. Don't limit yourself to lower tier medical schools -- improve your application and aim higher!

 

[impervious0ne]

Going into a top tier schools (Harvard, Mayo, WashU, etc) will help you get into competitive residencies, but the USMLE scores and recommendations will have far more weight into the process. You, the applicant, are entering into the residency, not the school.

Going into better school, imo, will only indirectly help you, as you compete with more qualified candidates.

 

[johnisles2011]

I think you just shouldn't worry about it. If you're going to end up at a lower tier school, then that's just going to be the way it is. You'll still have a shot of placing into highly competitive specialties and even the best residencies in them, but obviously not as great as if you went to a top tier school. A lot will depend on how you do while you're there, so do the best you can.
Again, it's not worth worrying about. Go to your favorite school of those you get into, and do the best you can. Try to crush Step 1 and get involved in some research. You'll have done everything you can.

 

[TexasPhysician]

Residency placements depends a lot of step 1 scores, what you did in medical school in terms of research etc, your clinical years grades, LORs etc. Just like going to a low tier school for UG has little to no effect on attending medical schools, attending a low-tier medical school will have little to no effect on residencies.

Agree with this. Where you attend school is highly over-rated on SDN. Everyone thinks it is so important, but from someone who has been through it all, the name of the school matters VERY little.

 

[thesauce]

I've seen many examples in the more competitive specialties where it has clearly made a difference. You'll match to a specialty based on your performance in med school, but some programs within the specialty will be out of reach without that pedigree.

 

[Gut Shot]

You'll match to a specialty based on your performance in med school, but some programs within the specialty will be out of reach without that pedigree.

If one's goal is to keep all programs in all specialties open, one will have a long, hard row to hoe.

 

[jhamaican]

Residency placements depends a lot of step 1 scores, what you did in medical school in terms of research etc, your clinical years grades, LORs etc. Just like going to a low tier school for UG has little to no effect on attending medical schools, attending a low-tier medical school will have little to no effect on residencies.

you are clueless. of course it matters. Many lower tier schools do not even have departments in some of the more competitive specialties. Big name schools are more difficult to get into = more competition meaning your high class rank has more meaning. Higher ranked school = more $ = bigger names for LOR and research.

 

[TexasPhysician]

you are clueless. of course it matters. Many lower tier schools do not even have departments in some of the more competitive specialties. Big name schools are more difficult to get into = more competition meaning your high class rank has more meaning. Higher ranked school = more $ = bigger names for LOR and research.

Minimal disadvantage. A friend of mine matched derm at Cornell from a low tier school with no derm department and no derm research. I've got plenty more examples that include anesthesia at Vanderbilt, neurosurg at Mayo, etc. I attended a state school and got interviews at every place I applied to including Yale, Duke, Vanderbilt, Emory, etc. Even got my #1 choice.

The name on your diploma is one of the least important things on your resume.

 

[1TB4RKSB4CK]

Minimal disadvantage. A friend of mine matched derm at Cornell from a low tier school with no derm department and no derm research. I've got plenty more examples that include anesthesia at Vanderbilt, neurosurg at Mayo, etc. I attended a state school and got interviews at every place I applied to including Yale, Duke, Vanderbilt, Emory, etc. Even got my #1 choice.

The name on your diploma is one of the least important things on your resume.

👍

 

[NatrixCaelicola]

Just marry an american for their citizenship... 🙂 not really ethical but the idea of citizenship isn't either.

 

[todds]

I think more than "low-tier" category, regional bias effects residency placement more. Top tier places tend to view students graduating from their surrounding area more favourably than from other areas.

For example, to low tier school in the midwest will give you a better shot at UWash or Northwestern than UCLA. Going to UMass will give you a better shot at Harvard than going to Univ of Florida, going to SUNY better chance at Cornell/Columbia, going to Wayne State gives you better chance for Michigan/Ohio state etc.. There is regional bias everywhere.

However, what elite schools give you is a recognizable name to allow you to have a shot to go anywhere coast-coast. So if you go to a top 10 school, you can apply anywhere you want and still looked as favourably as those applying from that region.

So what I would say is that take into consideration what "area" would you like to be in for residency because thats the area you have the greatest chances of staying. Its not absolute, but a better chance. If you get a chance to go to a top 10 school, then you'll have a great chance at any geographic location.

 

[chiapet874]

you are clueless. of course it matters. Many lower tier schools do not even have departments in some of the more competitive specialties. Big name schools are more difficult to get into = more competition meaning your high class rank has more meaning. Higher ranked school = more $ = bigger names for LOR and research.

This would only be relevant if you were comparing two students who had the exact same class rank, STEP score, and research experience.

If you were looking at two students, with different class ranks, different STEPS, and totally different research experiences, how could you even qualify a direct comparison between the two students? You couldn't- there is no criteria saying "oh a student who is rank 1 in a 'lower tier' med school is equivalent to a student who is rank 20 in a 'higher tier' school".

 

[Skinceutical]

Minimal disadvantage. A friend of mine matched derm at Cornell from a low tier school with no derm department and no derm research. I've got plenty more examples that include anesthesia at Vanderbilt, neurosurg at Mayo, etc. I attended a state school and got interviews at every place I applied to including Yale, Duke, Vanderbilt, Emory, etc. Even got my #1 choice.

The name on your diploma is one of the least important things on your resume.

The fact that you can name a few people from lower tier schools who matched into competitive programs doesn't really prove anything. I don't think anyone has suggested that attending a lower tier school will make it entirely impossible to match into a competitive program. Perhaps the rest of their applications were strong enough to overcome the relative disadvantage of their medical school pedigree.

Here's the IM intern class at the Brigham:
http://www.brighamandwomens.org/Dep...nals/residency/medical/interns2011.aspx?sub=0

Here's the IM intern class at UCSF:
http://medicine.ucsf.edu/education/residency/current/

There is a smattering of (no doubt highly competitive) interns from lesser known institutions, but I'd estimate 85 or 90% are from top 25 medical schools.

Or you can take a look at the 2011 Charting Outcomes. Overall, just over 33% of US senior applicants that year attended NIH top 40 medical schools. However, those students made up 43.6% of successful US senior derm applicants. Other competitive fields: 44.8% in neurosurgery, 38.6% in ENT, 52.7% in integrated plastics, and 45.5% in rad onc.

Like I said before, I don't think top students from lower tier schools are precluded from matching into highly competitive programs, but attending a prestigious school does have an advantage.

 

[CopaceticOne]

This may be true for US citizens, but international students are bound to face greater barriers in residency placement. OP, as far as I know, if you are interested in practicing in the US in the future, it is imperative that you obtain the H1B work visa for residency. A limited number of residency programs are willing to go through the expensive and convoluted H1B visa application process. I haven't looked into it too much, but Canadian citizens may not be eligible for the similar J1 work visa, which is offered by a far greater number of institutions.

Given these challenges, and particularly if you are interested in competitive residency programs, it would behoove you to gain every advantage possible in your medical education. Don't limit yourself to lower tier medical schools -- improve your application and aim higher!

It is VERY EASY for Canadians to get work permits for the USA. There is the special TN1 visa that specifically has physicians listed on the NAFTA occupation list. For other nationalites it can be far more difficult, but because of NAFTA, Mexicans and Canadian professionals should rest easy.

So OP, are you Canadian or do you hold a passport from a different country? It was unclear from your original post.

 

[thesauce]

If one's goal is to keep all programs in all specialties open, one will have a long, hard row to hoe.

Um yeah. No one said it would be easy.

 

[Gut Shot]

The fact that you can name a few people from lower tier schools who matched into competitive programs doesn't really prove anything. I don't think anyone has suggested that attending a lower tier school will make it entirely impossible to match into a competitive program. Perhaps the rest of their applications were strong enough to overcome the relative disadvantage of their medical school pedigree.

Here's the IM intern class at the Brigham:
http://www.brighamandwomens.org/Dep...nals/residency/medical/interns2011.aspx?sub=0

Here's the IM intern class at UCSF:
http://medicine.ucsf.edu/education/residency/current/

There is a smattering of (no doubt highly competitive) interns from lesser known institutions, but I'd estimate 85 or 90% are from top 25 medical schools.

Or you can take a look at the 2011 Charting Outcomes. Overall, just over 33% of US senior applicants that year attended NIH top 40 medical schools. However, those students made up 43.6% of successful US senior derm applicants. Other competitive fields: 44.8% in neurosurgery, 38.6% in ENT, 52.7% in integrated plastics, and 45.5% in rad onc.

Like I said before, I don't think top students from lower tier schools are precluded from matching into highly competitive programs, but attending a prestigious school does have an advantage.

Your analysis fails to account for selection bias, and thus has a big hole in it.

Besides, I look at those numbers and see that over half of all derm, neurosurgery, ENT, and rad onc residents did not attend a top 40 medical school.

Lies and damned lies, as they say.

 

[SLC]

I've got a pal who scrambled into gas at Yale after failing to match at mid to lower end residencies, what does that say about this argument?


I think there's probably a fair bit of selection bias at play here, most of you won't go top 25 (a good chunk of you won't even go at all), and when that happens you'll focus on mid-tier residencies because that's what you'll think you're competitive at. SDNers are afraid to fail, and obsessed with other's perceptions.

 

[thesauce]

Minimal disadvantage. A friend of mine matched derm at Cornell from a low tier school with no derm department and no derm research. I've got plenty more examples that include anesthesia at Vanderbilt, neurosurg at Mayo, etc. I attended a state school and got interviews at every place I applied to including Yale, Duke, Vanderbilt, Emory, etc. Even got my #1 choice.

The name on your diploma is one of the least important things on your resume.

But you applied IM, right? This would not have been the case if you applied in a more competitive specialty. Not a knock against you - I know you had great numbers, but Harvard or MSKCC Radonc wouldn't have taken someone from a state school.

 

[TexasPhysician]

The fact that you can name a few people from lower tier schools who matched into competitive programs doesn't really prove anything. I don't think anyone has suggested that attending a lower tier school will make it entirely impossible to match into a competitive program. Perhaps the rest of their applications were strong enough to overcome the relative disadvantage of their medical school pedigree.

Here's the IM intern class at the Brigham:
http://www.brighamandwomens.org/Dep...nals/residency/medical/interns2011.aspx?sub=0

Here's the IM intern class at UCSF:
http://medicine.ucsf.edu/education/residency/current/

There is a smattering of (no doubt highly competitive) interns from lesser known institutions, but I'd estimate 85 or 90% are from top 25 medical schools.

Or you can take a look at the 2011 Charting Outcomes. Overall, just over 33% of US senior applicants that year attended NIH top 40 medical schools. However, those students made up 43.6% of successful US senior derm applicants. Other competitive fields: 44.8% in neurosurgery, 38.6% in ENT, 52.7% in integrated plastics, and 45.5% in rad onc.

Like I said before, I don't think top students from lower tier schools are precluded from matching into highly competitive programs, but attending a prestigious school does have an advantage.

You are being fooled by looking at match lists. The reason Brigham has an IM class full of Ivy league medical students is because of location. Most of its residents are from its own medical school. The rest is mostly regional medical schools. Brigham has only 1 of its interns from Stanford - the same amount as U of New Mexico. Do you think it is because Stanford isn't good enough for Harvard? The reason for this is that most Stanford medical students would HATE to go to Brigham for residency. Stanford students enjoy beautiful weather in California. Stanford residents choose residencies in California because that is usually where they want to be.

You are kidding yourself if you think that everyone WANTS to go to top ranked residencies in the NorthEast. Most public school TX med students wouldn't go to Harvard for residency if you doubled their pay. They have family in TX, enjoy warm weather, and hate public transportation.

Very few medical school graduates attempt to attend the highest ranking residency they can achieve. More important is location, family, quality-of-life, fit, etc.

It is equally as important to attend a residency close to where you want to practice. By the end of residency, you will meet plenty of private practice docs in your region. I have 3 years of residency left, and I've already gotten job offers in my region. Private practices that don't advertise openings hand pick who they want to hire. They do not want to interview tons of random people. While Harvard grads would be lost trying to find the best job in my region, I already know where some of the best jobs are, and I know the physicians who work there. Networking is much more important than residency choice.

 

[chronicidal]

The fact that you can name a few people from lower tier schools who matched into competitive programs doesn't really prove anything. I don't think anyone has suggested that attending a lower tier school will make it entirely impossible to match into a competitive program. Perhaps the rest of their applications were strong enough to overcome the relative disadvantage of their medical school pedigree.

Here's the IM intern class at the Brigham:
http://www.brighamandwomens.org/Dep...nals/residency/medical/interns2011.aspx?sub=0

Here's the IM intern class at UCSF:
http://medicine.ucsf.edu/education/residency/current/

There is a smattering of (no doubt highly competitive) interns from lesser known institutions, but I'd estimate 85 or 90% are from top 25 medical schools.

Or you can take a look at the 2011 Charting Outcomes. Overall, just over 33% of US senior applicants that year attended NIH top 40 medical schools. However, those students made up 43.6% of successful US senior derm applicants. Other competitive fields: 44.8% in neurosurgery, 38.6% in ENT, 52.7% in integrated plastics, and 45.5% in rad onc.

Like I said before, I don't think top students from lower tier schools are precluded from matching into highly competitive programs, but attending a prestigious school does have an advantage.

Good analysis. Here's a breakdown for the BWH IM intern class:

Harvard 	22	(7 master's, 2 PhDs, 1 JD)
Columbia 	2	
Duke 		2	
Stanford 	2	(2 PhDs)
Penn 		6	(4 PhDs)
Yale 		4	(1 master's)
UCSF 		2	(1 PhD)
U Washington 	1	(1 PhD)
TOP (1 - 10)	41	17 other degrees

Cornell 	2	(2 PhDs)
Pittsburgh 	3	(2 PhDs)
Chicago 	3	
Vanderbilt 	1	
UCLA 		2	(1 PhD)
Mt Sinai 	1	(1 master's)
Case Western 	3	
Cleveland Clin 	1	
Baylor 		1	
SECOND (11-25)	17	6

Mayo 		1	(1 master's)
Brown 		2	
Einstein 	2	(2 PhDs)
NYU 		1	
MCOW 		1	
U Mass 		3	
UMDNJ 		2	
U New Mexico 	1	
THIRD (25-100)	13	3

Tulane 		1	
Albany 		1	
Meharryl (sic) 	1	
FOURTH (unrank)	3	0

URio de Janeiro	1	
de La Salle 	1	
International	2	0

Of the 76 interns, 54% are from the top 10 schools, 76% are from the top 25 schools, 86% are from the top 50 schools.

 

[Gut Shot]

Here's the IM intern class at the Brigham:
http://www.brighamandwomens.org/Dep...nals/residency/medical/interns2011.aspx?sub=0

Here's the IM intern class at UCSF:
http://medicine.ucsf.edu/education/residency/current/

There is a smattering of (no doubt highly competitive) interns from lesser known institutions, but I'd estimate 85 or 90% are from top 25 medical schools.

My calculations yielded 75% and 77%, respectively.

 

[V5RED]

The fact that you can name a few people from lower tier schools who matched into competitive programs doesn't really prove anything. I don't think anyone has suggested that attending a lower tier school will make it entirely impossible to match into a competitive program. Perhaps the rest of their applications were strong enough to overcome the relative disadvantage of their medical school pedigree.

Here's the IM intern class at the Brigham:
http://www.brighamandwomens.org/Dep...nals/residency/medical/interns2011.aspx?sub=0

Here's the IM intern class at UCSF:
http://medicine.ucsf.edu/education/residency/current/

There is a smattering of (no doubt highly competitive) interns from lesser known institutions, but I'd estimate 85 or 90% are from top 25 medical schools.

Or you can take a look at the 2011 Charting Outcomes. Overall, just over 33% of US senior applicants that year attended NIH top 40 medical schools. However, those students made up 43.6% of successful US senior derm applicants. Other competitive fields: 44.8% in neurosurgery, 38.6% in ENT, 52.7% in integrated plastics, and 45.5% in rad onc.

Like I said before, I don't think top students from lower tier schools are precluded from matching into highly competitive programs, but attending a prestigious school does have an advantage.

It stands to reason that the best students tend to go to the best schools. I am not saying every top student goes to a top school, but it is likely that the top schools are composed of students that are on average better than the students at lower ranked schools.

It is likely that the innate abilities of these students will lead to better performance on the USMLE exams. These students also likely have more impressive overall resumes.

The name of the school probably plays a role, but it would be hard to quantify how much of a role the name of the school plays compared to the quality of the students.

 

[Gut Shot]

Of the 76 interns, 54% are from the top 10 schools, 78% are from the top 25 schools, 86% are from the top 50 schools.

How many would have failed to match at BWH had they gone to lower ranked schools?

 

[chronicidal]

You are being fooled by looking at match lists. The reason Brigham has an IM class full of Ivy league medical students is because of location. Most of its residents are from its own medical school. The rest is mostly regional medical schools. Brigham has only 1 of its interns from Stanford - the same amount as U of New Mexico. Do you think it is because Stanford isn't good enough for Harvard? The reason for this is that most Stanford medical students would HATE to go to Brigham for residency. Stanford students enjoy beautiful weather in California. Stanford residents choose residencies in California because that is usually where they want to be.

You are kidding yourself if you think that everyone WANTS to go to top ranked residencies in the NorthEast. Most public school TX med students wouldn't go to Harvard for residency if you doubled their pay. They have family in TX, enjoy warm weather, and hate public transportation.

Very few medical school graduates attempt to attend the highest ranking residency they can achieve. More important is location, family, quality-of-life, fit, etc.

It is equally as important to attend a residency close to where you want to practice. By the end of residency, you will meet plenty of private practice docs in your region. I have 3 years of residency left, and I've already gotten job offers in my region. Private practices that don't advertise openings hand pick who they want to hire. They do not want to interview tons of random people. While Harvard grads would be lost trying to find the best job in my region, I already know where some of the best jobs are, and I know the physicians who work there. Networking is much more important than residency choice.

You might be right. Here's a breakdown by region:

Harvard 	22
Columbia 	2
Penn 		6
Yale 		4
Cornell 	2
Pittsburgh 	3
Mt Sinai 	1
Brown 		2
Einstein 	2
NYU 		1
U Mass 		3
UMDNJ 		2
Albany 		1
NORTHEAST	51

Stanford 	2
UCSF 		2
U Washington 	1
UCLA 		2
WEST		7

Duke 		2
Vanderbilt 	1
Baylor 		1
U New Mexico 	1
Tulane 		1
Meharry		1
SOUTH		7

Chicago 	3
Case Western 	3
Cleveland Clin 	1
Mayo 		1
MCOW 		1
MIDWEST		9

URio de Janeiro 1
de La Salle 	1
International	2

Of 76 interns, 67% came from a northeastern medical school.

 

[TexasPhysician]

But you applied IM, right? This would not have been the case if you applied in a more repetitive specialty. Not a knock against you - I know you had great numbers, but Harvard or MSKCC Radonc wouldn't have taken someone from a state school.

I did not apply IM.

Funny you should mention MSKCC, a friend of mine from a TX state school received an interview from MSKCC radonc. He cancelled that interview. He wanted/matched at the one in Houston - MD Anderson. I don't personally know anyone that interviewed at Harvard radonc, but I only know a couple people that chose to apply radonc. It isn't a popular field.

 

[Skinceutical]

Besides, I look at those numbers and see that over half of all derm, neurosurgery, ENT, and rad onc residents did not attend a top 40 medical school.

That's great. It doesn't change the fact that the top 40 schools are overrepresented in all of those competitive fields.

 

[TexasPhysician]

How many would have failed to match at BWH had they gone to lower ranked schools?

No way of knowing. There is also no way of knowing if Big Foot actually exists.

 

[TexasPhysician]

That's great. It doesn't change the fact that the top 40 schools are overrepresented in all of those competitive fields.

True, but again it is a bias. If you are from a state school, there is a greater chance you lived in a rural area and wish to return to a rural area. If you didn't know, most rural areas can't support a neurosurgeon, or ENT, etc..

Take just one of my classmates for example. He is from rural west Texas, which is common in TX med schools. That is where he wants to live - rural Texas. He enjoys hunting and having a ranch. He scored a Step 1 of 250+ and received multiple awards. He chose to do Family Medicine in ruralville USA. Unless you know him, you would think he failed Step 1 to have chosen such an isolated residency.

Expensive private schools in the NE attract more people who want to thrive in big cities like Boston, NYC, D.C., etc. Of course, specialties would be more attractive in these locations. To live well in NYC, you need to make big money. A FM doc I know in west Texas makes $300K. How much money would you need to make in NYC to be equivalent to 300k in rural Texas?

It isn't that public schools can't match into competitive fields. It is that public school students do not want to apply to competitive fields in the numbers that elite private school students do.

 

[Skinceutical]

You are being fooled by looking at match lists. The reason Brigham has an IM class full of Ivy league medical students is because of location. Most of its residents are from its own medical school. The rest is mostly regional medical schools. Brigham has only 1 of its interns from Stanford - the same amount as U of New Mexico. Do you think it is because Stanford isn't good enough for Harvard? The reason for this is that most Stanford medical students would HATE to go to Brigham for residency. Stanford students enjoy beautiful weather in California. Stanford residents choose residencies in California because that is usually where they want to be.

You are kidding yourself if you think that everyone WANTS to go to top ranked residencies in the NorthEast. Most public school TX med students wouldn't go to Harvard for residency if you doubled their pay. They have family in TX, enjoy warm weather, and hate public transportation.

Great. Then look at UCSF's intern class.

Going through and counting, of their 62 interns:
14 are UCSF alums
9 are from other CA and West Coast schools.
39 are from the rest of the Midwest/South/East Coast

Let me guess, the ONLY reason UCSF ended up with those interns from Harvard, Yale, Columbia, Cornell, Emory, Pritzker, etc is because those people were all clamoring for residencies in sunnier climates.

It has NOTHING to do with UCSF selecting for people from top tier medical schools. I'm sure the ONLY reason I'm not seeing a single intern from Loma Linda, or USC, or U of AZ, or U of NV, or any other nearby mediocre medical schools is because no one from those schools was interested in moving to SF.

Let me also say that the fact that every single piece of evidence you have presented has been a personal anecdote regarding one of your friends, which has been VERY convincing.

 

[chronicidal]

Harvard		5
Johns Hopkins	1
UCSF		14
Penn		1
UWashington	2
Yale		3
Columbia	1
Duke		1
Stanford	3
TOP		31

UC San Diego	1
UCLA		2
UChicago	2
Northwestern 	1
Emory		3
Cornell		1
Case Western 	2
Mount Sinai	1
SECOND (10-25)	13

Albert Einstein	1
Brown		1
Dartmouth	1
NYU		1
UNC		4
Oregon HSU	1
UWisconsin	1
UColoradoDenver	1
THIRD (25-50)	11


Drexel		1
Tufts		1
Tulane		1
UTexas, Houston	1
UT San Antonio	1
U Utah		1
U Vermont	1
OTHERS		7

Of 62 interns, 50% are from top 10 schools, 71% are from top 25 schools.

Harvard		5
Johns Hopkins	1
Cornell		1
Penn		1
Yale		3
Columbia	1
Mount Sinai	1
Einstein	1
Brown		1
Dartmouth	1
NYU		1
UVermont	1
Drexel		1
Tufts		1
NORTHEAST	20

UCSF		14
UC San Diego	1
UCLA		2
UWashington	2
Stanford	3
Oregon 		1
UUtah		1
UColoradoDenver	1
WEST		25

Duke		1
Emory		3
UNC		4
Tulane		1
UT Houston	1
UT San Antonio	1
SOUTH		11

U Wisconsin	1
UChicago	2
Northwestern 	1
Case Western	2
MIDWEST		6

Of 62 interns, 40% are from western schools, 32% are from northeastern schools.

This regional bias is not as big as from BWH. Perhaps there are simply more highly ranked schools in the northeast.

 

[TexasPhysician]

Great. Then look at UCSF's intern class.

Going through and counting, of their 62 interns:
14 are UCSF alums
9 are from other CA and West Coast schools.
39 are from the rest of the Midwest/South/East Coast

Let me guess, the ONLY reason UCSF ended up with those interns from Harvard, Yale, Columbia, Cornell, Emory, Pritzker, etc is because those people were all clamoring for residencies in sunnier climates.

It has NOTHING to do with UCSF selecting for people from top tier medical schools. I'm sure the ONLY reason I'm not seeing a single intern from Loma Linda, or USC, or U of AZ, or U of NV, or any other nearby mediocre medical schools is because no one from those schools was interested in moving to SF.

Let me also say that the fact that every single piece of evidence you have presented has been a personal anecdote regarding one of your friends has been VERY convincing.

My anecdotes are more convincing than bad statistics. Your whole argument is match lists. If UCSF was the Harvard students' last choice, is it still impressive? No, but we don't know where each student ranked each program or where they applied.

How many students from LSU applied or wanted to go to San Francisco? We do not know. Just because an LSU applicant chooses to stay in Louisiana, doesn't make him/her less competitive than a Harvard grad.

Harvard med school takes more out-of-state students than Texas A&M does, a LOT more. Harvard also has more students than Texas A&M med school. Hence you are more likely to see Harvard grads represented in other states than Texas A&M applicants. Texas A&M med students are 90% from Texas. Where do you think A&M grads want to live - mostly? HINT: It isn't San Francisco.

You have a false assumption that match lists determine who is competitive and who isn't. This is FALSE. Med school match lists just show individual student's preference.

 

[KinasePro]

Currently at a top 20, and just wanted to echo the sentiment that match lists are extremely misleading. Looking at our 4th years who are getting ready to match, the most baller applicants are often ranking our home institution as #1. Just peeking at our AOA inductees from the last few years, you see a lot of names that are now residents in our home programs. Our residency programs are NOT "elite" in most of these fields, but excellent students decide to stick around for regional/personal reasons instead of pursuing more prestigious names.

A lot of what you read on SDN is bulls1ht, but the warnings re: interpreting match lists are legit. Some of your school's best students may be interviewing at BWH, MGH and Hopkins, but ranking them near the bottom or not at all.

 

[Gut Shot]

It has NOTHING to do with UCSF selecting for people from top tier medical schools.

Oh now you're just being melodramatic. I don't think it's reasonable to argue that name/pedigree has zero influence on matching, merely that some significant confounding factors make it impossible to quantify with the available data.

Of course that doesn't stop people from repeating the same faulty analysis to reach the same flawed conclusion.

Let me also say that the fact that every single piece of evidence you have presented has been a personal anecdote regarding one of your friends has been VERY convincing.

I suppose that depends on whether TexasPhysician is over-extrapolating from personal experience, or using anecdotes to illustrate a larger truth. One is bad form, the other is not.

 

[Skinceutical]

True, but again it is a bias. If you are from a state school, there is a greater chance you lived in a rural area and wish to return to a rural area. If you didn't know, most rural areas can't support a neurosurgeon, or ENT, etc..

Take just one of my classmates for example. He is from rural west Texas, which is common in TX med schools. That is where he wants to live - rural Texas. He enjoys hunting and having a ranch. He scored a Step 1 of 250+ and received multiple awards. He chose to do Family Medicine in ruralville USA. Unless you know him, you would think he failed Step 1 to have chosen such an isolated residency.

Expensive private schools in the NE attract more people who want to thrive in big cities like Boston, NYC, D.C., etc. Of course, specialties would be more attractive in these locations. To live well in NYC, you need to make big money. A FM doc I know in west Texas makes $300K. How much money would you need to make in NYC to be equivalent to 300k in rural Texas?

It isn't that public schools can't match into competitive fields. It is that public school students do not want to apply to competitive fields in the numbers that elite private school students do.

This can also easily be addressed by calculating the percentage of total applicants in those specialties who came from top 40 schools.

In dermatology:
39.7% of total applicants were from top 40 schools
43.6% of successful applicants were from top 40 schools

Neurosurgery:
43.5% total
44.8% successful

Plastics:
42.8% total
52.7% successful

RadOnc:
43.6% total
45.5% successful

Again, they're overrepresented among successful applicants, even taking into account their increased numbers in the applicant pool itself. Not surprisingly, the discrepancy is highest in the two most competitive specialties out there - integrated PRS and derm.

My anecdotes are more convincing than bad statistics. Your whole argument is match lists. If UCSF was the Harvard students' last choice, is it still impressive? No, but we don't know where each student ranked each program or where they applied.

The individual medical student's preferences are irrelevant to the argument I'm making. I could care less where the Harvard student ranked UCSF; the fact that he/she was far more likely to even get an interview than the kids from Loma Linda and USC is what I'm trying to point out.

Or do you believe that USCF did, in fact, fill its interview pool with applicants from local, mid-tier schools, but had to settle for the the applicants from Harvard and Emory because everyone from Loma Linda ranked them last.

 

[Skinceutical]

Oh now you're just being melodramatic. I don't think it's reasonable to argue that name/pedigree has zero influence on matching, merely that some significant confounding factors make it impossible to quantify with the available data.

As I've repeatedly pointed out, I'm not trying to argue that pedigree is the be-all, end-all factor in deciding match outcomes, or that competitive students from lesser known schools are not going to match well. I'm also not trying to "quantify" the advantage with the examples I'm presenting, I'm only trying to establish that it is a real factor and it does play a role, especially at highly competitive programs. Also having a buddy who matched in plastics at Yale despite coming from a no-name public school doesn't change the fact.

 

[Gut Shot]

I'm only trying to establish that it is a real factor and it does play a role, especially at highly competitive programs.

And you are failing.

 

[Skinceutical]

And you are failing.

That's funny, considering the fact that you admitted as much 1 post earlier.

 

[scarshapedstar]

And you are failing.

One of my mentors was a third-time applicant to No-Name State SOM and now he's a highly respected academic doctor whose textbook I've seen mentioned on SDN as the best in his field.

Nobody should fall for the Calvinist Pre-Med theory that great doctors are born, not made, and must prove it by gunning for Harvard starting at age 9.

 

[Mattchiavelli]

The only way I could see it being an issue is if the school is so small that it doesn't have it's own less populated fields and would be hard to do a rotation at your school, although you could very well do a rotation in the field away at another school, you will just have to do more work for yourself which will ultimately come off as bing self-motivated and hard-working. Examples would be rad-onc, global health, pm&r, even neurology at some smaller schools.

Connections also matter and an email or phone call can get your foot in the door at some places, won't really make or break a residency app tho. Having a big enough school where people trained at a lot of different places will be nice if say you're trying to get an interview at XXX program and there is a faculty member that did residency at XXX program, if they know you they will sometimes let XXX program you're a good applicant and would be a good fit in their program.

Ultimately it will make some career paths more tough but never impossible

 

[Gut Shot]

That's funny, considering the fact that you admitted as much 1 post earlier.

Yeah, but you're failing with numbers.

 

[Skinceutical]

Yeah, but you're failing with numbers.

Like I said, I'm not trying to quantify anything; I'm just pointing out a trend.

Considering the fact that all you and your buddies have come up with is a bunch of personal anecdotes and hypothetical situations to the contrary, I think I've made my point.

 

[thesauce]

I did not apply IM.

Funny you should mention MSKCC, a friend of mine from a TX state school received an interview from MSKCC radonc. He cancelled that interview. He wanted/matched at the one in Houston - MD Anderson. I don't personally know anyone that interviewed at Harvard radonc, but I only know a couple people that chose to apply radonc. It isn't a popular field.

My bad, I thought you were IM.

I use radonc as an example because it's the one I know well. I did not mention MDACC because they have traditionally been very willing to accept people from low and mid tier schools. Harvard and MSKCC have not.

 

[Gut Shot]

Like I said, I'm not trying to quantify anything; I'm just pointing out a trend.

Back up and look at the entire situation for a moment. A premed asks the question whether school name will impact his odds of matching into a competitive field. One sensible response is that name is a factor, but it is relatively small compared to an individual's performance. This information is useful, and serves to help premeds make an informed decision that balances many factors (cost, location, curriculum, etc.) without placing undue importance on rank.

In contrast, a less sensible response is to post a couple of resident lists from highly competitive programs and claim they show concrete proof of the prestige effect. This information is not useful, as it is an incomplete analysis that only reinforces common premed fears.

Considering the fact that all you and your buddies have come up with is a bunch of personal anecdotes and hypothetical situations to the contrary,

Again, the Achilles heel of your argument is the rather well characterized phenomenon of selection bias, which renders it so flimsy that a first year graduate student at Arizona State could shred it while asleep.

I think I've made my point.

You have indeed made a point, albeit not the one you intended.