Chances a top ranked/desired regions from a not so high ranked school

[Glaxo]

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Hey everyone, apologies I know this might be an oft asked question. I'm a third year at a middle of the pack state school (not top 50) with likely little name outside of the southern/SE region. We do have a solid ENT program though, def above average compared to other programs at our school, with some well known faculty members so that's a plus.
I just got back my Step 1 score last week which was a 266, I've done some nonENT research which I should be getting published (not first author) and I'll be doing some ENT research this year which I'm hoping I get at least one pub/presentation from. So I've got a pretty solid resume I would think at this point to be competitive for some good programs. My worry is I've heard that regionalism/top50ism is a huge factor.
I was wondering am I kind of screwed from the start in applying to schools out west or at the elite programs? Kind of a frustrating feeling that I'm judged by things I can't change...My absolute dream school would be UCLA or Stanford. For the obvious reasons plus my fiance's graduate schools of choice are in that region. Anything I can do to make myself a more attractive candidate? (away rotation etc) Appreciate any advice, thanks!

Edit: anyone have any knowledge of candidates like me matching at these kind of programs? Looking though schools resident lists doesn't look positive.

 

[neutropeniaboy]

I think your best bet is to do away rotations at the institutions you want to go to. I don't often recommend away rotations, because they usually make students look badly when on paper they look like super stars. So, the strategy would be to go to an institution and work your ass off: pre-rounding, getting involved in patient care, going to the OR, going to clinic, asking how to be helpful, READ BEFORE THE CASES, and walk the fine line between annoying and really a great student.

Getting more ENT research will help you. Research in other areas is +/-.

Lastly, having a 266 on your Step I plus some research does not make your resume "solid." Honestly, we've ranked students with much lower Step I scores based on letters of recommendation and performance on rotations.

As far as the regional discrimination goes, it's a real thing. We've had develop "personal issues" because of being so far from home...call it homesick if you want. One person several years ago dropped out because of it.


-nb

 

[Glaxo]

I think your best bet is to do away rotations at the institutions you want to go to. I don't often recommend away rotations, because they usually make students look badly when on paper they look like super stars. So, the strategy would be to go to an institution and work your ass off: pre-rounding, getting involved in patient care, going to the OR, going to clinic, asking how to be helpful, READ BEFORE THE CASES, and walk the fine line between annoying and really a great student.

Getting more ENT research will help you. Research in other areas is +/-.

Lastly, having a 266 on your Step I plus some research does not make your resume "solid." Honestly, we've ranked students with much lower Step I scores based on letters of recommendation and performance on rotations.

As far as the regional discrimination goes, it's a real thing. We've had develop "personal issues" because of being so far from home...call it homesick if you want. One person several years ago dropped out because of it.


-nb

Thanks a lot for the advice. Anything about what I'm doing that's not solid for ENT at this stage in 3rd year? I know plans need to be followed through on before I can actually be on solid footing. I do wish I did more to pursue outside interests in my free time first two years. Do non med and surgery rotations count for a lot? Got As so far but think there's a good chance I'm looking at a B in neuro. The one guy who was grading me, based on the three days I worked with him out of the 20 odd days in neuro clinic, gave me straight Bs on the midterm eval. Is AOA almost a requirement for the jump between tiers of schools?

Anything else go into regional discrimination? I figured familiarity between the PDs etc would play a decent sized role. I don't really have a region to be sick for I've moved around so much my whole life.

 

[TubesNTonsils]

I went to a top school in the midwest and I ended up going to 7 interviews on the left coast and was thrilled to match at one of them. Keep in mind, I didn't grow up in the west. At every single interview session at every single institution, I was asked "So...do you have any family in the area?" Later on as a resident, I realized that this question comes up because people want to know how serious you are about moving far away from home.

If you are serious about matching in California, I would strongly, strongly recommend doing a sub-I. There is always the risk that it could backfire, but it is also potentially be a great way to show that you're serious about moving to California. I honestly believe I wouldn't have gotten an interview at the place where I trained if I hadn't done a sub-I there. Doing the sub-I can also help with the fact that you come from a middle-tier med school as long as you kick ass. I saw this play out each year I was a resident. There were always one or two sub-I's that people LOVED, and three out of four years we matched one of the beloved sub-I's.

During your interviews, talk up any and all connections you have to the west coast (your best friend from college, your second cousin, the week you spent camping out there, whatever you got) as well as the California school that is your wife's top choice among all other places in the country.

A step 1 score in the 260's will certainly help in terms of getting an interview. Once you're in the interview pool, other things like LOR's and sub-I performance will weigh much more heavily. Try to do some ENT research, even if only a small case report. Find out if any faculty at your school knows other faculty on the west coast - be a little careful, though, about advertising the fact that you want to fly the coop. Good luck!

 

[jsong812]

I'm actually in a similar situation to the OP, except my board score isn't as high (I got a 256) and I was wondering what are some other ways I can make myself more competitive for a highly-desired geographic location like California or New York. I'm from a midwest school that has a fairly good ENT program and I've been doing a lot of research with one attending here, so I think I can get at least one solid LOR. I've honored about 2/3 of my preclinical courses and I've honored every single clinical rotation thus far (internal medicine, pediatrics, and family medicine). I've been working on a handful of case reports in ENT, which I know doesn't carry that much weight, but i'll have four submitted for publication probably around april to may of this year. I know I have to finish strong with my rotations but what are some other things I can do to increase my chances for an interview? I know some people say I should do an away at a place I'm interested in but it usually takes me a while to warm up and be comfortable with people so I'm afraid I may be one of those applicants who look better on paper than in person. Thanks in advance.

 

[KitesurfDaEarth]

honestly I wouldnt worry about what school you went to. I went to a relatively not so awesome medical school (Kansas). I had lower board scores than both of you, minimal, if you could even call it research. I didn't rotate where I matched....and I ended up in probably the best program in NYC. I got interviews because I had solid letters, I think. Do not underestimate the power of a solid letter. ENT is a small field and PDs and chairmen all know each other and so forth. Do well on your home rotation, do an away...like people have stated before the AI is a double edged sword. And I did very well in the interview process because I was very personable, honest, nice, humble and really really really good looking.