Competitive for internal medicine residency in manhattan?

[biotime1]

Thoughts on my shot at getting into a good internal medicine residency in Manhattan (eg NYU, Columbia, Sinai, Cornell): Currently 3rd year - 246 on Step 1, top quartile in a top 40 med school, several solid research projects, and an MPH.

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[WedgeDawg]

What does top 40 mean

 

[atomi]

Manhattan sucks. Look elsewhere.

 

[CherryRedDracul]

Manhattan sucks. Look elsewhere.

Fight me.

But, seriously, NYC's awesome, but it's one of the last places I would think about doing an IM residency in. The city programs are notorious for the strong nursing union and the lack of support staff to help the residents out. For example, expect to do much of the AM blood draws yourself.

 

[whoknows2012]

Fight me.

But, seriously, NYC's awesome, but it's one of the last places I would think about doing an IM residency in. The city programs are notorious for the strong nursing union and the lack of support staff to help the residents out. For example, expect to do much of the AM blood draws yourself.

False

 

[whoknows2012]

Thoughts on my shot at getting into a good internal medicine residency in Manhattan (eg NYU, Columbia, Sinai, Cornell): Currently 3rd year - 246 on Step 1, top quartile in a top 40 med school, several solid research projects, and an MPH.

Yes you’d be competitive. If aoa even more likely. Don’t expect an interview at all 4 but I suspect you’ll get 2 or 3 out of the 4.

 

[WiseOne]

Comments about the nursing situation are true. Some of my friends have had to roll patients to CT themselves because nurses were taking too long.

 

[WedgeDawg]

Comments about the nursing situation are true. Some of my friends have had to roll patients to CT themselves because nurses were taking too long.

This is an everyday occurance in NYC hospitals

 

[whoknows2012]

From my experience which is vast and at 2/4 manhattan academic programs and at monte in the Bronx. Transporting patients is rare in IM(not sure if the above anecdotes were from other specialties). Blood draws in an emergency or occasionally ABGs were my experience. Nursing is definitely different in NY they sometimes refuse to do things that are clearly their job but overall it rarely impacted patient care and often if you were nice and it really was their job they’d eventually do it. Also 10 yrs ago the issue of lack of ancillary service esp at nyc programs was a much bigger problem. Can not speak for every program and especially not the community ones but again from my experience this idea that you have to do everything yourself is VASTLY overstated and I welrcome anyone who trained in IM at one of these 4 programs to offer an alternate opinion should there be one

 

[Psai]

From my experience which is vast and at 2/4 manhattan academic programs and at monte in the Bronx. Transporting patients is rare in IM(not sure if the above anecdotes were from other specialties). Blood draws in an emergency or occasionally ABGs were my experience. Nursing is definitely different in NY they sometimes refuse to do things that are clearly their job but overall it rarely impacted patient care and often if you were nice and it really was their job they’d eventually do it. Also 10 yrs ago the issue of lack of ancillary service esp at nyc programs was a much bigger problem. Can not speak for every program and especially not the community ones but again from my experience this idea that you have to do everything yourself is VASTLY overstated and I welrcome anyone who trained in IM at one of these 4 programs to offer an alternate opinion should there be one

Sounds like it wasn't at Columbia or NYU

 

[whoknows2012]

Sounds like it wasn't at Columbia or NYU

Fair point you kinda nailed it on the head there an I applaud you. But at Sinai and Cornell as well as at monte this was not the norm

 

[IMreshopeful]

Fight me.

But, seriously, NYC's awesome, but it's one of the last places I would think about doing an IM residency in. The city programs are notorious for the strong nursing union and the lack of support staff to help the residents out. For example, expect to do much of the AM blood draws yourself.

Agree with this - have multiple friends who went through residency in NYC and didn’t love it for those reasons. It’s a great city and fun place to be but a really bad place to be if you want to make a living as a physician or raise a family on a physician salary or pay off your loans. Also it’s pretty saturated in most IM subspecialty markets so there’s that

 

[whoknows2012]

Agree with this - have multiple friends who went through residency in NYC and didn’t love it for those reasons. It’s a great city and fun place to be but a really bad place to be if you want to make a living as a physician or raise a family on a physician salary or pay off your loans. Also it’s pretty saturated in most IM subspecialty markets so there’s that

Salary itself is great (in training) but cost of living is so high. Agree That living in NYC post training is really untenable in academics unless you have a spouse who makes a lot of money or if you’re willing to sacrifice on lifestyle a bit (no vacations, no car, smaller apt etc). It’s truly not worth it IMO and as soon as my fellowship is over regardless of where my eventual job is we’ll (wife and daughter, probably 2nd child by then too) be moving to the suburbs. The other point I’d make is that I’ve see wildly variable salaries for my specialty (hem/onc) depending on which academic center. Anywhere from 180-270 which is insane to think you train for 6 yrs and make less than a Hospitalist at some centers

 

[atomi]

Anywhere from 180-270 which is insane to think you train for 6 yrs and make less than a Hospitalist at some centers

Especially when you can go to rural Midwest and easily break 600k.
I know a heme-onc in a very rural setting pushing 900k with productivity bonus.

What's 180k post NY tax? The effective pay difference after subtracting tax and cost of living difference is mind boggling. And what do you get in return for living in Manhattan?

Which brings me back to...

Manhattan sucks. Look elsewhere.

 

[atomi]

What does top 40 mean

It means he either goes to UC Davis or Einstein. Given the subject of the post, it means the OP goes to Einstein.

https://www.usnews.com/best-graduate-schools/top-medical-schools/research-rankings

 

[whoknows2012]

Especially when you can go to rural Midwest and easily break 600k.
I know a heme-onc in a very rural setting pushing 900k with productivity bonus.

What's 180k post NY tax? The effective pay difference after subtracting tax and cost of living difference is mind boggling. And what do you get in return for living in Manhattan?

Which brings me back to...

At 180 with local and state taxes you’re pushing 40 % tax rate. Take home is like 115,000 minus loan payments and probably some off the top for retirement contributions (pre-tax, obv). A 1 BR in NYC is at least $3500-3700 in a desirable location. If you’re single that leaves a decent amount of money to live comfortably. If you have a family though it’s tough without significant spousal income.

 

[IMreshopeful]

Salary itself is great (in training) but cost of living is so high. Agree That living in NYC post training is really untenable in academics unless you have a spouse who makes a lot of money or if you’re willing to sacrifice on lifestyle a bit (no vacations, no car, smaller apt etc). It’s truly not worth it IMO and as soon as my fellowship is over regardless of where my eventual job is we’ll (wife and daughter, probably 2nd child by then too) be moving to the suburbs. The other point I’d make is that I’ve see wildly variable salaries for my specialty (hem/onc) depending on which academic center. Anywhere from 180-270 which is insane to think you train for 6 yrs and make less than a Hospitalist at some centers

Cardiology usually makes half as much even in PP in NYC as you would any suburban or rural setting. It’s unfortunate. Some people undoubtedly are okay with this - I’m not sure I am after spending 7ish years in training. It’d really sad. Oh well - I’ll make do!