Difficulty getting residency far away from school/ Moving after residency

[Strider_91]

Hi all,

Forgive me if this is not the correct location or a subject which has been beaten to death and please direct me to the proper location.
I just got accepted into my state medical school which I am thrilled about. However, my dream in life is move out west (I live in the northeast) because I love the outdoors and it is my passion. I am thinking Colorado, Washington, Utah or Arizona but preferably Colorado or Washington.

Here are my questions:
a) how hard is it to match far away from your school for a mid tier field?
b) How hard is it to match far away form your school for a top tier difficulty field compared to near your school?
c) If all else fails, how hard is it to move as a physician after residency but before you begin practicing as an attending

Thanks in advance.

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[kmp0410]

I'm pretty sure location has almost nothing to do with residency matching. People match across the country all the time. Of the few people I know who have matched, all matched in completely different geographical regions. I think this is quite common. While the stats might point to people staying closer, that probably has nothing to do with "difficulty" in matching far away.

Someone can correct me if I'm wrong.

 

[Snoopy2006]

Location plays a role. How big of a role is up for debate. What will matter is how strong of an applicant you are relative to the average and other applicants in your pool. If you apply to PM&R with a 250, you should theoretically be able to match anywhere. If you apply to a mid-tier field with mid-tier statistics, you may find it more difficult to score California interviews if you've spent your entire life in Vermont.

Remember, residencies don't want to slide too far down their match list. Fair or not, many residency programs use location as a barometer of "how likely" someone is to actually rank that program highly. It's why in certain fields (the more competitive ones) it's recommended to do an away rotation in a particular region of the country you're interested in. If you've spent your entire life in Iowa City and do an away in Boston, it may show programs (theoretically) that you're more serious about coming to the East Coast for residency than someone else from the same part of the country.

People do match cross-country all the time. Some of these people have ties to that state (e.g. a homegrown California kid who goes to medical school in Chicago and returns to CA for residency) and others are just strong applicants (for their particular field) and able to go just about anywhere they desire. There's also a large degree of randomness involved.

Another thing to keep in mind is that some of the areas you mentioned - Colorado, Washington - are very popular destinations with strong medical institutions, and their residency programs are proportionally competitive as a result.

That said, I wouldn't take on ridiculous amounts of debt just because you like the outdoors. That'd be short-sighted. You can do away rotations in your 4th year of medical school targeting a particular area (Colorado, Washington), and even if you don't match where you want to, it's relatively easier as a new attending to move where you'd like. There's certainly exceptions - and the type of city you can live in will be determined by how saturated your field is - but if you're determined as an attending to make it out West and are willing to sacrifice a few things, you'll get there.

 

[Strider_91]

Another thing to keep in mind is that some of the areas you mentioned - Colorado, Washington - are very popular destinations with strong medical institutions, and their residency programs are proportionally competitive as a result.

That said, I wouldn't take on ridiculous amounts of debt just because you like the outdoors. That'd be short-sighted. You can do away rotations in your 4th year of medical school targeting a particular area (Colorado, Washington), and even if you don't match where you want to, it's relatively easier as a new attending to move where you'd like. There's certainly exceptions - and the type of city you can live in will be determined by how saturated your field is - but if you're determined as an attending to make it out West and are willing to sacrifice a few things, you'll get there.[/QUOTE]


Thank you for the thorough response, it is very helpful and logically makes sense to me. Can you clarify "not wanting to take on debt to do it" part. Do you mean by setting up an away rotation I would be taking on more debt or by not going to my state school I would be taking on more debt? (I have already committed to my state school).

Also, is it possible to contact programs and explain to them my passion to move to eventually live in their area? Would this just be seen as blowing smoke?

 

[Snoopy2006]

Thank you for the thorough response, it is very helpful and logically makes sense to me. Can you clarify "not wanting to take on debt to do it" part. Do you mean by setting up an away rotation I would be taking on more debt or by not going to my state school I would be taking on more debt? (I have already committed to my state school).

Also, is it possible to contact programs and explain to them my passion to move to eventually live in their area? Would this just be seen as blowing smoke?

The debt comment meant don't spend thousands of dollars to go to an expensive Colorado school over your state school just because of location, I wasn't paying attention to the time of year and forgot you've probably already started. Away rotations can be expensive but they are almost always worth the investment.

Contacting programs specifically just to say you're interested in their area wouldn't be recommended when you apply. You can personalize a personal statement for a particular residency and always hint at your reasons there, but actions speak louder than words - that's why doing aways in a particular area carry much more weight than simply saying you'd like to be there. Every year there's people on the interview trail that express fake interest in a particular program, so many committees tune that sort of stuff out.

 

[Strider_91]

The debt comment meant don't spend thousands of dollars to go to an expensive Colorado school over your state school just because of location, I wasn't paying attention to the time of year and forgot you've probably already started. Away rotations can be expensive but they are almost always worth the investment.

Contacting programs specifically just to say you're interested in their area wouldn't be recommended when you apply. You can personalize a personal statement for a particular residency and always hint at your reasons there, but actions speak louder than words - that's why doing aways in a particular area carry much more weight than simply saying you'd like to be there. Every year there's people on the interview trail that express fake interest in a particular program, so many committees tune that sort of stuff out.

Thank you again for the thorough response. I actually didn't start yet, I got accepted as an early decision applicant for next year. I weighed my options and decided I wouldn't be able to get into a school much better than my state shool and didn't want to waste money applying.
I will definitely look into setting up away rotations.

 

[Tenk]

I'm pretty sure location has almost nothing to do with residency matching. People match across the country all the time. Of the few people I know who have matched, all matched in completely different geographical regions. I think this is quite common. While the stats might point to people staying closer, that probably has nothing to do with "difficulty" in matching far away.

Someone can correct me if I'm wrong.

Actually, you are wrong for multiple reasons:

1) States like to retain physicians, especially states with high physician needs.

2) If you're an all star step 1 champ from a well known medical school and you are interviewing for residency in the middle of nowhere and aren't from there, that PD will think you are either using them for interview practice or backup (which you are...). Since their interviews are limited they may not interview you based on that alone. Yes you can be too good to interview somewhere not so good (unless you have family or a reason to be there).

3) Less likely than 1) and 2) but sometimes programs have gotten students from X school and they have been notoriously bad or didn't work, so they stop interviewing them. Yes this happens. No I don't endorse it.

Does location matter as much as scores, personality and the desired specialty? Nope! But it still matters.