Difficulty of getting into a top residency and top medical school

[polyploidy516]

Hi all,
I am curious to know which is more difficult to accomplish from an academic and selectivity standpoint; is it harder to get into a top medical school or top residency ( such as IM at a top hospital)?

I am interested in this because Ive heard many people say that once you get into medical school, especially a top one, certain residencies are easier to obtain based on the school's reputation/inbreeding/etc?

Your thoughts would be appreciated as I am really curious to know of this as there is a strong chance that I will be matriculating at a non top 25 and would like to maximize my chances at a top residency.

Thank you!

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[Lucca]

Hi all,
I am curious to know which is more difficult to accomplish from an academic and selectivity standpoint; is it harder to get into a top medical school or top residency ( such as IM at a top hospital)?

I am interested in this because Ive heard many people say that once you get into medical school, especially a top one, certain residencies are easier to obtain based on the school's reputation/inbreeding/etc?

Your thoughts would be appreciated as I am really curious to know of this as there is a strong chance that I will be matriculating at a non top 25 and would like to maximize my chances at a top residency.

Thank you!

By definition residency is more academically selective because all selection takes place within a population which has already been highly selected for (through the medical school admissions process). What "top residency" means is not a given either. For medical school we use shortcuts like "T10" and even then not everyone seems to agree quite on what "Top" is supposed to mean. Given that one knows what a top residency even is, it is not clear the distinction has any particular meaning to everyone equally.

If you want to maximize your chances at a top residency, there is a plethora of information available to you in order to do so. Just like applying to medical school, excellence will be expected in all of the relevant areas which are this time much more narrowly defined than in undergrad. Good clinical grades, a productive history in activities relevant to a specialty (a clinical rotation in the specialty, research / publications in the specialty's basic and clinical science journals), a good Step 1 score (the average has been creeping up for years and what score is competitive for what specialty is not uniform although, obviously, the higher the better) , respectable accolades like AOA or a high class ranking, strong letters from your mentors = a good match.

I would suggest searching through the Allopathic forum or the specialty-specific forums where this topic is discussed in far more detail and in earnest. In general, as you may have gathered from the list I provided above, the consensus is that individual performance is going to be more valuable to your future career than the school you attend although both clearly play a role and there are a few outliers.

 

[IlDestriero]

Inbreeding is real. Before our fellowship had a match, the vast majority of our fellows came from the same handful of highly regarded residency programs and many of them came from the top 10-20 research schools. Then many of them go on to be faculty at the best children's hospitals in the land and the cycle of inbreeding continues.


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Il Destriero

 

[aldol16]

I am interested in this because Ive heard many people say that once you get into medical school, especially a top one, certain residencies are easier to obtain based on the school's reputation/inbreeding/etc?

People will keep telling you on here that you can get into a top residency no matter where you go. That's true. But you also have a shot at winning the lottery if you play it. The key subtlety is that there's a difference between "being able to" get into a top residency and "having a good shot at" getting into a top residency. Because of the known relationship between med schools and their affiliated residency programs, your shot at getting into a particular residency increases if you attend that school. For instance, if you want to match at NYU Langone, you should go to NYU.

But your shot in general of matching into a top residency because of going to a top school is not really well-known. Yes, the top schools tend to have amazing match lists. But it's really difficult to dissociate whether they have a good match lists because they simply have the most high-achieving medical students who would have been high-achievers anywhere they went or if it's because of the school itself.

 

[Pepe18]

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[sliceofbread136]

It depends on how you look at it. I think if you a higher tier Med student going to Im you will have an easier time than a higher tier undergrad. A lot of the better applicants are going to different specialties

 

[IlDestriero]

It's probably worth noting that unless you're in the field, you probably won't be able to know what the "top residencies" actually are. That's why trying to interpret match lists are a bad idea.
Is Texas Tech a 5 star pain fellowship or a dusty Texas backwater? Or was it a 5 star program ~15 years ago and it's all rumors of old glory? Or did they just hire 2 superstars to rehab the program?


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Il Destriero

 

[Neuro244]

You are asking confounding questions.

Going to a top med school will make it easier to get a top residency program. period.

It is too difficult to compare getting a top residency to getting into a top med school. Too many variables. Different residencies have very different level of competitiveness, there is a lot of self selection, but you are more in control of the outcome. med school applications have more people competing for each seat (if you were comparing to something like IM residencies) and has more bs, etc.

If I go to medical school out of state (I currently live in California and have almost my whole life) let's say in Arizona, Washington, or Texas, but I want to do my residency in California so then I can work as an attending in California, would it be harder for me to match since I went to an out of state medical school? Would I/should I aim to definitely get into a California medical school if I want to land a residency in California? How are/to what extent are the two correlated, and what are some things I should consider? For instance, I'm shooting to get a 513 on my MCAT which is in the 90th percentile, but if I end up getting let's say a 510, would I still have a good shot at getting into places like UCLA,USC,UCR,UCSD,UCI,Stanford, and all the other california med schools? (My cumulative GPA is about 3.80-3.81).

Thanks and God Bless.

 

[meddesire]

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[efle]

Wait so are "top residencies" an assumed real thing in this thread? Or is it like that other thread on reading match lists where we assume MGH IM might not even be good, who even knows?

 

[Lost In Transcription]

Who cares?

 

[IlDestriero]

Wait so are "top residencies" an assumed real thing in this thread? Or is it like that other thread on reading match lists where we assume MGH IM might not even be good, who even knows?

The point is that all residencies, that aren't on probation, meet some minimum standard established for the field, at least they did the last time they were reviewed. Some residencies are a SD above average and some are a SD below average. Unless you're involved in the field, you are unlikely to know what's what. Big name medical centers can have shady programs and seemingly quiet backwaters can have superior programs.
Your personal ranking also depends on your goals. If you go to a good workhorse program and get a great PP job that you always wanted, you made a good choice. If you go to Haaarvard for the name and connections and end up doing research and super obscure cases that have limited value to your dream PP job, that's probably not the best choice for you.


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Il Destriero

 

[efle]

Some residencies are a SD above average and some are a SD below average.

What indicators would one look for to distinguish the former from the latter?

Your personal ranking also depends on your goals.

How often are goals chosen from a limited set? Like if I'm an average applicant but would love to do research and super obscure cases, can I expect to go Haaaarvard? That is, do I have to be some kind of cream of the crop to get interviewed and ranked well by some places, or is competition not really that fierce anywhere and it's just about people's preferences that determines where they go?

 

[IlDestriero]

What indicators would one look for to distinguish the former from the latter?


How often are goals chosen from a limited set? Like if I'm an average applicant but would love to do research and super obscure cases, can I expect to go Haaaarvard? That is, do I have to be some kind of cream of the crop to get interviewed and ranked well by some places, or is competition not really that fierce anywhere and it's just about people's preferences that determines where they go?

1. You'd have to talk to people in the field. It's specialty dependent as well.

2. Superior programs are extremely competitive, in all fields. For example peds isn't particularly competitive, but if you want to go to Harvard or Penn (Boston Children's or CHOP) you're competing with the best of the best. You need to be a special snowflake and average isn't going to cut it. Anesthesia isn't very competitive either. If you're average without red flags, you can get a solid match, but MGH, UCSF, Stanford, etc. won't even read your application if you're an average applicant. They get hundreds and hundreds of applications and have to screen aggressively. My fellowship is brutally competitive, though at the fellowship level who you know and your LORs are more useful than 99th percentile scores.



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Il Destriero

 

[Pepe18]

If I go to medical school out of state (I currently live in California and have almost my whole life) let's say in Arizona, Washington, or Texas, but I want to do my residency in California so then I can work as an attending in California, would it be harder for me to match since I went to an out of state medical school? Would I/should I aim to definitely get into a California medical school if I want to land a residency in California? How are/to what extent are the two correlated, and what are some things I should consider? For instance, I'm shooting to get a 513 on my MCAT which is in the 90th percentile, but if I end up getting let's say a 510, would I still have a good shot at getting into places like UCLA,USC,UCR,UCSD,UCI,Stanford, and all the other california med schools? (My cumulative GPA is about 3.80-3.81).

Thanks and God Bless.

Yeah, Cali is it's own special category.

What you can do is try to look for out of state schools that have many Cali residents and many matches back to Cali. For example, two schools I interviewed at like that were SUNY Downstate and Tulane

These schools are known to Cali residencies, which will increase your chances of matching back home.

Good luck!

 

[Neuro244]

Yeah, Cali is it's own special category.

What you can do is try to look for out of state schools that have many Cali residents and many matches back to Cali. For example, two schools I interviewed at like that were SUNY Downstate and Tulane

These schools are known to Cali residencies, which will increase your chances of matching back home.

Good luck!

Good to know, thanks.