discrepancy between med school admission and residency admission?

[robin911]

Yesterday my PI, boss, mentor, an MD-PhD was speaking to a current MS Y4 student who is applying for residencies and me.

The MS Y4 stated that she had the exact same application for medical school that she did for residency. For both, she discussed a love for research and passion to become an academic clinician. She had 4 publications for medical school apps and has not published anything new for residency (although she did work in a research lab 2 summers of med school).

She told me that she applied to 21 MD Schools with a competitive MCAT, decent LOR and 4 publications. She got one medical school interview and one acceptance out of 21 applications.

Fast forward 4 years of her med school career. She has 75 percentile USMLE scores (both step 1 and step 2) and no new publications. She said that she applied for 24 residency spots and has received 19 interviews already, with basically the same personal statement and goals.

She told me that she feels like there is a major disconnect between what medical school adcoms generally seek in matriculating students and what residency admissions seek. So much so that she told me many of her friends lied about wanting to go into primary care or rural medicine for med school interviews.

Overall, she felt like medical school adcoms and residency adcoms look for very different applicants. (I realize this highly depends on residency type: she wants to go into Internal Medicine).

Just wondering if anyone else had any feelings on this? This forum is not to attempt to place rural vs. research or anything else like that against each other, just thought it was a really interesting discussion.

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[DrBowtie]

The competitiveness of residency widely varied based on specialty and location

Also she has a PhD which is a big leg up for certain specialties.

 

[robin911]

The competitiveness of residency widely varied based on specialty and location

Also she has a PhD which is a big leg up for certain specialties.

Sorry if it was confusing: My boss is a faculty member... she is a MS Y4 and has no Phd.

 

[rilte4]

They say jump, we'll say how high.

 

[robin911]

They say jump, we'll say how high.

Hahah well said. It just seems a bit ridiculous that a few people would flat-out lie about their aspirations and still trickle into medical school. but i guess that can be said about all things in life.

 

[WedgeDawg]

Hahah well said. It just seems a bit ridiculous that a few people would flat-out lie about their aspirations and still trickle into medical school. but i guess that can be said about all things in life.

People also change their minds.

 

[Henry101]

I've heard it's easier to write up clinical cases as research instead of doing actual bench research in medical school. Does she have any of those?

 

[DrBowtie]

Sorry if it was confusing: My boss is a faculty member... she is a MS Y4 and has no Phd.

Ok. Still stands that it depends on where she applied, particularly in IM where there are places with super high standards down to places requiring a pulse.

 

[robin911]

I've heard it's easier to write up clinical cases as research instead of doing actual bench research in medical school. Does she have any of those?

Nope. She was working in the research lab with me on mouse work.

 

[Med Ed]

Most of it is a pure numbers game. Medical school admissions involves 50,000+ people vying for 20,000 positions at 143 programs. Residency is approximately 20,000 people vying for one of 30,000 positions at 4,600 programs. A decent candidate getting 15+ interview offers is not unexpected.

 

[goldy490]

^Darn, Med Ed beat me to it by 2 seconds

 

[robin911]

Ok. Still stands that it depends on where she applied, particularly in IM where there are places with super high standards down to places requiring a pulse.

She went to a public university in midwest for medical school, and is interviewing at top tier schools for residency (Hopkins, harvard, U Mich, Northwestern, U Chi etc.). Maybe it is just a coincidence or she is an outlier to the system.

 

[arc5005]

Most of it is a pure numbers game. Medical school admissions involves 50,000+ people vying for 20,000 positions at 143 programs. Residency is approximately 20,000 people vying for one of 30,000 positions at 4,600 programs. A decent candidate getting 15+ interview offers is not unexpected.

wait so are there approximately 10,000 unfilled residency spots each year?

 

[goldy490]

Some spots go unfilled, then IMGs and FMGs pick up the rest

Plus I'm not 100% on if the 20,000 includes DO grads

 

[WedgeDawg]

Some spots go unfilled, then IMGs and FMGs pick up the rest

DOs too.

 

[robin911]

What is IMG and FMG?
IMG = International?

 

[WedgeDawg]

What is IMG and FMG?
IMG = International?

IMG (international medical graduate) is used to refer to American citizens at non-US medical schools.

FMG (foreign medical graduate) is used to refer to non-US citizens at non-US medical schools.

We most commonly see IMGs in Caribbean schools.

 

[Goro]

Also keep in mind that at least half of the applicants to med school have no business setting foot on a medical school campus, except as cadavers or standardized patients.

I would hope that candidates for residency are a bit more knowledgeable about their chances at particular residency sites?

 

[TooMuchPressure]

Also keep in mind that at least half of the applicants to med school have no business setting foot on a medical school campus, except as cadavers or standardized patients.

I would hope that candidates for residency are a bit more knowledgeable about their chances at particular residency sites?

Glad to know someone appreciates me. Can always count on you goro.

 

[Mad Jack]

OP can't math.

 

[Psai]

I barely made it into medical school when I applied 4 years ago but now I have a bunch of interviews at great programs for residency.

 

[robin911]

I barely made it into medical school when I applied 4 years ago but now I have a bunch of interviews at great programs for residency.

Why do you think that is? Different resume or ECs?

 

[operaman]

So she's in the top quartile of med students nationally purely by board scores and Appleton to a relatively non competitive field that traditionally interviews a lot of people per program and you're wondering why she got lots of interviews?

I don't know why she didn't have as much success 4 years ago - my spidey sense says it was probably her gpa among other things. It really is a supply demand thing where the overall numbers matter. I promise you if she were applying in a smaller competitive field with that application, she would be lucky to have any interviews at all. Just visit the derm, Ortho, and Ent boards here to see what competitive really looks like.

 

[Psai]

Why do you think that is? Different resume or ECs?

Below average gpa, below average interviewing skills, below average ECs. Now I have nice scores, decent gpa, good ECs including published research, great letters and I've been spending the past year or so talking to sick people that I've never met before.

 

[Law2Doc]

Yesterday my PI, boss, mentor, an MD-PhD was speaking to a current MS Y4 student who is applying for residencies and me.

The MS Y4 stated that she had the exact same application for medical school that she did for residency. For both, she discussed a love for research and passion to become an academic clinician. She had 4 publications for medical school apps and has not published anything new for residency (although she did work in a research lab 2 summers of med school).

She told me that she applied to 21 MD Schools with a competitive MCAT, decent LOR and 4 publications. She got one medical school interview and one acceptance out of 21 applications.

Fast forward 4 years of her med school career. She has 75 percentile USMLE scores (both step 1 and step 2) and no new publications. She said that she applied for 24 residency spots and has received 19 interviews already, with basically the same personal statement and goals.

She told me that she feels like there is a major disconnect between what medical school adcoms generally seek in matriculating students and what residency admissions seek. So much so that she told me many of her friends lied about wanting to go into primary care or rural medicine for med school interviews.

Overall, she felt like medical school adcoms and residency adcoms look for very different applicants. (I realize this highly depends on residency type: she wants to go into Internal Medicine).

Just wondering if anyone else had any feelings on this? This forum is not to attempt to place rural vs. research or anything else like that against each other, just thought it was a really interesting discussion.

I guess I'm missing what you think the disconnect is. There are people who interview for lots of spots before deciding what to rank, either because they aren't sure how competitive they are, because the field is very competitive or because they are undecided. There are also programs that interview a lot of people per spot. When I was applying there was a NY a Times article about a couple trying to match into derm who went on 50 interviews. So getting lots of interviews without knowing the circumstances doesn't mean much.

 

[Mad Jack]

The other major factor is the Match. in medical school admissions, most schools interview two or three students per spot. But the Match allows you to interview a much larger pool of candidates (10-20 per spot) and still end up with optimal results. Not so with undergrad medical school admissions, where they have to send out a class worth of offers, wait for people to back out or reject, send out another batch...

 

[235009]

US MD school admissions is the true bottleneck in the process. OP is right though, the qualifications are very different. Part of it is your stated intentions but more importantly med schools are basically trying to figure out whether you can handle the rigor of med school and they are making the "moral" judgement of whether you essentially should be allowed to be a doctor. A lot of it is also that people filter out into different specialties, life priorities change so everything starts getting diluted out.

Your friend's experience is not unique at all. Mine has been very similar. Med school I only got love from my state schools and one low tier school. For residency (IM as well) I interviewed at a bunch of places that had trashed my application for med school. Now for fellowship I interviewed at places I didn't even bother applying to for med school and others that likely laughed at my application.

 

[Donald Juan]

If you're an above average applicant applying to a below average specialty (which I can only assume given only applied to 24 spots and received 19 interviews) then yes, it is easy to get a large number of interviews. Like someone said above, most places interview 15-20 people per residency spot, so it is a much different dynamic. The programs are trying to ensure that they don't go unmatched just like the applicants are.

 

[mimelim]

I don't really understand the disconnect. For the MS4 in your lab, it might not matter that her application is the same for middle of the road IM programs. But, even assuming you hit our USMLE minimums (which she wouldn't), someone expressing love for research/academics with zero academic productivity outside the classroom during medical school would essentially be a dead application.

Residencies need residents. It is a huge problem for them if they don't match. Even worse if no one fills the spot via the SOAP. In the same way that applicants play it safe by going on more interviews than they would typically need, programs do the same thing. We interview 70 for two spots despite never going outside of our top 10.

We absolutely look for different things than medical schools do. As long as you are a reasonable student, you are going to do your medical school proud. Yes, every school wants high fliers that are going to elevate the name of the school, but the amount of investment in each student for that is relatively limited. In contrast to residency, we only have 2 spots per year. If one of those turns out to be less than stellar, everyone suffers. It no longer is about being a good student, (we have >100 applications with steps >230), it is about whether or not you are going to be productive at our program. Residency is hard, but surgical residency is even more demanding. You have to work 80 hours/week and then also prepare your presentations, do research, be active on committees, etc. You certainly don't have to do all of those things, but we expect our residents (who all say they are aiming for a career in academics) to do more than just 'be a good student'.

 

[Goro]

This is a fascinating insight. I curious as to why you need to interview so many candidates when it seems like a short list of 10 would suffice. In many ways, this process is more analogous to a Faculty job search. For any given position at my school (and others I've been at) an ad will bring in some 100-300 CVs, yet only ~the top 5 or so get interviewed.

Residencies need residents. It is a huge problem for them if they don't match. Even worse if no one fills the spot via the SOAP. In the same way that applicants play it safe by going on more interviews than they would typically need, programs do the same thing. We interview 70 for two spots despite never going outside of our top 10.

 

[WingedOx]

This is a fascinating insight. I curious as to why you need to interview so many candidates when it seems like a short list of 10 would suffice. In many ways, this process is more analogous to a Faculty job search. For any given position at my school (and others I've been at) an ad will bring in some 100-300 CVs, yet only ~the top 5 or so get interviewed.

@mimelim is in a unique spot with what he does. (and he sould correct me if I'm wrong with any of thus) but pretty sure he's part of an integrated vascular program, which is more than a little selective and kind of a bonus for those who want to do vascular and match into it. Those who don't but want to do vascular will settle for GS residencies then fellowship afterward. Kind of like plastics.

You rank that many because you never know. Even competitive programs can have a bad recruiting year. Before I arrived my psych program had a match year where they had to scramble for 3 residents because the chair (who didn't really know what the hell he was doing) only ranked 40 % of our normal list length. We got lucky with the people we found in the scramble, but it could have been disaster. We usually get everyone in our top 40% of our list, but you ALWAYS prepare for the worst.

 

[mimelim]

This is a fascinating insight. I curious as to why you need to interview so many candidates when it seems like a short list of 10 would suffice. In many ways, this process is more analogous to a Faculty job search. For any given position at my school (and others I've been at) an ad will bring in some 100-300 CVs, yet only ~the top 5 or so get interviewed.

@mimelim is in a unique spot with what he does. (and he sould correct me if I'm wrong with any of thus) but pretty sure he's part of an integrated vascular program, which is more than a little selective and kind of a bonus for those who want to do vascular and match into it. Those who don't but want to do vascular will settle for GS residencies then fellowship afterward. Kind of like plastics.

You rank that many because you never know. Even competitive programs can have a bad recruiting year. Before I arrived my psych program had a match year where they had to scramble for 3 residents because the chair (who didn't really know what the hell he was doing) only ranked 40 % of our normal list length. We got lucky with the people we found in the scramble, but it could have been disaster. We usually get everyone in our top 40% of our list, but you ALWAYS prepare for the worst.

Aye, integrated vascular surgery. The main reason we interview so many is because we don't know who our top 10 will be pre-interview. Our interviews are extensive, 6-7 formal interviews, a lot (all free time while not interviewing) of hanging out with current residents. I tell our younger residents that we are picking someone that is going to be their junior for 2-5 years and they need to be someone that they can not only tolerate, but would want to see every day. Our top 10 rank list are not the people with the top 10 scores. They are the top 10 people that we think would be a good fit for us. That overlaps heavily with who we think that we are a good fit for as well. Clearly our residents agree since the ones that we have matched have ranked us relatively highly.

I think the fundamental difference between medical school and residency applications is that this is more of an apprenticeship than a school.

 

[bc65]

Anyone who got through med school with decent grades and board scores, and letters of recommendations from medical school faculty, is already much more a known quantity than any undergraduate. After that, what's going to be much more important in residency is personality. In a surgery program in particular, you will be in the OR for 8 to 12 hours a day with your residents in close quarters, under trying circumstances. The residents will actually be making critical decisions about your private patients. Thus, personality and fit is of crucial importance. Therefore, you will want to interview as many people as possible to make sure you find the ones who will be the very best for your program. Given the stringent criteria, you will also be competing with all the other programs for the best candidates. Programs really need to cast a wide net to find the best residents, regardless of the field.