Do you have to be at the top of your class at any school to match into competitive specialties?

[deleted1114112]

I noticed that pretty much all schools in the T50 apart from some primary care-focused schools (i.e.UCSF and some other state schools) tend to send roughly the exact same proportion of students into 'competitive' specialties and the like. Obviously this doesn't represent the 'quality' of said residency program, but even if you cap it at T50, most programs matched are of high regard/it won't impact any prospects.

Is there a reason for this? Will this change when STEP 1 is P/F—will top schools send a larger proportion into competitive specialties?

Honestly knowing the type of people that get into schools like NYU, etc. I can't imagine that 80% of them want to go into primary care and 20% to pych/FM. Unless I'm completely wrong in a superficial judgement of that cohort,

Even then I'm still confused, as it seems to be a commonality on this forum that a top school = easier chance to competitive specialties/residencies. Yet, among the good residency programs for specialties, a large proportion just seem to be mega-volume systems at state schools (which of course are hard to get into) but for the most part seem to take a large proportion of students from their own programs.

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[doomer_md]

I love how NYU seems to have taken over the #1 elite school everyone thinks of now and not Hopkins or Harvard. I guess that free tuition stunt is really working.

As for the question NMRP match data shows the % of people that match a specialty that have AOA and same for the people that don't match for that specific specialty. AOA is typically given to highest ranked students in terms of preclinical grades. So for example, 40% of US seniors that matched neurosurgery were AOA, whereas 20% of of the unmatched pool were also AOA. Theoretically, if AOA didn't matter at all, both these numbers should be the same, and the higher the margin of between those who have AOA and match and those who have AOA but don't match should suggest that AOA/preclinical grades matter for that specialty. But at the same time, in uncompetitive specialties like child neurology, pathology, and PMR, out the of the people that do not match, 0% are AOA. In other words, every AOA member that applied to these 3 specialties matched. Vascular surgery and radonc actually have higher proportions of unmatched AOA members than matched AOA members, which would suggest AOA doesn't matter at all for them. (edit: this of course assumes that AOA is the only differentiating factor among applicants, which is obviously not the case)

So maybe a little? There's also people that graduate from unranked P/F schools (which I hear are also generally the top ranked schools?) make things more complicated. There's a possibility that all the non-AOA people that matched derm, NS, ENT come from these schools but I doubt it. I'd say it pales in comparison to what was Step 1 and research pubs. I hear most programs are just using Step 2 CK now, so fundamentally not much has changed.

 

[deleted1114112]

I love how NYU seems to have taken over the #1 elite school everyone thinks of now and not Hopkins or Harvard. I guess that free tuition stunt is really working.

Ah, my bad on that one. Although I just looked at JHU and Harvard and both seem to follow a similar pattern; in fact, JHU actually seems to be more pronounced and sends even more people to peds/IM/etc. and less to competitive specialties than NYU and some top state schools (for last year at least).

As for the question NMRP match data shows the % of people that match a specialty that have AOA and same for the people that don't match for that specific specialty. AOA is typically given to highest ranked students in terms of preclinical grades. So for example, 40% of US seniors that matched neurosurgery were AOA, whereas 20% of of the unmatched pool were also AOA. Theoretically, if AOA didn't matter at all, both these numbers should be the same, and the higher the margin of between those who have AOA and match and those who have AOA but don't match should suggest that AOA/preclinical grades matter for that specialty. But at the same time, in uncompetitive specialties like child neurology, pathology, and PMR, out the of the people that do not match, 0% are AOA. In other words, every AOA member that applied to these 3 specialties matched. Vascular surgery and radonc actually have higher proportions of unmatched AOA members than matched AOA members, which would suggest AOA doesn't matter at all for them.

So maybe a little? There's also people that graduate from unranked P/F schools (which I hear are also generally the top ranked schools?) make things more complicated. There's a possibility that all the non-AOA people that matched derm, NS, ENT come from these schools but I doubt it. I'd say it pales in comparison to what was Step 1 and research pubs. I hear most programs are just using Step 2 CK now, so.

Interesting! To your last point, I think there are very few truly fully unranked medical schools (no AOA, no internal rankings, no "honors pass/high pass/pass/fail" BS (looking at Perelman..)/graded clinicals) I believe it's only Yale, Harvard, and UCSF (?) although I'm not sure on this front.

Fundamentally I'm just confused on whether these ratios (+/- a bit) for residences that seem to be fairly consistent throughout the top 40 schools are a product of student choice or if students are stratified beyond STEP 1. Even for schools with STEP 1 averages of ~248 (there are a few), they still do not have a significantly higher number of students pursuing 'competitive' specialties despite their STEP 1 score average being the average if not higher for many of those specialties. Further, if this were the case, then STEP 1 going P/F wouldn't even matter because the average student at these schools could already be a competitive specialty applicant based on their score yet actively chooses (or for other reasons) not to go into said residencies.

Of course, a lot of other stuff goes into those specialties like research, etc. so....bleh

 

[KnightDoc]

I love how NYU seems to have taken over the #1 elite school everyone thinks of now and not Hopkins or Harvard. I guess that free tuition stunt is really working.

Stunt? To me, it would be a $300K gift that I would otherwise have to pay back, with interest. I guess it's great for someone whose family can easily afford to write that check, or for someone who is counting on other people to subsidize their education through eligibility for need based financial aid, to turn their nose up at it and derisively refer to it as a stunt.

For everyone else, it was a brilliant move that is the culmination of years of dedicated fundraising, and has successfully achieved its desired result in a few short years by drawing the best and the brightest away from all the other top schools and, yes, vaulting NYU into a position as a top choice for tippy top applicants who do not qualify for need based scholarships at other top schools. It is what it is.

If any of its its newfound peers cared to match, they certainly have the ability and resources to do so. The expansion of the availability merit scholarships at schools like Penn and JHU are evidence that everyone is not sitting back and allowing NYU to poach all the top upper middle class students.

If not, money talks. What they did is the exact opposite of a gimmick or stunt, since it is a permanent endowment. There is really nothing else to do but welcome NYU to the T5, to the extent anyone cares about such things. The market has spoken.

 

[Princeton Medical Student]

Stunt? To me, it would be a $300K gift that I would otherwise have to pay back, with interest. I guess it's great for someone whose family can easily afford to write that check, or for someone who is counting on other people to subsidize their education through eligibility for need based financial aid, to turn their nose up at it and derisively refer to it as a stunt.

For everyone else, it was a brilliant move that is the culmination of years of dedicated fundraising, and has successfully achieved its desired result in a few short years by drawing the best and the brightest away from all the other top schools and, yes, vaulting NYU into a position as a top choice for tippy top applicants who do not qualify for need based scholarships at other top schools. It is what it is.

If any of its its newfound peers cared to match, they certainly have the ability and resources to do so. If not, money talks. What they did is the exactly opposite of a gimmick or stunt, since it is a permanent endowment. There is really nothing else to do but welcome NYU to the T5, to the extent anyone cares about such things.

The point would be a lot more valid if NYU had any semblance of a holistic admissions process that didn't already bias those with parental income well into the six figures.

 

[doomer_md]

Stunt? To me, it would be a $300K gift that I would otherwise have to pay back, with interest. I guess it's great for someone whose family can easily afford to write that check, or for someone who is counting on other people to subsidize their education through eligibility for need based financial aid, to turn their nose up at it and derisively refer to it as a stunt.

For everyone else, it was a brilliant move that is the culmination of years of dedicated fundraising, and has successfully achieved its desired result in a few short years by drawing the best and the brightest away from all the other top schools. It is what it is.

If any of its its newfound peers cared to match, they certainly have the ability and resources to do so. If not, money talks, it is the exactly opposite of a gimmick or stunt since it is a permanent endowment, and there is really nothing else to do but welcome NYU to the T5, to the extent anyone cares about such things.

I think you’re underestimating just how little 300k per student is to these schools. NYU didn’t make their tuition free out of the goodness of their hearts.

 

[deleted1114112]

Stunt? To me, it would be a $300K gift that I would otherwise have to pay back, with interest. I guess it's great for someone whose family can easily afford to write that check, or for someone who is counting on other people to subsidize their education through eligibility for need based financial aid, to turn their nose up at it and derisively refer to it as a stunt.

It literally is a stunt. I assume you're not from NYC? Despite free tuition, average indebtedness of NYU is actually more than Columbia and indebtedness is only 20k less than Sinai—you have to remember most of these schools already give out a lot of financial aid due to their status. Hofstra, a new NY school, is only raking in the high state people (despite it's low(er) rank) because their financial aid is essentially just free tuition.

COA at those schools is insanity. Same with Boston. I don't blame a lot of people for falling into this trap, though; scummy from NYU IMO but all the information is public so you just have to do your due diligence.

 

[KnightDoc]

I think you’re underestimating just how little 300k per student is to these schools. NYU didn’t make their tuition free out of the goodness of their hearts.

If that were true, they'd all be doing it.

 

[KnightDoc]

It literally is a stunt. I assume you're not from NYC? Despite free tuition, average indebtedness of NYU is actually more than Columbia and indebtedness is only 20k less than Sinai—you have to remember most of these schools already give out a lot of financial aid due to their status. Hofstra, a new NY school, is only raking in the high state people (despite it's low(er) rank) because their financial aid is essentially just free tuition.

COA at those schools is insanity. Same with Boston. I don't blame a lot of people for falling into this trap, though; scummy from NYU IMO but all the information is public so you just have to do your due diligence.

Exactly what is the source of this information? I GUARANTEE you that eliminating tuition from the equation will reduce the average indebtedness of NYU below all other NYC schools over time (not counting UG debt, which, obviously, has nothing to do with this and is beyond their control). Remember, NYU also gives additional money to those with need.

This program first started with the class that entered in 2019, and won't be graduating until 2023. It will take until the year after that for whatever surveys you are looking at to fully reflect the impact this policy has on average student indebtedness. One of the very reasons cited for the implementation of the program was to attack the problem you are referring to!

Again, just what is scummy about schools leveling the playing field by allowing ALL students, instead of only those who come from financially disadvantaged backgrounds, to graduate with little or no debt? After all, the debt would burden them equally, unless you believe that taxing the wealth of the parents of legally independent adults is the answer here.

 

[doomer_md]

If that were true, they'd all be doing it.

NYU’s medical school brought in 4.1 billion alone last year according to their website. Look, I’m not the type of person that complains about the COA of medical schools or inequality all day and I would love to go to NYU, but let’s be honest here, they just want to increase their US news rankings. I honestly don’t care that their rank is all the care about, I’m just calling it what it is.

Either way this is really off topic.

 

[deleted1114112]

Exactly what is the source of this information? I GUARANTEE you that eliminating tuition from the equation will reduce the average indebtedness of NYU below all other NYC schools over time (not counting UG debt, which, obviously, has nothing to do with this and is beyond their control). Remember, NYU also gives additional money to those with need.

This program first started with the class that entered in 2019, and won't be graduating until 2023. It will take until the year after that for whatever surveys you are looking at to fully reflect the impact this policy has on average student indebtedness.

Again, just what is scummy about schools leveling the playing field by allowing ALL students, instead of only those who come from financially disadvantaged backgrounds, to graduate with little or no debt? After all, the debt would burden them equally, unless you believe that taxing the wealth of the parents of legal independent adults is the answer here.

Average indebtedness in itself is not a highly useful figure of merit, but think about it like this.

Students at schools like NYU, Harvard, etc. are already extremely stratified towards the upper echelon of wealth. I would wager that a significant proportion of students at these schools do not have to worry about tuition in the first place, so indebtedness for them will be zero regardless of school. For students who actually need the tuition, they will get it anyways (or near it) at peer schools. NYU has the worst living/housing assistance program of the NYC schools from what I've heard from students picking between them.

Additionally COL in Manhattan is like, ~5-6k per month living extremely frugally, probably more if we are being realistic. Run the numbers, compare schools....anyways. If you are purely arguing that a middle-class person could benefit in NYC relative to other schools by going to NYU, yeah I would probably agree, but it's still a LOT of money if you compare outside of NY.

 

[KnightDoc]

Average indebtedness in itself is not a highly useful figure of merit, but think about it like this.

Students at schools like NYU, Harvard, etc. are already extremely stratified towards the upper echelon of wealth. I would wager that a significant proportion of students at these schools do not have to worry about tuition in the first place, so indebtedness for them will be zero regardless of school. For students who actually need the tuition, they will get it anyways (or near it) at peer schools. NYU has the worst living/housing assistance program of the NYC schools from what I've heard from students picking between them.

Additionally COL in Manhattan is like, ~5-6k per month living extremely frugally, probably more if we are being realistic. Run the numbers, compare schools....anyways. If you are purely arguing that a middle-class person could benefit in NYC relative to other schools by going to NYU, yeah I would probably agree, but it's still a LOT of money if you compare outside of NY.

Agreed. Average indebtedness has nothing to do with merit, and everything to do with net cost, and how students fund that cost. You said free tuition was a stunt, and pointed to NYU's average indebtedness as compared to other NYC schools as evidence of this. I just pointed out that whatever numbers you were looking at had to be dated, that the impact of free tuition has only begun to be reflected in those surveys, and that, over time, free tuition would significantly reduce the average debt of NYU MDs.

I have no idea what the wealth stratification is of students at top schools versus all the others, but, since top schools tend to have more generous need based aid programs, I'm not so sure that the students at top schools come from wealthier families than any other med schools.

In any event, spending other people's money is not my thing, and I'm reasonably certain a lot of people borrow for med school, regardless of how much money their parents have. If this were not the case, and you were correct, between extensive need based aid for those who are eligible, and rich kids being financed by their parents, average indebtedness at top schools should be around zero. Is it?

All of this said, @doomer_md is right, and this is way off-topic, even though you ARE the OP! We should either start a new thread or just end this!

 

[GreenDuck12]

I noticed that pretty much all schools in the T50 apart from some primary care-focused schools (i.e.UCSF and some other state schools) tend to send roughly the exact same proportion of students into 'competitive' specialties and the like. Obviously this doesn't represent the 'quality' of said residency program, but even if you cap it at T50, most programs matched are of high regard/it won't impact any prospects.

Is there a reason for this? Will this change when STEP 1 is P/F—will top schools send a larger proportion into competitive specialties?

Honestly knowing the type of people that get into schools like NYU, etc. I can't imagine that 80% of them want to go into primary care and 20% to pych/FM. Unless I'm completely wrong in a superficial judgement of that cohort,

Even then I'm still confused, as it seems to be a commonality on this forum that a top school = easier chance to competitive specialties/residencies. Yet, among the good residency programs for specialties, a large proportion just seem to be mega-volume systems at state schools (which of course are hard to get into) but for the most part seem to take a large proportion of students from their own programs.

A couple thoughts:
1. The P/F change for step 1 has yet to be implemented so it will be some time till we know how it will impact the interview process and the match. Many program directors have said that instead of using step 1 as a screening tool to winnow down the list of applicants who are reviewed, they will shift to using step 2.
2. Others have postulated that other factors may be more important such as LORs, research, grades (especially if the program has not switched to being ungraded for pre-clinical or clinical years).
3. It is possible that program directors will rely more on pulling students from known programs that have produced strong residents in the past - I don't think this is particularly different than it is now but it may be stronger in the future.
4. Many students enter medical school believing they are interested in one of the big 5 competitive specialties (probably 30% of my class was interested in ortho on day one) only to find that they are attracted to other areas of medicine. There are plenty of folks from top programs enter primary care fields for a variety of reasons - lifestyle, social justice, enjoying the work, etc.
5. That being said, programs at research powerhouse programs are more likely to have resources to help folks get into competitive specialties - more NIH funded research, more in house rotations, larger affiliated residency programs, etc.

There are certainly benefits attending a higher ranked program but IMO it is less about the numerical ranking and more about the potential for mentorship, research opportunities, and increased capacity for rotations in competitive specialties. Folks at top tier programs tend to perform higher on standardized tests such as the MCAT. They tend to also have above the mean class averages on step (which lends itself to being more competitive for competitive specialties). Is this due to a superior preclinical education or the result of selecting folks who tend to perform better on that metric?

I would prioritize evaluating offers between medical schools in the following way (assuming one has multiple offers):
1. Proximity to support network / ability to find/ create a support network - you never know when an emergency is going to pop up. It is not uncommon for someone to have to take a LOA due to a personal or family emergency - having a support system near by helps immensely.
2. Cost of the program and level of indebtedness after graduation. Everyone evaluates this one differently but cost is a huge factor. When choosing between 2 options, before picking the more expensive one - make sure you have really specific reasons for doing so other than it simply is ranked higher. Coming out with an extra 100k of debt will seriously impact one's net worth going forward - make sure that it will be worth it by doing your due diligence.
3. Availability of rotations in specialty of interest / affiliated hospitals with the medical school (a program affiliated with a wide variety of hospitals will have more to offer than one affiliated with a smaller rural hospital)
4. Opportunities to get involved in research - huge part of residency applications particularly in competitive fields. If the program does not have much research in the area you are interested in this can be a challenge for some specialties more than others.
5. Match lists - look at where the program routinely sends their graduates - is it to areas that you are interested in / to specialties you are interested in. If one program has matched one person in the last 5 years to the specialty you are interested in vs another program that matches 2-3 per year, pick the one with the stronger match rate.
6. Graded vs P/F. It may seem like a small thing but it is quite significant.
7. Student population: if you are a younger/older student, is the class make up similar or different to you? How will this impact you? Also try to figure out if the program tends to select folks who are more collaborative vs competitive. Depending on where you side on that equation being in a program opposite to your personal style may cause programs.

 

[srirachamayonnaise]

I noticed that pretty much all schools in the T50 apart from some primary care-focused schools (i.e.UCSF and some other state schools) tend to send roughly the exact same proportion of students into 'competitive' specialties and the like. Obviously this doesn't represent the 'quality' of said residency program, but even if you cap it at T50, most programs matched are of high regard/it won't impact any prospects.

Is there a reason for this? Will this change when STEP 1 is P/F—will top schools send a larger proportion into competitive specialties?

Honestly knowing the type of people that get into schools like NYU, etc. I can't imagine that 80% of them want to go into primary care and 20% to pych/FM. Unless I'm completely wrong in a superficial judgement of that cohort,

Even then I'm still confused, as it seems to be a commonality on this forum that a top school = easier chance to competitive specialties/residencies. Yet, among the good residency programs for specialties, a large proportion just seem to be mega-volume systems at state schools (which of course are hard to get into) but for the most part seem to take a large proportion of students from their own programs.

More and more schools are going P/F for both preclinical and clinical. Also a lot of schools are abandoning AOA. Top of the class becomes a moot point now. Competitive specialties care about where you go to med school, what research you have done and how dedicated you are to the field. Step 2 will be used as a screener soon.

 

[deleted1114112]

.

 

[voxveritatisetlucis]

Is it better to attend a school that gives preclinical grades now that the step 1 is pass/fail. Assuming similar rankings.

 

[KnightDoc]

Is it better to attend a school that gives preclinical grades now that the step 1 is pass/fail. Assuming similar rankings.

I'm sure it depends on the ranking. For top tier, probably not, if any top schools even still grade. For lower tier schools, the answer is probably yes, and anticipation of step 1 going p/f is probably a reason they never moved to p/f grading, since the step 1 move was speculated about for years before finally happening.

JMHO, but, as a current applicant, common sense dictates that you shouldn't need to distinguish yourself through grades at Harvard, but probably will at some random lower tier school now that step 1 is gone and no one really knows what's going to happen until it does.

 

[srirachamayonnaise]

Is it better to attend a school that gives preclinical grades now that the step 1 is pass/fail. Assuming similar rankings.

no. It's unnecessarily competitive by giving preclinical grades.

 

[GreenDuck12]

Is it better to attend a school that gives preclinical grades now that the step 1 is pass/fail. Assuming similar rankings.

Definitely not and here’s why: your job during preclinical years is to get ready to pass step 1, and to do all of the major research you are planning to have on your residency applications completed or mostly complete. Once clinical years hit your time will take a huge hit. Would you rather spend an extra 10 hours a week studying to get your in house exam scores as high as possible based off the subjective demands of your lecturers which likely do not align with step, or would you rather spend that time shadowing, doing research, or otherwise building up your CV while passing your in house exams?

 

[KnightDoc]

Definitely not and here’s why: your job during preclinical years is to get ready to pass step 1, and to do all of the major research you are planning to have on your residency applications completed or mostly complete. Once clinical years hit your time will take a huge hit. Would you rather spend an extra 10 hours a week studying to get your in house exam scores as high as possible based off the subjective demands of your lecturers which likely do not align with step, or would you rather spend that time shadowing, doing research, or otherwise building up your CV while passing your in house exams?

So why aren't all schools true P/F? Don't they want their students to succeed?

 

[GreenDuck12]

So why aren't all schools true P/F? Don't they want their students to succeed?

I can’t speak to the internal politics or motivations of medical programs. Since roughly 2015/2016 there are more pass/fail preclinical programs than there are for all other grading schemes combined. If choosing between two similar programs, I would pick the p/f program hands down. In every competitive specialty research ranks among the highest importance based on NRMP data with the vast majority of matched applicants having greater than 5 line items on their CV. It takes time and your first two years is when you should be getting most of this done.

 

[deleted1114112]

.

 

[KnightDoc]

Almost no school is true P/F. There are 5 or 6 IIRC (Harvard, Yale, UCSF, Mayo (?), Stanford, Sinai (?)). Meaning no AOA, Honors/high pass/pass/fail, no form of internal ranking (including hidden rankings in MPSE), etc. A lot of schools do the latter which is annoying and deceptive.

I don't have an exhaustive list, as some of this stuff is fairly difficult to find info about, but if anyone does that would be really helpful. In regards to @KnightDoc point, you'd have trouble finding a school in T50 that isn't P/F during pre-clinical aside from a few outliers.

@GreenDuck12 -- This ^^^ is what I'm talking about. It's clearly the trend for the upper tier schools. For the others, however, my understanding was that those schools that kept pre-clinical grading did so to give their over performers an edge in the match, since they are coming from lower tier schools and aren't going to have a step 1 score to rely on to distinguish themselves. Is this not possible?

This ties into everyone's concern about ranking being more important going forward. No one yet knows that this isn't going to be the case. That said, if one isn't fortunate enough to have a T50 option, would it really be a smart move to take a T130 P/F option if one can opt for a school that grades? Extra stress is a given, but the alternative is not being able to distinguish yourself academically at a T130 school, and hoping that research and LORs are enough to compete in the event step 2 does not become the new step 1.

 

[voxveritatisetlucis]

Is machine learning and big data the best way to get a lot of publications these days? Seems like this research can proceed much quicker than bench research. It is also applicable to any area of Medicine.

What are the most common languages used for this research?

 

[deleted1114112]

.

 

[GreenDuck12]

@GreenDuck12 -- This ^^^ is what I'm talking about. It's clearly the trend for the upper tier schools. For the others, however, my understanding was that those schools that kept pre-clinical grading did so to give their over performers an edge in the match, since they are coming from lower tier schools and aren't going to have a step 1 score to rely on to distinguish themselves. Is this not possible?

This ties into everyone's concern about ranking being more important going forward. No one yet knows that this isn't going to be the case. That said, if one isn't fortunate enough to have a T50 option, would it really be a smart move to take a T130 P/F option if one can opt for a school that grades? Extra stress is a given, but the alternative is not being able to distinguish yourself academically at a T130 school, and hoping that research and LORs are enough to compete in the event step 2 does not become the new step 1.

Many programs do still rank students and have AOA for CLINICAL years. I’m talking about preclinical years being p/f. Check my prior posts as they specify preclinical years being pass fail.

 

[srirachamayonnaise]

Is machine learning and big data the best way to get a lot of publications these days? Seems like this research can proceed much quicker than bench research. It is also applicable to any area of Medicine.

What are the most common languages used for this research?

Retrospective chart review and survey articles. Got 3 first authorship articles this way in M1.

 

[srirachamayonnaise]

After a bit more digging it seems like the schools I mentioned only do that for pre-clinicals, but then transition to still having some form of student ranking or 'comparative performance indicators (literally ranking, not sure why it's phrased like this...)" in the dean's letter that gets sent to residencies. All except for Yale and Mayo. So 2 schools, in reality.

It also seems like 'pass/fail' during preclinicals is a bit more widespread than I made it sound—I found a fair amount of schools ranked in the 60-90s that follow a similar pattern.

Honestly navigating this is much harder than it should, and MSAR since to disagree with school's own websites and current students' own experiences (is MSAR not updated?).

Agreed here, and you can even see this in T50s right now (relative to lower ranked schools, even slightly beyond there things seem to drop off quite quickly) without STEP 1 being P/F.

UCSF and Harvard too. No internal ranking, pf throughout, no AOA and no adjectives in MSPE.

 

[deleted555445]

Is machine learning and big data the best way to get a lot of publications these days? Seems like this research can proceed much quicker than bench research. It is also applicable to any area of Medicine.

What are the most common languages used for this research?

Python with Tensorflow

 

[collegestud2013]

Exactly what is the source of this information? I GUARANTEE you that eliminating tuition from the equation will reduce the average indebtedness of NYU below all other NYC schools over time (not counting UG debt, which, obviously, has nothing to do with this and is beyond their control). Remember, NYU also gives additional money to those with need.

This program first started with the class that entered in 2019, and won't be graduating until 2023. It will take until the year after that for whatever surveys you are looking at to fully reflect the impact this policy has on average student indebtedness. One of the very reasons cited for the implementation of the program was to attack the problem you are referring to!

Again, just what is scummy about schools leveling the playing field by allowing ALL students, instead of only those who come from financially disadvantaged backgrounds, to graduate with little or no debt? After all, the debt would burden them equally, unless you believe that taxing the wealth of the parents of legally independent adults is the answer here.

This. NYU just started being tuition free so the debt numbers you're looking at are still from previous classes. But this won't eliminate med school debt from NYU grads. They still have to pay for the living expenses of living in the most expensive city in the country and some will have pre-medical debt.

 

[collegestud2013]

So why aren't all schools true P/F? Don't they want their students to succeed?

Some schools, especially lower tier schools, believe that true P/F during pre-clinical years will lead to students being less prepared for Step 1; they would only have the incentive to study the minimum amount during the first 2 years to pass the classes, and this is obviously inadequate to do well on a scored Step 1. Even some of the top med schools have noticed slight drops in Step 1 scores in the past once they transitioned to P/F. Obviously with Step 1 being P/F this will no longer be an issue.

Almost no school is true P/F during the clinical clerkships of M3 year. And with a P/F Step 1 coming, this will just shift weight to Step 2 being used to stratify residency applicants. And since Step 2 is taken typically after M3 year, M3 year (which for most med students is already arguably the most stressful year in med school) will become even more high stakes. Med students will feel the pressure of having to do well on clinical rotations, shelf exams, AND now a higher stakes Step 2 exam.

 

[collegestud2013]

I noticed that pretty much all schools in the T50 apart from some primary care-focused schools (i.e.UCSF and some other state schools) tend to send roughly the exact same proportion of students into 'competitive' specialties and the like. Obviously this doesn't represent the 'quality' of said residency program, but even if you cap it at T50, most programs matched are of high regard/it won't impact any prospects.

Is there a reason for this? Will this change when STEP 1 is P/F—will top schools send a larger proportion into competitive specialties?

Honestly knowing the type of people that get into schools like NYU, etc. I can't imagine that 80% of them want to go into primary care and 20% to pych/FM. Unless I'm completely wrong in a superficial judgement of that cohort,

Even then I'm still confused, as it seems to be a commonality on this forum that a top school = easier chance to competitive specialties/residencies. Yet, among the good residency programs for specialties, a large proportion just seem to be mega-volume systems at state schools (which of course are hard to get into) but for the most part seem to take a large proportion of students from their own programs.

Yes, top med schools (as defined by US News Research ranking) will on average send a higher proportion of their grads to either more competitive specialties, or the most reputable programs within less competitive specialties. But I would argue that most of this comes of the selection process of students that attend these schools, as top med schools also tend to have higher Step 1 scores (though there are some exceptions). Also graduates from top med schools are more likely to go into academic medicine which involves being an expert in one niche rather than a generalist. And specialist training is much more suited to making you an expert in one area than just doing a FM or peds residency (assuming no additional fellowship training).

Also the school's reputation and opportunities definitely play a role as well. While top schools typically have strong departments and in-house residency programs for nearly every specialty, many lower tier med schools won't have in-house residency programs from the smaller specialties like plastics, neurosurgery, ENT, optho, derm. Obviously that doesn't mean grads from lower tier USMD schools can't match into competitive specialties but there are definitely larger obstacles to overcome. And yes it's much harder if to match into competitive specialties if you're coming from a DO or Caribbean school as many top programs won't even consider a DO or Caribbean grad no matter how good their grades, scores, or research are.

And while no knows for sure since the change to P/F Step 1 hasn't happened yet, the consensus is that a P/F 1 will benefit med students at well known prestigious med schools when matching into competitive specialties. There was a published survey of program directors in what factors they would look at once Step 1 transitions to P/F and many said they would consider the reputation of the students med school more highly. They also confirmed they would look at Step 2 more (but Step 2 can't 100% replace the role of Step 1 right way, since historically Step 2 has not been as rigorously tested for screening residency applicants by most programs)

 

[KnightDoc]

Some schools, especially lower tier schools, believe that true P/F during pre-clinical years will lead to students being less prepared for Step 1; they would only have the incentive to study the minimum amount during the first 2 years to pass the classes, and this is obviously inadequate to do well on a scored Step 1. Even some of the top med schools have noticed slight drops in Step 1 scores in the past once they transitioned to P/F. Obviously with Step 1 being P/F this will no longer be an issue.

Almost no school is true P/F during the clinical clerkships of M3 year. And with a P/F Step 1 coming, this will just shift weight to Step 2 being used to stratify residency applicants. And since Step 2 is taken typically after M3 year, M3 year (which for most med students is already arguably the most stressful year in med school) will become even more high stakes. Med students will feel the pressure of having to do well on clinical rotations, shelf exams, AND now a higher stakes Step 2 exam.

So, are you suggesting more lower ranked schools will now move to p/f for pre-clinical, now that step 1 is p/f? Seems counterintuitive to me, but you are the attending and I'm not!

 

[deleted1114112]

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[deleted1025488]

I think you are just overthinking it. Most schools in the T40-50 as dictated by NIH funding by AAMC or just research on USNews almost all have roughly (loosely stated) the same STEP 1 average and SD's for STEP 1 (it tapers off once you get into the 50s). This means that theoretically they should all have roughly the same distribution of residencies (very roughly) but it's still imperfect because some people want 'lesser competitive' specialties despite high STEP 1 scores, for a myriad of reasons.

In line with this, most T40 research schools have really strong at-home residences across the board and for the most part take a majority from their home institution. This includes large, strong state institutions like some UCs, UW, Ohio, Wisconsin, Pitt, etc. which really seem to take A LOT from their home institution medical school.

I don't see these state schools with relatively highly ranked competitive residencies completely abandoning their students in favor of the top privates just because STEP 1 is P/F. I think your perspective is just skewed, maybe you read on here too much and absorbed the notion that anything beyond T10 means your derm career is belly-up, but reality is far from that.

 

[Goro]

Is it better to attend a school that gives preclinical grades now that the step 1 is pass/fail. Assuming similar rankings.

PDs don't care about pre-clinical grades. As has been pointed out ad nauseum, they will use Step II as the screen.

 

[Browns99]

I love how NYU seems to have taken over the #1 elite school everyone thinks of now and not Hopkins or Harvard. I guess that free tuition stunt is really working.

As for the question NMRP match data shows the % of people that match a specialty that have AOA and same for the people that don't match for that specific specialty. AOA is typically given to highest ranked students in terms of preclinical grades. So for example, 40% of US seniors that matched neurosurgery were AOA, whereas 20% of of the unmatched pool were also AOA. Theoretically, if AOA didn't matter at all, both these numbers should be the same, and the higher the margin of between those who have AOA and match and those who have AOA but don't match should suggest that AOA/preclinical grades matter for that specialty. But at the same time, in uncompetitive specialties like child neurology, pathology, and PMR, out the of the people that do not match, 0% are AOA. In other words, every AOA member that applied to these 3 specialties matched. Vascular surgery and radonc actually have higher proportions of unmatched AOA members than matched AOA members, which would suggest AOA doesn't matter at all for them. (edit: this of course assumes that AOA is the only differentiating factor among applicants, which is obviously not the case)

So maybe a little? There's also people that graduate from unranked P/F schools (which I hear are also generally the top ranked schools?) make things more complicated. There's a possibility that all the non-AOA people that matched derm, NS, ENT come from these schools but I doubt it. I'd say it pales in comparison to what was Step 1 and research pubs. I hear most programs are just using Step 2 CK now, so fundamentally not much has changed.

Where did you hear that most programs are using Step 2CK? Don't come on the forum and give wrong information...you heard "most programs" from whom? I'm sure that Step 2 CK will be used as a screen or even take the place of Step 1, but they are not there yet, at least not "most programs."

NYU hating, free tuition stunt, if you want to post, know what you are saying first and then add something of value. Now, value means something that is not one's mere opinion or "what they heard" , rather something grounded in objective facts (i.e.- opinion of a program after rotating at that program). Those opinions can be negative or positive, but if they're are fact based, then they offer something of value to the readers here.

 

[efle]

It is indeed the case that the vast majority of competitive applicants choose not to pursue competitive specialties

Specialty Distribution of US MD Seniors with a 250+ Step 1 Score

This may be common sense to many, but was interesting to plot out for me. Based on the Tableau data for 2018. Many of us fall victim to heuristics, and one I caught myself thinking was that high board scores were synonymous with matching to a handful of specialties, most of the time. Namely...

forums.studentdoctor.net

Top schools tend to have a disproportionate number going after competitive specialties but even at a place like Hopkins or Harvard with high average boardscores and all the resources, when you look at their matchlist a majority are pursuing accessible specialties. Within those accessible specialties however they overwhelmingly match to big name academic centers.

 

[nimbus]

I love how NYU seems to have taken over the #1 elite school everyone thinks of now and not Hopkins or Harvard. I guess that free tuition stunt is really working.

As for the question NMRP match data shows the % of people that match a specialty that have AOA and same for the people that don't match for that specific specialty. AOA is typically given to highest ranked students in terms of preclinical grades. So for example, 40% of US seniors that matched neurosurgery were AOA, whereas 20% of of the unmatched pool were also AOA. Theoretically, if AOA didn't matter at all, both these numbers should be the same, and the higher the margin of between those who have AOA and match and those who have AOA but don't match should suggest that AOA/preclinical grades matter for that specialty. But at the same time, in uncompetitive specialties like child neurology, pathology, and PMR, out the of the people that do not match, 0% are AOA. In other words, every AOA member that applied to these 3 specialties matched. Vascular surgery and radonc actually have higher proportions of unmatched AOA members than matched AOA members, which would suggest AOA doesn't matter at all for them. (edit: this of course assumes that AOA is the only differentiating factor among applicants, which is obviously not the case)

So maybe a little? There's also people that graduate from unranked P/F schools (which I hear are also generally the top ranked schools?) make things more complicated. There's a possibility that all the non-AOA people that matched derm, NS, ENT come from these schools but I doubt it. I'd say it pales in comparison to what was Step 1 and research pubs. I hear most programs are just using Step 2 CK now, so fundamentally not much has changed.

FWIW I graduated from NYU eons ago. The teaching in IM clerkship and subinternship was the best part of the entire 4 years. We had more AOA members go into IM than any other specialty. And in my class most of the people who matched Ortho/ophtho/NS were not AOA. Granted it was a long time ago so things may have changed.

 

[YCAGA]

PDs don't care about pre-clinical grades. As has been pointed out ad nauseum, they will use Step II as the screen.

Some do care about AOA, at least as a way to screen for interviews. For instance, a "top" surgical sub-speciality residency faculty spoke to us about how doing quick screens like AOA and Step 1 >240 is a way to get to a more readable amount of applications. Then of course they also have to find a way to screen/read some non-AOA apps which according to him was a combination of having the student on an away rotation, going to that school for med school, and personal phone calls from big names in the field or alumni of the residency.

But I agree solely focusing on pre-clinical grades has never been a thing and won't be now. It is really AOA or not, and if not then it doesn't matter. And even then, AOA is not even top 5 of getting an interview or ranked highly, at least not based on survey data or anecdotes.

 

[KnightDoc]

Some do care about AOA, at least as a way to screen for interviews. For instance, a "top" surgical sub-speciality residency faculty spoke to us about how doing quick screens like AOA and Step 1 >240 is a way to get to a more readable amount of applications. Then of course they also have to find a way to screen/read some non-AOA apps which according to him was a combination of having the student on an away rotation, going to that school for med school, and personal phone calls from big names in the field or alumni of the residency.

But I agree solely focusing on pre-clinical grades has never been a thing and won't be now. It is really AOA or not, and if not then it doesn't matter. And even then, AOA is not even top 5 of getting an interview or ranked highly, at least not based on survey data or anecdotes.

So, is the consensus that now that step 1 is going p/f, there is zero reason for anyone to grade pre-clinical, and that we can expect all remaining schools to scrap it in the next few years? If not, why do any schools still have it? I always thought it was to help stars at low tiers distinguish themselves for the match, and not just to help with step 1.

 

[voxveritatisetlucis]

How good to be AOA? Top 5%, 15%?

Also inb4 step II goes pass fail

 

[KnightDoc]

How good to be AOA? Top 5%, 15%?

Also inb4 step II goes pass fail

Membership in AΩA may be attained as a medical student, resident, fellow, faculty member, alumni, clinician, or distinguished leader in medicine. Each school may elect up to 20% of the graduating class of students, up to 25 residents/fellows, up to 10 faculty, and three to five alumni, who, based on merit, demonstrate the characteristics of excellent physicians in alignment with AΩA's mission and values.

 

[voxveritatisetlucis]

Membership in AΩA may be attained as a medical student, resident, fellow, faculty member, alumni, clinician, or distinguished leader in medicine. Each school may elect up to 20% of the graduating class of students, up to 25 residents/fellows, up to 10 faculty, and three to five alumni, who, based on merit, demonstrate the characteristics of excellent physicians in alignment with AΩA's mission and values.

So is it usually the top 20% of scorers or do you have to be well liked amongst faculty?

 

[KnightDoc]

So is it usually the top 20% of scorers or do you have to be well liked amongst faculty?

I have no idea -- I just pulled it off their website to try to point you in the right direction. It's honestly the furthest thing from my mind right now!

As a premed though, does it really matter at all? Would you really choose one school over another, or an unranked school over a top ranked one, based on the existence of AΩA, or a better chance to be chosen?

 

[voxveritatisetlucis]

I have no idea -- I just pulled it off their website to try to point you in the right direction. It's honestly the furthest thing from my mind right now!

As a premed though, does it really matter at all? Would you really choose an unranked school over a top ranked one based on the existence of AΩA, or a better chance to be chosen?

Just curious because I will probably forget about it until like M3 (if i get in) and then it will be too late

 

[KnightDoc]

Just curious because I will probably forget about it until like M3 (if i get in) and then it will be too late

Yeah, I hear you. I've never been a big honor society person myself.

In general, if it's there and you're competitive, it's a nice to have. If not, it doesn't matter. What's important is to do as well as you can so that you can distinguish yourself in whatever way is possible.

Every school, from top to bottom, successfully places at least a few people in great residencies in great places every year. If that's your goal, the key is to put yourself in the best position to attain it. I don't know anything about AΩA at all, but, given the fact that every school doesn't do it, I'm reasonably sure it's not essential for success.

If it turns out to be important, there is no chance you will forget about it. Otherwise, it really won't matter!

 

[doomer_md]

Where did you hear that most programs are using Step 2CK? Don't come on the forum and give wrong information...you heard "most programs" from whom? I'm sure that Step 2 CK will be used as a screen or even take the place of Step 1, but they are not there yet, at least not "most programs."

NYU hating, free tuition stunt, if you want to post, know what you are saying first and then add something of value. Now, value means something that is not one's mere opinion or "what they heard" , rather something grounded in objective facts (i.e.- opinion of a program after rotating at that program). Those opinions can be negative or positive, but if they're are fact based, then they offer something of value to the readers here.

Well an adcom on here just confirmed what I said, so believe it if you want.

NYU hating, free tuition stunt, if you want to post, know what you are saying first and then add something of value. Now, value means something that is not one's mere opinion or "what they heard" , rather something grounded in objective facts (i.e.- opinion of a program after rotating at that program). Those opinions can be negative or positive, but if they're are fact based, then they offer something of value to the readers here.

Lol

FWIW I graduated from NYU eons ago. The teaching in IM clerkship and subinternship was the best part of the entire 4 years. We had more AOA members go into IM than any other specialty. And in my class most of the people who matched Ortho/ophtho/NS were not AOA. Granted it was a long time ago so things may have changed.

That’s actually not surprising. Top IM is very competitive.

 

[deleted1025488]

I don't know anything about AΩA at all, but, given the fact that every school doesn't do it, I'm reasonably sure it's not essential for success.

The vast majority of schools still have AOA or some form of academic stratification. I can count on one hand the schools that don't have either unless some have been added within the last year. Even then for 99.99% of us you still can't completely slack off if you want to match competitively (probably). But yes this is probably a non-issue for literally every premed because if you get into a non-AOA/ranking school you will probably 100% attend there without a doubt, and if you don't get in, well, then you have to deal with it anyway.

 

[voxveritatisetlucis]

Tbh NYU owes a lot to ken langone (Home Depot co-founder). I wonder how much it improved their win rate compared to Hopkins, Harvard, Stanford etc. Even though living in NYC likely costs 35k a year, still big deal. Free tuition.