From SDN user: SoCalDreamin'
My conclusions regarding strength of application are as follows:
1.) An outstanding Step I score and/or AOA is the ticket for the ultra-competitive specialties, and we all know what they are.
2.) For Medicine, two factors bear more weight that an outstanding Step I score and/or AOA; such factors include:
a.) Strength/rank/reputation of your medical school
b.) Getting letters of recommendation from nationally renowned physicians
However, these statements in no way imply that one should not try hard to obtain a good Step I score and a high class rank. These two factors might get you that top interview, even if your medical school's rank or the prestige of letter writers is not super-stellar. With this information in mind, let's consider the following 2 applicants:
On the one hand, we have med student X with the following statistics:
* Step 1 = 245
* AOA
* Attends a medical school that is not ranked in terms of NIH research funding or in US News & World Report
* Has letters of rec from 3 faculty members that are not well-published
On the other hand, we have med student Y with the following statistics:
* Step 1 = 225
* No AOA
* Attends a medical school that is ranked in terms of NIH research funding or in US News & World Report (e.g. Stanford, UCSF, HMS, UT Southwestern)
* Has a letter or rec from Dr. Topol of the Cleveland Clinic that is based on a cardiology elective he did there at the beginning of his fourth year
Of these two candidates, whom do you think will be more likely to land interviews at MGH and Brigham & Women's? If you said med student Y, then you are correct.
Luckily for me, I am not hung up on silly things such as rankings and academic reputation, so none of the above information mattered to me when it came down to deciding where I wanted to go for residency. Much larger factors weighed on my mind, such as work environment and house staff support, and most importantly, if I was going to be happy at a particular program. Things worked out just the way I wanted them to, and I couldn't be any happier.
From SDN user: SuFiBB
from my experience from going through the whole application ordeal, some programs indicated that they place significant emphasis on the IM department chairman's letter which reflects your performance in your sub-I because most of what you do in your internship is similar to your sub-I rotation. whatever you do, do as well as you can for your sub-I to form the basis for a good chairman's letter. read before, learn the pocket intern survivor's guide, take a few electives beforehand, learn cross-cover emergency stuff, learn how to write orders such as admit orders, and prepare & memorize each presentation you give about a patient during rounds to your attending.
From SDN user: Renovar
I would have to say that looking at my experience and my classmates', the biggest break point for competitive IM, at least for interview purposes, is going to be:
1. AOA vs non AOA
and
2. The "eliteness" of your med school - top 10 vs Top25 or so vs the rest
Step 1 score is massively overrated for IM. I agree, higher is ALWAYS better, but there is a point where any higher wont do you any more good - and this point is surprisingly low. I'd boldly say that anything above mid-230's (mid-high 90's on 2 point) should keep all doors open, and it will be up to your other stats to get you interviews.
I ran into this dude on my interview trail from HMS, openly stated that he is below average in his class and got below average Step 1, and still got interviews at everywhere he applies (places like Stanford, UCSF, JHU, HMS hospitals, etc). That just goes about saying how much advantange an elite med school carries you in this process.
From SDN user Kalel:
I agree with many of the things stated above. In IM, I think that step I is mainly used as a cutoff. However, after seeing a few of my classmates who I know had below avg step I scores but seemingly strong clinical skills not match where they wanted to go (but got interviews at), I wonder how much of a factor it really is used to evaluate your app in IM. In general, AOA and avg step I will probably get you farther in IM then 260 step I and poor clinical evaluations. I dont know how much of their below average step I score played into where they matched, but I did notice that my classmates who scored above average on step I were able to match into one of their top 2-3 choices. A confounder in this observation is that those who did not do as well on step I probably do not do as well on their shelves, which can adversely affect their clinical grades as well. I strongly agree with the assertion that a schools reputation plays a huge role in where one will be able to get interviews at. I know of a student at a top 5 medical school who had below average step I and clinical grades but who was able to secure a good number of interviews at top-ranked schools which were not interviewing many of my classmates who had better step I scores and grades but who came from my state school. I still dont think that its worth a lot of extra money to go to a top 20 school just so that you can get into a top 20 IM residency because many students from unranked schools are still able to secure top IM residencies (they just have to be a little bit more competitive), and there are many unranked IM residencies that are still excellent training programs and have very high placements ratios in all competitive fellowships. Ultimately, if you are good, I think that you will be able to get whatever specialty you want to in IM coming from whatever school you are coming from in the US.
agreed
