Does med school prestige matter for IM Residency?

[LondonFog1997]

As I'm making my final medical school decision, I have been looking at the residents at the top 20 IM residency programs, and I've noticed it seems like a mixed bag - half come from top tier schools, around half from other mid to low-tier schools, and even some IMGs in the mix as well. To me it seems as if IM residency placement stems from performance in school, and that it is possible to break into JHU/MGH/BWH/Stanford IM if you're not from a top-tier school.

I am highly interested in IM (I know I'm not interested in any surgical specialties) and while I have been accepted at a T20 school, I am considering taking my cheaper IS option because IM isn't one of the highly compensated specialties like surgery is. It seems that T20 pays off the most when you're looking at competitive specialties like neurosurg, orthopedics, dermatology... Would anyone be able to provide insight into this? Am I missing something here?

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[Lawpy]

Top tier IM programs are extremely competitive (experts here say it's comparable to surg specialties/derm etc) and it's a huge boost to go to a T20 med school. T20 school offers a lot of research opportunities and a strong networking potential that will undoubtedly be valuable when applying for residency.

 

[siliso]

You’ll be able to do IM from anywhere. Academic IM from any USMD school. Top tier name IM more of a crapshoot and you’d probably have a marginally better shot from a top tier med school. But if you can kill it and distinguish yourself anywhere, you can get anywhere from anywhere and do anything you want.

 

[puahate]

Yes it matters.

 

[LondonFog1997]

Top tier IM programs are extremely competitive (experts here say it's comparable to surg specialties/derm etc) and it's a huge boost to go to a T20 med school. T20 school offers a lot of research opportunities and a strong networking potential that will undoubtedly be valuable when applying for residency.

The networking potential makes sense; what about if a person at a mid-tier takes initiative to find research at their school, presents at conferences, publishes, etc. I understand top-tiers have more research opportunities, but is research conducted at a top tier automatically considered more highly than research conducted at a mid-tier?

 

[Lawpy]

The networking potential makes sense; what about if a person at a mid-tier takes initiative to find research at their school, presents at conferences, publishes, etc. I understand top-tiers have more research opportunities, but is research conducted at a top tier automatically considered more highly than research conducted at a mid-tier?

Broadly speaking, publications and presentations are valuable no matter where you go. But its easier to get more research opportunities and publish in stronger journals at a top school that is filled with excellent faculty, many resources and lots of NIH money.

Its the matter of comparing relative difficulty between schools. Its easier to get a lot of things done at top school but doesnt mean its impossible to do the same at any US MD school. As you've seen and siliso noted, if you can distinguish yourself anywhere and prepare an outstanding application, you'll match where you want. But why make things harder when the top school is helping you?

 

[siliso]

I guess the other thing to consider are your aspirations and motivations. For me I wanted to be a physician who primarily takes care of patients and teaches in my home community where my family is. Regardless of what specialty I wanted I could have gotten to it from my state school, because it’s huge with every residency and I had the academic chops. If my aspirations were to have a nationally/internationally prestigious career in research, executive leadership, etc then shooting for top 20 would have made more sense.

 

[LondonFog1997]

Broadly speaking, publications and presentations are valuable no matter where you go. But its easier to get more research opportunities and publish in stronger journals at a top school that is filled with excellent faculty, many resources and lots of NIH money.

Its the matter of comparing relative difficulty between schools. Its easier to get a lot of things done at top school but doesnt mean its impossible to do the same at any US MD school. As you've seen and siliso noted, if you can distinguish yourself anywhere and prepare an outstanding application, you'll match where you want. But why make things harder when the top school is helping you?

I guess there's just this paradox for me right now: I go to the higher ranked school, take out more loans, and then go into an academic position where there is already a pay-cut. Seems like it would be much more difficult to pay off those loans and I'm wondering if I would be making my life much harder in the future post-residency?

 

[Lawpy]

I guess there's just this paradox for me right now: I go to the higher ranked school, take out more loans, and then go into an academic position where there is already a pay-cut. Seems like it would be much more difficult to pay off those loans and I'm wondering if I would be making my life much harder in the future post-residency?

I see the difficulty but it's getting a bit too far ahead, so i'll tag @siliso @aProgDirector for further inputs on academic IM regarding the finances and loan repayment

 

[siliso]

I have a standard amount of loans (250+) and an academic/VA GIM salary in early practice and don’t find that I’m overburdened making the payments on REPAYE/PSLF hopefully basis. Still room to live comfortably and save. If you were talking free and clear vs standard loan burden the calculus would be different.

 

[Med Ed]

As I'm making my final medical school decision, I have been looking at the residents at the top 20 IM residency programs, and I've noticed it seems like a mixed bag - half come from top tier schools, around half from other mid to low-tier schools, and even some IMGs in the mix as well. To me it seems as if IM residency placement stems from performance in school, and that it is possible to break into JHU/MGH/BWH/Stanford IM if you're not from a top-tier school.

I am highly interested in IM (I know I'm not interested in any surgical specialties) and while I have been accepted at a T20 school, I am considering taking my cheaper IS option because IM isn't one of the highly compensated specialties like surgery is. It seems that T20 pays off the most when you're looking at competitive specialties like neurosurg, orthopedics, dermatology... Would anyone be able to provide insight into this? Am I missing something here?

You're not missing anything. The only way it makes partial sense to pay a bunch of extra money for IM is if you're absolutely hellbent on JHU/MGH/BWH/Stanford. Otherwise you can go cheaper and easily match into one of the countless excellent university-based IM programs around the country. That route will leave you at no disadvantage should you choose to specialize.

 

[Med Ed]

I guess there's just this paradox for me right now: I go to the higher ranked school, take out more loans, and then go into an academic position where there is already a pay-cut. Seems like it would be much more difficult to pay off those loans and I'm wondering if I would be making my life much harder in the future post-residency?

For some perspective on the competitiveness of the IM match, this past cycle had 8,116 categorial IM positions and only 3,966 US senior applicants. That's a difference of 4,150 training slots.

This is partly why you see people from mid/low-tier MD schools well represented at highfalutin programs.

 

[siliso]

Not just top 20 or any at all USMD grads but also DOs and IMGs who get into my solidly midwestern university IM program can and do go to any and all specialties. This is true that nothing is foreclosed to you because of your med school. Even much less if you’re the sort of student who had multiple choices to pick from.

 

[scarletgirl777]

As I'm making my final medical school decision, I have been looking at the residents at the top 20 IM residency programs, and I've noticed it seems like a mixed bag - half come from top tier schools, around half from other mid to low-tier schools, and even some IMGs in the mix as well. To me it seems as if IM residency placement stems from performance in school, and that it is possible to break into JHU/MGH/BWH/Stanford IM if you're not from a top-tier school.

I am highly interested in IM (I know I'm not interested in any surgical specialties) and while I have been accepted at a T20 school, I am considering taking my cheaper IS option because IM isn't one of the highly compensated specialties like surgery is. It seems that T20 pays off the most when you're looking at competitive specialties like neurosurg, orthopedics, dermatology... Would anyone be able to provide insight into this? Am I missing something here?

You will absolutely be able to get into a great academic IM program from either choice. Of course people like to be able to brag about their incoming residents accomplishments including but not limited to wherever they went to med school, but not matching into a good IM program is not a real concern here.

I would say though that most premeds are wrong about what residency they want to try to match for. If you are lucky enough to have the option, it's best to pick a school that won't throw up an extra burden into matching to any specialty you choose, no matter how niche or competitive.