Originally posted by Tezzie
Huh? Most of the hospitals on the Downstate match list seem to be great. From well known to very prestigious.
Oh and something else. You will be surprised how many "elite" med schools have a bad name around with medical directors because their grads were sub-par.
All this "prestige" and "connections" crap are just made up stories. You do well then great. The school isn't going to put you anywhere. You have to do the work. On top of that i prefer to model myself after the top grads. What good does it do if you get into Harvard and finish last?
Furthermore all this BS about how great your career will be is just from kids who don't know what they are talking about. Try graduating from Columbia med with 250k debt, stay at Presbyterian and go into IM and see how many years it will take you to pay them off (while living in NYC) vs the UofIl graduate who did IM in whatever hospital. The salaries will be similar and guess who is the one with the best lifestyle in the end?
Since the OP asked about residency, I am just trying to present the facts as it is regarding the med school a person attends and applying to residency. I am NOT, in any way, trying to tell anyone that one definitely should go to a "prestigious" school. Everyone has different career goals and needs, and only the applicants themselves can decide what's best for them. In the end, we're all going to be doctors, and I respect all my future colleagues in whatever fields they choose.
That being said, as you can see from what's been posted by many MS4s undergoing the residency application process, where a person goes to med school DOES matter. As a forth year med student going through the same process myself, I can certainly attest to that. While Downstate definitely has people matching into competitive programs, the percentage of people doing so at places like Hopkins or Stanford are much higher. Furthermore, the percentages of people matching into competitive specialties such as radiology, surgery, ortho, etc., are much higher as well. There are several reasons to this. Many of these programs are very small, with a total of maybe 200-300 spots nationally. Therefore, in these specialties where most applicants have high board scores, the "connection" and who writes your recommendation can end up playing a very big role in your application. In top tier schools, you are more likely to have attendings and department chairs who are very well-known in their fields. Their recommendations will carry much more weight in the process. You have to remember that many of the competitive specialties are like little cliques. In addition to strong academic records, knowing the right people and having the right person make a call to the residency program director for you are the other keys to success in this process. With the small number of spots and high number of applicants in these specialties, it is not just a matter of going to a "prestigious" program vs a smaller community program. It can be the difference between matching and not matching at all.
As for the reputation of graduates from different med schools in the eye of residency program directors, I think one can look at the US News ranking for reference. There is one section of the ranking in which residency program directors rate the med schools. That's a good objective guage on how program directors perceive graduates from different med schools. As you can see, many of these "prestigious" med schools received the highest ratings from the program directors, the very same people who will be reading the residency applications.
As for why care about doing a residency at a "high end" program for other less competitive residencies like IM? Well, that brings us to the next level of the process: fellowship. If you want to do a fellowship after IM, especially in competitive fields like cardiology or GI, doing your residency at a competitive, academic program will help you a lot in getting a position. The reason is pretty much the same as above. The only difference is, during residency, there is no grade. There is no score. There is nothing like exam, GPA, or class rank to distinguish among applicants. All that they have are subjective written recommendations from faculty at your program. Therefore, connections, knowing the right people, having "big-name" LOR writers become even more important in this process. The other big factors in fellowship applications are research and publication. Most of these "prestigious" residency programs are well-known because of their research. That is another reason why, if you want to do a fellowship, going to a competitive, academic residency program will be beneficial. That being said, there are residents from less competitive programs that match into cardiology or GI. But there are also many that don't.
Unfortunately, the process becomes more and more arbitrary and subjective as you move on. The med school application process, believe it or not, is actually the least arbitrary and least dependent on intangibles like school reputations and prestige when compared to residency and fellowship apps. Whether or not that's totally fair? I don't know.
The last thing (I know this is getting very long) I want to respond to is the whole lifestyle/salary thing. No doctors are going to struggle and starve, evening with all those med school debts. I think many who are trying to get into these "presitigious" programs are those planning to pursue academic medicine, including myself. Given that academic medicine pays SIGNIFICANTLY less than private practice, I doubt that too many academic physicians care much about the whole lifestyle/salary thing. Most of them that I've seen are just as happy and satisfied with their jobs and salary as any private doctors I've seen.
The closing question is for Tezzie: why did you choose to go to Wash U undergrad as oppose to your state school for college? Maybe similar mentality would be applicable to those wanting to go to "top tier" med schools as well.
