Does the prestige of your medical school and residency/fellowship matter?

[brianwilson]

If you want to do private practice, what does it matter to be in a top tier residency.fellowship and med school? If you went to some bottom tiers and did well, ex over 250 MLE's, chief resident in residency, wouldn't you get the same type of job offers in the same pay range as other grads.

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[jjmack]

you will get offers. But I think they won't be the same. And the most selective practices may not make you an offer or as high an offer.

 

[FenderHM]

You probably would, but you might not get laid as much....

ha seriously, for private practice it doesn't really matter...only the networking necessary for academic medicine really necessitates going to a big name school.

 

[CTSballer11]

If you want to do private practice, what does it matter to be in a top tier residency.fellowship and med school? If you went to some bottom tiers and did well, ex over 250 MLE's, chief resident in residency, wouldn't you get the same type of job offers in the same pay range as other grads.

Everyone that makes it to their final year of residency is a chief resident. Also, your salary is based on what insurance companies feel your specialty deserves. Pretty much in private practice all of the job offers for recent docs who finished residency or fellowship is pretty much the same, in academics it is usually lower.

 

[newguy357]

Everyone that makes it to their final year of residency is a chief resident.

That is not true for all residencies.

 

[PhillyMD2006]

That is not true for all residencies.

yeah that really only applies to surgery residents

 

[CTSballer11]

yeah that really only applies to surgery residents

That is a misconception. There are no more residency's that have a pyramid system. Once you make it to the final year of residency in surgery you are guaranteed to be chief resident. That is why a ton of programs have like 4 or 5 chiefs. Stop getting your info from tv shows.

 

[TheMightyAngus]

For many residencies, your chief residency year is optional.

 

[Captain Fantastic]

That is not true for all residencies.

+1

My wife is a 3rd year IM resident (that would make it her last year). She is not chief resident -- she is simply a senior resident. The chiefs do administrative stuff like manage the jeapardy pool, make the schedules for the residents next year, etc. They have 4 chiefs because each person only serves as acting chief for a few months out of the year. It's a rotating basis where she's at -- but there are only 4 chiefs out of all the PGY-3s.

 

[HMSNeuro]

Stop getting your info from tv shows.

And I would suggest you stop making stuff up. sheesh

 

[MSIV]

CTSballer11 clearly has no idea what he is talking about. In internal medicine and pediatrics, 2 of the largest residency fields and both of which are 3 yrs in duration, NONE of the residents in their final year, ie PGY3's, are cheif residents.

For internal medicine, most of the time, chief residents are slected at the beginning of their 2nd year and stay on for an extra 4th year, while the rest of their classmates graduate after their 3rd year and go on to fellowship. Then there are other programs, like Hopkins, MGH, and cornell, in which the chief is someone who completed 1 year of fellowship and is asked to comeback to be a chief. Sure, a chief residency is optional, that is to say that you can turn it down, but it is an incredible honor and will set you up forever at that institution.

As for the posters original question...
It depends on what you want to go into. There are a few extremely competetive fields such as plastics, derm, and radiation oncology in which the reputation of your med school can be VERY helpful. For less competitive fields, such as internal medicine, if you are at the top of your class at ANY med school, ALL doors are open, even MGH. The differnece comes into play if you are in the middle of your class, at which point the person at the "better" med school has a considerable advantage for residency.

Now, why would you want to go to a "highly rated" residency program? Usually, the highly rated programs are highly rated for a reason...not only do they offer better research opportunities, but the training is better. Does that mean you can't be very well-trained from a "lower ranked" place. Certainly not, but medicine is all about percentages, and the chances are better that you will be better trained if you go to a better program. Also, better programs attract academic leaders. What better way to learn about a medical phenomenon than from the person who was the first to characterize it.

Finally, it is not true that private practices don't care where you trained. For example, while there are MANY cardiology practices in NYC, they are a few that are EXTREMELY lucrative and even fewer that are recruting. From talking with 3rd fellows, as long as you have an "easy-going", likable personality, the place that you trained can put you at a huge advantage at these exclusive practices. This is true for 2 reasons...first, as we said before, all else being equal, there is just a better percentage that the person from Harvard is better trained than the person from Podunck U and people feel more comfortable taking a chance on hiring someone from Harvard. 2nd the higher you go, the smaller everything gets, ie there is a ton of inbreeding. There is a better chance that higher ranked programs have placed fellows in these lucrative practices before, which means they are familiar with your fellowship program and are often friends with your letter writers.

In sum, you can't keep a smart doctor down. If you are really good, you will be successful and get to where you want to be no matter where you train. BUT its just a little easier if you go to highly ranked places. And if you are only end up being pretty good, going to highly ranked training programs may open doors that would not otherwise be available.

 

[Jupiter05]

So in the context of this very excellent advise, how would you rank training at the top 20 schools. Do you feel there is any difference between receiving the MD from Harvard, Columbia, U. Penn, UCSF, UCLA, etc?

 

[BOBODR]

CTSballer11 clearly has no idea what he is talking about. In internal medicine and pediatrics, 2 of the largest residency fields and both of which are 3 yrs in duration, NONE of the residents in their final year, ie PGY3's, are cheif residents.

For internal medicine, most of the time, chief residents are slected at the beginning of their 2nd year and stay on for an extra 4th year, while the rest of their classmates graduate after their 3rd year and go on to fellowship. Then there are other programs, like Hopkins, MGH, and cornell, in which the chief is someone who completed 1 year of fellowship and is asked to comeback to be a chief. Sure, a chief residency is optional, that is to say that you can turn it down, but it is an incredible honor and will set you up forever at that institution.

As for the posters original question...
It depends on what you want to go into. There are a few extremely competetive fields such as plastics, derm, and radiation oncology in which the reputation of your med school can be VERY helpful. For less competitive fields, such as internal medicine, if you are at the top of your class at ANY med school, ALL doors are open, even MGH. The differnece comes into play if you are in the middle of your class, at which point the person at the "better" med school has a considerable advantage for residency.

Now, why would you want to go to a "highly rated" residency program? Usually, the highly rated programs are highly rated for a reason...not only do they offer better research opportunities, but the training is better. Does that mean you can't be very well-trained from a "lower ranked" place. Certainly not, but medicine is all about percentages, and the chances are better that you will be better trained if you go to a better program. Also, better programs attract academic leaders. What better way to learn about a medical phenomenon than from the person who was the first to characterize it.

Finally, it is not true that private practices don't care where you trained. For example, while there are MANY cardiology practices in NYC, they are a few that are EXTREMELY lucrative and even fewer that are recruting. From talking with 3rd fellows, as long as you have an "easy-going", likable personality, the place that you trained can put you at a huge advantage at these exclusive practices. This is true for 2 reasons...first, as we said before, all else being equal, there is just a better percentage that the person from Harvard is better trained than the person from Podunck U and people feel more comfortable taking a chance on hiring someone from Harvard. 2nd the higher you go, the smaller everything gets, ie there is a ton of inbreeding. There is a better chance that higher ranked programs have placed fellows in these lucrative practices before, which means they are familiar with your fellowship program and are often friends with your letter writers.

In sum, you can't keep a smart doctor down. If you are really good, you will be successful and get to where you want to be no matter where you train. BUT its just a little easier if you go to highly ranked places. And if you are only end up being pretty good, going to highly ranked training programs may open doors that would not otherwise be available.

MSIV. I can't thank you enough for that cohesive, well thought out answer that makes sense. You obviously talk from experience. Could you answer one more question.
What is more important for getting into a practice, or academic medicine position. Your medical school or where you did your residency? Theoretical example. I go to NYMC and do extremely well and then do a residency at Cornell. Are doors going to be closed or is it going to be a lot harder to get a faculty position at the top academic centers in the country (uDuke, Yale etc)? Is your medical school going to matter that much, or do other doctors who are looking to hire, look more at your residency? Thank you for your thoughts.

 

[MSIV]

When you say "Do you feel there is any difference between receiving the MD from Harvard, Columbia, U. Penn, UCSF, UCLA, etc?", I don't know if you are asking if the quality of the training will be different or if your competiveness will be different.

As for the quality of the training, it totally depends on what field you want to go into. Programs like Bascom-Palmer (UMiami) and U Cinncinati are at the top for ophtho and emergency medicine, respectively. If you want to go into either of these fields, your training at those places will be top-notch. That "may" not be true for other fields.

If you are asking about your "competitiveness" upon graduating...
*it should be noted that most residency programs REALLY favor their own students.*

With that said, it all matters what you want to go into. To use the same example, if you go to U Miami for med school, this may not seem to be "the most prestigious", but you may be able to set yourself for an amazing ophtho residency. And since ophto programs are really small (around 5 people/year), there is guaranteed to be very good applicants at Harvard, Hopkins, Penn, etc who want to go to Bascom but will not be able to. Not a very big deal for them, because they will certainly get into somewhere else that is very good, but it would be sad if they were dead set on going to Miami.

In terms of "general competitiveness", it is only meaningful to place schools into tiers. Within a tier, residency directors do not differentiate between schools. The following is my assessment, supported by the internal medicine program director at my school, and supported by the applicant experience of friends and acquaitances at other schools who I met on the interview trial.

Tier 1: Harvard and Hopkins are probably in a class by themselves.

Tier 2: UCSF, University of Pennsylvania, Duke, Stanford, Washington University, Columbia P&S, Yale, University of Washington, UT-Southwestern, University of Michigan, UCLA, Vanderbilt, Cornell, University of Chicago, Baylor, Mayo

Tier 3: University of Pittsburgh, UCSD, Northwestern, Emory, Mount Sinai, New York University, Case Western Reserve, University of North Carolina, University of Virginia, Boston University, University of Wisconsin, Oregon HSC, University of Alabama, University of Colorado, Brown, University of Rochester, Tufts, USC, Dartmouth, University of Iowa, Albert Einstein, University of Maryland, Georgetown, Wake Forest, Thomas Jefferson, Tulane, University of Cincinnati, Ohio State, University of Connecticut, UMass, Indiana University, UC-Irvine UC-Davis (i'm sure I forgot some)

Tier 4😛retty much everything else

Of course, if you know you want to go to Columbia for residency, then you have an advantage if you go to Columbia over an equal program like Penn. Also, if you know you want to be in NYC, you will probably be at an advantage to go to a NY med school because, like I said, it gets really small and there is a better chance that residency admissions officers will know people you have worked with.

 

[CTSballer11]

CTSballer11 clearly has no idea what he is talking about. In internal medicine and pediatrics, 2 of the largest residency fields and both of which are 3 yrs in duration, NONE of the residents in their final year, ie PGY3's, are cheif residents.

For internal medicine, most of the time, chief residents are slected at the beginning of their 2nd year and stay on for an extra 4th year, while the rest of their classmates graduate after their 3rd year and go on to fellowship. Then there are other programs, like Hopkins, MGH, and cornell, in which the chief is someone who completed 1 year of fellowship and is asked to comeback to be a chief. Sure, a chief residency is optional, that is to say that you can turn it down, but it is an incredible honor and will set you up forever at that institution.

As for the posters original question...
It depends on what you want to go into. There are a few extremely competetive fields such as plastics, derm, and radiation oncology in which the reputation of your med school can be VERY helpful. For less competitive fields, such as internal medicine, if you are at the top of your class at ANY med school, ALL doors are open, even MGH. The differnece comes into play if you are in the middle of your class, at which point the person at the "better" med school has a considerable advantage for residency.

Now, why would you want to go to a "highly rated" residency program? Usually, the highly rated programs are highly rated for a reason...not only do they offer better research opportunities, but the training is better. Does that mean you can't be very well-trained from a "lower ranked" place. Certainly not, but medicine is all about percentages, and the chances are better that you will be better trained if you go to a better program. Also, better programs attract academic leaders. What better way to learn about a medical phenomenon than from the person who was the first to characterize it.

Finally, it is not true that private practices don't care where you trained. For example, while there are MANY cardiology practices in NYC, they are a few that are EXTREMELY lucrative and even fewer that are recruting. From talking with 3rd fellows, as long as you have an "easy-going", likable personality, the place that you trained can put you at a huge advantage at these exclusive practices. This is true for 2 reasons...first, as we said before, all else being equal, there is just a better percentage that the person from Harvard is better trained than the person from Podunck U and people feel more comfortable taking a chance on hiring someone from Harvard. 2nd the higher you go, the smaller everything gets, ie there is a ton of inbreeding. There is a better chance that higher ranked programs have placed fellows in these lucrative practices before, which means they are familiar with your fellowship program and are often friends with your letter writers.

In sum, you can't keep a smart doctor down. If you are really good, you will be successful and get to where you want to be no matter where you train. BUT its just a little easier if you go to highly ranked places. And if you are only end up being pretty good, going to highly ranked training programs may open doors that would not otherwise be available.

I was talking about surgery not internal med or pediatrics.

 

[kam730]

That is a misconception. There are no more residency's that have a pyramid system. Once you make it to the final year of residency in surgery you are guaranteed to be chief resident. That is why a ton of programs have like 4 or 5 chiefs. Stop getting your info from tv shows.

Umm, I don't know where you get your info from, but it's false. In surgery all 5th year residents are chiefs, but in medicine the chief resident has already finished residency and is technically the same level as attending. There is usually some competition to become a chief resident in medicine, or peds or other similar fields.

 

[MSIV]

The previous post was in response to Jupiter.

As for BOBODR...
All anyone cares about is where you did YOUR LAST STAGE OF TRAINING.

-Residencies only care about med school; they could care less about where you went to college.
-Fellowships only care about residency; they could care less where you went to med school.
-Hiring officers only care about where you did your fellowship, because only this will tell them what kind of specialist you will be.

The only situation in which this may not be completely true, is with those connections I was talking about. Those never go away. If you worked with a doctor while in residency at Columbia 10 years ago and the guy that is interviewing you at your Cardiology job interview is best friends with him, he may call this mutual acquaintance up and ask for his opinion. But that is mostly luck. This may happen to you from NYMC, but its just a little more likely to happen from Columbia.

In sum, there are no "cast systems" in medicine...if you do well, you can always advance.

 

[CTSballer11]

Umm, I don't know where you get your info from, but it's false. In surgery all 5th year residents are chiefs, but in medicine the chief resident has already finished residency and is technically the same level as attending. There is usually some competition to become a chief resident in medicine, or peds or other similar fields.

The post above yours i said that I was refering to surgery.

 

[BOBODR]

The previous post was in response to Jupiter.

As for BOBODR...
All anyone cares about is where you did YOUR LAST STAGE OF TRAINING.

-Residencies only care about med school; they could care less about where you went to college.
-Fellowships only care about residency; they could care less where you went to med school.
-Hiring officers only care about where you did your fellowship, because only this will tell them what kind of specialist you will be.

The only situation in which this may not be completely true, is with those connections I was talking about. Those never go away. If you worked with a doctor while in residency at Columbia 10 years ago and the guy that is interviewing you at your Cardiology job interview is best friends with him, he may call this mutual acquaintance up and ask for his opinion. But that is mostly luck. This may happen to you from NYMC, but its just a little more likely to happen from Columbia.

In sum, there are no "cast systems" in medicine...if you do well, you can always advance.

Thanks.

 

[PickyBicky]

That is a misconception. There are no more residency's that have a pyramid system. Once you make it to the final year of residency in surgery you are guaranteed to be chief resident. That is why a ton of programs have like 4 or 5 chiefs. Stop getting your info from tv shows.

As the previous posters have pointed out, this is not true for all residencies. For example, in internal medicine, the chief year is an additional year outside of the standard 3 year program. Further, in IM, only a selected few from each class are chosen to be chiefs. Other residency programs may vary. In at least some EM programs, chiefs are chosen from among members of the senior residents, but not all members of class are chosen, nor are the chiefs required to take an extra year to serve as chief. The bottom line is that the selection requirements, job descriptions, and time individuals serve as a chief resident vary by discipline, and in some cases, even by program. You, sir, are the one who needs to temper their arrogance and ignorance.

-PB

 

[CTSballer11]

As the previous posters have pointed out, this is not true for all residencies. For example, in internal medicine, the chief year is an additional year outside of the standard 3 year program. Further, in IM, only a selected few from each class are chosen to be chiefs. Other residency programs may vary. In at least some EM programs, chiefs are chosen from among members of the senior residents, but not all members of class are chosen, nor are the chiefs required to take an extra year to serve as chief. The bottom line is that the selection requirements, job descriptions, and time individuals serve as a chief resident vary by discipline, and in some cases, even by program. You, sir, are the one who needs to temper their arrogance and ignorance.

-PB

Did you not read the two posts above where i clarified my initial statement. I was refering to surgery.

 

[PickyBicky]

Did you not read the two posts above where i clarified my initial statement. I was refering to surgery.

Another CT surg "wanna be" tool...

-PB

 

[06applicant]

Stop getting your info from tv shows.

Yeah, get it from strangers on message boards

 

[CTSballer11]

Another CT surg "wanna be" tool...

-PB

First off I am not a CT surg wanna be and second I clarified my intial post about three times. Stop throwing out insults, I never insulted you or anyone on this board. I will say it one last time, there is no such thing in a surgical residency as a pyramidal program and every person who makes it to the PGV level becomes chief resident. No that does not apply to pediatrics, internal med, etc, just gen surgery.