Does your program recruit from within?

[MiddleRoad]

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The program where I matched has almost half of the incoming residents from it's home medical school. The psych program from my medical school did not have anyone match from my class.

From the outside, how do people usually view these different situations? I know from my own school that none of us going into Psych ranked our home program at the top because we all matched into our first choices somewhere else. On the flip side, one could see a program with a lot of people from the same home medical school as having problems recruiting strong candidates from other places.

Since I've only seen this from the perspective of an applicant, I'm curious how residents and attendings feel about recruiting med students from their home institution. Would you be surprised if none of the med students from your own institution matched into your program? What about the opposite, if a large percentage of the residents were all people who went to that same medical school?

 

[billypilgrim37]

Depends probably on a few factors.

The first, some schools have strong opinions about keeping their own students, which can go for or against. They might like having their own because they are known quantities, have already rotated on their service, have established themselves on rotations, etc. They know what they are getting. However, there are also some rumors of a few places who avoid ranking too many of their own to encourage more diversity in the class. Well, there's only one place that's rumored to do this, in New York. I'm not sure how many of us buy it. The other thing too, if a student does really suck, then a home program will know to shoo them elsewhere.

Interestingly, the few times I've seen someone shoo'ed away, they have wound up matching at more prestigious programs than they were shoo'ed away from. They probably didn't do well at those programs, because they sucked if you knew them, even if they might look good on paper.

The other factor is that psychiatry is a relatively easy match, so most people can wind up matching at a "better" psychiatry residency than the medical school they were admitted to. I went to a competitive medical school with a good but less competitive psychiatry program. There were several years where zero students from the school stayed there, and from what I heard, this was a point of contention between the program director and the M3 clerkship coordinator (i.e., he blamed her, rather than recognizing the gaps in prestige). So kids were matching in Boston, New York, and California instead of sticking around.

So in a lot of ways, programs have an interest in keeping their own, because they are known quantities, but are also, on average, going to be more competitive applicants than they will be able to recruit otherwise. The latter is probably true for all but about 5-10 programs. Outside of these few programs, I would say it's almost a pink flag (not really a red flag) that few students who know the program best don't want to stick around.

 

[atsai3]

The program where I matched has almost half of the incoming residents from it's home medical school. The psych program from my medical school did not have anyone match from my class.

From the outside, how do people usually view these different situations? I know from my own school that none of us going into Psych ranked our home program at the top because we all matched into our first choices somewhere else. On the flip side, one could see a program with a lot of people from the same home medical school as having problems recruiting strong candidates from other places.

Since I've only seen this from the perspective of an applicant, I'm curious how residents and attendings feel about recruiting med students from their home institution. Would you be surprised if none of the med students from your own institution matched into your program? What about the opposite, if a large percentage of the residents were all people who went to that same medical school?

In general, strong students at our own institution had a leg up on other students, primarily because (a) all of the faculty and residents knew these students from their 3rd year clerkships and 4th year sub-I's, and (b) when we read letters of recommendation written by attendings from our own institution we had a lot of accumulated information about the attendings' "curve" with regards to writing stellar letters.

All of the applicants to our program had 10 squillion publications in Science and Nature and had spent their medical school summers living in a garbage dump deworming kids in Kenya, so we really needed additional information to discriminate between applicants. And personal/institutional experience is one way to get that information. When reading a stellar letter, the key question then became whether or not a particular letter writer was known for being discriminating or not ("when this attending says 'most outstanding student in the past 10 years, does he really mean it or does he always write this?' "). Unless an outside letter writer had trained at our institution, we generally had little information about them.

 

[cleareyedguy]

I think you'd need to look at 5 years worth of classes, since a single data point is hard to interpret. I've heard rumors that certain places don't take their own or only take 2 (specifically 2) or don't take applicants from X school or Y region or that the absence of "homer" students at a program means either that no one wants to go there or that the program hates its own students, but
a) no program knows who's going to highly rank them. No place gets their top ten people, and even if a program made that their goal (to minimize the depth they go on their rank list), it's definitely a crap shoot.
b) med school classes vary quite a lot year to year.
c). Exposure as a student works for most applicants, but for others, better to not be seen except on paper and interview day.
d) no program can control who's going to apply or who is couples matching or who desperately needs to move to certain places. When I look at out overall list (and we rank everyone we interveiw), I don't see enough people to fill the whole class at any other program (including places we heavily compete against; I'm sure they have taken people we didn't interview, but presumably they also got applicants who didn't apply to us--and vice versa).

 

[TexasPhysician]

Psych is not very competitive, so even non-competitive students have good options. Usually a program not recruiting its own is a bad sign - especially if taking IMG's instead.

 

[digitlnoize]

Psych is not very competitive, so even non-competitive students have good options. Usually a program not recruiting its own is a bad sign - especially if taking IMG's instead.

I don't count it as a "bad" sign, but more of a "caution" sign.

There are some programs, which are fine programs, that don't take many of their own, because although the program is solid, the students from that school have "better" options for them and their career goals.

Does that mean that YOU shouldn't go there? Not at all. It just means that you need to pick the best place for you.

Now, that being said, if a place didn't take any of it's own students AND had other warning signs...I might be more likely to shy away.

For example, this year Program X was a good example of this during this interview season. No Med School X students there, almost all FMG/IMG, not a strong program otherwise, plus I didn't like the city...led to a non-rank for me. I'm sure it's a fine program, everyone was nice enough, I don't think it's malignant, but it wasn't right for me.

By comparison, Program Y, also doesn't take many of its own students. Still, I know it to be a solid, but hardworking program in a good location. Why don't they get more of their own? Probably a combination of factors. They want to work less hard, they want a "big name", they want a different city, etc, etc, etc.

I know of at least one student from Med School Y who applied to Program Y and desperately wanted to go there...but did not match there. So, there is certainly an element of chance involved as well.

 

[whopper]

From my own experiences, programs tend to take their own. I've seen this happen in several programs and when applying into forensic fellowship, many of the programs already filled one of their very few spots with one of their own (always making me feel at a disadvantage). One of the most accurate ways to truly judge an applicant is to actually see how they work on the field for several weeks. Turned out in Industrial Psychology studies, things such as LORs, CVs, grades, and standardized tests were all very weak indicators of how the person was in real-life with grades and standardized tests being the best of all-but still poor indicators with the exception of actually seeing the person do work on the field.

That said, most programs I know of never saw the psychology data because they are medical doctors without psychological knowledge are haven't thought outside the box enough to incorporate this data that has actually been tested quite thoroughly, but most programs still do tend to take their own because such candidates are known quantities. I've seen people on paper look great and do terrible on the field and vice-versa. One of the best residents I've seen failed Step II 3x, and only got into the program (rather inappropriately IMHO) because his brother, a graduate of the program and well-connected angrily demanded his brother be let in. While I thought that was out of line, and that the program caved-in to an angry demand that I too thought was unprofessional, that brother of his was actually a great resident and considered one of the best in the hospital out of all the fields in it.

If a program isn't taking their own, as mentioned above, that would make me raise an eyebrow. I've mentioned that some programs try to avoid "intellectual incest" by having people that spent their entire education at the institution and now practice there, but I haven't seen this much with medstudents going into the same program as residents. I've seen it more on the order of residents becoming attendings at the same program.