Does your School Matter for residency

Discussion in 'General Residency Issues' started by Drako, Jun 1, 2002.

  1. Drako

    Drako Senior Member

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    ...in matching to a residency of your choice at the end of four years of medical school?

    I talked to a guy who is doing his residence at Mt. Sinai about the above topic. He thinks that regardless of where you go to school, if you do well on the USMLE exams, your chance of matching into a competitive residency is the same as that of another student who attends a more prestigious school. In short, school's reputation doesn't play a role when it comes to matching to your top choice residency and speciality, even the ones that are highly competitive.

    Is this true? Or the school's US News ranking, reputation, and prestige do play a role in aiding its students to obtain residency spots and specialities of their choice?

    To be more specific, I am trying to decide between UCI and U. of Pittsburgh. The specialty I would like to study is Orthopedic Surgery.

    Thank you for your advice.
     
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  3. Bamboozeled

    Bamboozeled Member

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    dude, have u looked at UCSF's matching list?

    practically all of them place great residency...

    it is true to a certain extent, that ur grades and scores matter a lot, but that doesnt mean the presitege of a top 20 school is the same as a school not even in the top 50! just don't make a decision that you might regret later on, u know?!
     
  4. PittMD

    PittMD New Member

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    To be honest i think it does, but not a lot. May be it does if you were to attend a school like harvard/hopkins/ucsf, but after that the difference is no that major. I remember going to an interview (in general surgery) and I happen to take a quick glance at a sheet that an interviewer (in a Philly school). What I saw was rather interesting. It was a tally of points and they actually assesed more points to certain schools, specially to those that were highly ranked. For me, fortunately I was at Pitt and I got full (5 points). Some schools didn't even get points. But again, programs will mainly look at your board scores and AOA status, specially for ortho. Still, if you do go to Pitt, it will help quite a bit if you do get a letter from Dr. Fu, the chairman of ortho here, he's extremely well known nationally and internationally. His center for sports medicine (UPMC Sports Medicine Complex) is absolutely incredibly and brand new, I don't think any other medical center has anything close to it. Anyway, enough of my babbling. Just go wherever you feel most comfortable and do your best, and everything will work out.
     
  5. tonem

    tonem Senior Member

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    Drako,

    I sent you a PM that is pretty much along the same lines as PittMD's post.
     
  6. Winged Scapula

    Winged Scapula Cougariffic!
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    Except for the Top 5-10 schools, I don't think it makes a *significant* difference. Your USMLE scores, grades, LORs, etc. are the major factors in determining who gets an interview, then your performance there is the major factor in determining how highly to rank you.

    Another consideration - do students at Top 5-10 schools have higher than average USMLE scores and grades? Assuming the competition to get places in these medical schools is stiff, I would assume the caliber of the students there to be a bit higher, and perhaps these students obtain better residencies not because of the name of their medical school but rather because they are stellar candidates from the get-go.
     
  7. droliver

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    I think it definatly helps for some of the more competative surgical residencies like ortho, plastics, derm, and ENT. The influence that the program directors have @ some of those places is signifigant.
     
  8. hey drako..

    i found this on one of the threads...and I thought it would help u out, in ur decision making...

    it is the match list...

    <a href="http://www.mcwmd.com" target="_blank">Match Lists</a>
     
  9. Winged Scapula

    Winged Scapula Cougariffic!
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    Moving to Rotations and Residencies...
     
  10. bonecutter

    bonecutter Member

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    School reputation and prestige play a huge role. One important thing to note is that US news rankings do not always reflect a schools reputation with residency directors. Take a look some time at the lists of residents at top programs and you will notice some recurring themes in where they went to school. You can still get into a good program from anywhere but reputation really does help you

    Bonecutter
     
  11. Goofy

    Goofy Senior Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by bonecutter:
    <strong>School reputation and prestige play a huge role. One important thing to note is that US news rankings do not always reflect a schools reputation with residency directors. Take a look some time at the lists of residents at top programs and you will notice some recurring themes in where they went to school. You can still get into a good program from anywhere but reputation really does help you

    Bonecutter</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">d

    I have spent enough time in the ivy league to once again comment on this repetitive topic. This is absolute rubbish. We have been through this nonsense before, but that doesn't seem to stop anyone. Two students with identical numbers on paper, from two seperate US MD programs, regardless of the name, nine and half times out of ten have the exact same chance of obtaining a specific slot. The intangibles are what will make the difference.

    Aside from a few quack PD's, the screening process has nothing at all to do with a school's name, provided it's a US MD program. Students from such programs are lumped and screened together based on their paper support. Again, intangibles will make the difference.
     
  12. arthur v

    arthur v Member

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    I can only speak for my experience in dermatology this past year, but the candidates from the top medical schools had the luxury of applying to less programs and were more likely to land the coveted interviews than those who went to less prestigious institutions, even if they had lower credentials. Is that enough of a motivation to choose a medical school by prestige factor? Absolutely not. I went to my state medical school, sparing myself from a pile of debt, and matched at a great (although not "Tiffany") residency program. Still, to answer the question originally asked, for some specialties, it does matter.

    AV
     
  13. 2003doc

    2003doc Member

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    I am from a small accredited allopathic school that doesn't exactly carry an ivy league name (hehe); however, every year, we have people match in ortho, opth, radiology, derm, as well as "prestigious" medicine, peds, and the like programs. Name may help a little or matter in certain places more than others, but from what I've seen here, if you are an otherwise strong applicant with good scores, (lack of) name isn't a problem.
     
  14. bonecutter

    bonecutter Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Klebsiella:
    <strong> </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by bonecutter:
    <strong>School reputation and prestige play a huge role. One important thing to note is that US news rankings do not always reflect a schools reputation with residency directors. Take a look some time at the lists of residents at top programs and you will notice some recurring themes in where they went to school. You can still get into a good program from anywhere but reputation really does help you

    Bonecutter</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">d

    I have spent enough time in the ivy league to once again comment on this repetitive topic. This is absolute rubbish. We have been through this nonsense before, but that doesn't seem to stop anyone. Two students with identical numbers on paper, from two seperate US MD programs, regardless of the name, nine and half times out of ten have the exact same chance of obtaining a specific slot. The intangibles are what will make the difference.

    Aside from a few quack PD's, the screening process has nothing at all to do with a school's name, provided it's a US MD program. Students from such programs are lumped and screened together based on their paper support. Again, intangibles will make the difference.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Nine and a half times out of ten? What study are you quoting? Where is the evidence? The only objective data I have encountered seems to indicate that students at top level schools match better (taken from match lists at top schools). While I certainly don't deny that you can go anywhere from anywhere, just playing the numbers game your chances are better (not to be read 100 percent, just better) at one of the big name schools

    Bonecutter

    Bonecutter
     
  15. so drako which school did u end up picking? :)
     
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  17. Goofy

    Goofy Senior Member

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    Bonecutter said:

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Nine and a half times out of ten? What study are you quoting? Where is the evidence? The only objective data I have encountered seems to indicate that students at top level schools match better (taken from match lists at top schools). </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">There aren't any 'studies' that prove my assertions, nor does there need to be. Certainly my conclusions are opinions based on evidence on match list sites, as well as a wealth of personal experience in the ivy league itself.

    I have looked at the match lists and compared the lower tier schools with my program. All medical schools have students matching in all specialities including the most difficult ones. All schools have students matching in top programs. The discrepencies arise from differences in networking potential and cunning of the student entering. It aint the school that gets the residency, it's the student. Don't confuse the two.

    As Kimberli astutely points out, name brand schools tend to attract more resourceful students. While I would debate the 'caliber' argument, as I largely regard most medical students as equally bright, the more resourceful students seem to be more persistent and cunning. As a result, the student population at a Penn or Harvard may be somewhat different.

    Having said that, two students with identical numbers have equal chance at obtaining said residency. Intangibles will decide who gets the spot in a tie. A PD will reject a snooty know it all, for an equally stellar state school applicant any day of the week.

    School name largely, almost completely, has little to no role other than what I have postulated. I know it may seem hard to believe, but having worked in this capacity, I know it to be true. The connections one student may have at any ivy league can easily be compensated with away rotations.

    If you are a resourceful, cunning, bright and determined student, you will achieve the same level success from any US MD program.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> While I certainly don't deny that you can go anywhere from anywhere, just playing the numbers game your chances are better (not to be read 100 percent, just better) at one of the big name schools </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Again, I think you are making a gross generalization based on what less than 1/2% of PD's may do. The overwhelming majority of PD could care less where you come from (provided it is a US MD program). What does matter a whole heck of a lot is the score on your USMLE report, and what your clerkship evaluators had to say about your performance.

    I should add that the reason I am so vocal on this issue is because I personally got burned badly from a strictly financial perspective. I too bought the 'name brand' baloney when I chose my school. I am confident that I would have achieved the same level of success at a state school, and my debt load would have been relatively small.

    While I am proud of my education, I feel as if I could have had the same caliber education at one of the excellent state programs. I am left with truly burdensom debt that has, and will have a significant affect on my financial well being.

    I remind those early in the process, that it is very easy to lose touch with debt load. When toiling through med school it almost seems as if you are playing with the house's money. At the end of the fourth year, like a prison cell slamming home, the debt becomes frighteningly real. To borrow a line from blood brothers, 'a debt is a debt, and must be paid!' For me, it is the equivalent of a mortgage on a rather expensive house.

    Did I learn medicine any better? Unlikely. Would I have achieved the same success elsewhere. Very likely.

    Don't get caught up in the name game, it'll cost ya.
     
  18. Sevo

    Sevo Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by bonecutter:
    <strong>School reputation and prestige play a huge role. One important thing to note is that US news rankings do not always reflect a schools reputation with residency directors. Take a look some time at the lists of residents at top programs and you will notice some recurring themes in where they went to school. You can still get into a good program from anywhere but reputation really does help you

    Bonecutter</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I don't know about that. I recently compared the match list of my school (in the top 15) with the big state school in the area (ranked in the lower 1/3rd of the US News rankings). The match lists were virtually identical.

    I think going to UCSF, Harvard, and Hopkins might get you interviews at places where it may be almost mandatory to do away-rotations at. However, when it comes down to it, where you, as an American medical school graduate, will eventually end up will depend almost strictly on your board scores, your recs, and your performance during your interviews.
     
  19. Whisker Barrel Cortex

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    I agree with those who point out that the more impressive match lists for some of the top schools are more likely due to the fact that these students are generally more competitive. They study harder for the boards, do more research, etc. and this will get them better interviews. Also, you'll notice that a lot of the "great" programs that people get into from these top schools are at their own hospital. At every school, a big chunk of the graduating class will stay (at our school 42 out of 190 stayed at MCW).
     
  20. zpdoc

    zpdoc Senior Member

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    Klebsiella,
    Just out of curiosity, have you had the chance to talk to some residency directors, and have they confirmed what you have been saying? Has anyone else ever talked to residency directors (esp. for competitive residencies) about what factors affect their desicions?
     
  21. Goofy

    Goofy Senior Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Whisker Barrel Cortex:
    <strong>I agree with those who point out that the more impressive match lists for some of the top schools are more likely due to the fact that these students are generally more competitive. They study harder for the boards, do more research, etc. and this will get them better interviews. Also, you'll notice that a lot of the "great" programs that people get into from these top schools are at their own hospital. At every school, a big chunk of the graduating class will stay (at our school 42 out of 190 stayed at MCW).</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">WBC,

    You make a very good point about students staying at their own school.
     
  22. Goofy

    Goofy Senior Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by zpdoc:
    <strong>Klebsiella,
    Just out of curiosity, have you had the chance to talk to some residency directors, and have they confirmed what you have been saying? Has anyone else ever talked to residency directors (esp. for competitive residencies) about what factors affect their desicions?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Absolutely. Additionally, I have also spoken to a broad range of hierarchy that supports the PD. In most cases, this support crew has more say than the PD, as rank lists are very often first screened, and once supporting info is sent, rank is achieved by committee consensus.

    US medical schools represent the best medical education to be had, and the difference in quality between the 'best' and 'worst' is superficial at best.

    Work hard and do well wherever you go, you wont have any barriers whatsoever with a convincing file. What you will have if you choose the more expensive route, is an enormous amount of debt that few pre-meds have the forsight to avoid (myself included).
     
  23. beezar

    beezar Senior Member

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    So, my question is if you place a middle of the road student from a top 10 school into a lower tier school, will he/she be at the top of the class at that lower tier school? If so, that would be quite unfair for students in top 10 schools, especially if grades and class rank is so important in the residency matching process.
     
  24. dcdo

    dcdo Senior Member

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    For what it's worth...

    I applied internal medicine in California with a top 10 ranking in my class, a 240 on the USMLE, a 669(99th %)on COMLEX and an enthusiastic letter of rec from one of the vice chairs at UCSF. I was also a bone marrow donor at UCSF. What did this get? No interviews from UCSF, Stanford, UC Davis or Santa Clara Valley Medical Center. I also rotated at Harbor UCLA, got a good eval with a prestigious cardio attending telling me I did a great job and hoped I would be back next year. I did not get an interview, and the PD told me that "Of course every competitive program likes to have residents from well known and prestigious schools." I did get an interview from UCLA.

    Also, a UCSF attending told me "UCSF graduates always get great residencies, even when they're not any good."

    Maybe being a DO student clouds this argument a bit, but I'm just telling you what happened.

    P.S.,

    I did still get a pretty decent residency. <img border="0" alt="[Clappy]" title="" src="graemlins/clappy.gif" />
     
  25. Sevo

    Sevo Senior Member
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by dcdo:
    <strong>For what it's worth...

    Maybe being a DO student clouds this argument a bit, but I'm just telling you what happened.

    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Being a DO student SIGNIFICANTLY affected your chances at these places.

    I don't have any problems with DOs and I know and respect many DOs that I've worked with, but a lot of PDs still feel that DO students are still second tier medical students.
     
  26. Goofy

    Goofy Senior Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Sevo:
    <strong> </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by dcdo:
    <strong>For what it's worth...

    Maybe being a DO student clouds this argument a bit, but I'm just telling you what happened.

    </strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Being a DO student SIGNIFICANTLY affected your chances at these places.

    I don't have any problems with DOs and I know and respect many DOs that I've worked with, but a lot of PDs still feel that DO students are still second tier medical students.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Sevo is exactly right. Your experience unfortunately reflects rampant and rather disturbing disdain for the DO establishment. Equally unfortunatley, allopathic programs as a general rule, look at DO candidates as inferior. This is what made your application process so harrowing. Sadly, this is the norm.
     
  27. Winged Scapula

    Winged Scapula Cougariffic!
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    Gotta say that I agree with Klebsiella and Sevo on this one. Even if a particular PD didn't have a problem with DOs, the fact is that having residents with the DO degree is often seen as a negative in the allopathic medical world.

    I'd say that your degree was what hurt you the most at those schools- competitive programs for anyone.
     
  28. Hi all,

    I'm a pre-med and new to the forum and looking for some answers (or something pretty close to it). I was wondering if it would be preferable to go to DO school or a Caribbean school like Ross. Any thoughts?
     
  29. Winged Scapula

    Winged Scapula Cougariffic!
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by A&W:
    <strong>Hi all,

    I'm a pre-med and new to the forum and looking for some answers (or something pretty close to it). I was wondering if it would be preferable to go to DO school or a Caribbean school like Ross. Any thoughts?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Since you are new, you are undoubtedly aware that this topic has been discussed ad nauseum, largely in the International Forum. I suggest you look there - but essentially the consensus is that while both may suffer some stigma in the US (largely) allopathic medical community, it is much preferable to go to a US DO school over a Caribbean one.

    BTW, if you are assuming that DO schools are much less competitive than MD ones, those days are over.
     
  30. drusso

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    Now, wait a minute...I think some of you are over-stating the case. Many DO students don't bother applying to top programs because of some perceived "discrimination." As a recent residency interviewee, and someone who rotated at a variety of allopathic institutions, I think that this osteopathic "discrimination" business is vastly overstated. Do some DO students have more difficulty matching at some programs than others? Yes. But, on the whole, I think that residency program directors are a smart bunch of people. They know better than to judge an applicant solely based on where they went to medical school or type of medical degree earned. They want qualified, smart residents who will show up on time every day dressed to play---regardless of type of medical degree earned.

    We all know that the residency match process is a *GAME* of the highest order. It's a big vetting process: The programs fawn over the candidates and promise them slots, the candidates send gushing thank you letters saying "I'm ranking you number one." The chief resident calls the candidate and says "we're highly interested in you." Lo' and behold you don't match...why? Because getting jerked around is how the game is played. Both MDs and DOs get jerked around every year this way.

    I don't know the specifics of dcdo's situation, but I think the fact that dcdo, although he has excellent board scores and superb credentials, graduated from a brand-spanking new osteopathic school with little track record may have something to do with his "harrowing" match experience. Also, for all we know, dcdo might come across as a real jerk in interviews (JK) :)

    In my class at TCOM, we had students match categorical internal medicine at Cleveland Clinic, Mass General (Harvard), and Hopkins. Now, this could be a fluke, but I think the fact that TCOM has a 35 years old track record of producing quality physicians and has an established faculty with national "connections" might give us an edge over a newer osteopathic school.

    Also, I'm *NOT* convinced that US MD students view programs with DO residents in them as poorer quality programs. This flies in the face of every conversation I've ever had with MD interviewees and students. In fact, from a program director's perspective there is evidence that the contrary is true: Interest in dual AMA/AOA accreditation of residency programs has never been higher...

    <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9846049&dopt=Abstract" target="_blank">Ref 1</a>
    <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9597532&dopt=Abstract" target="_blank">Ref 2</a>

    There is a plethora of published research that suggest that AMGs (USMD and USDO students) and program directors view programs with FMGs in them as inferior.

    <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8645405&dopt=Abstract" target="_blank">Ref 3</a>
    <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9356575&dopt=Abstract" target="_blank">Ref 4</a>
    <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7859953&dopt=Abstract" target="_blank">Ref 5</a>

    So, it almost becomes a self-fulfilling prophecy: Programs the depend on FMGs, tend attract more FMGs, which in turn, drives away qualified AMGs.

    <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8769548&dopt=Abstract" target="_blank">Ref 6</a>

    Thus, I think that the real situation is complex. Some program directors might be biased against DO's, as some are biased against FMGs, women, black people, etc. But, I do not think that there exists some nefarious, widespread conspiracy driven by osteopathic "discrimination." Like most things in life, and in accordance with proven sociological research, attitudes change once individuals get an opportunity to challenge their biases. One kick-ass DO in a competitive residency program opens the door for more DO's in the future. This has been occurring rapidly over the last 15 years and is referred to in osteopathic circles as the "trailblazer" phenomenon. For example, Scott & White Medical Center in Texas (referred by some as the "Mayo of the South") used to be a "closed shop" for DOs---especially in competitive subspecialties such as interventional cardiology---don't even bother applying. Now, the cardiology program has four DO interventional cardiologists, including the chief of interventional cardiology!

    <a href="http://www.sw.org/staff_dir/cardiology.htm" target="_blank">Ref 7</a>
     
  31. dcdo

    dcdo Senior Member

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    Drusso,

    Unfortunately, the programs I mentioned didn't even grant me an INTERVIEW, so I didn't get to dazzle them with my incredible personality. :cool: Maybe it's a California thing, since these same programs also don't take IMGs for residencies or even rotations for that matter. I went to TUCOM which is new, but we're gradually making inroads in Cal. As mentioned before, I did get interviewed at UCLA which doesn't interview many people and I did get into UCI.

    By the way, if I interviewed with you I would make you believe the sun rose and set on your rear end! <img border="0" alt="[Laughy]" title="" src="graemlins/laughy.gif" />
     
  32. Winged Scapula

    Winged Scapula Cougariffic!
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    drusso...

    Obviously DO candidates are looked upon favorably in many places and the stigma perceived/presumed is not evident at every program. In addition, we will never really know why drdo didn't even get interviews at the programs he listed.

    I am glad that your experience has been different. However, each of us can only comment on our own experience and that which we find in the literature. The fact is that I KNOW there are programs in which DOs are not prized...mine is one of them (and this despite the fact that we didn't fill last year). While most will tell you that DOs are every bit as bright and hardworking as the next (allopathic) candidate, many do fear the stigma or the reputation of having less than the best and brightest. Its not fair, I agree...and perhaps I was overstating the case...but given my intimate knowledge of some of the California programs to which he applied, I think I may not have been.
     
  33. dcdo

    dcdo Senior Member

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    I would guess that the scant representation of DO schools on the west coast until recently has a lot to do with it. DOs were eliminated in CA from 1961-1974, with COMP being founded around 1977 and TUCOM and AZCOM not coming until 1997.

    Things are improving. I remember our dean around 3 years ago told us that there was no way we were going to get residencies in the Cal bay area. Now we have graduates from TUCOM at most of the programs here, although not UCSF, UCD or Valley Medical. By the way, Valley Medical doesn't even let DO students rotate there in medicine or GI for whatever reason, although other rotations are open.
     
  34. Ligament

    Ligament Interventional Pain Management
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    man, I had a feeling this thread would turn to DO's as soon as I read it....I dont know if this is good or bad...

    ?
     
  35. Goofy

    Goofy Senior Member

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    Hi Drusso,

    You said:

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> I think that this osteopathic "discrimination" business is vastly overstated. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I think you are grossly understating the problem. There is a big problem. I have seen it first hand. Looking at match lists only confirms the suspicions.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> Do some DO students have more difficulty matching at some programs than others? Yes. But, on the whole, I think that residency program directors are a smart bunch of people. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Firstly, I would debate the nuances of your comments on this 'smart bunch of people'. Secondly, smarts has absolutely nothing to do with it. There is rampant prejudice against the osteopathic establishment in the allopathic world. When I say rampant, I mean glaring, offensive, and denigrating. It is everywhere. PD who accept large numbers of DO's are perceived as not being successful in the match. This is how they achieve their grades. Granted there are stellar DO applicants, but they don't walk around the hospital with board scores on their forehead. The perception, however sick it is, is how things are determined.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> I don't know the specifics of dcdo's situation, but I think the fact that dcdo, although he has excellent board scores and superb credentials, graduated from a brand-spanking new osteopathic school with little track record may have something to do with his "harrowing" match experience. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I do know because he made public his osteopathic upbringing. In my opinion, turning a blind eye to this rampant and pervasive problem only serves to exacerbate the problem for osteopathic candidates. The establishment needs to fully embrace the problem, and not bury it under the carpet, if meaningful change is to be realized.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">In my class at TCOM, we had students match categorical internal medicine at Cleveland Clinic, Mass General (Harvard), and Hopkins. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">This is comforting news, and perhaps the seeds of change are being placed. The problem is that the exception is not the rule. Osteopathic physicians have been gaining access to top programs for a long time now. But only in tiny tiny numbers. No one is saying it cant be done, but the opportunities for a osteopathic candidate are recognizably smaller.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Also, I'm *NOT* convinced that US MD students view programs with DO residents in them as poorer quality programs. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">As someone who just graduated an US MD program I can tell you that this is not correct. Conversations with my peers about this subject often elicits comments and rhetoric too demeaning to post here. On rounds, DO physicians are often the butt of jokes. I'm sorry to say that the ego of many of my peers is being nurtured and nourished to look down on osteopathic students. I'm not saying it's right.

    Personally, I think of DO students as my peers. We have all been through an almost identical process. I would even venture to say that osteopathic students actually receive more training than MD students. But to conclude that things aren't that bad is somewhat purblind to me. Application stats, match lists, experience all suggest something wildly and disturbingly different.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">There is a plethora of published research that suggest that AMGs (USMD and USDO students) and program directors view programs with FMGs in them as inferior.
    </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I have actually heard from more than one PD that sometimes IMG's are actually admitted before DO of equal qualification because the IMG can still wear the MD on the coat, and most people wont know the difference.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> Thus, I think that the real situation is complex. Some program directors might be biased against DO's, as some are biased against FMGs, women, black people, etc.</font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I think you are sugar coating a rampant and glaringly obvious problem that has severely handicapped the opportunities of DO candidates by making these comparisons.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> But, I do not think that there exists some nefarious, widespread conspiracy driven by osteopathic "discrimination." </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Actually, your comment however sensationalized it might seem, isn't too far off. Yes, the problem is that bad for osteopathic students.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> Now, the cardiology program has four DO interventional cardiologists, including the chief of interventional cardiology! </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">This is indeed comforting to hear. However, these examples are abundant. Sadly, they remain the exception to the rule, and opportunities for osteopathic candidates remain terribly limited. Perhaps things will change rapidly, and the allopathic establishment will embrace our osteopathic colleagues on equal terms. Sadly, all of my research and experience indicates otherwise.
     
  36. drusso

    Physician Moderator Emeritus Lifetime Donor Classifieds Approved

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    Klebsiella,

    Where did you go to school? If you don't feel like being specific, just give me a general geographic area. I'm amazed that such "rampant" "denigrating", "demeaning", "insulting" attitudes exist toward DO's where you're from. Well, maybe if you're in Louisiana, Arkansas, or Mississippi I'm not that surprised...

    If disgust with the "osteopathic establishment" really is so prevalent, I'm surprised no one has taken the time to study it. Medical educators seemed to have studied attitudes towards FMGs, minorities, disabled people, and women in academic medicine, why not DO's?

    And, if the situation is really has bad as you paint it, which I have a hard time accepting based upon my own personal experiences, those of my peers, and published research, then what we face is truly a crisis of professionalism. Are DO's **REALLY** the last dog left to kick in medicine? "Shucks, can't bash women, minorities, and gays anymore---I got an idea, let's humiliate the DO!"

    Maybe I'm the most competent DO to ever set foot in a hospital (I doubt it), so intimidating that no one would dare say anything to my face (I doubt it), or just so absolutely clueless that I don't recognize when upper-levels or attendings are making fun of me for being a DO (Again, unlikely). How can our experiences be so different?

    Finally, I don't buy this "I'll take an FMG over a DO because they can where a MD behind their name and no one will know the difference" bit at all. That's pucky. There are real documented problems with the educational standards at foreign medical schools that anyone who has been around academic medicine for two seconds is keenly aware of. Besides, there is more paperwork and red-tape involved in accepting foreign graduates. These issues, coupled with post-911 jitters about anyone with a student visa coming to the USA, really suggest that your perceptions are skewed.

    I've worked in hospitals as a DO student, with DO housestaff and attendings, and can attest that it is the rare, rare patient who ventures to ask, "What does DO mean?" I've never seen a patient not satisfied with a simple explanation, "An osteopathic doctor," and I've have never seen nor heard of a patient say, "I don't want to be treated by no osteopath!" And, if this did happen, I think they'd pretty much be SOL: They could just sit in their puddle of urine, emesis, or blood until one of my fellow MD colleagues could get around to see them. And, we all know how happy he or she would be to have *THAT* patient on their service. Everyone loves a doctor shopper!

    So, again, how can it be that wherever you are attitudes toward DO's seem to be frozen circa 1962, and here in good 'ol Texas (not exactly the most progressive place in the world) things are so...different?
     
  37. Goofy

    Goofy Senior Member

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    Hi Drusso,

    I want to preface this next reply by saying my comments are mere observation. I by no means endorse this kind of pathetic and egotistical view of osteopathic medicine. I view osteopathic medicine as simply a different route to the same ends. I would even argue that the osteopathic route is even more comprehensive than allopathic. I certainly view my osteopathic colleagues as equals.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Where did you go to school? If you don't feel like being specific, just give me a general geographic area. I'm amazed that such "rampant" "denigrating", "demeaning", "insulting" attitudes exist toward DO's where you're from. Well, maybe if you're in Louisiana, Arkansas, or Mississippi I'm not that surprised... </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I went to school on the east coast. I would add that I have had similar experience in no fewer than four states and at least a dozen hospitals. It is pathetic I admit, but exists nonetheless.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> If disgust with the "osteopathic establishment" really is so prevalent, I'm surprised no one has taken the time to study it. Medical educators seemed to have studied attitudes towards FMGs, minorities, disabled people, and women in academic medicine, why not DO's? </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Simply because something hasn't been studied extensively doesn't mean it doesn't exist. There are millions of studies that might be useful, but limited resources. I guess attitudes towards osteopathic physicians isn't high on the list. Perhaps you might undertake the endeavor. I will be keeping a close look out in NJM for it :) .

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> And, if the situation is really has bad as you paint it, which I have a hard time accepting based upon my own personal experiences, those of my peers, and published research, then what we face is truly a crisis of professionalism. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I thing you need to consider two things. First, can we agree that DO's have bigger barriers to success and opportunity than equally qualified MD's? Secondly, I think you can understand why a DO might not be privy to the lockeroom antics of infantile MD's. To really appreciate the limitations, one only has to look toward match lists. If you can forward me a copy of your schools match list, I think I can show you what I mean. Again, I am dismayed that DO's are cast in this light, but as you put it, there really is a 'crisis in professionalism.'

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> How can our experiences be so different? </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I cant speak for your region of the country, but I have never seen a DO confronted in such a deragatory way either. I have seen rampant rhetoric behind closed doors.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> Finally, I don't buy this "I'll take an FMG over a DO because they can where a MD behind their name and no one will know the difference" bit at all. That's pucky. There are real documented problems with the educational standards at foreign medical schools that anyone who has been around academic medicine for two seconds is keenly aware of. Besides, there is more paperwork and red-tape involved in accepting foreign graduates. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I am simply sharing with you views I have been privy to, no matter how mundane they may seem.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> These issues, coupled with post-911 jitters about anyone with a student visa coming to the USA, really suggest that your perceptions are skewed. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Again, you are distorting my comments. These are not my views. I think if you review my posts over the past year, you will find I have been one of the biggest proponents of DO's. These aren't my perceptions/views/opinions or otherwise.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> I've worked in hospitals as a DO student, with DO housestaff and attendings, and can attest that it is the rare, rare patient who ventures to ask, "What does DO mean?" </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">This is another argument entirely. I have worked with many excellent DO's, and if the confusion doesn't exist, why do 9/10 DO's choose to put 'doctor so and so' on their white quote in the place of 'DO'. I don't think there is rampant confusion in this regard, but enough for many DO's to give up the title entirely.

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> So, again, how can it be that wherever you are attitudes toward DO's seem to be frozen circa 1962, and here in good 'ol Texas (not exactly the most progressive place in the world) things are so...different? </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I believe (and I stress 'I') that the problem is a lot more pervasive than you let on. If you look at match lists, residency and fellowship lists, research and attending appointments, you will find that the opportunities for equally qualified DO's are much much lower. It shouldn't be that way, and I'm glad that you will serve as a true 'trailblazer' to give your colleagues the well earned respect they deserve.
     
  38. Sandpaper

    Sandpaper Member

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    Hmmmm....same old arguments. Lemme settle it once and for all. :D As a former student at a school that has both an osteopathic and allopathic program, I can tell you that generally speaking the MD students do look at the DO students as being academically inferior. Some made light of the fact that though we took the same identical pre-clinical courses, the pass rate for the osteopathic student is 70% while it is 75% for the allopathic student. Individually, my osteopathic friends are cool, but collectively, many had chips on their shoulders. I can also tell you that friends of mine who had a choice between the MD and DO schools and chose the latter regretted it big time when they hit the interviewing trail this year. More bits and pieces of anecdotal gems are available but that serve nothing here. I think that our DO colleagues would be wise to realize that discrimination against the DO degree is more prevalent than one would think, and that ya'll would be better serve to fight the problem rather than minimalizing it.
     
  39. Med4ever

    Med4ever Senior Member

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    Hey does your school matter for residency or is more of a USMLE I and II thing.

    Thanks
     
  40. Spiderman [RNA Ladder 2003]

    Spiderman [RNA Ladder 2003] Platinum Member

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    Yes, it MAY. It will depend on your grades and boards scores. Top 10 school have a stong trend for the students t get better residency programs than people with similar grades from other non-top-10 schools. It also depends on how well you are "connected."
     
  41. saman

    saman Junior Member

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    From what I heard USMLE, class rank, and any kind of research (for residency programs that need them i.e. surgery) are more important than school.
     
  42. dr kevin40

    dr kevin40 Senior Member

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    being in the top 30% of a top ten should mean a lot more than being in the top 5% of a non-top 30 med school

    school should matter for residency. as to whether it actually does, i don't know
     
  43. CANES2006

    CANES2006 Miami chica

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    kevin,
    From what I heard, your scenario does not happen. If you are top 5% from a non-top 30 med school and have good boards, you will probably get a better residency than one who is top 30% from a top ten with equal boards. A top 5% class rank is way different than a top 30% class rank no matter what school you come from. I do not doubt, however that a top 10-15% in a top ten will get a better residency than one with a top 1-5% from a non-top 30 med school with all things being equal. From what I heard, top ten don't mean crap if you perform at a mediocre level. Bottom line: class rank and boards determine your residency placement for the most part.
     
  44. LizardKing

    LizardKing Veteran Member

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    Just like in the med school admissions game, where you went to school has some effect on the residency game.

    Now I don't have any statistics or studies to back up my statements. But after talking with lots of residents and looking at tons of matchlists, I find there is a pattern. If you look at the most sought after residencies (optho, derm, neurosurgery, etc.) in the top hospitals (Hopkins, UCSF, NY-Presby, MGH, etc.), the majority of residents come from top ten schools. This alone isn't strong evidence, but it can't be denied either.

    Residents also tell me that many students from Harvard, etc. automatically get interviews for derm, surgery, etc. without doing that well in school (even those in the lower 50% of the class). To interview for the same residencies coming from USC-Keck, for example, would probably require you to be in the top 5% of the class--not an easy task for anyone. So before the interview process even begins, you can be at a disadvantage.

    Also, the intangibles. You make connections at the school you go to. Sometimes residency directors favor applicants from their own med system. It also helps to get letters of rec from the exact department you're applying to.

    Ultimately, though, if you pull outstanding board scores, clinical evals, grades, and letters of rec, you won't have a problem getting your top choice residency. To eliminate the school factor, though, you really gotta work your a** off.

    I wish the school you came from weren't so important. But I think it's the reality.
     
  45. LizardKing

    LizardKing Veteran Member

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    Also, this may be obvious, but it really depends on what residency you're talking about. What are you interested in?
     
  46. Med4ever

    Med4ever Senior Member

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    Orthopedic surgury or General Surgury
     
  47. nylee

    nylee Corean Member

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    I have to agree with LizardKing...just from experience. I followed around the Hopkins ENT-otolaryngology team on their rounds and got to meet the residents and house staff. When I asked them where they graduated from, it was basically Hopkins, UCSF, Duke, Harvard, Yale...and maybe Vanderbilt. Plus, ENT is really competitive at Hopkins because it's currently ranked number one...

    After talking to a neurologist in my lab (graduated from Harvard med), I found out that Mass General also has a lot of bias towards their own Harvard students. It's almost cake to get into a residency there if you're from their med school.

    however, like Lizardking said, it depends on which specialty you're interested in and which hospital...:)

    Actually...my PI who's a neurologist at Hopkins graduated MD/PhD from UIC and he received his residency at Hopkins and now he's head of ALS research...i think he was at the top of his class, though. So I guess you don't necessarily have to be from a top 10 or even a top 50 school...but it may help you get the initial boost to an interview.
     
  48. just a thought.. a number of schools on the P/F or H/P/F system do not rank students for the first two years at all. Examples are Tufts and U Conn. Your class rank from these two schools will be based on your performance in the clinical years (the grading system changes during yrs 3 + 4 at TUSM). So, while a strong performance in the first two years at these types of schools may help you out a little bit, your USMLE scores, letter from the dean, and performance during the clinical years will be the big factors determining your residency placement. BTW, Tufts' match list was outstanding this year IMO, lots of specialty matches in radiology and dermatology and opthamology and many IM, Peds, and OB/GYN matches at places like Yale, Boston Children's, UCLA, Cedars Sinai, MGH, JHU, etc.. Cool considering how much our school gets bashed on this board:)
     
  49. qweewq11

    qweewq11 Smiley orgy organizer

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    Lots of people on here have bought into the post hoc ergo propter hoc fallacy.

    Take a look at the MCAT scores for Harvard/Cornell/UCSF students. They're around 35. The reason these kids got into these schools is b/c they were extremely intelligent to begin with, and they prolly would have in the top 5 students at a less well known school anyway, and had stellar USMLEs. The Harvard degree was just icing on the cake.

    To put it another way, they got into top schools b/c they were good enough to get the residencies regardless of whether they got in.
     
  50. After talking to a neurologist in my lab (graduated from Harvard med), I found out that Mass General also has a lot of bias towards their own Harvard students. It's almost cake to get into a residency there if you're from their med school.

    True, but interestingly enough, Tufts sends a decent # of grads to MGH as well. We have a professor who graduated from Tufts med who did his residency at MGH and is now a trauma surgeon there.

    however, like Lizardking said, it depends on which specialty you're interested in and which hospital...:)

    Very much true as well; and there tends to be a location bias among students rather than a bias toward the most prestigious hospitals at certain schools. NYMC, for example, tends to match a lot of people at NYMC-affiliated hospitals and in CA because that is where their students often prefer to go (being from NY or CA), and University of Maryland SOM, not surprisingly, matches a remarkable number of graduates to UMAB-affiliated hospitals cause 90% of the student body are Maryland residents and want to stay there. Just something to keep in mind when evaluating how "good" a match list is.

    Actually...my PI who's a neurologist at Hopkins graduated MD/PhD from UIC and he received his residency at Hopkins and now he's head of ALS research...i think he was at the top of his class, though. So I guess you don't necessarily have to be from a top 10 or even a top 50 school...but it may help you get the initial boost to an interview.

    Although neurology is a very challenging specialty, I read the other day that it is considered to be a non-competitive residency because there are relatively few applicants for all the available spaces. I'm sure your PI is a fantastic physician and scientist, but if he had been interested in radiology and tried to get a residency at Hopkins he MIGHT have had a harder time getting into Hopkins.
     
  51. Chowdah

    Chowdah Junior Member

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    Not only that, but someone in a top 10 school actually cares about how prestigous their residency is.
     
  52. atsai3

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    If you examine medical schools' match lists, you will find that most of them tend to place a high proportion of students in their own hospitals' training programs. CWRU students match to CWRU programs, NYU students match to NYU programs, etc. It may simply be "favoring one's own", or it may be a familiarity with the student and the training process at the home institution ("we trained her, so we know she's good").

    More broadly speaking, residency committees employ a variety of data, and the extent to which they employ which pieces of data varies from program to program. For example, one study compared OB/Gyn and Family Medicine on six factors: dean's letter, personal statement, transcripts, application form, USMLE scores, and chairman's letter. Family Medicine residency directors emphasized the dean's letter but ranked USMLE scores as 5 out of 6 (in terms of importance). But Ob/Gyn residency directors ranked the transcript as 1/6 but USMLE only 3/6. [Taylor CA, Weinstein L, Mayhew HE. The process of resident selection: a view from the residency director?s desk. Obstet Gynecol. 1995;85:299-303]

    A more recent study of selection criteria reported similar results: more competitive specialties (i.e., those with >85% fill rates) relied more on "hard" data such as transcripts, AOA, and USMLE scores. [Wagoner NE, Suriano R. Program directors? responses to a survey on variables used to select residents in a time of change. Acad Med. 1999;74:51-58]

    Cheers
    -a.
     

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