Found out I'm fourth quartile in my class. Are strong academic IM programs out of reach for me now?

[Avoiding_Involvement]

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[janprincetondoc]

It Depends what u mean by mid tier. If you mean brown/geisel etc. then probably fine but if u mean a school like ucf/loyola/slu (decent programs but low mid tier at best) then it will be hard. A lot of programs might look at fourth quartile as not good clinically despite what letters say

 

[Avoiding_Involvement]

I appreciate the response. I honestly don't know the reputation of my program.
This is the PD ranking of schools I saw passed around when I was a premed. The associated USNWR ranking is beside it.

My program sits in the 40s, with Brown/Geisel right at 40. I don't see Loyola/SLU on the list, but UCF is ranked a 102.
I also want to touch on how my school does clinical grading.

In order to be H/HP/P you have to honors both the clinical portion and shelf portion of the grade. Whichever is lower, is the final grade you get. I always ended up with Honors on the clinical portion. All my evaluations talk about how my "knowledge is above average" but I usually only HP my shelf by a 1 to 3 questions. So, I ended up just HP majority of my rotations.

Of course, I don't know if my MSPE will describe that. At the very least however, the comments will all say I had above average knowledge when I practiced clinically.

 

[janprincetondoc]

Davis Jeff BU wake Georgetown Tennessee won’t help. I think brown and Geisel carry more weight since they’re ivys even if it doesn’t really matter for med school purposes/quality

 

[Avoiding_Involvement]

If that's the case, what programs should I focus on applying to then? Should it be more Top 30 to 60 range?

 

[eyeeye_captain]

First, don’t take the advice of another medical student as gospel.

Second, what do you consider a strong academic IM program? Only the big 4? Something ~T50? Something ~T50 in your region?

I’m not IM, but you probably have a good enough application for a what is at best a middle of the road competitive specialty (when talking upper tier). I suspect the LORs and research mitigate some of the grade stuff. Is your school’s department better than your medical school rank? Jefferson is a good example of an average school with a ridiculously good eye department so applicants get a boost.

Talk to your mentors and see where they think you’re a good fit. If they’ve got connections somewhere, especially in the region, then I think you’ll find strong enough options.

 

[Avoiding_Involvement]

I'd be content matching into any top 50 academic IM program at this point.

My school's IM ranking is pretty similar, maybe slightly worse than its medical school ranking. If my medical school is top 40 to 50, then I'd say it's IM department is 50 to 60 in terms of ranking.

Programs I am VERY interested in are places like USC, Cedars-Sinai, Rush, UPMC. I am aware programs like Northwestern, UCLA, Mount Sinai are probably out of reach but I'll apply to a couple of Reaches anyways.

I have spoken to my advisors quite a bit. They don't have a lot of good recommendations other than "I should have a chance at these programs, but top 20 programs is a crapshoot for anyone. I'd recommend adding a couple more target/safety programs".

 

[eyeeye_captain]

I'd be content matching into any top 50 academic IM program at this point.

My school's IM ranking is pretty similar, maybe slightly worse than its medical school ranking. If my medical school is top 40 to 50, then I'd say it's IM department is 50 to 60 in terms of ranking.

Programs I am VERY interested in are places like USC, Cedars-Sinai, Rush, UPMC. I am aware programs like Northwestern, UCLA, Mount Sinai are probably out of reach but I'll apply to a couple of Reaches anyways.

I have spoken to my advisors quite a bit. They don't have a lot of good recommendations other than "I should have a chance at these programs, but top 20 programs is a crapshoot for anyone. I'd recommend adding a couple more target/safety programs".

Then I completely agree with your mentors, and I think you’re handling everything correctly. Luck of the draw, but if the rest of your stuff is good (I think so) and something resonates with whoever reads your app, or if you’re some kind of fit for a program, that luck improves.

Glancing at the Doximity rankings, it looks like you’re cool with upper-middle tier, which sounds very reasonable. Geographic flexibility is nice too. Yeah, looks like a plan with some reaches and safeties. I’m too old to know how to play the signals game, but if you can strategize that as well, I suspect you’ll interview at places that excite you.

Hopefully some IM residents/attendings stop by for more directed thoughts.

 

[janprincetondoc]

I would say though that the major thing is using signals wisely they’re very important for IM