Geographic Bias in IM

[incomingmed101]

---

Members don't see this ad.

hello sdn! New to the forum

As a medical student at a upper mid tier US MD in the southeast, how tough will it be to match up in the mid atlantic/new england area? (I grew up in mid atlantic and attended college in new england)

Im looking for some advice on what scores are needed on step 2 to match academic IM, how much research and how to best position myself to get interviews back home in my region.

I know a lot of people are saying this is premature since Im only incoming, but I feel like I keep getting blindsided because I have 0 guidance when making decisions in this process or even while I was crafting my application to med school so I want to hit the ground running

 

[Nontrad_FL_LGBT]

Mid-tier academic IM is not hard to match into as a mid-tier MD. Don't fail anything, get average test scores, do a few research items, you should match somewhere.

If you want to go to like, MGH, you'll need to look closer to a neurosurgery applicant.

It's all how hard you want to go but if you're okay with mid-tier, you're fine.

 

[incomingmed101]

Mid-tier academic IM is not hard to match into as a mid-tier MD. Don't fail anything, get average test scores, do a few research items, you should match somewhere.

If you want to go to like, MGH, you'll need to look closer to a neurosurgery applicant.

It's all how hard you want to go but if you're okay with mid-tier, you're fine.

Hey thanks for your response! What are some examples of mid tier?

Also what step 2 scores should I aim for ideally for mid tier

 

[eteshoe]

Do the best you can. For the really competitive programs - mid 240s will keep you in the running at a lot of places, 250s will open more doors, 260s+ will have diminishing returns but won't make up for not having all the other parts of your app on par.

 

[NotAProgDirector]

I think the "geographic bias" is less of an issue now with regional preferences and signals. Application inflation led to programs getting overloaded with applications and they had to find ways to cull the pile without a complete review. Focusing on applicants from the local geo area was one way to do that. Now with signals, we know if someone from outside our area is serious or not.

 

[incomingmed101]

I think the "geographic bias" is less of an issue now with regional preferences and signals. Application inflation led to programs getting overloaded with applications and they had to find ways to cull the pile without a complete review. Focusing on applicants from the local geo area was one way to do that. Now with signals, we know if someone from outside our area is serious or not.

Makes sense. I only ask because when I check residencyexplorer.com some programs in NYC or in Boston appear to still interview between 5-20% of applicants that attend Med school OOS. I have no idea how that bodes for me. Personally i plan to use all the signals I can for my top programs in my regions of familiarity (mid atlantic and new england). Why do they still interview very few OOS people?

To be doubly sure should I do a few away rotations in IM in New England and the mid Atlantic?

 

[incomingmed101]

Do the best you can. For the really competitive programs - mid 240s will keep you in the running at a lot of places, 250s will open more doors, 260s+ will have diminishing returns but won't make up for not having all the other parts of your app on par.

245-250 would be sufficient? Cant find average admitted stats anymore 🙁

 

[Nontrad_FL_LGBT]

Makes sense. I only ask because when I check residencyexplorer.com some programs in NYC or in Boston appear to still interview between 5-20% of applicants that attend Med school OOS. I have no idea how that bodes for me. Personally i plan to use all the signals I can for my top programs in my regions of familiarity (mid atlantic and new england). Why do they still interview very few OOS people?

To be doubly sure should I do a few away rotations in IM in New England and the mid Atlantic?

Most people want to stay where they train or go back to where they came from. It doesn't really make a ton of sense to interview tons of people who have no connection to the region.

I've been told by multiple people that IM aways are a waste of time or even a negative because you're going to be compared to home students that know their system already. Maybe do one of you really really want to go somewhere but I'd just do well on tests and get some research done instead.

 

[incomingmed101]

Most people want to stay where they train or go back to where they came from. It doesn't really make a ton of sense to interview tons of people who have no connection to the region.

I've been told by multiple people that IM aways are a waste of time or even a negative because you're going to be compared to home students that know their system already. Maybe do one of you really really want to go somewhere but I'd just do well on tests and get some research done instead.

Would my background at a college in New England give me ties? Was thinking I could do an away out in New England to establish a tie there

 

[Nontrad_FL_LGBT]

Would my background at a college in New England give me ties? Was thinking I could do an away out in New England to establish a tie there

I would think so, but I'm not a PD either.

 

[eteshoe]

245-250 would be sufficient? Cant find average admitted stats anymore 🙁

Yea it's hard to find the stats - but it's mostly my sense from talking to friends and see where folks matched. Aim for 250+ and you'll be Gucci. Also just because you have a high step 2 doesn't mean you won't get a couple rejections - especially at programs that feel you won't actually want to end up at that hospital (something that happened to me)

 

[NotAProgDirector]

Would my background at a college in New England give me ties? Was thinking I could do an away out in New England to establish a tie there

You're overthinking this. You would indicate new England as a region of interest. There's a spot for "why", and you'd mention that you went to college and want to return. You'll signal programs in NE. Nothing more than that is needed. An away is certainly a choice, and might help esp at that site if you do well, but isn't absultely needed.

 

[Dr. Robb Bassett]

Hey there—welcome to SDN, and major props to you for thinking strategically this early on. I know some folks might say “you’ve got plenty of time,” but honestly? That advice is well-meaning but misguided.

Here’s the truth most students don’t hear early enough: you have way less time than you think to make one of the most consequential decisions of your professional life—choosing your specialty. The traditional idea that you’ll just “figure it out” during third-year rotations sounds nice in theory… but it’s incredibly rushed in reality.

You’re smart to be thinking about geographic fit and program competitiveness already, but I’d challenge you to go even one step deeper: start actively exploring different specialties from day one of med school. And not just by shadowing residents or talking to near-peers—connect with attending-level physicians. Residents and fellows are still in the thick of training and may not have full visibility into what the long-term lifestyle, career arc, or job market actually looks like.

In terms of Internal Medicine:

• The average Step 2 CK score for successful applicants is around 245–251.
  
  
• More competitive academic IM programs (especially in the Northeast) typically favor scores above 250, which puts you in the 75th percentile nationally.
  
  
• There’s no great resource for score ranges by geographic region, but prestige and selectivity do correlate loosely with higher scores and academic output.
  

Beyond scores, strong clinical evals, solid LORs, and some meaningful research (even one project with a poster or presentation) go a long way. If you can show real interest in a region—via ties, away rotations, or relationships—that helps too.

But again, what will really set you apart is clarity. And the only way to get that clarity is by starting early and going deep—before the pressure of third year compresses your options. You're asking the right questions already. Keep going.