Going to a Top Tier residency program from a mid-tier school

[DrVanNostran]

I go to a "mid-tier" school. I was wondering, what do the "top-tier" programs look for from a student like me? Do they want higher board scores, more research, more extracurricular activities? I went through a bunch of house staff rosters and it really seems that a majority of students at the best places come from the best schools with a handful of students from lower-ranking schools.

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[atsai3]

I go to a "mid-tier" school. I was wondering, what do the "top-tier" programs look for from a student like me? Do they want higher board scores, more research, more extracurricular activities? I went through a bunch of house staff rosters and it really seems that a majority of students at the best places come from the best schools with a handful of students from lower-ranking schools.

Board scores, grades, research, stellar letters. Not so much the extracurricular activities, unless you have one activity that is something like like "founded Partners in Health and singlehandedly altered the trajectory of World Health Organization treatment policy on tuberculosis in resource-limited settings". People on the selection committee will be saying things like "we've never had a resident from Backwater State Medical School. What does 'honors' mean -- we have no idea what the training is like there". Good comments and detailed letters can help put that to rest.

You can also think about picking one or two programs where you really would like to match-- and then do an away rotation. (Clearly this can backfire. If you aren't stellar then you could end up lower on their rank list than you would have had you not done the away rotation.)

-AT.

 

[DrVanNostran]

Board scores, grades, research, stellar letters. Not so much the extracurricular activities, unless you have one activity that is something like like "founded Partners in Health and singlehandedly altered the trajectory of World Health Organization treatment policy on tuberculosis in resource-limited settings". People on the selection committee will be saying things like "we've never had a resident from Backwater State Medical School. What does 'honors' mean -- we have no idea what the training is like there". Good comments and detailed letters can help put that to rest.

You can also think about picking one or two programs where you really would like to match-- and then do an away rotation. (Clearly this can backfire. If you aren't stellar then you could end up lower on their rank list than you would have had you not done the away rotation.)

-AT.

Thanks for the input, I really appreciate it 😀

 

[Anon527]

I'm from a mid-tier school and got very good interviews (eg: Hopkins, MGH, Penn etc). Based on my experiences and my friends' - I think the key is Honors in your core clerkship in Medicine. Honors in other clinical clerkships and a 240+ board score helps as well. Honors in your subI and 1-3 medicine electives is very important. Great LORs, especially a strong subI letter and substantial research are other major factors. Consider taking a year off to do research (HHMI/Doris Duke are great options) - but you don't have to, I didn't...

An away at a place that you're interested is certainly helpful. I don't recommend a subI (b/c hard to pick up new hospital system/emr) - pick an elective. Work hard, read a lot and have a good attitude - it'll pay off by having attendings and residents dropping the PD a line saying you were great to work with. Make sure you meet with the PD when you're there...try and talk to as many residents as you can when away. Note several programs take resident feedback in admissions very seriously.

Understand that many of these programs are looking for candidates who want to be "leaders" in the fields - either through research or otherwise. So have specific goals and speak about them, and you can always throw in that it might change based on residency experiences, but at least you have goals.

 

[Deferoxamine]

Okay I'm bored right now and there's nothing on TV, so I'll go ahead and spill some details for the nervous MS3's.

I know a lot of people dismiss certain elements of the application (extracurriculars in med school, leadership experience, occupation and activities before med school, Personal Statement, Step 2 CK, etc.). However, after watching my classmates and I all go through this process together over the past 5 months, I'm convinced that these things start to matter when the cohort of 240+ / AOA / Research / Honors in Medicine group gets bigger and bigger. If the rumors from the trail this season are true, then top programs clearly had more qualified applicants than usual this season, and they were probably forced to look at other things on the application.

This year on the interview trail, applicants discussed this stuff a lot (often to the point where it became annoying). I stayed in touch with about 5 or so other applicants I met this season, and we'd swap notes about programs we liked or hated, which places are or aren't interviewing us or our friends, etc.

People give the usual shpiel about "The Big 4". Those that got invites from MGH usually got one from Hopkins too, and vice versa. Brigham and UCSF were once again the ceiling, and those of us that broke that threshold almost always got both MGH/Hopkins as well.

This season also taught us not to underestimate the UPenn / UWash / Michigan / Columbia / Duke cluster. They are extremely picky eaters with pretty unpredictable interview invite patterns. Getting interviews from these places often depended on your medical school's relationship with that particular program, as well as your geography (regional bias, if you're perceived to be "urban" or "small town", etc). If you grew up locally or went to med school locally, you probably got pretty strong consideration from them. If you're applying from 10 states away, it's not impossible, but still an uphill battle. I'd argue that this group is quickly becoming the toughest to please. I'd throw WashU into this category to round out the "Top 10" (whatever the hell that even means anymore), but they seemed to extend far more invites to people probably because they have a very large intern class to fill.

My piece of good news to upcoming IM applicants is that the grass isn't necessarily that much greener at some of these "top" programs, other than a glamorous fellowship Match List. There are plenty of other Top 20/25/30 programs that impressed the pants off of a lot of us, and really do seem to provide everything we are looking for in a strong IM residency program --- plenty challenging with tons of doors open for your career, but with a gut feeling that left you feeling like you would definitely thrive there with those colleagues, that PD, etc. Many of these places seemed more in tune with our personalities, our families, our hobbies, our career goals. And at the end of the day, that's pretty tough to ignore.

I'm sure I'll be told to STFU by some experts or whatever, but I'm just dishing it out. Only 1 guy's opinion here, probably flawed. But I think someone here might be curious to hear someone else's view besides the usual SDN cardiology gamebot "If I don't match at the Big 4, I'm a disgrace to my family" nonsense.

EDITED TO ADD: I also agree with what atsai and Anon wrote above me.

 

[jdh71]

Okay I'm bored right now and there's nothing on TV, so I'll go ahead and spill some details for the nervous MS3's.

I know a lot of people dismiss certain elements of the application (extracurriculars in med school, leadership experience, occupation and activities before med school, Personal Statement, Step 2 CK, etc.). However, after watching my classmates and I all go through this process together over the past 5 months, I'm convinced that these things start to matter when the cohort of 240+ / AOA / Research / Honors in Medicine group gets bigger and bigger. If the rumors from the trail this season are true, then top programs clearly had more qualified applicants than usual this season, and they were probably forced to look at other things on the application.

This year on the interview trail, applicants discussed this stuff a lot (often to the point where it became annoying). I stayed in touch with about 5 or so other applicants I met this season, and we'd swap notes about programs we liked or hated, which places are or aren't interviewing us or our friends, etc.

People give the usual shpiel about "The Big 4". Those that got invites from MGH usually got one from Hopkins too, and vice versa. Brigham and UCSF were once again the ceiling, and those of us that broke that threshold almost always got both MGH/Hopkins as well.

This season also taught us not to underestimate the UPenn / UWash / Michigan / Columbia / Duke cluster. They are extremely picky eaters with pretty unpredictable interview invite patterns. Getting interviews from these places often depended on your medical school's relationship with that particular program, as well as your geography (regional bias, if you're perceived to be "urban" or "small town", etc). If you grew up locally or went to med school locally, you probably got pretty strong consideration from them. If you're applying from 10 states away, it's not impossible, but still an uphill battle. I'd argue that this group is quickly becoming the toughest to please. I'd throw WashU into this category to round out the "Top 10" (whatever the hell that even means anymore), but they seemed to extend far more invites to people probably because they have a very large intern class to fill.

My piece of good news to upcoming IM applicants is that the grass isn't necessarily that much greener at some of these "top" programs, other than a glamorous fellowship Match List. There are plenty of other Top 20/25/30 programs that impressed the pants off of a lot of us, and really do seem to provide everything we are looking for in a strong IM residency program --- plenty challenging with tons of doors open for your career, but with a gut feeling that left you feeling like you would definitely thrive there with those colleagues, that PD, etc. Many of these places seemed more in tune with our personalities, our families, our hobbies, our career goals. And at the end of the day, that's pretty tough to ignore.

I'm sure I'll be told to STFU by some experts or whatever, but I'm just dishing it out. Only 1 guy's opinion here, probably flawed. But I think someone here might be curious to hear someone else's view besides the usual SDN cardiology gamebot "If I don't match at the Big 4, I'm a disgrace to my family" nonsense.

Good stuff

I hope you don't stop posting in here in the coming years.

 

[deuce]

Anybody who got a BW interview got a UCSF interview this year; not quite the other way around - both these programs were very tough interviews - believe what you want, but when match day rolls around, getting into these IM programs is easily as difficult as getting a great urology, plastics spot (if not derma)..bravo to anyone who matches at these places

MGH was a bit harder to get an interview than JHU; but at both I was surprised who was getting interviews from my school - there were definitely kids there with boards <<250, not AOA..will be interesting to see who matches

Columbia was slightly harder than Penn interview than some of the other "tier 2 programs" re selectivity, but that may be because my school is in the northeast too and far too few applicants to Michigan and Duke to make meaningful assessment, but lets get real, vast majority of people will go to Columbia rather than Durham or Ann Arbor

the "best " programs ? hands down Penn , Wash U, when you factor in everything including education/service balance and collegiality. These programs deserve more props IMO. They don't bust you chops like Duke or Ann Arbor, let alone MGH or the Hop, much better facilities and less commuting than UCSF, and unlike skewed experience at BW, full panoply of patients, spectrum of illness, tertiary care and venues..but of course . most people like NY, Boston and SF over St Louis and Philly

 

[infarct]

Anybody who got a BW interview got a UCSF interview this year; not quite the other way around - both these programs were very tough interviews - believe what you want, but when match day rolls around, getting into these IM programs is easily as difficult as getting a great urology, plastics spot (if not derma)..bravo to anyone who matches at these places

MGH was a bit harder to get an interview than JHU; but at both I was surprised who was getting interviews from my school - there were definitely kids there with boards <<250, not AOA..will be interesting to see who matches

Columbia was slightly harder than Penn interview than some of the other "tier 2 programs" re selectivity, but that may be because my school is in the northeast too and far too few applicants to Michigan and Duke to make meaningful assessment, but lets get real, vast majority of people will go to Columbia rather than Durham or Ann Arbor

the "best " programs ? hands down Penn , Wash U, when you factor in everything including education/service balance and collegiality. These programs deserve more props IMO. They don't bust you chops like Duke or Ann Arbor, let alone MGH or the Hop, much better facilities and less commuting than UCSF, and unlike skewed experience at BW, full panoply of patients, spectrum of illness, tertiary care and venues..but of course . most people like NY, Boston and SF over St Louis and Philly

Interesting comments. I donno how you can say you are surprised who is being offered interviews when you arent on the selection committee. It's not really for you to decide. Did you read their applications? Go through their step results? Where yours higher and you didnt get said interviews? Frankly it doesnt matter. They got interviews because they were wanted by the programs. Simple.

 

[DrVanNostran]

Great posts everyone. Thanks for chiming in. It gives hope to us mortals out there 🙂 Although, I am still utterly confused on what to apply for next year.

 

[jdh71]

Interesting comments. I donno how you can say you are surprised who is being offered interviews when you arent on the selection committee. It's not really for you to decide. Did you read their applications? Go through their step results? Where yours higher and you didnt get said interviews? Frankly it doesnt matter. They got interviews because they were wanted by the programs. Simple.

I'm quite frankly aghast these programs would offer an interview to anyone but the only awesome of the awesomest from the mist awesome ever medical school. Because we all know that awesome people are so much better and awesome than the rest of everyone else. I mean seriously less than 250?!? What do these programs want a bunch of obvious ******s?

 

[jdh71]

Great posts everyone. Thanks for chiming in. It gives hope to us mortals out there 🙂 Although, I am still utterly confused on what to apply for next year.

Hope?!!!? You have no hope. Abandon all, ye who even think to apply to programs so obviously above your pedigree.

It might be considered very droll at this time but I'd prevent all of you people from icky mid tier scho from even applying to university programs, outside of your own non-important home university program.

 

[DrVanNostran]

Hope?!!!? You have no hope. Abandon all, ye who even think to apply to programs so obviously above your pedigree.

It might be considered very droll at this time but I'd prevent all of you people from icky mid tier scho from even applying to university programs, outside of your own non-important home university program.

I tried to book a flight through southwest to the northeast and I got blacklisted!

 

[deuce]

of course who gets interviews are not my call- thats a fatuous accusation and I never implied that - I was merely was following up on desferoxamines commenting that certain schools seemed to be having very high cut-offs a priori as to who was getting interviews based on grades/boards; to this extent, by definition, these places are relatively more selective/harder to match at; this does not make JHU is any less august than MGH, it doubtlessly means there will be more overlap applicants ranked to match at MGH who will also be ranked to match at JHU than vice versa ..what is so controversial about that ? is it shocking that UCSF, BW and MGH can be more selective than JHU because more people prefer to spend 3 years in Boston, SF than Baltimore ? and at least at my east coast USNWR top 20 med school, the only students getting interviews at UCSF and BW were AOA with acknowledged Boards scores well into 250+ range; not so picky at any other IM program

BW and UCSF IM residencies every bit as selective it appears as most excellent plastics, urology, rads, ortho residencies (too few people applying in derma or rad onc at my school for me to extrapolate there)

for the record, I would be delighted to match at any of them, but BW simply wont have to go down as far on their rank list as say JHU to match their slots- they interviewed less than half the number of applicants as JHU did this year from what I have been told

 

[DrVanNostran]

My wife and I have been going through IM programs on frieda and we have come up with the list below. My question is, do you think I should apply to more programs? I feel like >50% of my list is reach. So yeah, I am applying to 30+ programs, but possibly 20ish are reaches.

A little about me:
Mid-tier state school and a non-name brand undergrad and MPH
HP in medicine, damn it.
Step 1=240, Step 2=September
Probably won't get AOA, but top 1/3 or 1/4 of class.
Modest ECs, definitely nothing special. 2 leadership positions, mild volunteering, nothing abroad
Awarded a summer research fellowship at a prestigious Cancer institute, but no pub yet...still in the works.
No pubs, just 2 small presentations
LORs: The Chairman letter (which everyone needs), Vice-Chairman letter (I worked with him), Assistant PD (worked with him), Sub-I letter--Will be doing this in July. And if possible, my research letter.
I won't be able to do any aways, my wife will be near the end of her pregnancy, I don't want to miss that 🙂

I did not add my home school on this list. Any places you think I should add? I am interested in Heme-onc>>Cardiology. I'm a Chicago guy, but not in the state for school. Would love to end up in Chicago, but I know that may not be the case.

Thanks 🙂

The 36 programs so far, in no particular order:
MGH
BWH
JHU
UCSF
Duke
Penn
Michigan
Washu
U Washington
Columbia
Yale
Stanford
UCLA
Vandy
UTSW
Pitt
Northwestern
BIDMC

Cornell
UChicago
NYU
MSSM
UCSD

UAB
Wisconsin
UNC
Virginia
Mayo
Emory
Boston U
OHSU
Colorodo
Baylor

Rush
UIC
Loyola

 

[jdh71]

You'll get at least 10 invites with your scores from that list and 10 will be enough. So what if, say 15 are "reaches" (I don't think so, not 15), it's cheap to apply and probably 3-5 take a look with a >240 and research experience.

Nail your sub-I. You are in your way.

Any of those places will find you a nice heme-onc match provided you don't suck as a resident. Good luck!!

 

[deuce]

based on the people who interviewed with me, who matched, and who will be an intern next week, you can't expect more than a handful of those to extend an interview to you, and you must consider MGH, BWH, UCSF major, major reaches - (e.g., many Harvard Med school grads, and AOAS at other schools with board scores > 260 on both part 1 and 2 as well did not match this year at MGH and BWH in IM even though they wanted to ) ; Penn, JHU and Columbia probably as well.

That said, it does sound though like you have a strong set of recommendations, and nailing sub-I will be critical in boosting your chances at places you get interviews at. And medicine is NOT that hard to secure an interview these days, you will get interviews from at least several of the top 20 on your list , and probably most in the second half of your list. and as other poster says , you simply wont be able to interview at much more than 10 - most my classmates really got fatigued and none I know applying in int med felt the need to interview at more than ten programs, few did more than seven, and many did ~5.

as for Chicago, Id say your chances at Northwestern for interview are 50-50, BUT of all the places I had some experience with last year, students really found Northwestern and BIDMC to be much more selective than they anticipated, while Duke and Michigan much less so - why ? doubtlessly it was location and workloads/expectations; unlike med school, let alone undergrad, location is probably the most important criteria for vast majority of 4th year student applicants. They either are married have family and have specific targets where they want to settle raise a family OR they are single and need to be in cities that are very popular with the 25-35 crowd. In either case, even the best students applying in medicine these days want a life as a resident- otherwise why not apply in a surgical discipline ?

One thing I did learn to appreciate on the trail and more recently during orientation - residency is only the first step in the gauntlet- applying for fellowships is no joke, even with the match date move back to third year starting next year. Hem onc and cardiology (still) can be expected to be competitive even three years from now, so give some thought to the prestige of the program and maintaining your research momentum - specifically, if you want to do hem onc be sure to strongly consider ranking/matriculating at those IM residencies that have strong hem onc fellowships-you wont be sorry if you do,trust me


BTW- a few specific comments - unless you are a masochist, take UTSW off your list- Vandy works the residents very hard too, but its a great program so i'D interview there if I got the chance and decide for yourself if the trade off is worth it - and if you get an invite to BIDMC, northwestern, UNC, UVa be sure to make the trips-you wont be disappointed- these programs are every bit as good at Hopkins etc.

Good luck- I think you'll be happy with where you match - the breadth your list suggests you have an open mind re this process-thats very salutory.

 

[lockness21]

.

 

[mercaptovizadeh]

How much would a PhD, but not many other ECs, mean?

Is there number of pubs or the quality more important?

What about knowledge of a useful foreign language (e.g. Spanish, Chinese in SF, etc.)?

 

[jdh71]

As someone who came from a top 30 med school and applied this past year, I think it's safe to say that medicine has taken a huge leap in terms of competition. Based on your scores and your CV, you won't get interviews at MGH, BWH, UCSF, Columbia, Penn, Duke, Stanford, and the Chicago schools will be a stretch. And in the off chance you do get an interview, it's pretty certain you won't match. I'm not trying to be mean, but just giving an opinion.

The one thing I realized about the interview process and match after the whole thing ended was that coming from a non-top 10 medical school really screws you over in terms of lee way. ie, you can't just be AOA and expect to have a chance to match. AOA will get you the interview, but you need to have a near perfect transcript. Even one HP is viewed more negatively from a top 30 school than having 2 HPs from a top 10 school. it sucks, but that's the reality. I found that out the hard way.

My best advice is to keep an open mind, and yes, as deferoxamine has pointed out, look for those diamonds in the rough. You'll find out on the interview trail that programs who are not MGH, BWH, UCSF, actually do have comparable fellowship match lists, and in some cases, even better. (ex. columbia's cards match list is better than UCSF's, and UW's heme/onc match list is just as impressive as MGH's...now that's my opinion. many of you will debate that, but take a close look and you'll see what i saw). The quality of life at some of these programs that aren't Big 4 is also pretty awesome. Some of the happiest and smartest residents I met were at programs I really didn't expect. The whole residency/fellowship road is a really long. There's no point in deferring happiness now for some purported pot of gold later b/c that pot of gold doesn't exist. The joy is in the journey and the ppl you work with.

There exists a certain snobbery in the NE not found elsewhere, so while I agree about MGH, BWH, Columbia, and Penn for sure, and also UCSF (but they are selective of the best regardless of med school from what I've seen from). Stanford likes research orientated people much more than they give a flying rat's about "top medical school". Duke is easily the most "lenient" of the top 10 - is it a location thing? Maybe, but I know plenty of folks from mid tier school who got interviews at Duke with similar stats to DrVan here. The Chicago programs only seem so selective, but they are like UCLA, they merely seem that way because they do give a preference to peeps from the area, rather than folks from the coasts who are like, "Hmm, I guess I could maybe live in Chicago." Dr.Van's CV is good enough to get interviews at the Chicago programs for someone from there.

There's SO much more involved in the process from the program level than you having an honor and AOA and >250 step1. You need to understand why places like Duke, UofChicago, and NWern seem so selective to someone from a top 30 school, is that generally the SAME applicant pool applying to UCSF, Hopkins, MG, BW, etc. are ALSO applying to Duke and NWern and UofChicago, but simply not ranking them as high. So what the point. Programs pick applicants who they think will want to come to their program - otherwise why waste everyone's time?

 

[jdh71]

How much would a PhD, but not many other ECs, mean?

Is there number of pubs or the quality more important?

What about knowledge of a useful foreign language (e.g. Spanish, Chinese in SF, etc.)?

The PhD will help, especially if you're planning to apply to research tracks (they will take you serious). Since most people apply don't really have a ton of publications, just having one is good, more is awesome. It can't hurt you.

Speaking multiple languages makes you interesting and different and can only help.

You still need to nail step1 (have you taken it yet?)

 

[Deferoxamine]

Haha, I forgot about threads like this where I posted before the Match.

As my intern year is right around the corner, I keep forgetting there's a whole new batch of kiddos gearing up for application season. Let's just say I was happy to match here, even happier to move here, and am thoroughly enjoying my morning runs right by the medical center where I begin working next week. There has been something about this program and place all along, where I could just picture myself working here. It's kinda difficult to explain.

Applicants, almost EVERYONE will try telling you to take emotion out of this process, but you can't. Go where you know you'll succeed, and be alert to those funky gut feelings and vibes.

 

[gutonc]

Applicants, almost EVERYONE will try telling you to take emotion out of this process, but you can't. Go where you know you'll succeed, and be alert to those funky gut feelings and vibes.

Those people are idiots, do not listen to them. It's OK to look at the numbers but listen to your gut and go with it.

 

[deuce]

often those places will be the programs many people respond positively too - and other than a few places, the more prestigious programs are not more abusive/thoughtless/lacking in teaching than less distinguished places; if anything just the opposite. "The usual suspect" are the usual suspects for a reason(s). Keep an open mind, set your sights high, THEN go with your gut in ranking programs.

One practical caveat- it IS difficult to get into top selective progams despite what the ROADS advocates suggest. Top medicine programs still attract a disproportionate number of highly successful academically oriented AOA gunner type applicants (maybe because they are not into the money so much ?) so it is competitive despite fact that many programs (even top 10 ones) in IM will interview far more people than they can possibly rank and match - why this is I simply don't know - it goes beyond any AA efforts from what I observed. (In my experience only the BWH kept their interview list down to a plausible level and were highly respectful of your time and money in this regard.) You can quickly exhaust yourself, chew up six months and much $$ interviewing at places that turn out to be a waste of time as other posters have said. To triage, you might limit such interviews at clear reach schools to places that are easier to travel to or in cities you would really like to be in. Its axiomatic that the top students in your class can be more selective and the bottom students in your class have to apply and interview anywhere they can. For most everyone, though, you have to be somewhat strategic and practical at a certain level.

 

[DrVanNostran]

Thanks for the replies everyone. I appreciate your insights and opinions (and Lockness, your post was NOT mean, it was a great opinion and I am very glad you shared). I am definitely going to apply to the "Reach" programs, if I get interviews I will be excited, if not, at least I can say I tried. When I got my HMS rejection letter for medical school it was more expected than death and taxes, but I enjoyed getting a letter from HMS lol.


I really can't wait to interview to get those special vibes Def talks about. I have a gut feeling it may come from a local chicago place, but I want to keep my options open,

I think I will add a few more programs since the cost may be well worth it in 40 year 🙂
Adding: Case, CCF, OSU, UChicago North-Shore, Lutheran General, Iowa.

Any other "gems" I may be missing? I feel like interviews will be such a crap shoot that I might as well go nuts on the application.

 

[jdh71]

Any other "gems" I may be missing? I feel like interviews will be such a crap shoot that I might as well go nuts on the application.

Missing University of Minnesota, Uinversity of Florida - Gainesville, University of Maryland

 

[Deferoxamine]

The 36 programs so far, in no particular order:
MGH
BWH
JHU
UCSF
Duke
Penn
Michigan
Washu
U Washington
Columbia
Yale
Stanford
UCLA
Vandy
UTSW
Pitt
Northwestern
BIDMC

Cornell
UChicago
NYU
MSSM
UCSD

You may be in for a few nice surprises from this group. Despite the way we talk about these things here on SDN, this is not black-and-white. Plus, there's definite regional advantages certain mid-tier schools seem to have with matching at certain Top Tier programs, for example:

Temple/Drexel with UPenn
AECOM/Downstate/NYMC with Columbia/Cornell
UMass/Tufts with the Boston programs
Southern schools with Duke
Midwestern schools with Michigan
etc. etc.

And last but not least, I think you may find the love you get from programs might SLIGHTLY depend on the quality of the cohort applying for Internal Medicine this year from your medical school. As I too was from a mid-tier school, it seems like many places might put a quota on medical schools they are not as familiar with (i.e. "Of these 12 from School X, let's interview the 2 we like the most."). Just a theory. Yet another reason why going to a mid-tier medical school SUCKED.

 

[dragonfly99]

I don't think the OP is likely to be competitive at places like Harvard, UCSF, and probably will not even get an interview. If he has the money, no reason not to try.
He'll get some good interviews w/his application. Doing well in your sub-I is key. Getting a LOR from full professors at your school might help, particularly if they know people @some of these other institutions.

 

[texasguy]

The PhD will help, especially if you're planning to apply to research tracks (they will take you serious). Since most people apply don't really have a ton of publications, just having one is good, more is awesome. It can't hurt you.

Speaking multiple languages makes you interesting and different and can only help.

You still need to nail step1 (have you taken it yet?)

Just wanted to chime in and thank everyone for their comments on behalf of those of us applying this year!

i'm in Mercapto's shoes and am hoping to match at a large university program that'll allow me to continue to keep my feet wet in research.

My board scores are average, I got an HP in medicine back in 3rd year many moons ago (which was my first 3rd year rotation) and my sub-I's coming up! I'm hoping the phd helps me with the match, as well...

Is the interview process more extensive or separate altogether for research-track programs?

 

[jdh71]

Just wanted to chime in and thank everyone for their comments on behalf of those of us applying this year!

i'm in Mercapto's shoes and am hoping to match at a large university program that'll allow me to continue to keep my feet wet in research.

My board scores are average, I got an HP in medicine back in 3rd year many moons ago (which was my first 3rd year rotation) and my sub-I's coming up! I'm hoping the phd helps me with the match, as well...

Is the interview process more extensive or separate altogether for research-track programs?

As I understand it, you apply separately. We need to have gutonc chime back in. He'll have a little more insight. On research pathways, but as I'm sure you understand all too well. There are investigators at many programs that would LOVE to have someone who knows what they are actually doing - a PhD - doing the heavy lifting on their research grants.

 

[mercaptovizadeh]

The PhD will help, especially if you're planning to apply to research tracks (they will take you serious). Since most people apply don't really have a ton of publications, just having one is good, more is awesome. It can't hurt you.

Speaking multiple languages makes you interesting and different and can only help.

You still need to nail step1 (have you taken it yet?)

Yes, I'm in my PhD now. The step 1 score is fine. Trying to learn Spanish during my free time (i.e. nights after I come home from work). Honestly, it's more out of personal interest than resume-padding, but if it helps, that's always good.

Thanks for your input.

 

[atsai3]

There exists a certain snobbery in the NE not found elsewhere, so while I agree about MGH, BWH, Columbia, and Penn for sure, and also UCSF (but they are selective of the best regardless of med school from what I've seen from). Stanford likes research orientated people much more than they give a flying rat's about "top medical school". Duke is easily the most "lenient" of the top 10 - is it a location thing? Maybe, but I know plenty of folks from mid tier school who got interviews at Duke with similar stats to DrVan here. The Chicago programs only seem so selective, but they are like UCLA, they merely seem that way because they do give a preference to peeps from the area, rather than folks from the coasts who are like, "Hmm, I guess I could maybe live in Chicago." Dr.Van's CV is good enough to get interviews at the Chicago programs for someone from there.

There's SO much more involved in the process from the program level than you having an honor and AOA and >250 step1. You need to understand why places like Duke, UofChicago, and NWern seem so selective to someone from a top 30 school, is that generally the SAME applicant pool applying to UCSF, Hopkins, MG, BW, etc. are ALSO applying to Duke and NWern and UofChicago, but simply not ranking them as high. So what the point. Programs pick applicants who they think will want to come to their program - otherwise why waste everyone's time?

Duke and Hopkins tend to be more 'lenient' because

• (a) Durham and Baltimore are not viewed as the most attractive places to live, which forces them to interview more candidates as other comparably sized programs in (say) San Francisco and Boston. My characterization of San Francisco and Boston as "attractive places to live" applies mostly to young, childless, unattached medical students; 35 year-olds with children who are looking to buy a house will see things differently.
• (b) they have the mentality that they can mold you into a great clinician, and therefore your pedigree matters less than raw ability (which can be found at any medical school, not just the "top 10"). Clearly this is true for any residency -- since the point of residency training is to learn medicine -- but it is far more true at these tradition-bound institutions where you are going to be molded into a "Duke marine" or an "Osler marine" (or a "[UT] Southwestern doc"). It's not that there isn't snobbery. It's just of a different form.

 

[sunset823]

based on the people who interviewed with me, who matched, and who will be an intern next week, you can't expect more than a handful of those to extend an interview to you, and you must consider MGH, BWH, UCSF major, major reaches - (e.g., many Harvard Med school grads, and AOAS at other schools with board scores > 260 on both part 1 and 2 as well did not match this year at MGH and BWH in IM even though they wanted to ) ; Penn, JHU and Columbia probably as well.

That said, it does sound though like you have a strong set of recommendations, and nailing sub-I will be critical in boosting your chances at places you get interviews at. And medicine is NOT that hard to secure an interview these days, you will get interviews from at least several of the top 20 on your list , and probably most in the second half of your list. and as other poster says , you simply wont be able to interview at much more than 10 - most my classmates really got fatigued and none I know applying in int med felt the need to interview at more than ten programs, few did more than seven, and many did ~5.

as for Chicago, Id say your chances at Northwestern for interview are 50-50, BUT of all the places I had some experience with last year, students really found Northwestern and BIDMC to be much more selective than they anticipated, while Duke and Michigan much less so - why ? doubtlessly it was location and workloads/expectations; unlike med school, let alone undergrad, location is probably the most important criteria for vast majority of 4th year student applicants. They either are married have family and have specific targets where they want to settle raise a family OR they are single and need to be in cities that are very popular with the 25-35 crowd. In either case, even the best students applying in medicine these days want a life as a resident- otherwise why not apply in a surgical discipline ?

One thing I did learn to appreciate on the trail and more recently during orientation - residency is only the first step in the gauntlet- applying for fellowships is no joke, even with the match date move back to third year starting next year. Hem onc and cardiology (still) can be expected to be competitive even three years from now, so give some thought to the prestige of the program and maintaining your research momentum - specifically, if you want to do hem onc be sure to strongly consider ranking/matriculating at those IM residencies that have strong hem onc fellowships-you wont be sorry if you do,trust me


BTW- a few specific comments - unless you are a masochist, take UTSW off your list- Vandy works the residents very hard too, but its a great program so i'D interview there if I got the chance and decide for yourself if the trade off is worth it - and if you get an invite to BIDMC, northwestern, UNC, UVa be sure to make the trips-you wont be disappointed- these programs are every bit as good at Hopkins etc.

Good luck- I think you'll be happy with where you match - the breadth your list suggests you have an open mind re this process-thats very salutory.

As someone who came from a top 30 med school and applied this past year, I think it's safe to say that medicine has taken a huge leap in terms of competition. Based on your scores and your CV, you won't get interviews at MGH, BWH, UCSF, Columbia, Penn, Duke, Stanford, and the Chicago schools will be a stretch. And in the off chance you do get an interview, it's pretty certain you won't match. I'm not trying to be mean, but just giving an opinion.

The one thing I realized about the interview process and match after the whole thing ended was that coming from a non-top 10 medical school really screws you over in terms of lee way. ie, you can't just be AOA and expect to have a chance to match. AOA will get you the interview, but you need to have a near perfect transcript. Even one HP is viewed more negatively from a top 30 school than having 2 HPs from a top 10 school. it sucks, but that's the reality. I found that out the hard way.

wow this thread is depressing. I'm studying for Step 1 right now, but I'm definitely not convinced I could pull out the score the OP did (I think a 240 is fantastic!), but it seems a lot of people here are debbie downers. We are talking IM, right, not ortho or neurosurg??

I'm interested in research (no Phd, but lots of pubs, I'll have 2-3 peer reviewed in heavy hitting journals (not lead author) and several posters come app time) and definitely want to do a fellowship (either critical care (probably without the pulm), heme/onc, or maybe ID - no interest in cards or GI), but I threw out the idea of the Big 4 a long time ago. But is it really getting this hard to match IM at a university program from a mid/low tier school? I'm open about location, though I prefer the snobby northeast, upper Midwest (UMich, Mayo/UMN, Wisconsin), or (fat chance, being a lifelong Midwesterner) pacific northwest. I'll be in the app process next year.

 

[NOsquid]

But is it really getting this hard to match IM at a university program from a mid/low tier school?

Nah, people on this forum just cry if they don't match somewhere in the USnews top 10. If you're a little more open-minded and/or don't enjoy being treated like a frat pledge you'll be fine.

 

[jdh71]

Nah, people on this forum just cry if they don't match somewhere in the USnews top 10. If you're a little more open-minded and/or don't enjoy being treated like a frat pledge you'll be fine.

pwned

 

[jdh71]

wow this thread is depressing. I'm studying for Step 1 right now, but I'm definitely not convinced I could pull out the score the OP did (I think a 240 is fantastic!), but it seems a lot of people here are debbie downers. We are talking IM, right, not ortho or neurosurg??

I'm interested in research (no Phd, but lots of pubs, I'll have 2-3 peer reviewed in heavy hitting journals (not lead author) and several posters come app time) and definitely want to do a fellowship (either critical care (probably without the pulm), heme/onc, or maybe ID - no interest in cards or GI), but I threw out the idea of the Big 4 a long time ago. But is it really getting this hard to match IM at a university program from a mid/low tier school? I'm open about location, though I prefer the snobby northeast, upper Midwest (UMich, Mayo/UMN, Wisconsin), or (fat chance, being a lifelong Midwesterner) pacific northwest. I'll be in the app process next year.

You're going to be fine homes. Some of the people who post here are kind of idiots. There has been a definite increase in the competitive of the more "elite" programs, and in some ways across the board for IM, but this is still IM. I'm sure it's not lost on you that everything is taken together and it all can help (or hurt, in some cases), but an AMG with a real interest in IM, and research, with publications, is ahead of the game here for sure, and the truth is the future here, literally is wide open for a guy like you, even if you don't score a 250, or make AOA.

 

[jdh71]

Yes, I'm in my PhD now. The step 1 score is fine. Trying to learn Spanish during my free time (i.e. nights after I come home from work). Honestly, it's more out of personal interest than resume-padding, but if it helps, that's always good.

Thanks for your input.

You really shouldn't have too much trouble finding the IM spot you want then.

 

[DrVanNostran]

wow this thread is depressing. I'm studying for Step 1 right now, but I'm definitely not convinced I could pull out the score the OP did (I think a 240 is fantastic!), but it seems a lot of people here are debbie downers. We are talking IM, right, not ortho or neurosurg??

I'm interested in research (no Phd, but lots of pubs, I'll have 2-3 peer reviewed in heavy hitting journals (not lead author) and several posters come app time) and definitely want to do a fellowship (either critical care (probably without the pulm), heme/onc, or maybe ID - no interest in cards or GI), but I threw out the idea of the Big 4 a long time ago. But is it really getting this hard to match IM at a university program from a mid/low tier school? I'm open about location, though I prefer the snobby northeast, upper Midwest (UMich, Mayo/UMN, Wisconsin), or (fat chance, being a lifelong Midwesterner) pacific northwest. I'll be in the app process next year.

Thanks Def, JDH, and others!

You will be fine sunset. The "top" 15-20 programs are definitely going to be tough to match into. The purpose of me posting was to gauge on where ELSE to apply. The first 20ish on my list are programs that tend to be more selective. Remember, thats 20 out of the 386 programs available. There are are over 100 university IM programs. We will match somewhere, but it is a question of where. I am trying to apply broadly like many of the the good folks on this list to to get a feel of different programs and hopefully increasing my chances of an eventual fellowship. Now, go do well on step one. Good luck🙂

 

[texasguy]

As I understand it, you apply separately. We need to have gutonc chime back in. He'll have a little more insight. On research pathways, but as I'm sure you understand all too well. There are investigators at many programs that would LOVE to have someone who knows what they are actually doing - a PhD - doing the heavy lifting on their research grants.

Appreciate the feedback! Yeah, the icing on the cake for me is actually the mentors/PIs present at a lot of the 'top' programs (who I understand I wouldn't get to work with until fellowship) - but that's really what attracts me to them..I'd imagine the residency training at most strong university programs would be comparable. I'm guessing the best time/place to mention that would be at the interview if I can land them...or would it be frowned upon if I were to mention that and not cite the 'amazing clinical opportunities at XYZ hospital' during each interview?

 

[atsai3]

Appreciate the feedback! Yeah, the icing on the cake for me is actually the mentors/PIs present at a lot of the 'top' programs (who I understand I wouldn't get to work with until fellowship) - but that's really what attracts me to them..I'd imagine the residency training at most strong university programs would be comparable. I'm guessing the best time/place to mention that would be at the interview if I can land them...or would it be frowned upon if I were to mention that and not cite the 'amazing clinical opportunities at XYZ hospital' during each interview?

No reason not to mention both as a reason why you would want to match at a specific program.

 

[jdh71]

Thanks Def, JDH, and others!

You will be fine sunset. The "top" 15-20 programs are definitely going to be tough to match into. The purpose of me posting was to gauge on where ELSE to apply. The first 20ish on my list are programs that tend to be more selective. Remember, thats 20 out of the 386 programs available. There are are over 100 university IM programs. We will match somewhere, but it is a question of where. I am trying to apply broadly like many of the the good folks on this list to to get a feel of different programs and hopefully increasing my chances of an eventual fellowship. Now, go do well on step one. Good luck🙂

Honestly . . . It's really only 8 programs in the "top 10" that are super-duper picky. Other programs have their eccentricities but I bet you get at least 5 interviews out of that batch you feel is "top 20".

You'll see this, but, you may not want a top 20 after you've interviewed. Find a good fit personality and career wise. I think s guy like you not only has a good chance of matching to NWern, but you'd probably like it too. Make sure Chicago programs know you're from there. Perhaps list your parents addy ad your "permanent" address, put it in your personal
statement (you can write multiple and have one be Chicago specific and another more general)

My PM box is always open for any opinions you don't want hashed out in the open forum.

Good luck. I love this time of year!!

 

[DrVanNostran]

Honestly . . . It's really only 8 programs in the "top 10" that are super-duper picky. Other programs have their eccentricities but I bet you get at least 5 interviews out of that batch you feel is "top 20".

You'll see this, but, you may not want a top 20 after you've interviewed. Find a good fit personality and career wise. I think s guy like you not only has a good chance of matching to NWern, but you'd probably like it too. Make sure Chicago programs know you're from there. Perhaps list your parents addy ad your "permanent" address, put it in your personal
statement (you can write multiple and have one be Chicago specific and another more general)

My PM box is always open for any opinions you don't want hashed out in the open forum.

Good luck. I love this time of year!!

Definitely will take your recommendation on have a Chicago specific PS.

I have another question, this time LOR related....As of right now, here is what I have:

1. Chairman letter
2. Vice-Chairman letter-Worked with this guy for a month and he offered to write
3. LOR from my research mentor at MDACC
4. Debate between two:
a: I worked with a Nephro attending for a month during my third year, he is an Associate Prof and Assistant PD
b. I am on my sub-I now with an attending who is an Assistant prof.

Do I go with B since that is the "sub-I" letter, or would B carry more weight since this guy has major say for residency selection and a higher professorship?

Thanks!

Edit:
I just wanted to add that rounding with no shelf on my mind is actually a lot of fun. Long rounds aren't to dreadful anymore lol.

 

[deuce]

IM is really a bit strange match wise these days-e.g., very sharp drop off at the top; while BW IM categorical easily as difficult as any plastics rads eye, more difficult than any ortho, and as difficult as any rad onc, derma uro to get into but if drops off pretty quickly after the first 5 on your list and definitely the first 8-10; but with the exception of 2-3 programs at most you certainly don't need to have attended HMS and have 260 + boards and a PhD

the facts are these - medicine overall is not as popular a residency as it once was BUT is still attracts a disproportionate share of really bright intellectual research oriented high achieving and yes gunner types, but there just aren't that many of these types of candidates to fill spots beyond the top 5 and certainly 10 programs - the ROADS specialties are sucking many of them away these days

 

[jdh71]

Definitely will take your recommendation on have a Chicago specific PS.

I have another question, this time LOR related....As of right now, here is what I have:

1. Chairman letter
2. Vice-Chairman letter-Worked with this guy for a month and he offered to write
3. LOR from my research mentor at MDACC
4. Debate between two:
a: I worked with a Nephro attending for a month during my third year, he is an Associate Prof and Assistant PD
b. I am on my sub-I now with an attending who is an Assistant prof.

Do I go with B since that is the "sub-I" letter, or would B carry more weight since this guy has major say for residency selection and a higher professorship?

Thanks!

Edit:
I just wanted to add that rounding with no shelf on my mind is actually a lot of fun. Long rounds aren't to dreadful anymore lol.

Nice that the Vice-Chair offered, that means he wants to write you a GOOD letter. And he should know what a GOOD letter looks like.

The nephro attending is higher up the food chain, so the letter from him will be better, plus you'll have your grade from your sub-I that will do plenty of "talking"

 

[omegaxx]

👍

I'm from a mid-tier school and got very good interviews (eg: Hopkins, MGH, Penn etc). Based on my experiences and my friends' - I think the key is Honors in your core clerkship in Medicine. Honors in other clinical clerkships and a 240+ board score helps as well. Honors in your subI and 1-3 medicine electives is very important. Great LORs, especially a strong subI letter and substantial research are other major factors. Consider taking a year off to do research (HHMI/Doris Duke are great options) - but you don't have to, I didn't...

An away at a place that you're interested is certainly helpful. I don't recommend a subI (b/c hard to pick up new hospital system/emr) - pick an elective. Work hard, read a lot and have a good attitude - it'll pay off by having attendings and residents dropping the PD a line saying you were great to work with. Make sure you meet with the PD when you're there...try and talk to as many residents as you can when away. Note several programs take resident feedback in admissions very seriously.

Understand that many of these programs are looking for candidates who want to be "leaders" in the fields - either through research or otherwise. So have specific goals and speak about them, and you can always throw in that it might change based on residency experiences, but at least you have goals.

👍👍👍

 

[morbo]

The first filter is always numbers. Past that, they start looking at your personal statement, rec letters, and then the peripherals come into play.

Basically, the first people with enticing stuff at the beginning get interviewed, but once you get the interview it's level playing field time.