How hard is it to match into competitive specialties in competitive areas with no ties> (NYC, Cali, Chicago)

[Baller27]

As an incoming medical student in the midwest who is interested in leaving for residency, I was wondering just how difficult it is to match into a competitive specialty in a competitive area? Would name brand make that much of a difference, say between a T40 and a T20? (both midwest) I know that prestige matters more now with Step 1 being P/F, but I also see people saying it's much more on the individual student rather than the school. How much can you overcome school name/region when doing so?

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[LunaOri]

It’s possible. Do everything you need to make yourself a great applicant. Away rotations at your top program choices can help.

 

[CJhooper123]

Very hard. It's about connections.

 

[eyeeye_captain]

Obviously you have to do well wherever you go, but I agree that connections get you the farthest. Department strength can make it much easier or harder to make connections and get research. Your letters/phone calls help, but it’s still hard.

Hypothetical Midwest T20 and T40 - UChicago and Wisconsin. If you wanted to do ophtho, the department rankings are flipped, and you would likely get better resources at the lesser ranked school in UW. Jefferson is the classic example of being maybe a T50 but having probably the second best program in the country. Yale is a T10 with maybe a T50 program.

Since it looks like we’ve got an ortho presence, Jefferson is similar there, and Rush benches even higher above its weight.

In my experience, CA and TX are pretty notorious for liking people with connections to those states. Chicago has at least something of a Midwest bias. NYC has a lesser bias for the Northeast. Some of this is also going to be self-selection from applicants, as there are plenty of people who couldn’t possibly live somewhere other than XYZ.

 

[VincentAdultman]

Matching into a competitive specialty is hard. Matching into a competitive specialty in a competitive city is harder. Its going to be easier to do that at a top 20 school simply by virtue of the fact that it'lll be easier to make connections with people who matter. But ultimate it falls on you to be a great applicant because no ones going to write a great letter for a bum.

Away rotations are huge as well.

 

[Baller27]

It’s possible. Do everything you need to make yourself a great applicant. Away rotations at your top program choices can help.

I heard that certain specialties recommend to limit the number of away rotations you can do, is it recommended to just do more?

 

[Baller27]

Very hard. It's about connections.

When you say connections, do you mean LORs and research conferences? Or even just cold-reaching out to faculty at different schools and getting involved in research there?

 

[VincentAdultman]

When you say connections, do you mean LORs and research conferences? Or even just cold-reaching out to faculty at different schools and getting involved in research there?

Yes.

Basically finding someone iportant who will write you a great letter or make a call on your behalf. Its easier to make connections like that at top 20 schools.

 

[VincentAdultman]

Obviously you have to do well wherever you go, but I agree that connections get you the farthest. Department strength can make it much easier or harder to make connections and get research. Your letters/phone calls help, but it’s still hard.

Hypothetical Midwest T20 and T40 - UChicago and Wisconsin. If you wanted to do ophtho, the department rankings are flipped, and you would likely get better resources at the lesser ranked school in UW. Jefferson is the classic example of being maybe a T50 but having probably the second best program in the country. Yale is a T10 with maybe a T50 program.

Since it looks like we’ve got an ortho presence, Jefferson is similar there, and Rush benches even higher above its weight.

In my experience, CA and TX are pretty notorious for liking people with connections to those states. Chicago has at least something of a Midwest bias. NYC has a lesser bias for the Northeast. Some of this is also going to be self-selection from applicants, as there are plenty of people who couldn’t possibly live somewhere other than XYZ.

I overlooked that. Department strength is tricky. At least when I was applying, one of the strongest ortho programs was...Iowa. Maybe better than some Ivy leagues.

 

[Baller27]

Yes.

Basically finding someone iportant who will write you a great letter or make a call on your behalf. Its easier to make connections like that at top 20 schools.

I see, because the department and researchers are more connected across state borders at higher institutions. How effective is cold-emailing for connections in medicine? (did some business in undergrad and know that it was a semi-effective method)

 

[VincentAdultman]

I see, because the department and researchers are more connected across state borders at higher institutions. How effective is cold-emailing for connections in medicine? (did some business in undergrad and know that it was a semi-effective method)

Competitive specialties are small worlds (at least based on my experieince.)

As far as cold-emailing? Eh, never tried it. Guess it couldnt hurt?

 

[LunaOri]

I heard that certain specialties recommend to limit the number of away rotations you can do, is it recommended to just do more?

Your school will advise you. Some schools limit the number you can do. Try to do a couple if you can.

 

[Baller27]

Competitive specialties are small worlds (at least based on my experieince.)

As far as cold-emailing? Eh, never tried it. Guess it couldnt hurt?

Yeah, I don't know if cold-emailing would be frowned upon as it seems rarer for med school

So mainly just word of mouth via conferences and mentor networks it seems

 

[Baller27]

Your school will advise you. Some schools limit the number you can do. Try to do a couple if you can.

Yeah I'll def try to do as many as I can. I'm choosing a school w lesser name for cost so will work harder

 

[Baller27]

Also curious, are top IM programs doable from a T40? What sort of networking do you do for this, bc I heard that IM programs don't necessarily like aways

 

[eyeeye_captain]

I overlooked that. Department strength is tricky. At least when I was applying, one of the strongest ortho programs was...Iowa. Maybe better than some Ivy leagues.

Surprisingly Iowa is a T10 ophtho spot as well. Utah seems to be a heavy hitter for both too *shrug*

Also curious, are top IM programs doable from a T40? What sort of networking do you do for this, bc I heard that IM programs don't necessarily like away

Can be. The Big 4 are notoriously elitist, but even they take some folks from outside the family. You can try to figure out who the big names are at any spot, but everyone is probably going to want to do research with/schmooze them, so who knows how much time they have for you. If they’re on the wards, maybe you butter up the rotation coordinator and try to get on their team and impress them.

Anecdotal, but I randomly wound up on a third year rotation with an internationally known former medicine chair for a good IM program. Based on the LOR he insisted on dictating in front of me, I would have been in excellent shape for a top IM program. For better or worse, I’m an eyeball mechanic instead, with similar connections having gotten me some interviews my application may not otherwise have deserved.

 

[SweetBurger]

i did it, honestly was really hard, need scores, need grades, need research, need someone with a big name in the specialty to vouch for you, plus helps to be charismatic (if we are being honest throw in being physically attractive lol)
Aways are hit or miss (depends on specialty) can hurt or help

 

[Baller27]

Surprisingly Iowa is a T10 ophtho spot as well. Utah seems to be a heavy hitter for both too *shrug*


Can be. The Big 4 are notoriously elitist, but even they take some folks from outside the family. You can try to figure out who the big names are at any spot, but everyone is probably going to want to do research with/schmooze them, so who knows how much time they have for you. If they’re on the wards, maybe you butter up the rotation coordinator and try to get on their team and impress them.

Anecdotal, but I randomly wound up on a third year rotation with an internationally known former medicine chair for a good IM program. Based on the LOR he insisted on dictating in front of me, I would have been in excellent shape for a top IM program. For better or worse, I’m an eyeball mechanic instead, with similar connections having gotten me some interviews my application may not otherwise have deserved.

I see, so did aways help in your case or was it at your home program? It seems that connections is trying to get towards places that have high-ranking people and hoping that you'll rub elbows with them

 

[Baller27]

i did it, honestly was really hard, need scores, need grades, need research, need someone with a big name in the specialty to vouch for you, plus helps to be charismatic (if we are being honest throw in being physically attractive lol)
Aways are hit or miss (depends on specialty) can hurt or help

Thanks for the advice, the good looking part does seem to help anywhere in life lmao. In order to get a big name to vouch for you, did you do it with research or rotations?

 

[eyeeye_captain]

I see, so did aways help in your case or was it at your home program? It seems that connections is trying to get towards places that have high-ranking people and hoping that you'll rub elbows with them

Aways may help you get an interview at a place you’re not necessarily what they’re looking for on paper. You don’t always work with someone long enough to build a relationship like if you were to work on projects or shadow/work on the wards over months to years. As such, it’s harder to get a letter or phone calls from someone. All of my letters, including the IM one, were from my home institution. My lesser known ophtho letter came from a young attending who’d been a star trainee at a very good program, and if I’d gotten that far down my rank list I’m pretty sure I would’ve matched there - not every name has to be “big” if they know the right people.

Aways can bite you if the wrong person doesn’t like you. They can also be a waste. There’s no guarantee you’ll get an interview, and if you do, it may be out of courtesy only. At least for eyes, I think doing a couple is reasonable - one at a program your mentors think is a good fit and one reach. It can be a foot in the door, but it’s more at the individual programs than a specialty as a whole.