How hard would it be to come back home (California) for residency?

[jrlybob1]

Born and raised in LA and did my undergraduate and gap years in SoCal as well. So nearly 25 years here. I'm probably going OOS for med school at a mid-high tier USMD. My question is, how much do regional and family ties help you in residency applications? Am I going to have to go above and beyond to even have a chance of matching in California? Compared to a student that attends a CA MD school. Or am I realistically going to be matching in the region of my med school.

Thanks in advance, sorry if this is posted in the wrong forum

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[Mr.Smile12]

I don't think you have to worry. Those who know the ERAS process can comment better, but if you are a strong candidate with an express interest to signal going back to California, you should be fine. Most of us know California applicants are "everywhere."

 

[jvquarterback]

Depends on how competitive your residency program is. If you want derm or plastics look into research opportunities and fourth year clinical options starting today. If you want IM just set up your subis at your preferred locations back home during fourth year and you should be good.

 

[amoxicillin_resistant]

I don't think you have to worry. Those who know the ERAS process can comment better, but if you are a strong candidate with an express interest to signal going back to California, you should be fine. Most of us know California applicants are "everywhere."

what about for mid competitive residencies like gen surg or neurology?

 

[gyngyn]

what about for mid competitive residencies like gen surg or neurology?

Neuro would be easy.
Gen surg is more competitive, but with a good Step 2, letters, and sub-I, you'll have as good a chance as anybody from a similar school in CA.

 

[deleted1208015]

Too many unknown factors to give a predictable answer to your question. The biggest factors would be your specialty and med school performance. CA programs won't "ding" you for going out of state. You would 100% need to make sure to mark the west coast as a geographic signal and use several program signals in the LA area. With that being said, several medical schools in California are very found of matching their own students, but you should be able to overcome this.

There's also the possibility you might change your mind and do residency outside of California.

 

[Entadus]

depends on specialty, but overall easier than getting into med school

(med school in midwest here, SOAP'ed into IM in SoCal)

 

[Choсolate]

I don't want to make a new thread, but I am in a slightly similar situation, so I would be grateful for some thoughts. I was born and raised on the west coast, which is where all of my family is also living. Currently also attending a medical school on the west coast. I have never been been to, nor do I have any connections in Florida, but I would nonetheless really really really like to match into residency in Florida, preferably Tampa (for reasons too long to state here). How feasible is this? Is Florida a competitive state to match into? Also, I am an average/below average student (trying really hard, but its really hard to compete against those with photographic memory and reasoning)

 

[eforest]

There are a lot of things that happen between premed and residency. People from my east coast school matched all over the country. I decided to focus on a state where I had no family, no ties, because I wanted a change. Had no issues getting interviews and wound up at my first choice.

 

[esob]

It depends on your ability to do a sub-i, which, if you do well, can often move you to the top of the candidate pool.

 

[RangerBob]

With regards to CA:

Med school: Ridiculously hard to get accepted in state--don't count on it. Maybe 25% odds (my best guess from how things were when I applied). Certainly not 50/50.

Residency: Easier to match in state if you went to med school there simply because you'll have more local connections/may have rotated at a community hospital with a residency program/residency programs may be familiar with your letter writers/mentors/etc, so you get a leg up. This can be abated by doing audition rotations where you're interested in going. In general, this advice is all true of matching into any state other than where you went to med school, but CA residency programs are typically more competitive on average because it's a more desirable state to live in.

Attending-hood: Have a medical degree (doesn't matter where)? Check. Board certified/eligible? Check. Heart beat? Check. Hire applicant. (True of all states--other than academic jobs and some jobs in very congested metro areas, you'll often have little to no competition.

I grew up in CA, went out of state for med school. For PM&R we only had 5 CA programs and most aren't really that great for what I wanted to do, so I ended up staying in the Midwest for residency. But I think if I wanted to prioritize coming back to CA and ranked those programs higher, I likely could have. Regardless, getting an attending job here was no issue whatsoever. Literally all community hospitals care about is are you legally able to practice medicine. Ideally you don't have a lot of baggage (personality issues, multiple malpractice cases, etc.), but you'd be surprised at how often those are not an impediment to getting a job--once you're at attending the market is very much in your favor.

With regards to matching into states you have no ties to, I found some programs didn't offer me preliminary (TY/pre-lim IM) interviews because they didn't think I was interested in matching there. Now, one of those states was known for not being "desirable" (Iowa), and another was in a not-so desirable city of a mid-tier desirable state, but after my application had been sitting for a while at those 2 or 3 programs I called them and the program coordinators told me I was a competitive/competitive enough applicant, but they didn't initially offer me an interview because they didn't think I was that interested in going there. I told them I was very interested in the program and at least one gave me an interview invite while I was on the phone, and I think the other one or two checked with the PD and gave me an invite later in the day or the next day.

Now, preliminary programs are different than categorical programs. For the later, people are much more likely to be willing to relocate, but if your application has been pending for a while and you know interview invites have been ongoing for a few weeks (follow your specialty thread here on SDN to see as every program sends invites out at a different time), it may not hurt to give a quick/polite call to say "I'm really interested in going here and wanted to check in on the status of my application, verify nothing was missing, etc."

 

[jrlybob1]

With regards to CA:

Med school: Ridiculously hard to get accepted in state--don't count on it. Maybe 25% odds (my best guess from how things were when I applied). Certainly not 50/50.

Residency: Easier to match in state if you went to med school there simply because you'll have more local connections/may have rotated at a community hospital with a residency program/residency programs may be familiar with your letter writers/mentors/etc, so you get a leg up. This can be abated by doing audition rotations where you're interested in going. In general, this advice is all true of matching into any state other than where you went to med school, but CA residency programs are typically more competitive on average because it's a more desirable state to live in.

Attending-hood: Have a medical degree (doesn't matter where)? Check. Board certified/eligible? Check. Heart beat? Check. Hire applicant. (True of all states--other than academic jobs and some jobs in very congested metro areas, you'll often have little to no competition.

I grew up in CA, went out of state for med school. For PM&R we only had 5 CA programs and most aren't really that great for what I wanted to do, so I ended up staying in the Midwest for residency. But I think if I wanted to prioritize coming back to CA and ranked those programs higher, I likely could have. Regardless, getting an attending job here was no issue whatsoever. Literally all community hospitals care about is are you legally able to practice medicine. Ideally you don't have a lot of baggage (personality issues, multiple malpractice cases, etc.), but you'd be surprised at how often those are not an impediment to getting a job--once you're at attending the market is very much in your favor.

With regards to matching into states you have no ties to, I found some programs didn't offer me preliminary (TY/pre-lim IM) interviews because they didn't think I was interested in matching there. Now, one of those states was known for not being "desirable" (Iowa), and another was in a not-so desirable city of a mid-tier desirable state, but after my application had been sitting for a while at those 2 or 3 programs I called them and the program coordinators told me I was a competitive/competitive enough applicant, but they didn't initially offer me an interview because they didn't think I was that interested in going there. I told them I was very interested in the program and at least one gave me an interview invite while I was on the phone, and I think the other one or two checked with the PD and gave me an invite later in the day or the next day.

Now, preliminary programs are different than categorical programs. For the later, people are much more likely to be willing to relocate, but if your application has been pending for a while and you know interview invites have been ongoing for a few weeks (follow your specialty thread here on SDN to see as every program sends invites out at a different time), it may not hurt to give a quick/polite call to say "I'm really interested in going here and wanted to check in on the status of my application, verify nothing was missing, etc."

Thank you for the detailed response. I am on the WL for a UC school so fingers crossed! If it doesn't work out, sounds like I'll be fine for residency as long as I express my interest/ties/desire to stay in CA and do my auditions there.