How important are basic science grades to top IM programs?

[Clemson Doc]

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We know that clinical rotation grades, as well as Step 1 scores, are important to internal medicine residency directors. It's also important to show a genuine interest in IM, and do a really good job on your medicine rotation and sub-internship. And getting good letters of recommendation is certainly important.

However, I have heard varying things about the importance of grades in basic science classes. Most have said that they aren't that important, even at top programs, while others have said that you need AOA status at top programs. If anyone out there has any advice on this, or any first-hand experience with low to average basic science grades and competitiveness at top programs, please share.

I am interested in IM programs with primary care tracks, if that helps anyone.

Thanks in advance!

 

[Clemson Doc]

I am surprised nobody has responded yet, because this has to be something that others have thought about as well. Anyone? Thanks in advance.

 

[Saabdriver]

I don't know the answer to your question but at least at my school you don't exactly need to ace your preclinical classes to get AOA. I think that its probably AOA > honors in Medicine clerkship > honors in other clinical clerkships > Step I scores > honors in preclinical courses but that's just my $0.02.

 

[eighty-twenty]

We know that clinical rotation grades, as well as Step 1 scores, are important to internal medicine residency directors. It's also important to show a genuine interest in IM, and do a really good job on your medicine rotation and sub-internship. And getting good letters of recommendation is certainly important.

However, I have heard varying things about the importance of grades in basic science classes. Most have said that they aren't that important, even at top programs, while others have said that you need AOA status at top programs. If anyone out there has any advice on this, or any first-hand experience with low to average basic science grades and competitiveness at top programs, please share.

I am interested in IM programs with primary care tracks, if that helps anyone.

Thanks in advance!

This is what I got from talking with a program director, a chief resident, and my friends who are housestaff at these "top" places (who were in on the selection process for previous classes):

Applicants are sorted first by AOA, USMLE Step 1 scores and whether you're MD/PhD (they tend to go in a separate pile).
They cannot filter on grades through ERAS at the moment.
So if you've got any of the those three, you may pass the first cut.
Then they look at the whole package (letters, pubs, clinical performance etc) , with preference for people who would likely stay in academics. The top IM programs obviously want to produce people who will eventually lead depts. at other places or the next MacArthur award winner.

Also, after doing an away at a certain hospital in Boston (where at least a third of the housestaff are dual-degree), I realized that it's not just AOA and good board scores. Having something different, such as significant international field work or novel research, gives you an edge. That said, if two people are equal after interviews, they look at grades as the tie-breaker.

 

[Clemson Doc]

This is what I got from talking with a program director, a chief resident, and my friends who are housestaff at these "top" places (who were in on the selection process for previous classes):

Applicants are sorted first by AOA, USMLE Step 1 scores and whether you're MD/PhD (they tend to go in a separate pile).
They cannot filter on grades through ERAS at the moment.
So if you've got any of the those three, you may pass the first cut.
Then they look at the whole package (letters, pubs, clinical performance etc) , with preference for people who would likely stay in academics. The top IM programs obviously want to produce people who will eventually lead depts. at other places or the next MacArthur award winner.

Also, after doing an away at a certain hospital in Boston (where at least a third of the housestaff are dual-degree), I realized that it's not just AOA and good board scores. Having something different, such as significant international field work or novel research, gives you an edge. That said, if two people are equal after interviews, they look at grades as the tie-breaker.

Thanks for your reply. I am fairly confident that I want to do an internal medicine residency with a primary care track (which most top programs have). Although I am leaning toward private practice, I would still prefer to get great training at a top institution. Do you think these things apply for primary care tracks also, or do they not expect as many general IM folks to stay in academic medicine?

 

[eighty-twenty]

Thanks for your reply. I am fairly confident that I want to do an internal medicine residency with a primary care track (which most top programs have). Although I am leaning toward private practice, I would still prefer to get great training at a top institution. Do you think these things apply for primary care tracks also, or do they not expect as many general IM folks to stay in academic medicine?

Don't tell them you're going into private practice. This is relatively contraindicated among academic IM programs--even for primary care. If anything, meet halfway and tell them you like the idea of a (teaching) hospitalist, community/public health, or are considering a fellowship.

Besides, I question the need (but not the desire) to match at a "top" academic program if you're not going into academics nor considering a fellowship. Pedigree doesn't matter as much in private practice. Great training in your case may relate more to breadth of patient population and relationship between attendings and housestaff.

 

[eighty-twenty]

Thanks for your reply. I am fairly confident that I want to do an internal medicine residency with a primary care track (which most top programs have). Although I am leaning toward private practice, I would still prefer to get great training at a top institution. Do you think these things apply for primary care tracks also, or do they not expect as many general IM folks to stay in academic medicine?

Don't tell them you're going into private practice. This is relatively contraindicated among academic IM programs--even for primary care. If anything, meet halfway and tell them you like the idea of a (teaching) hospitalist, community/public health, or are considering a fellowship.

Besides, I question the need (but not the desire) to match at a "top" academic program if you're not going into academics nor considering a fellowship. Pedigree doesn't matter as much in private practice. Great training in your case may relate more to breadth of patient population and relationship between attendings and housestaff.

 

[DoctorSax]

Don't tell them you're going into private practice. This is relatively contraindicated among academic IM programs--even for primary care. If anything, meet halfway and tell them you like the idea of a (teaching) hospitalist, community/public health, or are considering a fellowship.

Besides, I question the need (but not the desire) to match at a "top" academic program if you're not going into academics nor considering a fellowship. Pedigree doesn't matter as much in private practice. Great training in your case may relate more to breadth of patient population and relationship between attendings and housestaff.

I totally agree that folks who want to go into private practice right after residency should be exposed to a wide breadth of patients and get exposed to the professional relationships between attendings and housestaff. However, I think that nothing should stop you from telling programs what you want to do, even if it is private practice. Obviously if you're not sure, then tell them that you're not sure--my feeling is that PDs really want to hear what you want to do, even if you are undecided.

And wanting to go into practice after residency instead of fellowship or "academics" is neither a relative nor an absolute contraindication to going to a top-tier program. Go where you think you'll get trained well, learn a whole lot, and get training in the skills you'll need in a general medicine practice, academic or non. In fact, in an era when medicine is becoming more and more subspecialty driven and >90% of IM residents at many programs go into fellowships, the need for good ol' primary care docs in "private practice" is going up. PDs that I encountered on the trail for both primary care and even some categorical tracks were very supportive of folks going into practice instead of fellowship.

Best of luck!

DS