This should never be the case in medicine. If you had to undergo surgery, who would you want doing the operation: the more experienced, knowledgeable surgeon or the less knowledgeable surgeon who knows a lot of influential people?
Your attitude is disgusting. It's what's wrong in medicine. When you make medicine a popularity contest, you sacrifice the quality of patient care.
Although I do believe a qualified person should be doing the job, most qualified may not always be the best answer. There are many other factors here that need to be considered.
First off, if you never met someone, how do you know that they're most qualified for the job? Good test scores, and good grades doesn't always directly translate to good employee, good co-worker or good doctor.
Second, there's a baseline level of skill any employee should have to do the job well. However, once you're past that baseline level of skill, I would argue that good personality and how well you work with your colleagues and patients trumps any added skill, which benefits the whole team, and indirectly benefits the patient too.
Of course I'd want the best doctor seeing me. However, if the best doctor is a jerk, and I don't know him...how can I be expected to trust he is the best doctor?
Yet, if there's a doctor who may not be the best, but is more than qualified to do the job, and I know him well, I'll be more inclined to trust him and go to him.
Real life example of this. I've seen a patient get advice about a gastric surgery from a bariatric surgeon himself. Yet, this patient still wanted to talk to the family med doc to get his advice on whether the surgery was a good idea or not. The surgeon is way more qualified to advise this patient on what to do, yet the patient still wanted a second opinion from his family med doc. Why? It's most likely because this patient knew the family doctor, he trusted him.
These are extreme examples, but I'm just using them to clarify my point.
Competitive specialties like derm have numerous students with amazing test scores and grades. I'm speculating here, but they could probably fill their entire residency class with highly qualified students and still have plenty of equally qualified students to reject. Having them know you can give you an edge here. That's why people do away rotations if they really wanna go to a competitive program.
Even if you're highly qualified, I wouldn't be surprised if there was another applicant who is just as qualified, AND they know the program director well.
It's true, good qualifications are important. But, most qualified academically, doesn't always mean best applicant overall. There's a lot more at play here.
You might be most qualified on paper. But are you a good person? Easy to work with? Someone an employer can trust? Someone who can attract and retain patients? A good fit for that program or job? The only way to show that you are all of the above is to meet your employer in person and show them. No amount of test scores, or pieces of paper will be able to prove this to someone as well as you yourself knowing them can. It's human nature, we will trust someone we know over a complete stranger, unless there's a REALLY good reason to go with the stranger.
Of course you'll have your residency interview to show them, but I believe any added face to face time can only help in this regard.
Anyhow, residencies aside. You're gonna want to blow off steam and give your brain a break too, that's a part of doing well. I hope you do find some type of outlet and have at least one person you can talk to and rely on. This training process has been a brutal one, and for me, having some good friends was a big reason why I've made it as far as I have.
