How to "read" a school's match list?

[Dr.Sticks]

No. Research is one aspect .
The reality is that these places have money for toys , new technology, ancillary staffing, in house specialists of every stripe, you get to see some of the rarer medical conditions since they tend to be national referral centers and the benefits could go on. You are also training with academics so you will probably be up to date on the latest treatments etc. The benefits of training on this level are probably non trivial.

Sure, but that doesn't change the fact that being at a level 1 academic teaching hospital in a city isn't a priority for everyone.

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[Dr.Sticks]

True but beside the point. With the right app, most schools will get you were you need to go but not my point. My entire point was inbreeding at low/er tier schools is a red flag to me, when reading multiple match lists for the same school.

So the match is inbreeding for Neurosurgery, Ortho, Rad Onc, Derm, etc
Still a red flag?
Or do you only get suspicious when it is for stuff like Family Med or Internal Medicine?

 

[libertyyne]

True but beside the point. With the right app, most schools will get you were you need to go but not my point. My entire point was inbreeding at low/er tier schools is a red flag to me, when reading multiple match lists for the same school.

It isn't besides the point though. If the end goal is to become a dermatologist and your school has a dermatologist program where they take three residents each year. Would you go to that red flag school or a different school that doesn't have that inbreeding but lands a dermatologist spot every 5 years?

 

[libertyyne]

Sure, but that doesn't change the fact that being at a level 1 academic teaching hospital in a city isn't a priority for everyone.

I am not saying it is for everyone. I am saying there are more opportunities at these places and your training *might benefit from it.

 

[Mad Jack]

Hey everyone,

I've heard people saying that the match rate at most if not all USMD schools are quite high, and instead of worrying about match rate, I should look at the schools' match list to see if they can match into "competitive residencies". How would you classify a residency as "competitive"? What should i be looking for specifically in a school's match list? Any way to quantify this for a school in order to compare between schools?

Thanks a bunch

Impression: Moderate competitiveness. Cannot rule out high competitiveness complicated by primary care mission. Recommend follow-up on March 17th for definitive diagnosis.

 

[AnatomyGrey12]

No. Research is one aspect .
The reality is that these places have money for toys , new technology, ancillary staffing, in house specialists of every stripe, you get to see some of the rarer medical conditions since they tend to be national referral centers and the benefits could go on. You are also training with academics so you will probably be up to date on the latest treatments etc. The benefits of training on this level are probably non trivial.

Actually some of the more "prestigious" programs may not have the benefit you think. An example, the Mayo Clinic is extremely well regarded right? World renowned even. Well multiple surgical residents on these forums and to my face in real life have told me it is a bad place to train as a surgeon because you don't operate. I see this at the hospital I work at, most visibly on ortho. The guys who trained at big name programs quite frankly aren't great at operating, sure they are brilliant and have knowledge up the wazoo but the fresh community trained guys operate in circles around them because they were in the OR from day 1 of intern year.
One downside to all of these big name places that you talk about are that people come to be treated by big wig Dr. X, not some resident.

Also don't forget that the vast vast majority of medical students have literally no desire to be an academic big wig. They just want to be good, clinically strong community docs in whatever field they choose.

 

[750335]

So the match is inbreeding for Neurosurgery, Ortho, Rad Onc, Derm, etc
Still a red flag?
Or do you only get suspicious when it is for stuff like Family Med or Internal Medicine?

You are putting words in my mouth. I didn't mention prestige, and I also didn't mention any programs/specialties.

But:

It makes sense for them to stay back for competitive specialties; for one, few spots generally. Secondly, they tend to not be part of the core rotations, so chances are the only exposure you have/network/research experience is your limited exposure with the department at your home institution. Particularly in the past when away rotations were not as popular, but in most inbred schools it isn't just one or two departments though. They are all over their match list, and I highly doubt it is because all their residency programs are top notch.

We can drop it though, we won't convince each other.

 

[750335]

It isn't besides the point though. If the end goal is to become a dermatologist and your school has a dermatologist program where they take three residents each year. Would you go to that red flag school or a different school that doesn't have that inbreeding but lands a dermatologist spot every 5 years?

You guys are complicating my stance. I didn't say anything about the benefits or demerits of any school or program. I do stand by the fact that inbreeding in most (lower tier) places is likely out of necessity not loyalty. Obviously can't prove it with hard facts, but the personal decisions angle is a cop out I'm not buying. Like med school acceptance in general, sometimes, all you have is the one and you have to take it.

Also, I just read this PD's post on radiology which made me think of another dimension. He/she said, his/her program doesn't take a lot of imgs or dos because of the perception that if they do they couldn't attract better students. Never even thought of that for match list but I will add it to my distaste for inbreeding* because same could apply to inbreeding too.

 

[mimelim]

Doesn't that make it like, a terrible variable? Someone that applies to only the top and gets one of their less favorite among great options, can't really be called less successful than someone who matched their top rank because their top rank was a local community center.

No, it doesn't. Again, this is why you, at the point in training that you are at can not analyze this information. You may be obsessed with "the top" based on whatever external source you choose, but most people aren't and as previously explained several times what is someone's top choice is dependent on where they get interviews at and a whole host of personal factors. The success of a match is determined by how far down your rank list you go, the ONLY mitigating factor is that you can only rank programs that you interview at. No, you are not "more successful" going to a program with an attached name brand medical school.

You absolutely want to go to a strong program for your residency training. But, the concept that those attached to brand name medical schools are simply better or one-size fit all is incredibly naive. It depends on your career aims and where you want to end up, never mind the obvious biases in terms of specialty selection.

Is it not common for people to say "I'll be happy enough wherever, I just want to aim high" and apply to a list of generally best regarded places?

I would say that that it is pretty uncommon. Most people have realized by the time they hit their late 20s that "aiming high" for the sake of it is not the recipe for happiness. Is it important to end up at a program that will train you well, yes. But, again, the obsession with prestige/name disappears pretty quickly for many/most.

Why does geography become so powerful at the residency level, for a bunch of people that were happy to move across the country for college and/or medical school to go somewhere "da best" ?

Maybe it is a manifestation of where you went to undergrad and the people that you are around, but the majority of college aged people ARE geographically influenced. My high school on the East coast sent 5 people to Wash U. All of them returned to within 15 miles of our high school after graduating from Wash U with the exception of me. Yes, I moved considerable distances, as did many of my colleagues, but it is naive to think that we are the majority. And yes, this does shift even more as people age. Spouses, kids and aging parents play a huge role and yes, 4-5 years makes a difference. The average age of matriculants is what 24? That means an average of 28 with very few people younger than 26.

Do you think most people are like you, or are a huge chunk still like the crowd applying to medical schools and happy to live somewhere cold/hot, expensive etc as long as it is regarded extraordinarily well?

I would say that I am one of the more extreme examples in terms of moving and being happy. Of all the residents in our program, I have moved furthest distance if you include HS-->Undergrad-->Medical school --> Residency and it isn't very close. I am also one of the few that doesn't have children, despite being married for 8 years now. And after watching hundreds if not now a thousand students go through this process, I'd say that very few MS4s ignore geography or are minimally influenced by it. Climate and expense play a significant role. Just ask Mayo.

And the biggest question: how much does your residency matter for fellowships and/or the job afterwards? Is the standout student that matches Podunk Community Hospital to be near family on even grounds with the MGH grad for that competitive fellowship, or job? Do the program directors agree that nobody cares about prestige any more and they probably only went to Podunk for personal reasons?

You can't include fellowships and jobs in the same sentence. For starters, the majority of people don't do fellowships. Many know that they won't going into their program. Yes, what program you go to matters for fellowships, but again, it is the same as the residency match. It is even MORE individualized. People apply to fewer and more select programs. It is incredibly common for people to only interview at a handful of programs and say, "well if I don't get into one of these couple of programs that fit my academic interests and my personal constraints, I'll just go practice medicine as a Board Certified whatever". I would say that of the 3-4 institutions that I have spent a fair bit of time at the number that do that instead of, "I'm applying to dozens of programs and need this fellowship to continue" is probably 2-3 to 1.

This isn't about "not caring" about prestige anymore. This is about it simply not mattering to many people at baseline. Do they notice it? Of course. But does it drive or change decision making? No. By the time you finish residency, you have 3-7 years of more data about you available for evaluation. Again, comparing "podunk hospital" to MGH is silly. Nobody is arguing that there aren't differences in the extremes. Training environments vary. But, when looking at a match list, can YOU figure this out? No. I'm sorry, but you can't. Never mind all of the community hospitals associated with big name medical schools that are mediocre community training programs that to the untrained eye simply look like an HMS or Cornell program.

For the job market? Where you train makes a big difference in where you find a job. But, that is by virtue of the connections that you derive, not the relative competitiveness of where you went. All of my job offers have come from meeting people at conferences, being on the board of various entities, or introductions made by my faculty. But, the lions share of these are academic positions. For private positions? This matters little. What private practices are looking for is completely different than any of this and well beyond the scope of this thread.

 

[mimelim]

No. Research is one aspect .
The reality is that these places have money for toys , new technology, ancillary staffing, in house specialists of every stripe, you get to see some of the rarer medical conditions since they tend to be national referral centers and the benefits could go on. You are also training with academics so you will probably be up to date on the latest treatments etc. The benefits of training on this level are probably non trivial.

Research is the only thing. Access to clinical trials is another.

The toys that you need to do your job in that field will be available at community hospitals. The ancillary staffing tends to be better at community hospitals. In house specialists is not really different. You rarely interact with the super specialized folks and certainly are not trained by them. The fact that they are treating rare stuff completely independent of you does not impact your training in a meaningful way. Community hospital training programs are just as up to date as the academic centers. Sometimes they are even more progressive because they aren't as big and bulky and can change how they practice more easily.

On the other hand, the downsides at major academic centers can be immense. The most notable of course is clinical training. The raw number of cases that you do as a surgical trainee is not tied to the name of the parent school. It depends on a number of things, strength/volume of the practice it is built on, number of other trainees, lack of fellows above you taking the cases and faculty that will teach you. It is NOT uncommon for surgery residents graduating from the "big name" programs to not be able to operate at the same level as other programs. There are even some that the inside joke is that they HAVE to do fellowship, because otherwise they won't be able to operate. While it is mean and certainly not completely accurate, there is a certain element of truth to it.

It isn't besides the point though. If the end goal is to become a dermatologist and your school has a dermatologist program where they take three residents each year. Would you go to that red flag school or a different school that doesn't have that inbreeding but lands a dermatologist spot every 5 years?

#1 There are 124 Derm programs making up 1,400 trainees out of 130,000 ACGME trainees. While relevant for a handful of people every year, lets not pretend that this is an example that should be extrapolated from in any meaningful way.

#2 Personally, nobody should be picking what school they go to based on a single preferred specialty. However, the mentality is understandable. Yes, having a home program is important. Having academic faculty in a competitive specialty is helpful for research opportunities and mentorship and certainly having a program that tends to take their own residents is a good sign. But, again, this isn't about looking at and evaluating a match list as a whole and very rarely do you actually find those kinds of trends of meaningful size. We are still talking about very small sample sizes.

 

[efle]

No, it doesn't. Again, this is why you, at the point in training that you are at can not analyze this information. You may be obsessed with "the top" based on whatever external source you choose, but most people aren't and as previously explained several times what is someone's top choice is dependent on where they get interviews at and a whole host of personal factors. The success of a match is determined by how far down your rank list you go, the ONLY mitigating factor is that you can only rank programs that you interview at. No, you are not "more successful" going to a program with an attached name brand medical school.

You absolutely want to go to a strong program for your residency training. But, the concept that those attached to brand name medical schools are simply better or one-size fit all is incredibly naive. It depends on your career aims and where you want to end up, never mind the obvious biases in terms of specialty selection.

Maybe I phrased it poorly, let me make sure we are on the same page. Student A applies to derm at a bunch of competitive places and ends up matching their 4th ranked, UCSF. Student B applies to some community peds programs in a small city and gets their 1st ranked. Student B should be considered better evidence that grads of this school are very successful in the match?

I would say that that it is pretty uncommon. Most people have realized by the time they hit their late 20s that "aiming high" for the sake of it is not the recipe for happiness. Is it important to end up at a program that will train you well, yes. But, again, the obsession with prestige/name disappears pretty quickly for many/most.

Glad to hear this, I thought there would be a big chunk of people still gunning for prestige in med school.

Maybe it is a manifestation of where you went to undergrad and the people that you are around, but the majority of college aged people ARE geographically influenced. My high school on the East coast sent 5 people to Wash U. All of them returned to within 15 miles of our high school after graduating from Wash U with the exception of me. Yes, I moved considerable distances, as did many of my colleagues, but it is naive to think that we are the majority. And yes, this does shift even more as people age. Spouses, kids and aging parents play a huge role and yes, 4-5 years makes a difference. The average age of matriculants is what 24? That means an average of 28 with very few people younger than 26.

Yeah this must be a personal experience difference, because almost all the high achievers from my high school in SoCal went all over the country for college and the ones I've checked on facebook are usually still all over the place for various kinds of grad school.

Climate and expense play a significant role. Just ask Mayo.

Does Mayo struggle to get applicants?

when looking at a match list, can YOU figure this out? No. I'm sorry, but you can't. Never mind all of the community hospitals associated with big name medical schools that are mediocre community training programs that to the untrained eye simply look like an HMS or Cornell program.

We really should test this with some blinded match examples that have home institution removed, same area for the school and length of the lists matched. I'm very curious how accurately someone with zero experience like myself can distinguish say, "top 20" vs typical state vs brand new program, that kind of thing. Maybe I can test this out with one of my buddies and report back.

But, that is by virtue of the connections that you derive, not the relative competitiveness of where you went.

One more big question then: what it is that makes relatively more competitive residencies, relatively more competitive? If nobody is chasing prestige and the training isn't that superior and it doesn't get you better jobs except for a small minority...why are so many clamoring for certain places like MGH IM? Everybody and their families has a strong personal geographic preference to live in Boston?

 

[mimelim]

Maybe I phrased it poorly, let me make sure we are on the same page. Student A applies to derm at a bunch of competitive places and ends up matching their 4th ranked, UCSF. Student B applies to some community peds programs in a small city and gets their 1st ranked. Student B should be considered better evidence that grads of this school are very successful in the match?

Yes. They ended up where they wanted. (again with that caveat always thrown in that you can't tell if they would have interviewed at other places if they were given the opportunity) One could argue that this ONLY applies to people's first choice since everything after that is on a continuum and me matching at my 5th choice is the same as you matching at your 2nd (if my 2-5 are close in terms of how much I want them).

Glad to hear this, I thought there would be a big chunk of people still gunning for prestige in med school.

There are still plenty, mostly clustered in the big name schools. Some people figure it out in medical school, others when they actually make it to residency. I can think of a resident at a very academic program who absolutely hates where he is at right now because he has no interest in academics. He wants to take care of patients and be a doctor. Well, you can't JUST do that in academics. You have to do other stuff. But, he is afraid that he is now backed into doing yet another 1-2 years of training via fellowship because he won't be ready for independent practice and his program will be disappointed in him and not support him not getting an academic job.

Yeah this must be a personal experience difference, because almost all the high achievers from my high school in SoCal went all over the country for college and the ones I've checked on facebook are usually still all over the place for various kinds of grad school.

Another thing to consider, virtually everyone I went to undergrad/medical school with from California was looking for a way back for medical school or residency. Few did because there were simply less spots available than people able to go. It keeps going, I took a cursory glance at the job market in several major cities in California, I would take a 20-40% pay cut AND be forced to live in a far more expensive area.

Does Mayo struggle to get applicants?

I was a reasonably desirable applicant when I applied to residency. I applied to all but maybe 6 integrated vascular programs, Mayo was one of them. I am far from the only one. They don't struggle to match because there are an abundance of students that simply need spots and it is a good hospital. But, it most certainly hurts compared to other programs to attract students.

We really should test this with some blinded match examples that have home institution removed, same area for the school and length of the lists matched. I'm very curious how accurately someone with zero experience like myself can distinguish say, "top 20" vs typical state vs brand new program, that kind of thing. Maybe I can test this out with one of my buddies and report back.

I don't understand what you are trying to do. You mean look at a match list blind and see if you can tell if the school is highly ranked? I would think that you can, I certainly would be able to, don't think I implied otherwise anywhere. The issue is on the residency side, relative competitiveness of programs is not easy to figure out.

One more big question then: what it is that makes relatively more competitive residencies, relatively more competitive? If nobody is chasing prestige and the training isn't that superior and it doesn't get you better jobs except for a small minority...why are so many clamoring for certain places like MGH IM? Everybody and their families has a strong personal geographic preference to live in Boston?

Are tons of people clamoring for MGH IM? I am unaware of how many applications they get vs. how many spots they have compared to other IM programs across the country. My only data point is that the year I applied I know of two people that didn't rank them in their top 3. What makes them more competitive? Specialty, location and then institutional factors. I am in no way saying that where you train doesn't matter. I am saying that of all the people applying to IM in a given cycle, only a handful are even thinking about/considering MGH.

 

[efle]

Yes. They ended up where they wanted. (again with that caveat always thrown in that you can't tell if they would have interviewed at other places if they were given the opportunity) One could argue that this ONLY applies to people's first choice since everything after that is on a continuum and me matching at my 5th choice is the same as you matching at your 2nd (if my 2-5 are close in terms of how much I want them).

I would love to get the perspective of some other residents or attendings on this. I feel like you might be in the minority viewing only preference, and not the difficulty of achieving that preference, as the metric.

I don't understand what you are trying to do. You mean look at a match list blind and see if you can tell if the school is highly ranked? I would think that you can, I certainly would be able to, don't think I implied otherwise anywhere. The issue is on the residency side, relative competitiveness of programs is not easy to figure out.

What would give away the fact the list came from a highly ranked school, if not presence of many competitive res program matches?

Are tons of people clamoring for MGH IM? I am unaware of how many applications they get vs. how many spots they have compared to other IM programs across the country. My only data point is that the year I applied I know of two people that didn't rank them in their top 3. What makes them more competitive? Specialty, location and then institutional factors. I am in no way saying that where you train doesn't matter. I am saying that of all the people applying to IM in a given cycle, only a handful are even thinking about/considering MGH.

So to clarify, you do not personally believe MGH IM has a reputation that attracts an app from many of the best/most impressive med students? You feel any selectivity they have comes from things like geography and funding levels?

How do you feel about medical school competitiveness in comparison? Does the fact that Drexel has about the same apps per admit as Harvard mean that they are similarly desirable/competitive?

 

[Dr.Sticks]

I would love to get the perspective of some other residents or attendings on this. I feel like you might be in the minority viewing only preference, and not the difficulty of achieving that preference, as the metric.

@Jalby

 

[gyngyn]

An outsider to my specialty would never be able to guess which program is the most highly regarded, nor which highly regarded institutions have terrible programs.

 

[Dr.Sticks]

An outsider to my specialty would never be able to guess which program is the most highly regarded, nor which highly regarded institutions have terrible programs.

What's your specialty if you don't mind sharing?

 

[efle]

What's your specialty if you don't mind sharing?

You've been reading his name "gin gin" I take it

 

[efle]

An outsider to my specialty would never be able to guess which program is the most highly regarded, nor which highly regarded institutions have terrible programs.

North Carolina?

 

[Dr.Sticks]

You've been reading his name "gin gin" I take it

Oh..
Gynecologist
/facepalm
I also thought gyngyn was a female
Don't ask why

 

[Doctor Strange]

I would love to get the perspective of some other residents or attendings on this. I feel like you might be in the minority viewing only preference, and not the difficulty of achieving that preference, as the metric.


What would give away the fact the list came from a highly ranked school, if not presence of many competitive res program matches?



So to clarify, you do not personally believe MGH IM has a reputation that attracts an app from many of the best/most impressive med students? You feel any selectivity they have comes from things like geography and funding levels?

How do you feel about medical school competitiveness in comparison? Does the fact that Drexel has about the same apps per admit as Harvard mean that they are similarly desirable/competitive?

I feel like you're missing the big picture here. Matching at my top program is by far more important to me than how prestigious that program I ranked at the top is. It's my top program for a variety of reasons, and, while prestige is certainly one of them, it's not even remotely the major factor. I have programs I interviewed at that are far better ranked nationally but not even in my top three.

The Match is, more than anything, a very individualized process. It is not so much a metric of the quality of the school but the values that students at those schools tend to attract. Simply looking at where people matched tells you NOTHING about how happy they are with that match or how that match aligns with their individual values.

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[gyngyn]

North Carolina?

I only share this kind of info with those I'm directly responsible for (on a need to know basis)!
I can tell you that "top 10" medical schools can have really weak surgical programs (including Gyn).
Likewise, a program in the "deep" south might have the best reputation among insiders.

 

[efle]

I feel like you're missing the big picture here. Matching at my top program is by far more important to me than how prestigious that program I ranked at the top is. It's my top program for a variety of reasons, and, while prestige is certainly one of them, it's not even remotely the major factor. I have programs I interviewed at that are far better ranked nationally but not even in my top three.

The Match is, more than anything, a very individualized process. It is not so much a metric of the quality of the school but the values that students at those schools tend to attract. Simply looking at where people matched tells you NOTHING about how happy they are with that match or how that match aligns with their individual values.

So what in your opinion explains the much higher prevalence of prestigious matches coming out of the top med schools? Are those cohorts just weighting prestige more heavily on average? Or they're more inclined to want research funding and it just so happens the $$ opportunities overlaps with reputation?

 

[libertyyne]

So what I am gathering from this is that there needs to be a database of all the programs and

Average Hours worked per week
Case load/volume
Vacation/benefits
Call schedule
Didactics / education
CME days
Level of oversight
Attrition rates/transfer rates
Job placement rates /time to job offer
Pay
Housing stipend/subsidy
Survey of recent grads

To help make an informed decision about where to apply.

It seems like connections between the school dean/faculty and PDs may be a driving force considering they can only tell the students about the programs they are familiar with and this might be another reason for geographical patterns in placement.

 

[Doctor Strange]

So what in your opinion explains the much higher prevalence of prestigious matches coming out of the top med schools? Are those cohorts just weighting prestige more heavily on average? Or they're more inclined to want research funding and it just so happens the $$ opportunities overlaps with reputation?

It's a combination of all of the above.

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[Cyberdyne 101]

Actually some of the more "prestigious" programs may not have the benefit you think. An example, the Mayo Clinic is extremely well regarded right? World renowned even. Well multiple surgical residents on these forums and to my face in real life have told me it is a bad place to train as a surgeon because you don't operate. I see this at the hospital I work at, most visibly on ortho. The guys who trained at big name programs quite frankly aren't great at operating, sure they are brilliant and have knowledge up the wazoo but the fresh community trained guys operate in circles around them because they were in the OR from day 1 of intern year.
One downside to all of these big name places that you talk about are that people come to be treated by big wig Dr. X, not some resident.

Also don't forget that the vast vast majority of medical students have literally no desire to be an academic big wig. They just want to be good, clinically strong community docs in whatever field they choose.

Excellent post.

However, there must be some big name departments that offer stellar clinical/surgical training.

 

[mimelim]

I would love to get the perspective of some other residents or attendings on this. I feel like you might be in the minority viewing only preference, and not the difficulty of achieving that preference, as the metric.

I don't get it. You think that someone is less successful because they did exactly what they wanted and ended up at the program of their dreams, but it isn't associated with a highly ranked medical school? How does that logically compute?

So to clarify, you do not personally believe MGH IM has a reputation that attracts an app from many of the best/most impressive med students? You feel any selectivity they have comes from things like geography and funding levels?

How do you feel about medical school competitiveness in comparison? Does the fact that Drexel has about the same apps per admit as Harvard mean that they are similarly desirable/competitive?

*sigh* I'm still not sure if you are trolling. MGH IM has a reputation, like every program. How it stacks up against other IM programs, I have no idea. How desirable it is compared to other programs, I have no idea. Within vascular surgery, I have a pretty good feel, but only have having spent the better part of 6 years living and breathing vascular. You don't know the top programs in each specialty because the lay person does not know them. Even within each specialty, there are going to be variations in what people desire, most notably geographic location. MGH IM may be a great program. But, as @gyngyn points out, his specialty is just as misleading on surface value. At this point, from my perspective, you have drifted into the arguing for the sake of arguing and don't have an inclination to learn more about this topic. Therefore, I am going to exit at this point.

 

[efle]

I don't get it. You think that someone is less successful because they did exactly what they wanted and ended up at the program of their dreams, but it isn't associated with a highly ranked medical school? How does that logically compute?

I don't think I've ever mentioned association with a highly ranked medical school? Lets say Student A goes Miami Ophtho which was his third ranked, Student B gets their first ranked community peds. Am I really crazy to say a match list full of the former would reasonably give a different impression than a list full of the latter?

Therefore, I am going to exit at this point.

I don't think I'm that recalcitrant for asking those questions...

 

[Doctor Strange]

I don't think I've ever mentioned association with a highly ranked medical school? Lets say Student A goes Miami Ophtho which was his third ranked, Student B gets their first ranked community peds. Am I really crazy to say a match list full of the former would reasonably give a different impression than a list full of the latter?


I don't think I'm that recalcitrant for asking those questions...

Sure, it gives an impression, but it's misleading. Student B is thrilled. Student A may be happy to have matched into ophtho at all but may not be completely over the rainbow. The thing is, there's no way you can tell that from just looking at the match list, and, in the end, why does that matter? What matters is where you're going to rank and where you will want to end up in the future. You can't possibly know that for sure until you get to that stage in your life.

Even if there is some way to objectively measure how "good" a match list is, it's ultimately matters so little for the general applicant population and is so nuanced that it shouldn't even be worth considering when choosing a medical school.

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[Doctor Strange]

I don't think I'm that recalcitrant for asking those questions...

Spoiler alert: you are.

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[efle]

Sure, it gives an impression, but it's misleading. Student B is thrilled. Student A may be happy to have matched into ophtho at all but may not be completely over the rainbow. The thing is, there's no way you can tell that from just looking at the match list, and, in the end, why does that matter? What matters is where you're going to rank and where you will want to end up in the future. You can't possibly know that for sure until you get to that stage in your life.

Even if there is some way to objectively measure how "good" a match list is, it's ultimately matters so little for the general applicant population and is so nuanced that it shouldn't even be worth considering when choosing a medical school.

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I'll readily agree with the second point, I wouldn't ever use a match list to pick my med school. That's a totally different point than saying match lists are an enigma.

Again I think there are analogies elsewhere. My sibling wanted to attend an unknown liberal arts college and didn't even apply Ivy League, but I wouldn't argue from that most LACs and the Ivy League are equivalently impressive in their own ways as long as everyone ends up happy.

Spoiler alert: you are.

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How so? I'm legit confused as to why apps/seats would be a good metric, or whether the common SDN parlance about matching derm or matching MGH IM etc is wildly inaccurate. I had the impression that among residency applicants for a given specialty there were some places known to be a congregation point for the best and brightest, and that matching to such places would generally be harder than others. I'd never try to assess from a match list how happy people are with their matches, but I might try to get an idea of how high achieving the grads tend to be.

 

[AnatomyGrey12]

Excellent post.

However, there must be some big name departments that offer stellar clinical/surgical training.

Never said there isn't, UTSW is one that comes to mind, mostly just pointing out that big name =\= good training and that unless you have intimate knowledge of that specific field then you can't know which ones are which. I can look at a match list and go "ooh look they had some people match Yale for gen surg" but how am I supposed to know whether they are even a good program? Even a lot of medical students have no idea.

Another example is the research component, maybe that guy who matched at X community surgery program chose it because it was near his family, offered great clinical training, and he didn't want to do the 2 years of research often associated with large university programs. He might know he just wants to be a community surgeon at the local level 1 and never do research again. Maybe he knows that he could have good success getting a job in the area if he goes to that community program because they have some connections, maybe he was a 245+ candidate as well and could have gone wherever he wanted. The big thing is that we have no way of knowing any of things without a sit down personal discussion with him, but to him his match went absolutely perfectly.

but I might try to get an idea of how high achieving the grads tend to be.

The only idea you will get is what kind of students that school tends to recruit. Also remember that this is essentially population statistics, that have no bearing on how your individual match will go and cannot be extrapolated to you as a singular data point

 

[efle]

The only idea you will get is what kind of students that school tends to recruit. Also remember that this is essentially population statistics, that have no bearing on how your individual match will go and cannot be extrapolated to you as a singular data point

Sure, I'd def look at it as "who tends to go here" not "will this school help me match X"

 

[ace_inhibitor111]

Never said there isn't, UTSW is one that comes to mind, mostly just pointing out that big name =\= good training and that unless you have intimate knowledge of that specific field then you can't know which ones are which. I can look at a match list and go "ooh look they had some people match Yale for gen surg" but how am I supposed to know whether they are even a good program? Even a lot of medical students have no idea.

Another example is the research component, maybe that guy who matched at X community surgery program chose it because it was near his family, offered great clinical training, and he didn't want to do the 2 years of research often associated with large university programs. He might know he just wants to be a community surgeon at the local level 1 and never do research again. Maybe he knows that he could have good success getting a job in the area if he goes to that community program because they have some connections, maybe he was a 245+ candidate as well and could have gone wherever he wanted. The big thing is that we have no way of knowing any of things without a sit down personal discussion with him, but to him his match went absolutely perfectly.



The only idea you will get is what kind of students that school tends to recruit. Also remember that this is essentially population statistics, that have no bearing on how your individual match will go and cannot be extrapolated to you as a singular data point

But why is it that we see hardly anyone pick a community program at top schools? Looking at schools like UPenn, Harvard, JHU, Stanford, for example, I think it would be reasonable to assume that most of their students get their top choice, and have good advising to boot. Can't we assume that the programs they pick are generally good programs, and use these results to judge the match lists of other schools? Don't get me wrong, there are a few students who pick the less "prestigious" program over the more prestigious program for several reasons, but these seem to be U of Illinois over Yale rather than XXX Middlebury Clinic over Yale, etc.

(Yes, I am aware that students at top schools have an inclination towards prestige, but if personal factors are argued to weigh more heavily as med students age I would think it be true for those at the top 10 as well)

 

[Doctor Strange]

I think it would be reasonable to assume that most of their students get their top choice, and have good advising to boot.

This is a false assumption.

Yes, I am aware that students at top schools have an inclination towards prestige, but if personal factors are argued to weigh more heavily as med students age I would think it be true for those at the top 10 as well

These factors are not mutually exclusive.

 

[efle]

This is a false assumption.

Don't a lot of the top schools advertise some insane number like 90%+ matched to their rank 1-3 choices?

 

[gyngyn]

Don't a lot of the top schools advertise some insane number like 90%+ matched to their rank 1-3 choices?

Most schools do.
You can only match into programs that interviewed you...

 

[efle]

Most schools do.
You can only match into programs that interviewed you...

So then, if we see a bunch of people going somewhere we know they both interviewed (because they went there) and ranked it highly (since almost everyone is going to 1-3).

The question stands: If there is no magic surrounding some of these places, if they aren't a place known for filling with the best peeps, then why are the grads of top programs ranking them highly and going there so much more often?

 

[Doctor Strange]

So then, if we see a bunch of people going somewhere we know they both interviewed (because they went there) and ranked it highly (since almost everyone is going to 1-3).

The question stands: If there is no magic surrounding some of these places, if they aren't a place known for filling with the best peeps, then why are the grads of top programs ranking them highly and going there so much more often?

You keep asking the same questions and somehow are hoping to get us to give you a different answer that you want to hear. We've been over this. There are multiple factors... perceived prestige, academic vs community, research opportunities, advice from faculty mentors (whom have been there for years advising students)... Like I've said, different schools tend to attract different flavors of students. Is it so hard to swallow that students at "prestigious" schools simply tend to arbitrarily apply to more "prestigious" residency programs?

I'm also peacing out. It's like talking to a brick wall here.

Bye Felicia. Have fun with med school.

 

[efle]

You keep asking the same questions and somehow are hoping to get us to give you a different answer that you want to hear. We've been over this. There are multiple factors... perceived prestige, academic vs community, research opportunities, advice from faculty mentors (whom have been there for years advising students)... Like I've said, different schools tend to attract different flavors of students. Is it so hard to swallow that students at "prestigious" schools simply tend to arbitrarily apply to more "prestigious" residency programs?

I'm also peacing out. It's like talking to a brick wall here.

Bye Felicia. Have fun with med school.

It's because the answers haven't explained the phenomenon. It's like I keep asking "So are some med schools regarded as the best? Why do strong applicants from all over the country seem to congregate in certain places?" and the answer I keep getting is "Many factors go into choosing a medical school to attend, especially location, or maybe they were advised to go there, etc." Totally doesn't explain.

And yeah "it's arbitrary" is the lamest, least convincing possible answer.

Thanks I will! It will be interesting in the next few years to see whether there really is or isn't a pervading sense of most competitive/desirable residencies (per whatever specialty I go for) among my classmates and advisers. People certainly have location preferences etc for med school apps but that hasn't blocked out such a sense at this stage.

 

[gyngyn]

So then, if we see a bunch of people going somewhere we know they both interviewed (because they went there) and ranked it highly (since almost everyone is going to 1-3).

The question stands: If there is no magic surrounding some of these places, if they aren't a place known for filling with the best peeps, then why are the grads of top programs ranking them highly and going there so much more often?

You would need to know which were actually better programs and how they were ranked by individuals at different schools.
"Ivies" disproportionately fill with many Ivy grads. Whether this is because the students aren't actually aware of which programs are better or that these programs are used to choosing them is not clear. I see plenty of programs associated with fine medical schools that I wouldn't recommend.

 

[efle]

Whether this is because the students aren't actually aware of which programs are better or that these programs are used to choosing them is not clear.

Dang, really? Like large numbers of, say, Penn grads stay in their system for various specialties because alternatives aren't even on their radar?

 

[gyngyn]

Dang, really? Like large numbers of, say, Penn grads stay in their system for various specialties because alternatives aren't even on their radar?

Depending on how isolated your advisors are, they could just be repeating advice that was outdated a decade ago.
I see this all the time. It's similar to how you guys laugh at bad pre med advisors at otherwise excellent schools.

 

[BurghStudent]

It's hard to read.

I know people who give up matching at competitive places for family.

There are rank lists (lol), then there are real lists, i.e. maybe you don't care how many R01's the department has, is the department friendly towards having a baby in residency.

In the end, yeah Harvard vs Drexel is gonna look different.

 

[efle]

Depending on how isolated your advisors are, they could just be repeating advice that was outdated a decade ago.
I see this all the time. It's similar to how you guys laugh at bad pre med advisors at otherwise excellent schools.

Well damn, I'm really out of luck if advisers won't know of the best places, and SDN will tell me "best places" doesn't exist with any consensus at the residency level

 

[gyngyn]

Well damn, I'm really out of luck if advisers won't know of the best places, and SDN will tell me "best places" doesn't exist with any consensus at the residency level

Best programs exist. They just vary tremendously by specialty and aren't necessarily as good as the medical schools that they are associated with.

 

[Astra]

Best programs exist. They just vary tremendously by specialty and aren't necessarily as good as the medical schools that they are associated with.

Curious, do best programs fluctuate year to year ( a prominent doctor goes elsewhere, a program gets a new grant, a program gets new equipment etc.) or is it relatively stable similar to med school rankings?

 

[gyngyn]

Curious, do best programs fluctuate year to year ( a prominent doctor goes elsewhere, a program gets a new grant, a program gets new equipment etc.) or is it relatively stable similar to med school rankings?

The key components of a program are: a sufficient depth and breadth of cases, a sufficient number of cases for the number of residents, attendings who maintain a high level of scholarship and know how to teach, and an administration that is fair in its decisions and schedules.
The quality of a program can suffer or soar with a change in any of these factors.
Given how quickly hospital affiliations change and faculty re-locate, program quality can change faster than perceived quality change at medical schools.

 

[Astra]

The key components of a program are: a sufficient depth and breadth of cases, a sufficient number of cases for the number of residents, attendings who maintain a high level of scholarship and know how to teach, an administration that is fair in its decisions and schedules.
The quality of a program can suffer or soar with a change in any of these factors.
Given how quickly hospital affiliations change and faculty re-locate, program quality can change faster than perceived quality change at medical schools.

That's very enlightening.

Seems like trying to understand match lists as an incoming med student is even more a fool's errand because when looking at past match lists, a top program at that time might be mediocre now and this will lead to someone incorrectly thinking that school has never matched at a top program.

Thanks a lot for your reply!

 

[AnatomyGrey12]

will tell me "best places" doesn't exist with any consensus at the residency level

The issue is that the "best" is very subjective. What do you mean by best? What is best to one applicant may not be the best for another, are you looking for lots of high powered research? Well known academic faculty for mentorship? Fellowship opps? Lots of unique weird zebra cases? Lots of bread and butter? A program that is more open to you having a baby (if you are female)? Somewhere that will give you great technical skill and clinical prowess?

See the issue? First you have to determine what you mean by "best" and then realize that the criteria may be completely different for another applicant applying to the exact same specialty.

 

[efle]

The issue is that the "best" is very subjective. What do you mean by best? What is best to one applicant may not be the best for another, are you looking for lots of high powered research? Well known academic faculty for mentorship? Fellowship opps? Lots of unique weird zebra cases? Lots of bread and butter? A program that is more open to you having a baby (if you are female)? Somewhere that will give you great technical skill and clinical prowess?

See the issue? First you have to determine what you mean by "best" and then realize that the criteria may be completely different for another applicant applying to the exact same specialty.

I mean "best" as in reputation. You can apply the same logic to something like colleges or med schools - what is best for me might be cheap, local and with optional lecture while best for someone else might be lots of research, small class size, PBL etc. The fact that people will each have unique preferences doesn't stop me from being able to rattle off a handful of "best" names that would be agreed upon/also listed for that prompt by most.

I had the impression before this thread that similar is true of some residencies for a given specialty, like if you asked a bunch of IM peeps who was "best" handful you'd get some variation of Hopkins/MGH/B&W/UCSF etc not "well you see, what makes something best is different for each person depending especially on location..."

I've had a couple people tell me I'm dead wrong so far, so I suppose I'll learn how wrong I am in a few short years here.