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Impact of Geography on Residencies

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Andnosoupforyou

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Hi all,

I was wondering to what extent geographical location is a factor in being accepted to medical school residency? I am originally from the northeast, and anticipate returning to the northeast for residency; however, I've been accepted to one of my dream schools down south. (The school's match list indicates most of its students being matched to regional areas.) Would a school's location be a factor in determining residency placement? Is it something even worth considering when selecting a med school?

Thanks!
 
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cowme

If you are applying to a competitive residency (Rads, Derm, Urology, ENT), geographic bias is HUGE in residency interviews.

I grew up in the midwest, now go to school on the East Coast.

I was 12/17 in scoring East Coast interviews.
I was 3/10 in scoring midwest interviews
-Of places I didn't get interviews, they were all about the same level of competitiveness as places I did.

To be fair, I would prefer staying out east, and if returning to midwest was truly my goal, I could have applied more broadly.

You will definitely get interviews back on the east coast, but there is a regional bias for residency.

That said, definitely go to your dream school. Things usually work out in the match, and if going back East is truly what you want, you will make it work. You will do better in med school if you are happy, which will make your chances stronger to get back home.
 
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nabeel76

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If you are applying to a competitive residency (Rads, Derm, Urology, ENT), geographic bias is HUGE in residency interviews.

I grew up in the midwest, now go to school on the East Coast.

I was 12/17 in scoring East Coast interviews.
I was 3/10 in scoring midwest interviews
-Of places I didn't get interviews, they were all about the same level of competitiveness as places I did.

To be fair, I would prefer staying out east, and if returning to midwest was truly my goal, I could have applied more broadly.

You will definitely get interviews back on the east coast, but there is a regional bias for residency.

That said, definitely go to your dream school. Things usually work out in the match, and if going back East is truly what you want, you will make it work. You will do better in med school if you are happy, which will make your chances stronger to get back home.


I am not sure I understand your point here. It seems to me as if you have more ties to the midwest, having grown up there, than to the east coast, only having completed 4 years of school there, yet you have recieved more interviews on the East Coast? If anything this seems to predict that these schools like to recruit from outside of there region?

However, I don't really think your specific example can be used to predict anything in terms of regional preference, since you realistically have ties to BOTH the midwest and the east coast. I would chalk up your specific interview list to a variety of other factors including pure coincidence before I realistically infered any regional specificity to it.
 
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cowme

I am not sure I understand your point here. It seems to me as if you have more ties to the midwest, having grown up there, than to the east coast, only having completed 4 years of school there, yet you have recieved more interviews on the East Coast? If anything this seems to predict that these schools like to recruit from outside of there region?

However, I don't really think your specific example can be used to predict anything in terms of regional preference, since you realistically have ties to BOTH the midwest and the east coast. I would chalk up your specific interview list to a variety of other factors including pure coincidence before I realistically infered any regional specificity to it.

This was hardly a unique situation for anyone applying in rads or derm this year. I met new yorkers who were in med school in the midwest and didn't feel like they were getting as many NYC interviews as they had hoped. Same with cali people unable to return home.

All your ERAS application states is your birthplace and undergrad, they have no idea where you live the time between. Maybe it was a weird year, but I was not the only person who fared MUCH better in my med school's region than the region I spent the previous 21 years.

But you are certainly correct that my example can't predict anything accurately for the OP, just saying it is not out of the question, especially in super-competitive fields.
 

WingedOx

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It's true there's probably a bias involved... BUT premeds should remember that there is not official in-state residency requirements for residency since you are by definition a hospital employee rather than a university student.

/I've heard that asked more than once here on the pre-allo board.
 

TooMuchResearch

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Hi all,

I was wondering to what extent geographical location is a factor in being accepted to medical school residency? I am originally from the northeast, and anticipate returning to the northeast for residency; however, I've been accepted to one of my dream schools down south. (The school's match list indicates most of its students being matched to regional areas.) Would a school's location be a factor in determining residency placement? Is it something even worth considering when selecting a med school?

Thanks!

I don't think it should be anywhere near the top of the list. From conversations with faculty physicians, I's say the more major geographical factor involved in residency placement is where the applicant is willing to live.
 

WingedOx

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I don't think it should be anywhere near the top of the list. From conversations with faculty physicians, I's say the more major geographical factor involved in residency placement is where the applicant is willing to live.

that's been my experience... of course I'm also not in the world's most competitive specialty (though I'm shooting for the top programs in it). I've had a lot of programs ask "so, umm, why does someone from Philadelphia want to come here to [flyover state]." I usually have to explain that I grew up in that region of the country before they're convinced I wouldn't be totally miserable there :cool:.
 

nogolfinsnow

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I'm a CA native now in the northeast for school, did all my residency interviews back in CA and OR. My advising dean told me to list my parent's address (still in CA) as my permanent address and the first paragraph of my Dean's letter talked about me growing up, going to undergrad, and working in CA before moving East for school. This pretty much got the point across that I have lots of ties to the area. But I also met lots of people on the interview trail who didn't have that personal connection to the West coast. But what it really comes down to is how competitive you are and how impacted the field of your choosing is. I bet if some of the previous posters on this thread were doing peds or medicine instead of ROADs then they would have received interviews anywhere in the country.
 
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cowme

I'm a CA native now in the northeast for school, did all my residency interviews back in CA and OR. My advising dean told me to list my parent's address (still in CA) as my permanent address and the first paragraph of my Dean's letter talked about me growing up, going to undergrad, and working in CA before moving East for school. This pretty much got the point across that I have lots of ties to the area. But I also met lots of people on the interview trail who didn't have that personal connection to the West coast. But what it really comes down to is how competitive you are and how impacted the field of your choosing is. I bet if some of the previous posters on this thread were doing peds or medicine instead of ROADs then they would have received interviews anywhere in the country.



Agree. Hope I didn't freak you out with my example. As I said, if I made it my goal to return to the midwest I would have had more success. You should go to your dream school and not even think about this again until 3rd year. As long as you make it known what region you want to move to, you will be fine.
 

Andnosoupforyou

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This doesn't sound like very good news. Though I haven't yet started med school, I was contemplating one of the ROAD residencies. I had hoped UNC's reputation would outrank its geographical location for competitiveness for a northeastern ROAD residency, but now I'm starting to doubt myself. I love the school and am still almost certain to go there, but it's certainly not appealing to think that going to UNC might close doors that would otherwise have been open if I'd gone to a northeastern-based medical school--as all the evidence posted on this thread seems to show.
 

Parts Unknown

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Would a school's location be a factor in determining residency placement?

There is a lot of self-selection in this process. Medical schools tend to draw most their students from the surrounding geographic region. Virtually all of them will have ties to the area, and thus matching nearby will be a priority. Even those that are from other parts of the country will, by M4, often put enough roots down to make sticking around appealing.

Also look at it from the residency program director's standpoint. Programs have a limited number of interview spots each year, and they don't want to expend them on candidates who may not rank them very highly due to distance. It is pretty easy to throw a few residency applications out there on a whim (unlike AMCAS it gets cheaper the more you send), but if you are from the Northeast you will easily have a compelling case for returning, despite having gone to medical school elsewhere.

Andnosoupforyou said:
Is it something even worth considering when selecting a med school?

The only time I would consider it is if I were choosing between two similar schools, one inside my target geographic region and one outside. But if it's just one and it's your "dream school" then go for it, with gusto.
 

Parts Unknown

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This doesn't sound like very good news. Though I haven't yet started med school, I was contemplating one of the ROAD residencies. I had hoped UNC's reputation would outrank its geographical location for competitiveness for a northeastern ROAD residency, but now I'm starting to doubt myself. I love the school and am still almost certain to go there, but it's certainly not appealing to think that going to UNC might close doors that would otherwise have been open if I'd gone to a northeastern-based medical school--as all the evidence posted on this thread seems to show.

Yeah, see, here is where you need to not panic. Geography is a factor, but it's not an overriding one. Compared to board scores it's nothing. Look at any school's match list and you will see a coast-to-coast diaspora.

UNC has an excellent reputation that will serve you well anywhere in the country. Besides, after four years of biscuits and bluegrass you many not be so quick to leave.
 

WingedOx

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This doesn't sound like very good news. Though I haven't yet started med school, I was contemplating one of the ROAD residencies. I had hoped UNC's reputation would outrank its geographical location for competitiveness for a northeastern ROAD residency, but now I'm starting to doubt myself. I love the school and am still almost certain to go there, but it's certainly not appealing to think that going to UNC might close doors that would otherwise have been open if I'd gone to a northeastern-based medical school--as all the evidence posted on this thread seems to show.

Turning down UNC, probably one of the top 3 schools in the nation in terms of quality to cost ratio would be idiotic. period.

Any bias against you is going to be WAY WAY WAY less than if you went to a northeastern school like Drexel or Albany, which aren't in UNC's league, for example.
 

Andnosoupforyou

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Good to know UNC's reputation is out there. Let's see how the financial aid plays out.
 

2012mdc

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Good to know UNC's reputation is out there. Let's see how the financial aid plays out.

Given UNC's rep I think you have little to worry about.

I go to a smaller Southern school and the people that want to go outside of the region can. Students matching in LA, Chicago, the Northeast, DC etc.

Do well at UNC and you'll be fine
 

Law2Doc

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Hi all,

I was wondering to what extent geographical location is a factor in being accepted to medical school residency? I am originally from the northeast, and anticipate returning to the northeast for residency; however, I've been accepted to one of my dream schools down south. (The school's match list indicates most of its students being matched to regional areas.) Would a school's location be a factor in determining residency placement? Is it something even worth considering when selecting a med school?

Thanks!

First, ignore match lists. You don't know how to read them, and they are going to tell you nothing about what you personally will be able to do, only what choices a certain group of 100+ individuals happened to make.
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Truth of the matter is that residencies aren't going to waste their time on you unless they have reason to believe that you will come. That doesn't mean you have to go to med school locally, but it does mean you need a nexus to the region. If you can't show on paper that you are likely to move to Duluth for residency, no residency in Duluth is going to waste time on you. However if you grew up in Duluth, or attended college there, etc you probably will have a strong shot at getting considered, even if you did your med schooling in Miami. So you don't have to go to a particular med school to get a particular residency. But if you want to do your residency in a particular state, a PD better be able to scan through your application and figure out why you might be willing to come to that state. And it can't be something like "I've always wanted to see Duluth"
 

Andnosoupforyou

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Hope seventeen years of living and attending schools in New York City is enough of a nexus back to the city.

Actually, I'm thinking now that UNC might be awesome as far as residencies because now I'll have experienced both a rural-ish lifestyle and the city life from living in NYC a godforsaken amount of time.
 

WingedOx

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Hope seventeen years of living and attending schools in New York City is enough of a nexus back to the city.

Actually, I'm thinking now that UNC might be awesome as far as residencies because now I'll have experienced both a rural-ish lifestyle and the city life from living in NYC a godforsaken amount of time.

well you could compromise and later move to Charlotte. It has all the beauty and climate of NC, with the terrible attitudes of transplanted new york financial managers to make you feel right at home.
 
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