Importance of Residency Prestige?

[YanCanCook]

The pre-allo forum may not be the most appropriate place for this, but I will ask anyways. What is the importance of going to a strong-name residency over one that is nationally well-known. Is there any true difference between doing say a Optho residency at Univ. Maryland rather than JHU or Surgery at Temple versus UPenn? Just wondering why people when looking at match lists note placements at highly known hospitals.

---

Members don't see this ad.

 

[AnEyeLikeMars]

The pre-allo forum may not be the most appropriate place for this, but I will ask anyways. What is the importance of going to a strong-name residency over one that is nationally well-known. Is there any true difference between doing say a Optho residency at Univ. Maryland rather than JHU or Surgery at Temple versus UPenn? Just wondering why people when looking at match lists note placements at highly known hospitals.

When you're in residency, a lot of your learning comes from people, not books. You want to train with the best people, and generally (don't get on me guys, I'm saying generally) they are at the top medical schools.

BTW, you're screenname is awesome.

 

[Robizzle]

YanCanCook came to my school during my freshman year... He really CAN cook!

 

[Biscuit799]

When you're in residency, a lot of your learning comes from people, not books. You want to train with the best people, and generally (don't get on me guys, I'm saying generally) they are at the top medical schools.

BTW, you're screenname is awesome.

Addenum to this. It COMPLETELY depends on what you want to do. IM is generally more focused on prestige than other programs. The general rule is that if you want to sub-specialize, then it's better to go to a more prestigious residency program. Please note that prestigious residency program and prestigious medical school do NOT NECESSARILY CORRELATE. You've gotta do your homework. Now, if you do not want to sub-specialize, you're probably better off going to an unopposed program, which will be the smaller, less prestigious program. That way you'll be the only resident to take all the interesting cases. In Boston, you may be lucky enough to see a case of myositis ossificans, but ortho, plastics, IM, gen surg, and sports med will all have a massive turf war over the pt. In Iowa, you'll be the only resident on every case. Also, you will get more experience doing procedures at a smaller program. Again, let's take the Boston example. An interesting case comes in, but it's neurosurgical. The fellows will get it. If you're a gen surg resident, you're SOL. If you're in Iowa, you'll get it. Also, if you're an IM resident in Iowa, you're...you guessed it...still the ONLY ONE THERE. You'll do the colonscopies, the stents, and other procedures that other residents at more prestigious programs either have to wait to do, or won't do at all.
Long story short; specialize: go for prestige, generalist: go for clinical experience

 

[Biscuit799]

The pre-allo forum may not be the most appropriate place for this, but I will ask anyways. What is the importance of going to a strong-name residency over one that is nationally well-known. Is there any true difference between doing say a Optho residency at Univ. Maryland rather than JHU or Surgery at Temple versus UPenn? Just wondering why people when looking at match lists note placements at highly known hospitals.

For optho, go wherever will let you in, first. Second, go for location. Most residents practice w/in 50 miles of where they train. An optho is an optho, doesn't matter where you came from. Go where you'll be happy.

 

[Law2Doc]

The pre-allo forum may not be the most appropriate place for this, but I will ask anyways. What is the importance of going to a strong-name residency over one that is nationally well-known. Is there any true difference between doing say a Optho residency at Univ. Maryland rather than JHU or Surgery at Temple versus UPenn? Just wondering why people when looking at match lists note placements at highly known hospitals.

Well, some people aren't done when they get to residency, so you want to leave yourself in a good place when you apply for fellowships or subspecialties. Additionally, when you apply for jobs, the place you did your training looms large. While there are plenty of jobs out there, you are always in competition with others for desirable spots. In medicine you are as good as the last place you've been. Your med school pedigree fades into the background and you become that dude who did his residency training at Penn or Temple or Hopkins or whereever. So pick a good one because that label sticks with you until you get your next credential.

But I would suggest that if you are thinking about this in pre-allo, you are totally wasting your time. You don't even know what specialty you are going to want after you see more of them, and some of the programs that are good now, may not be in a few years (it is largely personnel dependant and people periodically get recruited and "poached" from one place to another; a big name chairman and aggressive hiring can put a department on the map in a couple of years, a malignant culture can tank a program's rep even quicker).

 

[Kfire326]

The pre-allo forum may not be the most appropriate place for this, but I will ask anyways. What is the importance of going to a strong-name residency over one that is nationally well-known. Is there any true difference between doing say a Optho residency at Univ. Maryland rather than JHU or Surgery at Temple versus UPenn? Just wondering why people when looking at match lists note placements at highly known hospitals.

2 family friends who have been MDs for about 8 years advised me that what medical school you go to means little in the long run, and its where you do your residency that REALLY counts. How to nail a great residency program? They say the biggest thing is your board score.

 

[PhotoMD]

2 family friends who have been MDs for about 8 years advised me that what medical school you go to means little in the long run, and its where you do your residency that REALLY counts. How to nail a great residency program? They say the biggest thing is your board score.

Medical school name, board scores, medical school grades, relative performance to others in your class, AOA, research, letters of recommendation, personal statement, and your demographics. All are important in netting the residency you want. I don't think one can say with certainty the relative importance of each factor. As in getting into medical school, getting your desired residency should not be about resume-building, but about being the best student you can be while you're having fun.

 

[SupergreenMnM]

2 family friends who have been MDs for about 8 years advised me that what medical school you go to means little in the long run, and its where you do your residency that REALLY counts. How to nail a great residency program? They say the biggest thing is your board score.

Step 1, m3 grades, LOR, rank, pubs, AOA, school prestige, m1-2 grades, ECs.

That order varies depending on what residency you want (for example in rad onc the LOR is probably more important) but that seems to be the general order (per Iserson)

 

[Law2Doc]

I don't think one can say with certainty the relative importance of each factor.

I actually think many people in med school have been given approximate hierarchies by their advisors/mentors (some of whom are involved in their school's residency process). All I have heard of put step 1 scores at or toward the top of the list. Once in med school you will find someone in the know and get the scoop.

 

[Law2Doc]

Step 1, m3 grades, LOR, rank, pubs, AOA, school prestige, m1-2 grades, ECs.

That order varies depending on what residency you want (for example in rad onc the LOR is probably more important) but that seems to be the general order (per Iserson)

That's pretty close to what I have been advised as well. Knowing the right people belongs on that list too -- never underestimate the effects of "pull". Medicine is a very small world.

 

[AnEyeLikeMars]

That's pretty close to what I have been advised as well. Knowing the right people belongs on that list too -- never underestimate the effects of "pull". Medicine is a very small world.

I'm a lowly pre-med, but I'd add "rock your interviews" to that list as well. The people interviewing you are going to be your future colleagues. If they don't like you, they're not going to want to work with you.

 

[PhotoMD]

I actually think many people in med school have been given approximate hierarchies by their advisors/mentors (some of whom are involved in their school's residency process). All I have heard of put step 1 scores at or toward the top of the list. Once in med school you will find someone in the know and get the scoop.

The upshot of my post was that it doesn't make a huge difference on your residency application if your Step 1 score is a 230 or a 250. Boards scores are but one part of an application that is incomplete without the other components. As with the MCAT, once you cross a certain threshold, your application garners further consideration on its other merits

Edit: For what it's worth, I am in med school too.

 

[Law2Doc]

I'm a lowly pre-med, but I'd add "rock your interviews" to that list as well. The people interviewing you are going to be your future colleagues. If they don't like you, they're not going to want to work with you.

No question. Away rotations with those same people help too -- basically an extended interview.

 

[AnEyeLikeMars]

No question. Away rotations with those same people help too -- basically an extended interview.

Just as an aside, I had a question about away rotations that maybe you can answer. Are away rotations one-shot deals (you do an away rotation at one program that you really want to go to) or do people generally do several away rotations at various programs that they're interested in?

It seems to me like it'd be hard to choose one place to do an away rotation.

 

[Law2Doc]

The upshot of my post was that it doesn't make a huge difference on your residency application if your Step 1 score is a 230 or a 250. Boards scores are but one part of an application that is incomplete without the other components. As with the MCAT, once you cross a certain threshold, your application garners further consideration on its other merits

Edit: For what it's worth, I am in med school too.

I don't know if I agree with that. There are competitive programs where you might still be crossing your fingers with a 230. If you look at the residency boards on SDN, some of the averages listed for folks matching into things like derm, ENT, etc are routinely asserted to be better than 230.

 

[deleted113029]

YanCanCook came to my school during my freshman year... He really CAN cook!

he's also a sellout without a real accent. he does it to sound authentic...what a loser!

 

[robberbaron]

230 is just about the cutoff for everything that's highly competitive. Check this year's NRMP data. There's not one specialty in the regular match that has an average step I over 234 or 235. My friends in the early match have said the same about their specialties. Of course these are only averages and reflect a range of scores but as someone who matched this year and talking to my peers who matched no one has heard of *any* 230+ score being a deterrent from a successful match. My impression from interviewing is that PDs understand that above a certain threshold boards are just an indicator of one's willingness to study and sacrifice <and slave> rather than a proxy for intellect.

 

[smq123]

I don't know if I agree with that. There are competitive programs where you might still be crossing your fingers with a 230. If you look at the residency boards on SDN, some of the averages listed for folks matching into things like derm, ENT, etc are routinely asserted to be better than 230.

What our student deans tell us is that "If you have a 230 or better, no door is closed to you." Doing better than a 230 is obviously great, but that's what we've been told.

 

[jaydoc07]

Remember that 230 is only at or below the average though for those specialties. So not a point against you, but not really one for you either.

 

[Law2Doc]

230 is just about the cutoff for everything that's highly competitive. Check this year's NRMP data. There's not one specialty in the regular match that has an average step I over 234 or 235. My friends in the early match have said the same about their specialties. Of course these are only averages and reflect a range of scores but as someone who matched this year and talking to my peers who matched no one has heard of *any* 230+ score being a deterrent from a successful match. My impression from interviewing is that PDs understand that above a certain threshold boards are just an indicator of one's willingness to study and sacrifice <and slave> rather than a proxy for intellect.

All I know is if you do a search on SDN residency forums, you will come up with discussions in past years where residents suggest that a number of fields (ENT, Derm, etc) had average scores of match matriculants higher than 230. Note that 234 and 235 are higher than 230.

 

[Anka]

My impression from interviewing is that PDs understand that above a certain threshold boards are just an indicator of one's willingness to study and sacrifice <and slave> rather than a proxy for intellect.

And which do you think is more important to PDs, your intellect or your willingness to slave?

 

[SupergreenMnM]

That's pretty close to what I have been advised as well. Knowing the right people belongs on that list too -- never underestimate the effects of "pull". Medicine is a very small world.

Yeah, good point, especially small fields like ped optho or rad onc, hopefully your LOR addresses that part.

 

[robberbaron]

All I know is if you do a search on SDN residency forums, you will come up with discussions in past years where residents suggest that a number of fields (ENT, Derm, etc) had average scores of match matriculants higher than 230. Note that 234 and 235 are higher than 230.

You are basing your position on anonymous internet posts. Common sense dictates that you should take what you read here-especially where self reported scores are concerned-with a grain of salt. Undoubtedly there are outliers in the step distribution applying to each specialty, each year; but it is more instructive to look at where the distribution is centered rather than its tails, don't you agree? Thus, I suggest that you go to the source for your information on "competitiveness" criteria rather than trusting some lurker posting on SDN. Also don't split hairs about scores in the 230s because anyone who's actually taken a step knows that the difference between scores in such a small interval amounts to very few questions.

 

[Pinkertinkle]

You are basing your position on anonymous internet posts. Common sense dictates that you should take what you read here-especially where self reported scores are concerned-with a grain of salt. Undoubtedly there are outliers in the step distribution applying to each specialty, each year; but it is more instructive to look at where the distribution is centered rather than its tails, don't you agree? Thus, I suggest that you go to the source for your information on "competitiveness" criteria rather than trusting some lurker posting on SDN. Also don't split hairs about scores in the 230s because anyone who's actually taken a step knows that the difference between scores in such a small interval amounts to very few questions.

230 may be fine if you just want to match into radiology, but if you want to match radiology in very desirable location or a big academic institution, you'll want higher.

 

[Law2Doc]

You are basing your position on anonymous internet posts.

Um, I'm basing it on the same numbers you provided in your prior post -- ie 235. Which if my math is correct is >230...

 

[robberbaron]

All I know is if you do a search on SDN residency forums, you will come up with discussions in past years where residents suggest that a number of fields (ENT, Derm, etc) had average scores of match matriculants higher than 230.

This is what I was referring to. Forget it. Good luck in next year's match.

 

[jaydoc07]

never tried to attach an image but here it goes. i think this is 2005 data, but i would bet if anything the averages are same or higher for the ultra-competitive in 2007

 

[Gabujabu]

View attachment 8111

never tried to attach an image but here it goes. i think this is 2005 data, but i would bet if anything the averages are same or higher for the ultra-competitive

According to this graph, a 230 would be on the low end for some of the most competitive specialties (such as Derm, Plastics)! However, for most everything else it is a competitive score.

 

[therealdeal555]

The pre-allo forum may not be the most appropriate place for this, but I will ask anyways. What is the importance of going to a strong-name residency over one that is nationally well-known. Is there any true difference between doing say a Optho residency at Univ. Maryland rather than JHU or Surgery at Temple versus UPenn? Just wondering why people when looking at match lists note placements at highly known hospitals.

Where you do your residency does make a big deal, I'd say almost regardless of field. But I think the one poster earlier who mentioned about how it's more important in IM makes a valid point. I think the difference in programs is significant in a field like that where so many programs exist, whereas the differences are more subtle in competitive fields where there are so few spots (although on interviews, you can almost definitely tell a good program from an average one).

And an aside--I know you did it to make a point, but the difference between Maryland and JHU in virtually any field is much, much, much smaller than the difference between Temple and Penn.

 

[8744]

Har. You guys slay me. The most important factor in selecting a residency is whether you can eat for free at the hospital or (more importantly to me) score the seven or eight Diet Cherry Cokes that you require to keep yourself from turning tricks for them.

If post-residency salary is a criteria, I betcha' the podunk areas where people who are about prestige would never consider moving pay a lot more for the same board certification. An EM physician in Lousiana, for example, makes a good deal more than one in San Francisco.

 

[Law2Doc]

The most important factor in selecting a residency is whether you can eat for free at the hospital or (more importantly to me) score the seven or eight Diet Cherry Cokes that you require to keep yourself from turning tricks for them.

I was under the impression that residents were expected to bend over and take it pretty regularly, whether they got free soda or not.