I'm curious how much more competitive students at top-tier med schools are than students at your run-of-the-mill state med school. All things being equal, would a Harvard grad with a 230 be more competitive than a mid-tier student with a 240? If it isn't a 10 point difference, what is it?
Is an HMS student with a 230 more competitive than a state school 240?
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100% yes. Could be even more than a 10 point difference.
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Not sure if we can assume “all things being equal” since that’s hardly true. But school name plays a huge role for competitive academic residencies across specialties. I’m pretty sure a Harvard grad with average Step scores and clinical grades can match comfortably in academic programs. And matching into academic programs can be important to match into desirable fellowships.
A Harvard grad with 230 would likely have an easier time matching into a top tier residency than a state school grad with 240 or higher. Connections and name brand are huge.
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Out of 160 students, they probably have ~60 students with a 230 or lower.
Now look at their match list. https://meded.hms.harvard.edu/files...rd_medical_school_match_list_for_web_2018.pdf
It's crazy.
Now look at their match list. https://meded.hms.harvard.edu/files...rd_medical_school_match_list_for_web_2018.pdf
It's crazy.
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Yes. Residency programs do, for what it’s worth, care about the med school of origin of their residents to some degree because it helps in their marketing (even if the residents in question are dead average). That’s life. People from Ivy caliber undergrads are more likely to go to Ivy caliber medical schools or get jobs in top finance companies etc as well.
This is a part of life that you cannot control, so why dwell on it? Do the best you can.
This is a part of life that you cannot control, so why dwell on it? Do the best you can.
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It does carry weight but I think it's hard to separate it out and truly make an 'all things being equal' comparison. The match list is impressive but it's also easy to see the connections and geographic and academic preferences at work there too. Obviously these things come with the name, but it's near impossible to screen out the 'name' itself and disregard all the other things that come with it. Without this, it's nigh impossible to quantify the spread in step score needed to overcome the name advantage.
EDIT: according to the NBME, there is no statistically significant difference between a 230 and a 240 from any school. Scores must differ by 16 points to differ significantly.
EDIT: according to the NBME, there is no statistically significant difference between a 230 and a 240 from any school. Scores must differ by 16 points to differ significantly.
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for the most part, yes. if the 240 has 12 first author publications and a great CV, and the Harvard 230 has no publications, and they are applying to something competitive like derm, obviously the 240 state school will have better odds... this is an extreme scenario though, a Harvard 230 is better off than a state school 240 most of the time, as long as the other variables are relatively comparable
Lot more than 10 points advantage. Plus nearly all HMS students get full honors in M3 which is a huge advantage over your typical 230-240 student at a state school who is lucky to get a few (due to shelves, limits of 10-20% H, etc). Yes, they may show the distribution of H at your school but top residencies still expect you to get the honors regardless.
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My impression is also yes. The most recently reported step 1 average for Hopkins was only a 235. The national median score is currently ~231. Yet the match list looks very different from a "run of the mill state med school." It's not just about the name, but all the other stuff that comes with it - research resources, who writes you LoRs, having home residencies that are very strong in most specialties, etc - adds up to more than a few bonus points on step
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Totally off topic but... that was an interesting “other” section. Someone graduated medical school to become... a dancer?
People who get into HMS are excellent students with incredibly well rounded applications. Even if they scored 230, you have no idea where else they have excelled and who they have impressed with their work ethic.
Unless there is study that can control all factors except school attended, there is no way to know how much of an impact school ranking has. Even the PD surveys show relatively low importance to prestige for most specialities.
Unless there is study that can control all factors except school attended, there is no way to know how much of an impact school ranking has. Even the PD surveys show relatively low importance to prestige for most specialities.
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Yes - I think this is key. If I recall correctly something like over half of most Hopkins students take a gap year for research in order to publish well prior to residency apps. Same with Duke as well I think. The goal of these medical schools is to produce research leaders in their fields, not to necessarily create top well rounded clinicians (which can be said the same of the residencies and fellowships in their institutions). By contrast many “lower ranked” or “state” schools have a mission to create clinicians who will serve the community in which they work in. Both are noble pursuits. But there’s no doubt which of these makes a candidate more competitive for residency apps.
And yes - most of the attendings at these places have strong connections within their specialty and are well known. A letter of rec from them goes much farther.
To be clear I don’t advocate necessarily choosing a school for this reason. These schools tend to also be quite expensive. It depends on your life goals. You can become a good physician in any field irrespective of where you go. It may give you a leg up if you have a hard on for prestige and name and working at HMS as faculty one day. Otherwise no matter where you are you can work hard and make your way through to your goal.
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I went to IM residency with a bunch of grads from HMS, other big name schools, as well as State schools and everything in between. The fact is that everyone was strong. An HMS grad with 10pt lower Step 1 than a State grad MIGHT get the slightest edge, assuming all else being equal, but the fact is nothing is ever equal. As someone else said, to get into HMS in the first place you need an impressive resume, which will help then for residency. Where I think school name matters a touch more is the top-tier programs, which seem to prefer big-name grads overall, or sometimes competitive residencies (derm, etc.). If the main purpose of going to a big name school is to gain an edge for residency, it's very debatable whether the price difference is worth it, for most people it's not imo.
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There's a lot of inbreeding in residency programs, so yeah.
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Pretty sure this was in premed and got moved !
Finally venturing out of the pre-med forums I see.
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It does... Probably 15+ points over people from mid tier and 20+ over people from low tier, and 30+ over DO.
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Before we all go crazy, they report 42 IM matches. Then, they only list 13. So this list is only the top 25% or so of the class.
PD's are well aware of the grade inflation at HMS (although it's been tempered somewhat more recently).
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I'm pretty sure that it's those 13 hospitals that those 42 students matched into. The amount of in-breeding at HMS getting into BIDMC or MGH IM is staggering. I don't think we're seeing just the top x percentage of the class.
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Proportion of students matching extremely competitive specialties (often at very highly ranked locations within those specialties)
Proportion of people matching IM who are at top residencies (near 100% usually for Hopkins, HMS) usually because IM has highest number of applicants
It is a fact of life that having the name and resources associated with the name will go miles in helping achieve a top residency. You have to consider (1) whether it makes a difference in your life goals whether or not you go to a top residency (2) whether you are a competitive applicant regardless of your medical school and (3) how much emphasis you put on things like “prestige”
Ultimately you’re still a doctor, you’re still in medical school (a huge achievement that is one associated with the top 1% of students) and you’ll do fine.
Raney Schauer
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As aPD alluded to above, there's a lot of, to borrow a phrase from The Wire, "juking the stats". You can't change the underlying data, but you can use what you want to present the information in a way that supports your intent.
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I was going to show you how ridiculous this statement was. Then I checked the intern lists for BWH, MGH, and BIDMC. The latter doesn't seem to have their interns listed (or I couldn't find it), but there are 10 grads each at the first two. So, I expect you're correct. Amazing.
Yeah they had 10 MGH, 10 UCSF, 7 BWH, 4 NYP, 4 Hopkins and 3 BIDMC for IM last year.
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That Stanford match list is really good too. I think you’re misinterpreting the comment underneath it. “There’s not many non pedigreed matches” means there are a lot of matches to high quality academic institutions
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Have no opinion on how it compares to anywhere else, and to be fair maybe this is just the homer in me talking due to going there, but anyone that looks at that list and comes away with the impression that it's "underwhelming" is out of their god damn mind.
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While it's fine to be proud of our achievements, I think it's a bit of stretch to say that the average medical student is within the top 1% of all students. There are enough medical students such that for the population of med students to include only top 1% students, almost all 1% percent students would have to pursue medicine. Around three million students graduate from high school each year, and with the expansion of medical schools, and including DO, close to 30k students will graduate med school each year. But many top students pursue, PhDs, computer science, law, finance, business or other interests. There are only four schools for which the average mcat is at the 99th percentile, and the average for MD schools is around the 80th percentile, whereas the average for DO schools is around the 60th. Medical students are an intelligent and hard-working group. The vast majority of us are likely with the top quarter of intelligence and/or academic performance, with a disproportionally high number of us within the 99-100th percentile. But let's not exaggerate.
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Consider the average MD student though, with an MCAT around 80-85th percentile. To say that's near top 1% overall is to say the population that sits for the MCAT is a sample of the top 5-7% or so. That doesn't sound too outrageous considering all the filters before that point - going to a 4 year university, attempting premed, making high enough grades in weedout courses like physics and organic chemistry to make sense continuing, studying for the test and deciding after your prep that you are ready to take it.
Saying all med students are top percent would be too much. But to say an average or slightly above average MD student is around there, isn't so crazy. After all, there are tons of students who were top couple percentile on the SAT/ACT that fail to perform well enough to get into MD schools
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While I can't provide precise data, I think there is reason to believe that the population who takes the MCAT isn't as extraordinary as you speculate. For starters, unlike the USMLE, there are no strict institutional barriers to taking the MCAT: basically anyone can take it, though MCAT examinees are essentially always pre-med college students or graduates. About 70% of high school graduates attend college, so being a college student - the minimum qualification for taking the MCAT - does not indicate strong academic performance. The average GPA of med school applicants for 2017 is 3.55. While this is above average, because of grade inflation, the average GPA of college students (20% of whom are necessarily below average in academic ability) is approaching 3.2.
Also, many people who take the MCAT are not prepared to do well on it - subjective assessment of one's ability is not a valid filtering mechanism. For example, I know someone who had to drop AP science classes in HS because they were too difficult, didn't do well on the SAT/ACT, but still managed to graduate pre-med from college with above a 3.0. He wanted to be a doctor so badly that he ignored the signs that he would do poorly on the MCAT, and scored in the 480s/490s both times he took it. He was considering the Caribbean, so I asked him, since he struggled with the MCAT, why he thought he believed he would do well enough on the step exams to match (he was thinking surgery) in the US? His response was that he thought that he would find the material more interesting. Don't underestimate people's capacity for self-delusion.
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Not true of BIDMC. The few people I know who went there said they make it a point to not take many HMS students. Based on my interview there, this seems to be the case, maybe a few in each class. Which is on par with most programs associated with a med school.
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Yep, plus others in consulting, research, etc. Wow, there only 3 peeps going into family practice & with only 2 institutions listed perhaps 2 of those 3 are couples match (?) versus 11 dermatology (!?!) Talk about the rich getting richer as far as the match.
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Welcome to America. If you’re a rich kid who’s daddy went to Harvard, you get preference. If you went to Harvard undergrad you get preference for HMS. And so on and so forth
Nepotism, inbreeding, and cronyism is a real thing in medicine. I have no doubt you still can’t be an idiot if you go to these schools. But we all know this happens - there’s a big lawsuit against Harvard for discrimination and turns out they do in fact do these sorts of things
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Raney Schauer
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It also happens that Harvard turns out enough well-connected lawyers, judges and sundry politicians to probably be less than concerned about such suits.
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Yes, going to a top 5 med school makes it much easier to get into a prestigious residency or a prestigious field. Life is not a meritocracy. Every physician went through the same process of applying to med school and has an understanding of just how difficult and how exceptional of an applicant one must be to get into one of those institutions. It’s a massive accomplishment and a testament to that individuals intelligence and work ethic. As an attending, a person lives and dies by his/her clinical abilities but going to a top 5 med school makes getting into residency or a competitive medical field exponentially easier. So stop worrying about things outside of your control and just try to do the best at whatever you’re doing today.
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My understanding was that about five years ago, the entire scale shifted up such that the highest grade is 'honors with distinction', the second highest grade is 'honors', and so forth. Of course now most students are getting honors and above. Most recently, students were going to be blinded to their clerkship grades (other than satisfactory/unsatisfactory) and only when declaring a residency specialty will more granular grades for select clerkships of relevance be revealed for the purpose of the MSPE.
Do you think they are in a position to be overly selective, or are they just have stiff competition? The majority of HMS graduates going into IM end up at one of the big four (MGH, BWH, Hopkins, UCSF).
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Hard to say, maybe, maybe not.
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