Is research important for Los Angeles matches?

[jzrocker]

Hi everyone! I'm an MS3 almost 100% sure I want to go into psych. I'm attending an unranked US medical school. I did well on step 1 (255) and I'm aiming to honor all my clerkships this year, but I have pretty much zero extracurricular/research experience in med school. I did research in undergrad but no publications. If I wasn't limited in matching to only a few programs (USC, UCLAs, UC Irvine, and places close to LA) because of my husband, I wouldn't be worried, but because I am limited, I need to make myself as competitive as possible. I'm fairly confident that I will have a good personal statement and good LoRs.

I would really appreciate any thoughts or suggestions anyone has for me about
1. Should I do some research?
2. Will an away rotation at Los Angeles help me? I'm currently on the East Coast, but I can be considered a California resident because we pay California taxes.

Thanks in advance!

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[PistolPete]

1. Can't hurt. Do it if you can publish.
2. Definitely. Having a California address on your ERAS will help.

 

[Doctor Bagel]

I applied ages ago and didn't train in LA, but as I recall, the main UCLA is the only truly research heavy program in the area. The rest seem more community-ish, so research would be a less important feature of your applicant, which is already pretty strong. If you can get it, yeah, great, but I wouldn't worry all that much. Also, yeah, noting your ties to the region somewhere in your application would help.

 

[Nasrudin]

You'll match in LA. You're a strong applicant and the LA programs cover the spectrum of competitiveness. So it's like applying broadly in one area.

Wether or not research would make a difference, who could say. I think you'll match well in LA with or without it.

 

[notdeadyet]

Only bother with research if you want to go into research. Otherwise, it's not worth the investment. No one will care if you're doing the equivalent of scrubbing test tubes, and to get to the point that you're doing meaningful stuff in research as a medical student is a huge time investment. A great one if you're going to go that route, but if you aren't, you could do some equally impressive things in other areas that are true to your passion that would get you just as much traction. Even at programs like UCLA and UCSF, a majority of folks who match do not have research backgrounds. It's not necessary.

California residencies will judge you a Californian by gestalt. If you were raised here and went away to college and med school, you can make the Californian claim with confidence. Same if you were raised elsewhere, but came to California for college and medical school and now consider yourself local. Raised elsewhere but came to California for college, went away to medical school? You can make a case. Where you pay taxes makes a nice footnote, but you make your case by where you have spent formative years.

The whole Californian thing amounts to this: can residency programs feel somewhat confident that you're going to remain in California after residency to provide services to residents of the state. Even programs like UCLA and UCSF take folks with no ties or tentative ones. But they like to see folks who have demonstrated a commitment to the state. It's part of the mission of any state's public medical schools.

I'd spend a bit of time doing some extracurriculars. It can be research, but it doesn't need to be. It also doesn't need to be clubs. Find something you're passionate about and explore it. Not only does this make you a much more interesting candidate to interview, but you'll likely be happier throughout the rest of medical school and happier people tend to get better evaluations on clerkships. If you honor a good few of your clerkships and interview at least moderately well, with your Step 1, you should have no problem matching at an LA program. If you do this and your "unranked US medical school" is allopathic, UCLA is a very real possibility. Congrats on your successes to date!

 

[MacDonaldTriad]

I’m confused about all of this emphasis on geographic connections to a program. If an applicant comes to interview, there is an assumption that there is an interest. Even if there isn’t, what is the harm of having them embedded on a program’s list? So what, they don’t come and you move on to the next name.

I hear a lot of advice telling applicants to make sure they emphasize their connection to the area, but I have never heard a program director care about this. It would take a very green inexperienced training director to play the game of moving applicants up the list because they are more likely to come. Everyone knows that the right way to play the game is to rank them by talent and let the process do the rest. All of the other strategies are just trying to make the match look better, but not be better. If a program is this shallow, it would speak very poorly for how they handle the important issues in managing training.

The argument that they want graduates to help supply the local demand really doesn’t apply to places like Los Angeles, New York, or Chicago. If after 4 years, you want out of the city, you will leave and if you don’t, you will stay. Metropolises don’t have to worry very much about planting seeds. If 10 psychiatrists leave, the vacuum will attract 10 more fairly reliably. The pay is higher, but the cost of living is much higher. The steady state is not very dependent on how many psychiatrists are locally trained. If you want to train here great, if you don’t, don’t come. There are plenty of other people who will be willing. If Philadelphia, Boston, San Francisco, are not your cup of tea, good for you, you will have an easier time matching and maybe a “connection” will be helpful, but if you want a large city, saying “hay I’m from here” is a big so what. Lots of people are from here. Go interview where you want to live. This is the 21st century, people move around and that is understood.

 

[notdeadyet]

I’m confused about all of this emphasis on geographic connections to a program. If an applicant comes to interview, there is an assumption that there is an interest. Even if there isn’t, what is the harm of having them embedded on a program’s list? So what, they don’t come and you move on to the next name.

I hear a lot of advice telling applicants to make sure they emphasize their connection to the area, but I have never heard a program director care about this. It would take a very green inexperienced training director to play the game of moving applicants up the list because they are more likely to come.

I think you misunderstand. If my post contributed to this, I apologize.

Demonstrating your ties to a geographic area is not for the sake of implying that you will rank the program more highly. You're right that any decent program director doesn't play that game. If a PD feels a candidate is great but less likely to rank the program more highly, you do a full court press on recruiting to attract the applicant. Not interviewing them if they were willing to come in is silly.

The reason that it's good to be able to demonstrate ties to a geographic area is because many public programs have an explicit mission to train residents that will supply services to the populace of its state. Someone with no ties to California who wants to train at a University of California will have a tougher task (but not insurmountable) of convincing a program that their intention is to train in California and practice there post-residency. If you're $hit hot, programs are more likely to take the risk, but many public programs will be directly looking at the likelihood that someone wants to practice in-state as part of their process. It's part of the mission.

Sorry if this is confusing.

The argument that they want graduates to help supply the local demand really doesn’t apply to places like Los Angeles, New York, or Chicago. If after 4 years, you want out of the city, you will leave and if you don’t, you will stay. Metropolises don’t have to worry very much about planting seeds. If 10 psychiatrists leave, the vacuum will attract 10 more fairly reliably.

See the above. Even at places like UCLA and UCSF, they like to see folks with a demonstrated interest in remaining in California. California is still largely underserved by psychiatrists. The more psychiatrists you get in high prevalence areas, the more folks that will filter down to practice in less prevalence areas.

Again, this is for the public state programs. I have no idea how it is at Stanford. They may not care at all. But I have a hunch they at least pay service-to-the-state lip service, so demonstrating ties to California is a good idea. And I have a hunch this will only help you in Nevada, Mississippi, Missouri, etc.

 

[MacDonaldTriad]

Even the most diehard altruistic public service minded program would only give about 2% kudos to an applicant that says they want to work in a public setting when compared to a stronger applicant. Public systems that fund public training are always complaining about how programs never feel beholden to their wishes, but programs really are not thinking about this very often. You can get them to say that they are when speaking to a particular audience, but in practice, it is always get the best you can period. In an ideal world, this could be different, but it does have its own quality of fairness.

I think it would be more accurate to say that public system trainings attract altruistic residents more than the other way around. Mental health leaders do not monitor graduation jobs and decide to increase or cut funding based on these results. They will cut funding in a New York minute if they perceive the service delivery as more expensive than what they can contract it out for.

 

[notdeadyet]

Even the most diehard altruistic public service minded program would only give about 2% kudos to an applicant that says they want to work in a public setting when compared to a stronger applicant.

You're using "public" different than me. When I talk about public training programs in California, I'm referring essentially to University of California. I'm not talking about county hospitals and the like. U.C. residency programs explicitly have in their mission a need to produce physicians for the state of California. Whether these psychiatrists work in public settings or private practice matters much less than the fact that they practice in California. Ergo, University of California will have a bias towards folks who will practice in California or at least give that impression.

The altruism of applicants and who winds up practicing public psychiatry doesn't really have much to do with what I'm talking about, though your point is very valid.

 

[Doctor Bagel]

The other potential benefit of ties to a region is that a program would prefer people who match there to stay there. If people are from another part of the country, they might decide they don't like wherever their residency is and transfer somewhere else. Also, residents with more social supports where they are might do better because they have more stabilizing influences. I don't know if there's data for this, but it could be a reason why someone might like people with ties to a region.

Anecdotally, I think most people do well even when going far away without supports, but my program had a resident totally decomp really even before starting training following a big geographic move. This is a person who would probably decomp in general, though, but would be less likely to had they stayed closer to home.

 

[jzrocker]

thanks everyone for your encouraging responses!