It's insanely difficult to get into a Top IM Program from a non-top 25 medical school

[gutonc]

This thread just scared the **** out of me. I turned down Wash U and Penn for a full tuition scholarship to Mt. Sinai, saving 280K. Should I try and see if I can change course this late in the summer?

Please tell me you're joking. You're losing exactly nothing (other than 280K in student loan debt) by going to Mt Sinai.

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[IM2GI]

This thread just scared the **** out of me. I turned down Wash U and Penn for a full tuition scholarship to Mt. Sinai, saving 280K. Should I try and see if I can change course this late in the summer?

No way, be proud of the scholarship and do well in med school.

 

[Greenberg702]

Please tell me you're joking. You're losing exactly nothing (other than 280K in student loan debt) by going to Mt Sinai.

This whole thread seems to emphasize the fact that Harvard and UCSF students (and by extension I'm assuming Penn and Wash U) have a colossal advantage when applying to elite residency programs. I absolutely love my school and am very grateful for the scholarship but the prospect of having to work much harder than the kids from the previously mentioned schools for a much less certain outcome is a little off-putting.

 

[Greenberg702]

Take the free ride and run. You can still get an awesome fellowship from Mt. Sinai and not having debt = amazing.

I agree. I absolutely thought I made the right choice before stumbling upon this thread. Do you mean an awesome fellowship coming from an IM residency? I was kind of hoping to land a top IM residency program (surprise, surprise).

 

[gutonc]

I agree. I absolutely thought I made the right choice before stumbling upon this thread. Do you mean an awesome fellowship coming from an IM residency? I was kind of hoping to land a top IM residency program (surprise, surprise).

Keeping in mind that all of the ranking systems people talk about are total bulls***, the one everybody talks about the most (USNWR - which only seems to still exist for the sole purpose of their listicles) has MSSM-Icahn in the Top 20. Again, you're not losing anything over WU or Penn going to Sinai. The End.

 

[IlDestriero]

You need to take advantage of your opportunities as they present themselves. I wouldn't turn down a scholarship that is worth that much to go to a top 10 medical school.
Study smart, work hard, network with faculty and residents, get involved early with projects and you will be fine.

 

[Deferoxamine]

Um... if a Top 20 medical school gives you a scholarship... unless it's an automatic scholarship because you're the 1 or 2 Native American Aborigine Bisexual Mormon Goth Taoist Hispanic Blind medical students in the history of ever, it probably means you're pretty damn capable of doing decently well in medical school and landing a great residency on your own, with or without the Top 5 pedigree to your name.

Keep the scholarship. And buy your med school friends lots of booze with the extra cash.

 

[DermViser]

This whole thread seems to emphasize the fact that Harvard and UCSF students (and by extension I'm assuming Penn and Wash U) have a colossal advantage when applying to elite residency programs. I absolutely love my school and am very grateful for the scholarship but the prospect of having to work much harder than the kids from the previously mentioned schools for a much less certain outcome is a little off-putting.

Yes, but Mt. Sinai is not a rinky dink medical school. It's ranked #19. See title of thread.

 

[DermViser]

Yup. These people really need to be educated as soon as possible that as unfortunate and seemingly unfair it is, pedigree matters. A lot. And not only does it matter, but the degree to which it matters (at least in the academic world, from what I've seen) seems to exponentially increase as you move to the "next level." Maybe others have some hard data on this (which may or may not support what I am saying), but top med schools will almost always take the applicant from Harvard/Stanford with the 3.7 GPA & 32 MCAT over the state school applicant with a 3.9 GPA & 36 MCAT. When two applicants apply to or interview at the same elite residency spot, you can put money on the fact that the guy from UCLA with the 235 step 1 will get the spot over the University of Wherever guy with 255/AOA/research. When applying to fellowship, the average-performing resident with minimal research who did his residency at UCSF will almost certainly get the spot at Brigham over the mid-tier residency superstar chief resident with multiple publications. Are there exceptions? Yes, but as someone else mentioned, they are just that: exceptions.

Are the higher-pedigree applicants inherently better physicians (or even better researchers) than the generics? I doubt it. But it is what it is, and I for one severely underestimated these aspects of academia when I was a medical school applicant (and a college applicant). In the future, if my children or the children of my friends have any interest in wanting to go into medicine from a young age (i.e. high school) and are otherwise bright, the number 1 piece of advice I would give them (besides considering other fields in addition to medicine) is to try to build pedigree in the earliest stages of education (starting with making oneself as competitive as possible for elite colleges) in order to maximize the number of academic opportunities available down the road. There is this notion these days that even speaking of pedigree makes one an elitist, classist, etc, that in our new, progressive world assertions as simple as "pedigree matters" are antiquated and crass, and that instead "you can do anything as long as you set your mind to it." This mindset and the unwillingness to engage in such discussions with young people truly does them a disservice and needs to change.

If anything, the progressive world values pedigree more than conservatives.

 

[rafman]

Which ranking list are people referring to in this forum to determine the ranking of their medical school? I'm assuming USNWR?

 

[padastra]

This whole thread seems to emphasize the fact that Harvard and UCSF students (and by extension I'm assuming Penn and Wash U) have a colossal advantage when applying to elite residency programs. I absolutely love my school and am very grateful for the scholarship but the prospect of having to work much harder than the kids from the previously mentioned schools for a much less certain outcome is a little off-putting.

Nope. Wash U and Penn do not give the same advantage as Harvard and UCSF. Also. Dude. 280k right now is equal to 560k at the end of fellowship. That's how compound interest works (assuming 8%, which is pretty reasonable).

 

[Greenberg702]

Thanks for the info/encouragement. Definitely sticking with my choice.

 

[chris_awad]

Any chance I could get some opinions? I got into Emory, which has a COA of 360k, and Vermont Medical School which has a COA of 300k, but I got a 200k scholarship. What would be better to do if I'm interested in a top IM residency?

 

[Crayola227]

why do you need a top IM program?

I would go for the scholarship

 

[chris_awad]

why do you need a top IM program?

I would go for the scholarship

I guess I'm just interested in becoming an academic physician and want the opportunity to practice reading, writing, and research.

 

[IMreshopeful]

I guess I'm just interested in becoming an academic physician and want the opportunity to practice reading, writing, and research.

1. Vermont is an excellent medical school with a strong academic tradition.
2. Yes, it is generally easier to get into medical residency at a “top” program if you go to a higher ranked medical school...with caveats. I know people who have gone to Emory, which is a decent med school and has good name recognition. That being said there’s a lot of nonsense IMO being peddled here as to how much of a difference it makes...if you’re a mediocre or low performing student at Emory, it won’t do you any favors. I personally feel the jump from okay medical school —> top IM residency is a lot easier than the jump from okay IM residency —> top fellowship.
3. Often at the “top” ranked Med schools, in addition to being more expensive, there is a strong push to do extra degrees or a research year in addition to your four years of Med school. If you’re into that, great, but factor that into your decision making. It’s also another reason why the applicants from those schools tend to have more research.
4. Having a scholarship for Med school is a HUGE deal. You will be in debt through residency and as an early attending, and there is something to be said for only owing 100k in debt as opposed to 300k. You don’t think about this a lot as a college student but as someone who is now a PGY5, believe me, it’s becoming more real to me every day.
5. Tailor your career goals from the start. If you are dead set on academics then start research early in med school and stay involved in addition to your studies. Do an MPH or something similar. Either way you can probably do that at either school you listed. I was interested in research insofar as it would help me get into fellowship but not as a career - I ultimately want to practice medicine, not sit in a room writing grants, papers, IRBs, and dealing with institutional politics.
6. You will be in the medical school you choose for 4 years of your life. You need to be happy with it or you’ll be miserable. People make lasting friendships, sometimes find their spouses, and have a great time in medical school and you don’t want to be in a situation where you hate going to school every day.

 

[Anicetus]

I guess I'm just interested in becoming an academic physician and want the opportunity to practice reading, writing, and research.

As someone at a medical school around the calibur of Vermont, I’d say take Emory in a heartbeat.

Pedigree is a huge factor in top IM programs as I’ve noticed this year. People with step scores in the 220’s at top med schools were still getting way more interviews than people from my school with 240+. The only true way to break out of the “low tier MD” stigma was to get 250+ and AOA.

 

[PlutoBoy]

Any chance I could get some opinions? I got into Emory, which has a COA of 360k, and Vermont Medical School which has a COA of 300k, but I got a 200k scholarship. What would be better to do if I'm interested in a top IM residency?

Get the scholarship. No doubts.

 

[rokshana]

ask if emory will give you a scholarship...

 

[ilovecorgis]

Any chance I could get some opinions? I got into Emory, which has a COA of 360k, and Vermont Medical School which has a COA of 300k, but I got a 200k scholarship. What would be better to do if I'm interested in a top IM residency?

If you're anticipating generous family support and can graduate from Emory with much of the debt paid off, I think it's reasonable to pick Emory. If you're taking most of the 360k in loans (an absurd amount IMO...), I would definitely choose Vermont; even if you want an academic career, you'll have the chance to participate in 95% of opportunity for research relevant to an MS1-3 at Vermont that you would have at Emory.

 

[gutonc]

Most of what you're going to do to generate an academic career for yourself will be done during residency anyway. You are going to be the limiting factor in getting a "top" residency spot, not UVM vs Emory. Save yourself the quarter mil and enjoy Burlington.

 

[IMreshopeful]

As someone at a medical school around the calibur of Vermont, I’d say take Emory in a heartbeat.

Pedigree is a huge factor in top IM programs as I’ve noticed this year. People with step scores in the 220’s at top med schools were still getting way more interviews than people from my school with 240+. The only true way to break out of the “low tier MD” stigma was to get 250+ and AOA.

Vermont is not considered a low tier medical school bruh

 

[IMreshopeful]

If you're anticipating generous family support and can graduate from Emory with much of the debt paid off, I think it's reasonable to pick Emory. If you're taking most of the 360k in loans (an absurd amount IMO...), I would definitely choose Vermont; even if you want an academic career, you'll have the chance to participate in 95% of opportunity for research relevant to an MS1-3 at Vermont that you would have at Emory.

This x 1000

As someone who went to a mid tier Med school and subsequently matched an upper mid tier residency, most of the research I did was in residency. Sure it’s good to get a head start but nobody expects you to have published extensively unless you’re a PhD/took dedicated research time out. Med school is busy and hard - having a few pubs and or abstracts is sufficient to get into a good medicine residency.

 

[Crayola227]

Most of what you're going to do to generate an academic career for yourself will be done during residency anyway. You are going to be the limiting factor in getting a "top" residency spot, not UVM vs Emory. Save yourself the quarter mil and enjoy Burlington.

Yes, yes! To gutonc, you listen

 

[Crayola227]

The name of your school will make zero difference if you don't do well

 

[NewYorkDoctors]

A practical question is why the med student wants to consider entering a top academic IM residency.

If the answer is to do cutting edge research , become a leader in the field , and be part of the forefront of RCTs , then those are good answers .

If it’s to go get a “name brand” diploma go satiate ones ego (as was likely conditioned at a young age to go to the best college ) , to believe one will have greater non-research job opportunities in private practice , or to make more money , then these are not good reasons not out of any moral high horse viewpoint but from a practical standpoint .

Top programs are for physician scientists . Other programs are for a mix of that and community practice .

Your parents won’t love you any more for securing a Stanford residency and fellowship the same way you’ve got into Stanford undergraduate early decision .

 

[GastriqueGraffin]

A practical question is why the med student wants to consider entering a top academic IM residency.

If the answer is to do cutting edge research , become a leader in the field , and be part of the forefront of RCTs , then those are good answers .

If it’s to go get a “name brand” diploma go satiate ones ego (as was likely conditioned at a young age to go to the best college ) , to believe one will have greater non-research job opportunities in private practice , or to make more money , then these are not good reasons not out of any moral high horse viewpoint but from a practical standpoint .

Top programs are for physician scientists . Other programs are for a mix of that and community practice .

Your parents won’t love you any more for securing a Stanford residency and fellowship the same way you’ve got into Stanford undergraduate early decision .

Perfectly put. Your training should prepare you for the kind of career you are seeking. Going to a research heavy big name place with goals of becoming a busy clinical private community practioner makes no sense. Likewise the reverse is also true.

 

[Anicetus]

A practical question is why the med student wants to consider entering a top academic IM residency.

If the answer is to do cutting edge research , become a leader in the field , and be part of the forefront of RCTs , then those are good answers .

If it’s to go get a “name brand” diploma go satiate ones ego (as was likely conditioned at a young age to go to the best college ) , to believe one will have greater non-research job opportunities in private practice , or to make more money , then these are not good reasons not out of any moral high horse viewpoint but from a practical standpoint .

Top programs are for physician scientists . Other programs are for a mix of that and community practice .

Your parents won’t love you any more for securing a Stanford residency and fellowship the same way you’ve got into Stanford undergraduate early decision .

Or to match into the incredibly competitive Subspecialty, GI.

 

[GastriqueGraffin]

Or to match into the incredibly competitive Subspecialty, GI.

That's not true but I don't really feel like debating this. Suffice it to say if you're competitive enough to match into a "top residency" but decide to go to another university hospital where you will be happier, you will be more than fine if you're a US MD.

 

[MyTachyBradyHeart]

Honestly, I think it's the dismissive attitudes from a few posters about everything they don't think is important that's killing this place. As an infrequent poster, I never felt comfortable posting in the "WAMC" thread because I knew the responses were going to be "Oh, only AOA and 250+? You're clearly going to match in Timbuktu." Same thing in the "Help Me Rank" thread. Go read what kind of super helpful responses people with solely competitive schools on their ROL got. We get it. We're being unnecessarily neurotic and from your perch of infinite wisdom, you can see how insignificant all these queries are. If the topic is one you consider irrelevant and uninteresting but others find meaningful, how about letting them have their conversation instead of stifling it for everyone with caustic replies?

Regardless, I, for one, was not advocating for any course of action. I just wanted to provide a counterpoint for the pervasive advice that the playing field was somewhat level coming out of allopathic US medical schools. It's not; it's ridiculously steep. I don't see anyone advocating that this is an unfair situation that needs to be fixed. We're just arguing that premeds should be aware of it, so they know how they're limiting their future selves.

Agree with op, having trained at a non-ranked medical school and matched into top (insert number) programs for both residency and fellowship. My biggest qualm with this whole process was that the advisors for IM at my medical school made it sound like it was a foregone conclusion that I would interview at most and match at a top IM residency (260+, AOA, +research). While thankfully it worked out for me in the end, I was also surprised by the number of rejections I got from top programs since (I thought, maybe mistakenly) I had a very competitive application.

Matching into a top program does not correlate with how good of a doctor a person will be down the line, but it does give an applicant the most number of options. For most people, that is the most important factor (even for those who wishes to go into private practice/primary care, going to the most competitive program will open up the most doors when looking for jobs). For a small percentage of doctors who are married/have kids, this is less important.

Any chance I could get some opinions? I got into Emory, which has a COA of 360k, and Vermont Medical School which has a COA of 300k, but I got a 200k scholarship. What would be better to do if I'm interested in a top IM residency?

Personally, I would choose Emory. See my above post, but going to Emory gives you more options down the road. This is compounded each step of the way (residency, fellowship, etc) and as a US MD, you'll be able to make that money back when you are an attending. It is better to spend the extra money rather than having regrets 20 years down the line.

If there are other issues (i.e. significant other in the NE, didn't like ATL, or didn't get along with Emory students/faculty), then that's a different story.

 

[PlutoBoy]

Agree with op, having trained at a non-ranked medical school and matched into top (insert number) programs for both residency and fellowship. My biggest qualm with this whole process was that the advisors for IM at my medical school made it sound like it was a foregone conclusion that I would interview at most and match at a top IM residency (260+, AOA, +research). While thankfully it worked out for me in the end, I was also surprised by the number of rejections I got from top programs since (I thought, maybe mistakenly) I had a very competitive application.

Matching into a top program does not correlate with how good of a doctor a person will be down the line, but it does give an applicant the most number of options. For most people, that is the most important factor (even for those who wishes to go into private practice/primary care, going to the most competitive program will open up the most doors when looking for jobs). For a small percentage of doctors who are married/have kids, this is less important.



Personally, I would choose Emory. See my above post, but going to Emory gives you more options down the road. This is compounded each step of the way (residency, fellowship, etc) and as a US MD, you'll be able to make that money back when you are an attending. It is better to spend the extra money rather than having regrets 20 years down the line.

If there are other issues (i.e. significant other in the NE, didn't like ATL, or didn't get along with Emory students/faculty), then that's a different story.

You don't get paid less for graduating from a "low tier" program. I'm also not sure if that extra boost that Emory would give to a potential residency applicant is worth $200,000. This is simply my opinion.

 

[MyTachyBradyHeart]

You don't get paid less for graduating from a "low tier" program. I'm also not sure if that extra boost that Emory would give to a potential residency applicant is worth $200,000. This is simply my opinion.

True, you will probably not make that money back and are down $200k (plus interest) at the end of your career. I would gladly pay that amount (and more) in order to have more options for residency, fellowship, and beyond. With that being said, the drop-off between Emory and Vermont isn't as large as say... Stanford and University of Hawaii. You just have to decide how much more are you willing to pay for a more reputable program.

Medical school applicants and students should know that reputation absolutely matters (maybe more than everyone is willing to admit) when it comes to residency/fellowship applications. On the flip side, reputation has next to no bearing on how good of a doctor a person will become.

 

[gutonc]

True, you will probably not make that money back and are down $200k (plus interest) at the end of your career. I would gladly pay that amount (and more) in order to have more options for residency, fellowship, and beyond. With that being said, the drop-off between Emory and Vermont isn't as large as say... Stanford and University of Hawaii. You just have to decide how much more are you willing to pay for a more reputable program.

Medical school applicants and students should know that reputation absolutely matters (maybe more than everyone is willing to admit) when it comes to residency/fellowship applications. On the flip side, reputation has next to no bearing on how good of a doctor a person will become.

I'm the first to say that "name matters, even though it shouldn't". But pretending there's a quarter million dollar difference between UVM and Emory (or frankly, UVM and Hopkins) does nobody any favors.

 

[GastriqueGraffin]

Personally I can't wait to leave the academic world and the underlying arrogance of comparing brand reputations.

 

[IMreshopeful]

True, you will probably not make that money back and are down $200k (plus interest) at the end of your career. I would gladly pay that amount (and more) in order to have more options for residency, fellowship, and beyond. With that being said, the drop-off between Emory and Vermont isn't as large as say... Stanford and University of Hawaii. You just have to decide how much more are you willing to pay for a more reputable program.

Medical school applicants and students should know that reputation absolutely matters (maybe more than everyone is willing to admit) when it comes to residency/fellowship applications. On the flip side, reputation has next to no bearing on how good of a doctor a person will become.

This depends on your life goals again. For someone who wants to be the “top” in their field and go to the “top” place to satisfy their ego, sure, spend an extra 200k. That way when they take a low paying academic job, sure they’ll be in debt and it’ll take a longer while to pay off that cash, but they’ll have that “satisfaction” that comes with it. I genuinely think we brainwash people in medical school to think that somehow if you’re not interested in staying academic it’s some sort of shameful thing.

Neither my residency nor my fellowship program are considered the “top” places (though still quite good). All of our graduates - subspecialty or not - have gotten jobs where and how they want and are relatively happy in their lives. I’m not sure where this myth comes from that doing training at X Y or Z place limits where you can get a good job.

 

[IMreshopeful]

Personally I can't wait to leave the academic world and the underlying arrogance of comparing brand reputations.

Agree, the politics and arrogance of it is appalling. It’s left such a bad taste in my mouth. Kudos to those who get a kick out of it though

 

[NewYorkDoctors]

Or to match into the incredibly competitive Subspecialty, GI.

Correction ... to match into a very competitive specialty in a top big city for lifestyle purposee . The latter is the kicker . If one can not fathom doing GI at some community tertiary hospital away from a big metro area , then one would have to strive for the top residency then .


As for money earning potential , going by mean salary is unreliable as the sampling bias may be large on those medscape surveys. Further , the higher the listed salary per specialty , the greater the malpractice premiums anyway (Nsx for example )

It would seem the biggest earners are either the top physician researchers with lots of honoraria or who have converted their research into a useful medical product or community physicians who have an assembly line business practice doing procedures or just seeing high volumes of patients . And I mean break seven figures and then some ..

 

[HoldTheCoffee]

Something that I think is worth pointing out is that you can list a scholarship on your ERAS application for residency. So if you go to a less famous school but in the honors/awards section you have a full tuition or massive scholarship, that I think factors in a bit. That way at the selection committee meetings if some stuffy old doc asks why they should consider someone who went to a "lower" tier school, at least someone could infer that your scholarship factored in. I can't say definitively that it'll matter at all places but I think it'll help at some.

Of course, the most important thing (than scholarship or name brand) is just doing well on rotations and being involved in some aspect of medicine that you're passionate about, be it some sort of research, education, or policy. Regarding fellowship, I generally think that your residency program weighs in a bit more at that point, especially if you have LORs that vouch for your work ethic and ability as a physician.

 

[fasteddie911]

I went to an average med school and matched into a top-25 program. My co-residents had similar stats to me or even better (250+, +/- aoa, good letters, extra-curriculars), coming from all schools including HMS and the like. We were all equally qualified to be there and we all worked hard get there, their school reputation didn't necessarily make or break them. It's unlikely a top-25 program will take someone with weak stats because they came from a good school. Any smart PD will realize that talent can be found anywhere and med school name (which typically comes at a cost) shouldn't matter much.

True, you will probably not make that money back and are down $200k (plus interest) at the end of your career. I would gladly pay that amount (and more) in order to have more options for residency, fellowship, and beyond. With that being said, the drop-off between Emory and Vermont isn't as large as say... Stanford and University of Hawaii. You just have to decide how much more are you willing to pay for a more reputable program.

Medical school applicants and students should know that reputation absolutely matters (maybe more than everyone is willing to admit) when it comes to residency/fellowship applications. On the flip side, reputation has next to no bearing on how good of a doctor a person will become.

Funny you say that, my program had one person from Hawaii, none from Stanford. From what they told me their school matches pretty well and they attract the top notch students from the area who want to save money on tuition, many of whom did undergrad in US mainland but are still considered residents.

 

[TAVR2sday]

Something that I think is worth pointing out is that you can list a scholarship on your ERAS application for residency. So if you go to a less famous school but in the honors/awards section you have a full tuition or massive scholarship, that I think factors in a bit. That way at the selection committee meetings if some stuffy old doc asks why they should consider someone who went to a "lower" tier school, at least someone could infer that your scholarship factored in. I can't say definitively that it'll matter at all places but I think it'll help at some.

Of course, the most important thing (than scholarship or name brand) is just doing well on rotations and being involved in some aspect of medicine that you're passionate about, be it some sort of research, education, or policy. Regarding fellowship, I generally think that your residency program weighs in a bit more at that point, especially if you have LORs that vouch for your work ethic and ability as a physician.

Hits the nail on the head. If I’m reviewing your app, I’m just as impressed with your scholarship at Vermont as I am with your MD from Emory. Actually, I care far more about your med school performance than the prestige of the program. If you’re really concerned, you can compare the two IM match lists and see where top people have gone in the past but I would caution against putting too much weight there...you may end up switching to derm.

Unless your parents are writing the checks, take the 200k and don’t look back. No brainer.

I went to an average med school and matched into a top-25 program. My co-residents had similar stats to me or even better (250+, +/- aoa, good letters, extra-curriculars), coming from all schools including HMS and the like. We were all equally qualified to be there and we all worked hard get there, their school reputation didn't necessarily make or break them. It's unlikely a top-25 program will take someone with weak stats because they came from a good school. Any smart PD will realize that talent can be found anywhere and med school name (which typically comes at a cost) shouldn't matter much.



Funny you say that, my program had one person from Hawaii, none from Stanford. From what they told me their school matches pretty well and they attract the top notch students from the area who want to save money on tuition, many of whom did undergrad in US mainland but are still considered residents.

All of this. It’s easier to get your foot in the door from HMS but if you’re a superstar you’ll find your way to an excellent program from any U.S. MD program. If you’re just average, med school prestige won’t save you.

 

[Mad Jack]

Pedigree is mattering more and more as the match gets tighter. US MD class sizes are larger than ever but those coveted top IM programs have the same number of seats. Anything that can differentiate you will be worthwhile, so take it. You can always make more money later.

What other people are saying is also true, which is to say it is more of a value judgment on your part. I'd pay the 260k for the name recognition, personally.

 

[MyTachyBradyHeart]

I'm the first to say that "name matters, even though it shouldn't". But pretending there's a quarter million dollar difference between UVM and Emory (or frankly, UVM and Hopkins) does nobody any favors.

Is there a $250k difference between UVM and Emory? Of course not. Students from both will graduate with M.D.

To me, it's absolutely worth spending extra $250k to choose a more reputable program (not saying UVM is NOT reputable) in order to have more options when it comes to residency applications (which translates into fellowship applications). I say this since it was my experience coming from a nonranked medical school matching well and talking to many applicants in my position who were frustrated by how difficult it has become to match at a top IM program.

The majority of advice on this forum, esp by gutonc, is to save money over going to an slightly more reputable institution. I agree "reputation" is mostly B.S., but that's not the point of this thread. While this can be a good decision for some applicants, it is also important for applicants to know that this comes with a cost, which can be offset by being a stellar medical student, but not everyone can get 250+/AOA. Therefore, similar caliber applicants who go to a more reputable institution will have an advantage. It is up to each individual person to determine what that "advantage" is worth to you.

I harp on this point, so applicants can get advice from the other perspective.

Funny you say that, my program had one person from Hawaii, none from Stanford. From what they told me their school matches pretty well and they attract the top notch students from the area who want to save money on tuition, many of whom did undergrad in US mainland but are still considered residents.

You knew it was an analogy and still felt the need to give a counter-example. Commenting on good applicants from Hawaii totally misses the point.

 

[Instatewaiter]

As someone at a medical school around the calibur (sic) of Vermont, I’d say take Emory in a heartbeat.

Pedigree is a huge factor in top IM programs as I’ve noticed this year. People with step scores in the 220’s at top med schools were still getting way more interviews than people from my school with 240+. The only true way to break out of the “low tier MD” stigma was to get 250+ and AOA.

As someone who went to a medical school less than the caliber of Vermont and matched to one of the top 4 IM residencies I'd say take the money and run.

Does pedigree help? Sure. Is it worth a quarter of a million dollars - more after you factor in interest? Nope

FYI- every year the applicants discuss how much harder it has become to match into IM but realistically the needle has not moved much.

 

[siliso]

So then so what? The interesting q to me is if you can do the kind of clinical, research and teaching work that you want to do as a physician? You can do about any of that from most any academic IM program if you have the interest and put the work in. Middle midwestern Uni IM program - we have folks going into every specialty everywhere, even Top Name wherevers. And we take solid candidates from everywhere, most especially any US MD school without question.

Students from associated middle Midwest Uni med school also match to Name Places, if they’re the caliber of student who gets academic scholarships and AOA and that’s what they want. Don’t forget in matches for specialty and fellowship that people are not uniformly driven to go for Top Name, much much less so than strivers looking to get into a college, and may for good reason prefer location/connections/QOL exactly because of above paragraph.


Take that free money and run

 

[PlutoBoy]

Pedigree is mattering more and more as the match gets tighter. US MD class sizes are larger than ever but those coveted top IM programs have the same number of seats. Anything that can differentiate you will be worthwhile, so take it. You can always make more money later.

What other people are saying is also true, which is to say it is more of a value judgment on your part. I'd pay the 260k for the name recognition, personally.

No.

 

[PlutoBoy]

So then so what? The interesting q to me is if you can do the kind of clinical, research and teaching work that you want to do as a physician? You can do about any of that from most any academic IM program if you have the interest and put the work in. Middle midwestern Uni IM program - we have folks going into every specialty everywhere, even Top Name wherevers. And we take solid candidates from everywhere, most especially any US MD school without question.

Students from associated middle Midwest Uni med school also match to Name Places, if they’re the caliber of student who gets academic scholarships and AOA and that’s what they want. Don’t forget in matches for specialty and fellowship that people are not uniformly driven to go for Top Name, much much less so than strivers looking to get into a college, and may for good reason prefer location/connections/QOL exactly because of above paragraph.


Take that free money and run

Not to mention that the vast majority of programs will train you to be a competent physician, all things considered.

Medicine is largely a self taught field. How good of a doctor you become is more a reflects how much work you put into rather than the school you attended.

FWIW, one of the dumbest GI doctors I trained with attended NYU, Brown, Harvard, and Hopkins. Dumb as a rock. I was a PGY-2 and had to explain to him that the patient we were seeing had acute hepatitis. I have more stories about him.

 

[CatFactorial]

Not to mention that the vast majority of programs will train you to be a competent physician, all things considered.

Medicine is largely a self taught field. How good of a doctor you become is more a reflects how much work you put into rather than the school you attended.

FWIW, one of the dumbest GI doctors I trained with attended NYU, Brown, Harvard, and Hopkins. Dumb as a rock. I was a PGY-2 and had to explain to him that the patient we were seeing had acute hepatitis. I have more stories about him.

So what you're REALLY saying is that he must have learned his hepatology whilst at NYU or Brown, right?

 

[PlutoBoy]

So what you're REALLY saying is that he must have learned his hepatology whilst at NYU or Brown, right?

Haha. No. What I'm saying is that "pedigree" doesn't guarantee that the physician is good.

If one's interest is becoming a great physician that can help patients, attending Vermont instead of Emory and saving $200,000 is not going to hurt!

And people match to even the most competitive specialties out of some community hospitals!

 

[NewYorkDoctors]

Though nepotism is the trump card in all of medicine .

Incompetent lazy resident at community hospital ... (think step 1 188 and was kicked out of pgy1 surgery , had no clinical acumen , showed up to work late , etc.. see one of my earlier posts ... becomes chief resident ... gets into general cards at the home program after dropping way down his rank list at the overt dismay of the home cards program ... then gets to go to UCSF for interventional cardiology by virtue of family donating a Wing... that guy won the game of life ) can make it big with nepotism

 

[IMreshopeful]

Though nepotism is the trump card in all of medicine .

Incompetent lazy resident at community hospital ... (think step 1 188 and was kicked out of pgy1 surgery , had no clinical acumen , showed up to work late , etc.. see one of my earlier posts ... becomes chief resident ... gets into general cards at the home program after dropping way down his rank list at the overt dismay of the home cards program ... then gets to go to UCSF for interventional cardiology by virtue of family donating a Wing... that guy won the game of life ) can make it big with nepotism

This is life unfortunately. Those with wealth typically stay wealthy and have it easier in life than others