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

[NewYorkDoctors]

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

Indeed . Not so much a complaint as it is an observation.

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[Anicetus]

No.

While there are valid points from both sides, it still sucks to see people from top tier MD schools match top tier IM programs with 0 publications and a step 1 in the 220’s and no AOA. So I really think it depends on who you are asking.

 

[Stagg737]

People keep talking about the $200,000 difference, but it's really much more than that. After interest accruing through residency it'll be more like $250k by the time you're making an attending salary, more if you do a fellowship. That's $250k you don't have to invest early in your career. If you invested that $250k for 30 years at a 5% rate (which you should be doing early), you'd end up with $1.1 million. Which is a much more drastic difference than the initial $200k.

Only OP can really decide if the financial difference is worth it for the career options, but let's also not underestimate how big of a financial difference it could actually be.

 

[beijingband]

As an incoming M1, I had no idea med school name mattered that much. I'm assuming that's more important for top 20 vs state school. I'm interested in heme/onc and trying to decide between Temple and VTC. I would really prefer VTC but would it hold me back for a strong IM residency (like Emory or Baylor) I just don't know if the difference between the schools is big enough for residencies?

 

[gutonc]

As an incoming M1, I had no idea med school name mattered that much. I'm assuming that's more important for top 20 vs state school. I'm interested in heme/onc and trying to decide between Temple and VTC. I would really prefer VTC but would it hold me back for a strong IM residency (like Emory or Baylor) I just don't know if the difference between the schools is big enough for residencies?

Vermont Technical College?

 

[beijingband]

Vermont Technical College?

Sorry, Virginia Tech Carillion.

 

[IMreshopeful]

As an incoming M1, I had no idea med school name mattered that much. I'm assuming that's more important for top 20 vs state school. I'm interested in heme/onc and trying to decide between Temple and VTC. I would really prefer VTC but would it hold me back for a strong IM residency (like Emory or Baylor) I just don't know if the difference between the schools is big enough for residencies?

I know residents who graduated from both. Neither is a bad medical school. However, Temple has better name recognition for sure as the VT Carillion school is newer. Also the medicine residency at Temple is much more well regarded (and one of the prior PDs, Dr. Moyer, is the president (was?) of the ACP) - the VT residency is mostly DOs and IMGs with little name recognition. It doesn’t mean the training is bad, but unfortunately the nepotism is still pretty strong with the field of medicine.

 

[usmd2022]

Stumbled across this thread and was wondering if people had insight into how true this still is? It seems like it's harder to judge what makes someone competitive for a top IM program compared to what makes them competitive for a specialty like dermatology or ortho. Also, what medical schools (beyond the obvious) seem to actually provide this "top 25" advantage (the rankings shift a bit every year). Seems hard to believe Emory would provide an advantage (#25 this year) whereas UVA (top 30) would not. At what point does it actually matter a lot?

 

[tantacles]

Stumbled across this thread and was wondering if people had insight into how true this still is? It seems like it's harder to judge what makes someone competitive for a top IM program compared to what makes them competitive for a specialty like dermatology or ortho. Also, what medical schools (beyond the obvious) seem to actually provide this "top 25" advantage (the rankings shift a bit every year). Seems hard to believe Emory would provide an advantage (#25 this year) whereas UVA (top 30) would not. At what point does it actually matter a lot?

Yes, it's harder. No, it's not impossible. and ultimately, it doesn't really matter where you go; you will still be a doctor afterwards who can provide great care to patients.

 

[ace_inhibitor111]

Stumbled across this thread and was wondering if people had insight into how true this still is? It seems like it's harder to judge what makes someone competitive for a top IM program compared to what makes them competitive for a specialty like dermatology or ortho. Also, what medical schools (beyond the obvious) seem to actually provide this "top 25" advantage (the rankings shift a bit every year). Seems hard to believe Emory would provide an advantage (#25 this year) whereas UVA (top 30) would not. At what point does it actually matter a lot?

You can check the previous match lists and count the percentage of people who get into a Top 20. It’s pretty constant every year for most schools. UVa doesn’t seem to do well in this regard but Emory is consistently really good.

 

[Elixir6]

It matters more and more, especially with more applicants, more pass/fail med school models, and now with pass/fail of USMLE Step 1. I imagine in 10 years Step 2 will also go pass/fail.

As has been said here ad nauseam, it's not impossible to go from a no name place to some ivory tower, it's just harder.

The question you have to ask by looking deep down into yourself is what is important to you in life, and is the juice worth the squeeze. Sure some people fell ass backwards into privilege, but over time in academia hard work and long hours are needed to achieve prominence.

I personally have clawed my way to the top starting as student on a visa coming from a university outside of USA that no one has heard of and slowly climbed my way up this prestige ladder from med school to residency to fellowship. I'm happy I did it because this was important to me personally. This long journey included luck, a lot of elbow grease and some sacrifice, but I've come to the conclusion that what I originally envisioned as "success” may not be worth it.
While a lot of people at the "top" can be happy and satisfied, many are not because of the pressures of academia. Also the attending pay at these places sucks.

 

[disorder]

It matters more and more, especially with more applicants, more pass/fail med school models, and now with pass/fail of USMLE Step 1. I imagine in 10 years Step 2 will also go pass/fail.

As has been said here ad nauseam, it's not impossible to go from a no name place to some ivory tower, it's just harder.

The question you have to ask by looking deep down into yourself is what is important to you in life, and is the juice worth the squeeze. Sure some people fell ass backwards into privilege, but over time in academia hard work and long hours are needed to achieve prominence.

I personally have clawed my way to the top starting as student on a visa coming from a university outside of USA that no one has heard of and slowly climbed my way up this prestige ladder from med school to residency to fellowship. I'm happy I did it because this was important to me personally. This long journey included luck, a lot of elbow grease and some sacrifice, but I've come to the conclusion that what I originally envisioned as "success” may not be worth it.
While a lot of people at the "top" can be happy and satisfied, many are not because of the pressures of academia. Also the attending pay at these places sucks.

This times one million. You really have to think about what's important to you? Deep down, heart of hearts, if you want to attempt to "change" the field of medicine and be truly academic, AND this will make you happy, then yes... go after that prestige and aim for the "top".

Also, to you @Elixir6 , don't feel bad or regret your conclusion of what "success" should look like. This, ultimately leads you to the next step in finding what makes you happy/satisfied with whatever you're going to do next. Priorities change in life, too.

 

[deleted980918]

I had an academic attending who once said he has been getting job offers from private practices and if he were to leave academia he would instantly triple his pay. Then he went on to say he can buy a fancy car and a big house but he commented that these wouldn’t make him happier.

But to many others, these would make them happier.

 

[Elixir6]

This times one million. You really have to think about what's important to you? Deep down, heart of hearts, if you want to attempt to "change" the field of medicine and be truly academic, AND this will make you happy, then yes... go after that prestige and aim for the "top".

Also, to you @Elixir6 , don't feel bad or regret your conclusion of what "success" should look like. This, ultimately leads you to the next step in finding what makes you happy/satisfied with whatever you're going to do next. Priorities change in life, too.

Thanks. No, I don't regret it. But it's hard to know whether academia will make you happy/fulfilled or private practice. In training at academic centers you don't really know what private practice is like to compare. I'm sure they deal with a different set of issues as compared to academia, and of course every place whether academic or PP is different.

But it's a dilemma we all deal with. Heck, at each stage of a medical career, most people don't really know what they are signing up for when it comes to the next step.

From my perspective for what's worth, the moral is searching deep down and make the best educated guess about your happiness and if you actually think it's worth the hard work, and don't be too extreme about anything. People in medicine get too bent out of shape and miss the forest for the trees.

 

[gutonc]

Thanks. No, I don't regret it. But it's hard to know whether academia will make you happy/fulfilled or private practice. In training at academic centers you don't really know what private practice is like to compare. I'm sure they deal with a different set of issues as compared to academia, and of course every place whether academic or PP is different.

But it's a dilemma we all deal with. Heck, at every state of a medical career, most people don't really know what they are signing up for when it comes to the next step.

From my perspective for what's worth, the moral is searching deep down and make the best educated guess about your happiness and if you actually think it's worth the hard work, and don't be too extreme about anything. People in medicine get too bent out of shape she miss the forest for the trees.

Two really great points here.

1. Outside of the whole "get grants or move the meat" thing which is universal in academic medicine, no two academic gigs are the same. Likewise, no two community based places are the same. Heck, I direct a community based, academ-ish oncology group (13, soon to be 15 docs covering 5 different locations) and I think the experiences at the different sites are different enough to basically consider them different practices.

2. Be flexible and have some grace for yourself and others. This will keep you from turning every change or setback into a catastrophe, which I see all day, every day.

 

[disorder]

Two really great points here.

1. Outside of the whole "get grants or move the meat" thing which is universal in academic medicine, no two academic gigs are the same. Likewise, no two community based places are the same. Heck, I direct a community based, academ-ish oncology group (13, soon to be 15 docs covering 5 different locations) and I think the experiences at the different sites are different enough to basically consider them different practices.

2. Be flexible and have some grace for yourself and others. This will keep you from turning every change or setback into a catastrophe, which I see all day, every day.

Also, great points.
1. It wasn't until I started looking for jobs did I realize the variety of jobs out there. Literally, .every.single.job. is different. And not a little different, VERY different. But, I'm a specialist so it may be different in other fields. I found one I think/thought would fit what I wanted, and so far so good.
2. Agreed. Being nice and staying humble will take you far.