Location of med school = location of residency?

[Slide]

A while ago I was reading the match list of last year's graduating class and it seems that a good majority of the M4s stayed instate or went to an adjacent state for their residency. This got me wondering if the location of one's medical can play a part in where someone will likely do a residency. I know the most common cliche answer is to "spank the boards, ace the rotations", etc., but when I read the match list of the 07 graduates, I noticed very few people were able to land positions on the east coast/northeast/west coast area (less than 5, as I recall). I honestly want to make staying at my state med school the last 4 years I have to stay in this god-forsaken state, and ideally I hope to get a residency somewhere on the east coast, but so far the match lists I've seen for the recent graduates don't seem very promising for my hopes.

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[nka1985]

I was wondering about this too...I want to go back to the west coast after I finish med school. The east coast so far is a nice enough place, but all of my family and my fiance's family are on the west coast.

 

[Doctor Bagel]

The explanation I've heard for this is that people like to stay where they are or at least in the region, and honestly that seems pretty true based on conversations I've had with people at my school. Also, I think students get some advantage in the super competitive residencies at their home school. But I don't think (hopefully) that it's at all impossible to get a residency in another location.

 

[SomeDoc]

A while ago I was reading the match list of last year's graduating class and it seems that a good majority of the M4s stayed instate or went to an adjacent state for their residency. This got me wondering if the location of one's medical can play a part in where someone will likely do a residency. I know the most common cliche answer is to "spank the boards, ace the rotations", etc., but when I read the match list of the 07 graduates, I noticed very few people were able to land positions on the east coast/northeast/west coast area (less than 5, as I recall). I honestly want to make staying at my state med school the last 4 years I have to stay in this god-forsaken state, and ideally I hope to get a residency somewhere on the east coast, but so far the match lists I've seen for the recent graduates don't seem very promising for my hopes.

You also don't know the board scores of your colleagues, their application portfolio, or their geographical preferences. I'd stick with the common cliche answer- your options will be more so than to do otherwise. Do your best, and then see where the road leads.

 

[humuhumu]

The explanation I've heard for this is that people like to stay where they are or at least in the region, and honestly that seems pretty true based on conversations I've had with people at my school.

I agree. I'd love to stay here for residency.

 

[Law2Doc]

but when I read the match list of the 07 graduates, I noticed very few people were able to land positions on the east coast/northeast/west coast area (less than 5, as I recall).

How can you tell from a list what people were able to do, as opposed to what they wanted to do? Many people go to med school in a place that is geographically appealing (i.e. close to family, a city they like etc). 4 years later, many people still find those places geographically appealing and stay. Others end up with spouses, SOs, kids during med school and stay put for those reasons. And so on. You simply cannot look at a list of what people chose and think you know how they came to that decision. For all you know, everybody who stayed local turned down a coastal option.

 

[PeepshowJohnny]

Well, I'm in a fly over state medical school, and last year our match list had about a fifth of the class end up on the East/West coast (including matches at Cedars Sinai and Mass Gen.) Now, granted, most of these were in less competitive spceialties. So if you're wanting to go back to California and you've got your heart set on Ortho or Derm...you may wind up unhappy.

 

[Slide]

How can you tell from a list what people were able to do, as opposed to what they wanted to do? Many people go to med school in a place that is geographically appealing (i.e. close to family, a city they like etc). 4 years later, many people still find those places geographically appealing and stay. Others end up with spouses, SOs, kids during med school and stay put for those reasons. And so on. You simply cannot look at a list of what people chose and think you know how they came to that decision. For all you know, everybody who stayed local turned down a coastal option.

This is what I thought originally, and this is true for a good number of people in my school. However, I'm just more concerned about the students like me that want to go to a different region. Just seeing that around 5% of our class actually leaves the south is disturbing to me; each year anywhere from 30-50% of our graduates go out of state to do their residency, but it is generally the state next door or maybe the Carolinas (and that's reaaallly pushing it). Maybe some of these students have turned down coastal options, but still, they could have applied and not gotten an interview.

What really worries me is more than that; if I wanted to do a non-competitive or mildly competitive specialty, I really wouldn't be worried, but right now my interests are leaning towards optho/ortho. I know that my interests are subject to change after rotations, but the issue still remains that the more competitive specialties could be taken up in that area by students in that region because simply the residency directors may be more comfortable with having students from the region rather than risking a limb to recruit a graduate from a state where post-basic education is definitely not a priority in the state's grand scheme of things.

You also don't know the board scores of your colleagues, their application portfolio, or their geographical preferences. I'd stick with the common cliche answer- your options will be more so than to do otherwise. Do your best, and then see where the road leads.

Average board scores for our school usually corresponds with the national mean. On an exceptional year we will be 2% higher than the national mean (or so I've heard from the dean). Some of the students in our school are there simply because no other med school would take them (me, for example).

 

[Gut Shot]

However, I'm just more concerned about the students like me that want to go to a different region.

There's nothing you can do right now except put your head down and work. When the time comes you can do away rotations and apply to a broad range of programs wherever you desire. We all face the same problems.

 

[elwademd]

This is what I thought originally, and this is true for a good number of people in my school. However, I'm just more concerned about the students like me that want to go to a different region. Just seeing that around 5% of our class actually leaves the south is disturbing to me; each year anywhere from 30-50% of our graduates go out of state to do their residency, but it is generally the state next door or maybe the Carolinas (and that's reaaallly pushing it). Maybe some of these students have turned down coastal options, but still, they could have applied and not gotten an interview.

What really worries me is more than that; if I wanted to do a non-competitive or mildly competitive specialty, I really wouldn't be worried, but right now my interests are leaning towards optho/ortho. I know that my interests are subject to change after rotations, but the issue still remains that the more competitive specialties could be taken up in that area by students in that region because simply the residency directors may be more comfortable with having students from the region rather than risking a limb to recruit a graduate from a state where post-basic education is definitely not a priority in the state's grand scheme of things.



Average board scores for our school usually corresponds with the national mean. On an exceptional year we will be 2% higher than the national mean (or so I've heard from the dean). Some of the students in our school are there simply because no other med school would take them (me, for example).

there are so many variables that go into one's decision to go into a particular residency and where to go for residency that are beyond the things on paper, that you may not want to worry about what other people have been doing or are doing.

How can you tell from a list what people were able to do, as opposed to what they wanted to do? Many people go to med school in a place that is geographically appealing (i.e. close to family, a city they like etc). 4 years later, many people still find those places geographically appealing and stay. Others end up with spouses, SOs, kids during med school and stay put for those reasons. And so on. You simply cannot look at a list of what people chose and think you know how they came to that decision. For all you know, everybody who stayed local turned down a coastal option.

agreed. just work on you.

i'm from cali, went to college in new orleans, went to med school in atlanta, ended up in residency back in california.

if you really want to do optho/ortho, then it would seem likely that you'd go anywhere in the country to do it, regardless of where it would be... unless you really don't want it that bad.

 

[osli]

1. Most people likely want to stay where they have put down some roots.

2. Your chances of matching to a program are increased by having rotated through that program and them having seen your face and gotten to know you at least a bit. It is much easier logistically to rotate through a nearby program, and of course your own school should be pretty comfortable with knowing your face.

 

[jdh71]

Yeah, some people may like to stay in their area . . . but it actually looks more like this is determined more by the programs themselves. Where you want to go is a big moot point if you cannot get a program to grant you an interview. Most programs - those that are not considered TOP in their particular discipline (TOP programs get TOP applicants from everywhere) - for instance, solid mid tier state university programs will take their own first, then will ask regionally, and if they have anything left you might get an invite - seems especially so in the south and midwest.

 

[thedelicatessen]

My school's match list is also heavy in in-state match, which I think is attributed to demographics. Most students are from the state, most students attended college in the state, and most students have close family ties in the state. Some people just aren't really into adventure I suppose.

Interestingly, California also retains a lot of their residents who attended med school in the state. Although California has way more prestigious academic programs than most states, the same reasoning probably applies. I personally also plan to gain as much outside experience as I can and hopefully practice in another area, but I haven't absolutely ruled out my state either.

 

[chrisisinnocent]

A lot of this is program driven too I think. I am currently applying for residency and I am from a California med school. I had interview offers from almost all the Ca programs I have applied to but only two from the East coast, one from the midwest and one from the South. I think some programs assume that even if hey offer me an interview I would probably rank California programs ahead of them so why waste an interview slot on someone who may not come there (which is not true for me, I have no problem moving).
Also, it may be due to people not knowing your letter writers. Getting a strong LOR from someone the PD knows personally probably has a lot more impact than from someone they have never met.

 

[Ashers]

A lot of this is program driven too I think. I am currently applying for residency and I am from a California med school. I had interview offers from almost all the Ca programs I have applied to but only two from the East coast, one from the midwest and one from the South. I think some programs assume that even if hey offer me an interview I would probably rank California programs ahead of them so why waste an interview slot on someone who may not come there (which is not true for me, I have no problem moving).
Also, it may be due to people not knowing your letter writers. Getting a strong LOR from someone the PD knows personally probably has a lot more impact than from someone they have never met.

I had the residency director for the speciality I want to go into from my school tell me basically something to that effect. Since I said I'm from HI, he said he would never interview someone from HI (who went to school in HI) even if they looked great on paper because they would probably not rank the school highly, and it'd just take an interviewing slot from someone else.

I've also heard stories from friends from my school who interviewed in AZ who grew up in cold places. They were asked if they would be able to tolerate the heat.

Fortunately for me, I went to school in AZ and now WI, but I think I like hot better than cold.

 

[Xandie]

I grew up in Michigan, college in Michigan, medical school in Wisconsin, interviewing for residency almost exclusively in the Northeast. Every program has asked me "why leave the Midwest". My answer, which I won't detail here because I'm lazy, seems to have been sufficient. Then they're itching to tell an "outsider" about how fun it is to live in whatever city it is.

Remember, the majority of most medical school's populations are in-state, and people do want to be close to family (as detailed above).

 

[Ashers]

I grew up in Michigan, college in Michigan, medical school in Wisconsin, interviewing for residency almost exclusively in the Northeast. Every program has asked me "why leave the Midwest". My answer, which I won't detail here because I'm lazy, seems to have been sufficient. Then they're itching to tell an "outsider" about how fun it is to live in whatever city it is.

Remember, the majority of most medical school's populations are in-state, and people do want to be close to family (as detailed above).

But that's LEAVING the midwest for more desireable places, not coming to it from, like, Hawaii.

 

[Xandie]

Of course. I would be remiss to point out that some people desire to be in the Midwest.

My post was more about the OP's question, which was that he goes to school not on the east coast, and wants to move there, much like myself.

 

[phospho]

Bump.

I was recently accepted to a west coast medical school. I am sick and tired of living here in the midwest (Columbus, OH). I have always wanted to move out west (California, Nevada, Utah, Oregon, etc...)

My two options:

1- Move west right now, i.e. take that west coast school's acceptance offer

2- Stay here in Columbus for medical school and pay cheaper tuition, and then apply to residency in the west coast.

I really don't mind moving right now if I have to or if it puts me at a better advantage come residency time. I'm having trouble finding concrete advice about this. I'm also having trouble believing that a school like Wright State or Ohio State would put me on the same level of competition as a west coast applicant when it comes to matching.

Also, it might help to mention that I'm generally hoping to get into primary care. I am not interested in any of the competitive specialties.

Any opinions/advice?

 

[njbmd]

Location of residency is largely a personal choice. My medical school was located on the east coast (private) with about half of the students from the west and about half from the east. Most people elected to return to their home base for residency. Now, with most of us in practice or fellowship, we are spread across the country.

The best performers in any medical school have their more choices of specialty or specialty location. Your medical school per se isn't going to make you more competitive but your performance in said school will. Your medical school isn't going to guarantee a high board score but your ability to prepare for boards will.

When you are sending in that check every month for student loans, your medical school location isn't going to be of much consequence but the cost of said medical school will be of huge consequence. Thinking that adding a couple of hundred thousand to your debt load is going to buy you some advantage is a costly mistake. Every time I look at my paycheck, I am thankful that I didn't choose a more expensive school because I am debt free and I have the career that I wanted (academic medicine) from a lesser-ranked medical school that gave me a full-ride. My guess is that I would have been fine from any of the medical schools that accepted but the money was very nice.

If you do well in school, you have your pick of residency no matter where you attended medical school. I had no problems getting interviews in surgery at the top programs in the country from my lowly medical school (which has a former president of the American College of Surgeons). My residency program had three former presidents of the American College of Surgeons. In the end, it was my performance and not my school that counted. I got the location that I wanted in the program that I wanted.

 

[BigRedBeta]

This whole discussion is difficult to accurately assess, because we don't have all the data. We have one class' final results without having any idea what original intentions were as M1's, how those changed, where this particular class applied, where they got interviews, what the priorities were when it came time to submit rank lists and what positions on those lists were the ultimate destinations. There's simply too much confounding going on to have a good notion of anything.

Certainly specialty choice has an impact. There are only so many spots in a particular location and given that people do tend to stay close, it makes for increased competition even in less competitive fields when you're looking at places like California.

If I were an incoming M1, I'd honestly not give residency implications a voice in where I ended up for school - there's simply too much that's going to happen over the course of the next 3 years leading up to residency applications. If you like the west coast and can move now AND you like the schools enough to overcome the cost issue, then by all means move - you'll be happier. If on the other hand you stay in Ohio, nothing is going to prevent you from doing audition rotations as a fourth year on the west coast, from applying only to programs west of Denver and ultimately ranking only programs that meet your geographic criteria. That said, don't be too shocked if you somehow manage to meet a wonderful guy and end up in a committed relationship that means enough to you for you to stay in Ohio or you end up falling in love with Orthopedic surgery or derm to the point that you'll move (or stay) anywhere to be one...four years is a lot of time and a great many things can happen.

 

[phospho]

Location of residency is largely a personal choice. My medical school was located on the east coast (private) with about half of the students from the west and about half from the east. Most people elected to return to their home base for residency. Now, with most of us in practice or fellowship, we are spread across the country.

The best performers in any medical school have their more choices of specialty or specialty location. Your medical school per se isn't going to make you more competitive but your performance in said school will. Your medical school isn't going to guarantee a high board score but your ability to prepare for boards will.

When you are sending in that check every month for student loans, your medical school location isn't going to be of much consequence but the cost of said medical school will be of huge consequence. Thinking that adding a couple of hundred thousand to your debt load is going to buy you some advantage is a costly mistake. Every time I look at my paycheck, I am thankful that I didn't choose a more expensive school because I am debt free and I have the career that I wanted (academic medicine) from a lesser-ranked medical school that gave me a full-ride. My guess is that I would have been fine from any of the medical schools that accepted but the money was very nice.

If you do well in school, you have your pick of residency no matter where you attended medical school. I had no problems getting interviews in surgery at the top programs in the country from my lowly medical school (which has a former president of the American College of Surgeons). My residency program had three former presidents of the American College of Surgeons. In the end, it was my performance and not my school that counted. I got the location that I wanted in the program that I wanted.

This whole discussion is difficult to accurately assess, because we don't have all the data. We have one class' final results without having any idea what original intentions were as M1's, how those changed, where this particular class applied, where they got interviews, what the priorities were when it came time to submit rank lists and what positions on those lists were the ultimate destinations. There's simply too much confounding going on to have a good notion of anything.

Certainly specialty choice has an impact. There are only so many spots in a particular location and given that people do tend to stay close, it makes for increased competition even in less competitive fields when you're looking at places like California.

If I were an incoming M1, I'd honestly not give residency implications a voice in where I ended up for school - there's simply too much that's going to happen over the course of the next 3 years leading up to residency applications. If you like the west coast and can move now AND you like the schools enough to overcome the cost issue, then by all means move - you'll be happier. If on the other hand you stay in Ohio, nothing is going to prevent you from doing audition rotations as a fourth year on the west coast, from applying only to programs west of Denver and ultimately ranking only programs that meet your geographic criteria. That said, don't be too shocked if you somehow manage to meet a wonderful guy and end up in a committed relationship that means enough to you for you to stay in Ohio or you end up falling in love with Orthopedic surgery or derm to the point that you'll move (or stay) anywhere to be one...four years is a lot of time and a great many things can happen.

thank you both very much for your replies.

Bedredbeta, so what you're saying is that if i go to a no name ohio school (i.e. wright state), I will still be able to do audition rotations on the west coast, and will still be able to match there? I know it's too early to say this, but i'll take any specialty if given the right geographics. I'm sick and tired of freezing my ass off here.

Not sure if you noticed, but i am VERY interested in wright state. I will be choosing it over Ohio State, and I think it is the perfect fit for me. However, if the only way I can go to the west is to go to school there, then I will do it. But from your post, I'm getting the impression that i would be okay.

quick side questions: are audition rotations competetive? for example, can a no name med school send its students anywhere in the country it wants?

i think i may know the answer to this one, but i'm assuming residencies favor people from their state, right? i.e. i would still be "sort" of at a disadvantage coming from the midwest to the west coast, right?

again, thank you SO very much!

 

[PeepshowJohnny]

...but i'll take any specialty if given the right geographics.

I guarantee by the end of third year you will look back on this statement and laugh. I'm not meaning to make fun, but by the end of third year you'll find some areas of medicine you despise so much you'd rather leave medicine than practice them.

Anywho, on to your questions.

-"So what you're saying is that if i go to a no name ohio school (i.e. wright state), I will still be able to do audition rotations on the west coast, and will still be able to match there?" - For the majority of residencies, yes. As long as you build up some connection to the west coast through away rotations, you should be fine. Competitive residencies, you have absolutely no guarantee to match into the west coast.

- "Not sure if you noticed, but i am VERY interested in wright state. I will be choosing it over Ohio State, and I think it is the perfect fit for me. However, if the only way I can go to the west is to go to school there, then I will do it. But from your post, I'm getting the impression that i would be okay." It's not the only way. Honestly, going to a west coast school will probably give you a bit of advantage to applying for a west coast residencies, but not such a huge advantage that you should think about not going to a "dream school"

-"quick side questions: are audition rotations competetive? for example, can a no name med school send its students anywhere in the country it wants?"- They're a bit competitive...if you're a poor med student, they may pass on you. However, the big thing is basically paperwork. By the time you get in, there may be a more streamlined system in place, but currently it's a big paperwork nightmare to set them up and get them scheduled and that's the biggest obstacle.


-"i think i may know the answer to this one, but i'm assuming residencies favor people from their state, right? i.e. i would still be "sort" of at a disadvantage coming from the midwest to the west coast, right?"-

As above, slight, but not huge. Good numbers, strong away rotations, and maybe a bit of social engineering in away rotations and proving you really do have an interest in west coast, you should be okay.

 

[phospho]

I guarantee by the end of third year you will look back on this statement and laugh. I'm not meaning to make fun, but by the end of third year you'll find some areas of medicine you despise so much you'd rather leave medicine than practice them.

Anywho, on to your questions.

-"So what you're saying is that if i go to a no name ohio school (i.e. wright state), I will still be able to do audition rotations on the west coast, and will still be able to match there?" - For the majority of residencies, yes. As long as you build up some connection to the west coast through away rotations, you should be fine. Competitive residencies, you have absolutely no guarantee to match into the west coast.

- "Not sure if you noticed, but i am VERY interested in wright state. I will be choosing it over Ohio State, and I think it is the perfect fit for me. However, if the only way I can go to the west is to go to school there, then I will do it. But from your post, I'm getting the impression that i would be okay." It's not the only way. Honestly, going to a west coast school will probably give you a bit of advantage to applying for a west coast residencies, but not such a huge advantage that you should think about not going to a "dream school"

-"quick side questions: are audition rotations competetive? for example, can a no name med school send its students anywhere in the country it wants?"- They're a bit competitive...if you're a poor med student, they may pass on you. However, the big thing is basically paperwork. By the time you get in, there may be a more streamlined system in place, but currently it's a big paperwork nightmare to set them up and get them scheduled and that's the biggest obstacle.


-"i think i may know the answer to this one, but i'm assuming residencies favor people from their state, right? i.e. i would still be "sort" of at a disadvantage coming from the midwest to the west coast, right?"-

As above, slight, but not huge. Good numbers, strong away rotations, and maybe a bit of social engineering in away rotations and proving you really do have an interest in west coast, you should be okay.

thank you!!!!!

 

[docscience]

I guarantee by the end of third year you will look back on this statement and laugh. I'm not meaning to make fun, but by the end of third year you'll find some areas of medicine you despise so much you'd rather leave medicine than practice them.

I kinda feel the same way about geography/weather as one can tell from my other posts. I hate cold weather and want to stay/go to warm weather year round...snow storms, sporadic up and downs of temp, etc. just don't make me happy.

I know it is hard to match into uber competitive specialties like ortho, derm, radiology, radiation onc, etc. but what about FM, IM, Peds, etc.

Does an average med student from out of state have a chance in matching in one of those? Also, away rotation are done usually 4th year before applying for residencies right?

Thanks again for the help guys.

 

[Law2Doc]

...

Does an average med student from out of state have a chance in matching in one of those? Also, away rotation are done usually 4th year before applying for residencies right?
...

Usually. You can theoretically continue to do these into the winter, but the snag is that you don't want to sign on for an away rotation and then have to miss days to interview elsewhere, so you really want to finish these up before your interviews start up.

 

[njbmd]

thank you both very much for your replies.

Bedredbeta, so what you're saying is that if i go to a no name ohio school (i.e. wright state), I will still be able to do audition rotations on the west coast, and will still be able to match there? I know it's too early to say this, but i'll take any specialty if given the right geographics. I'm sick and tired of freezing my ass off here.

Not sure if you noticed, but i am VERY interested in wright state. I will be choosing it over Ohio State, and I think it is the perfect fit for me. However, if the only way I can go to the west is to go to school there, then I will do it. But from your post, I'm getting the impression that i would be okay.

quick side questions: are audition rotations competetive? for example, can a no name med school send its students anywhere in the country it wants?

i think i may know the answer to this one, but i'm assuming residencies favor people from their state, right? i.e. i would still be "sort" of at a disadvantage coming from the midwest to the west coast, right?

again, thank you SO very much!

The medical schools doesn't SEND students anywhere. Students choose where and if they want to apply for visiting clerkships. I applied for and was granted a visiting clerkship at Mayo Clinic in Rochester, MN. The application was not competitive and closely resembled what I had to put together for residency anyway. In addition, Mayo granted me a scholarship to cover the cost of my travel, room and board for that rotation (they do this for some students but not all).

Most places accept students who wish to do visiting clerkships with an application that is similar to the Mayo application. Things that have to be sorted out are malpractice (my school covered all students), insurance issues, housing issues and transportation costs. Most students who do away clerkships cover these things for themselves or with logistical help from the program that they are visiting.

If Wright State works out for you, you will do better at Wright State than at Ohio State. If given a choice, attend the medical school that you can thrive in. Wright State is LCME-accredited which means that you are eligible for residency in any ACGME-accredited residency program in this country that you are competitive for. Your competitiveness will be determined primarily by your grades and your board scores.

Residency program directors and faculty look at the performance of the individual applicants and not at the state that they came from or even particularly the school that they came from. I can tell you that my grades and board scores opened all kinds of doors that I didn't even know were there. This wasn't because of my school (though I had good letters from faculty) but was because I had done well in my studies.

 

[PeepshowJohnny]

I kinda feel the same way about geography/weather as one can tell from my other posts. I hate cold weather and want to stay/go to warm weather year round...snow storms, sporadic up and downs of temp, etc. just don't make me happy.

I know it is hard to match into uber competitive specialties like ortho, derm, radiology, radiation onc, etc. but what about FM, IM, Peds, etc.

Does an average med student from out of state have a chance in matching in one of those? Also, away rotation are done usually 4th year before applying for residencies right?

Thanks again for the help guys.

The problem is when you start geographically limiting yourself you're cutting into the number of programs you can apply to in general. I'd suggest going on FREIDA and putting a search in a specialty you're interested in like ortho or rads and seeing how many programs are available in states you find tolerable. It may be relatively sparse.

I will tell you, however, in the cream of the crop fields like Derm and Plastics, geography goes out the window. Sure, once you get the interviews you can start weeding down, but you don't really hear about people applying to those fields limiting themselves to a certain region. This may also be the case if you're applying for a competitive fields and your numbers are average to below average.

 

[mikedc813]

The problem is when you start geographically limiting yourself you're cutting into the number of programs you can apply to in general. I'd suggest going on FREIDA and putting a search in a specialty you're interested in like ortho or rads and seeing how many programs are available in states you find tolerable. It may be relatively sparse.

I will tell you, however, in the cream of the crop fields like Derm and Plastics, geography goes out the window. Sure, once you get the interviews you can start weeding down, but you don't really hear about people applying to those fields limiting themselves to a certain region. This may also be the case if you're applying for a competitive fields and your numbers are average to below average.

The more competitive the program, the less choosy you can be. When I was applying to rad onc, I was just hoping to end up somewhere. I didn't care where. I just wanted to match. If I was doing something like medicine, peds, or surgery I probably could have been more selective and only applied in a certain geographic area. This isn't to say one field is better or worse than another, but that's just how things are based on the number of positions in each field.

 

[phospho]

The problem is when you start geographically limiting yourself you're cutting into the number of programs you can apply to in general. I'd suggest going on FREIDA and putting a search in a specialty you're interested in like ortho or rads and seeing how many programs are available in states you find tolerable. It may be relatively sparse.

I will tell you, however, in the cream of the crop fields like Derm and Plastics, geography goes out the window. Sure, once you get the interviews you can start weeding down, but you don't really hear about people applying to those fields limiting themselves to a certain region. This may also be the case if you're applying for a competitive fields and your numbers are average to below average.

The more competitive the program, the less choosy you can be. When I was applying to rad onc, I was just hoping to end up somewhere. I didn't care where. I just wanted to match. If I was doing something like medicine, peds, or surgery I probably could have been more selective and only applied in a certain geographic area. This isn't to say one field is better or worse than another, but that's just how things are based on the number of positions in each field.

I agree with you both... i guess that's why i was saying that i really don't care what i match in as long as i match in somewhere warm or with no clouds. I know this sounds stupid. The sun came out today and yesterday, but we hadn't seen it for like a week before that...

people are saying i'm crazy if I take any of my acceptances over my OSU acceptance... but for me, it's either wright state or utah at this point... it's wright state if i decide to stay here in ohio, and utah if i decide to get out...

we don't have any mountains here... it's as flat as it gets...

 

[nontrdgsbuiucmd]

I can relate, as a midwest native..we'd go weeks without sun in the winter at times.

And after living in CO for nearly 10 yrs, I've experienced how humdrum another sunny, warm, 50 degree February day can feel (somewhat facetiously). The weather in Utah will be similar to CO -- 50 degrees here is very different from 50 degrees in Ohio - even 40 degrees means sweatshirt and slippers, eating breakfast outside. Humidity makes a big change in how temp feels.

Depends which is more important to you. I love the mountains, but truly if you're looking at 25K instate versus 42K out of state tuition * 4 yrs, I would choose instate - that extra 68K of debt + interest seems pretty substantial, and can make a big impact on quality of life and possibly which specialty you can realistically choose.

My household earning is in the low six figure range now w/over 1K per month student loan payment; believe me -- this feels like a big chunk of our spending after making the mtg payment, taxes, etc.

 

[Steiner]

I think some of the reason people seem to stay near where they went to medical school is they make the mistake of ranking places higher on their ROL because they think they have a better chance of getting in there, not because of how much they like the program. I've seen people do it a lot. "I have a better chance of getting a spot there so I'll rank them higher, even though I prefer this other program." Like I said, this probably accounts for some of this apparent attachment to the region where you went to school.

 

[docscience]

I think some of the reason people seem to stay near where they went to medical school is they make the mistake of ranking places higher on their ROL because they think they have a better chance of getting in there, not because of how much they like the program. I've seen people do it a lot. "I have a better chance of getting a spot there so I'll rank them higher, even though I prefer this other program." Like I said, this probably accounts for some of this apparent attachment to the region where you went to school.

so just to clarify...these people who do rank these places higher...you mean they rank places that are closer (proximity) to them higher???

 

[Black Surgeon]

Yes. I think this is true for most programs. Most of the New York schools (for example) match about 80% of their students in New York residencies.

 

[werd]

there's generally a geographic bias, both on the part of the applicants and of programs. it varies by appicant and program but it's generally there. applicants will generally stay in the same part of the country, whether due to family or they just like the area; i think the programs do it because they'd rather train folks who are actually thinking of staying in the area to serve their population.
the geographic bias comes out especially in the more competetive specialties. i went to med school in the southeast... when i applied i got most interviews in the southeast, fewer in the northeast, 1 in the midwest, and none west of the mississippi.

 

[phospho]

I think some of the reason people seem to stay near where they went to medical school is they make the mistake of ranking places higher on their ROL because they think they have a better chance of getting in there, not because of how much they like the program. I've seen people do it a lot. "I have a better chance of getting a spot there so I'll rank them higher, even though I prefer this other program." Like I said, this probably accounts for some of this apparent attachment to the region where you went to school.

there's generally a geographic bias, both on the part of the applicants and of programs. it varies by appicant and program but it's generally there. applicants will generally stay in the same part of the country, whether due to family or they just like the area; i think the programs do it because they'd rather train folks who are actually thinking of staying in the area to serve their population.
the geographic bias comes out especially in the more competetive specialties. i went to med school in the southeast... when i applied i got most interviews in the southeast, fewer in the northeast, 1 in the midwest, and none west of the mississippi.

Thank you both. I think that definitely answers my question. It will increase my chances -- even if by a little bit -- to get into a west coast residency if I go to a west coast school. Yes, I do realize that a lot of people might match in the state they went to medical school at because that's what they had initially wanted and ranked higher.

I'm still waiting for financial aid to come through to see what kind of tuition/aid difference there will be. Hopefully that'll make my decision a bit easier

 

[DwyaneWade]

The more competitive the program, the less choosy you can be. When I was applying to rad onc, I was just hoping to end up somewhere. I didn't care where. I just wanted to match. If I was doing something like medicine, peds, or surgery I probably could have been more selective and only applied in a certain geographic area. This isn't to say one field is better or worse than another, but that's just how things are based on the number of positions in each field.

Maybe a difference of opinion, but I'd rather not match than match somewhere I hated, even if I was doing a competitive field like rad onc.

 

[BigRedBeta]

Maybe a difference of opinion, but I'd rather not match than match somewhere I hated, even if I was doing a competitive field like rad onc.

Half dozen of one, 6 of the other...if you don't match into rad onc at all, then you're going to end up scrambling into something that is less desirable (in a way by definition) than any rad onc program would be.

If I were going into something highly competitive, I'd be following mikedc's path - make me an orthopod or a radiologist or a dermatologist anyway you can - it's only 5 or 6 years for a career's worth of satisfaction.

 

[DrJosephKim]

It really depends on the region. People in the south tend to stay in the south. People who love California don't want to leave and want to stay as close as possible. Etc.

 

[Taliesinrk]

Thank you both. I think that definitely answers my question. It will increase my chances -- even if by a little bit -- to get into a west coast residency if I go to a west coast school. Yes, I do realize that a lot of people might match in the state they went to medical school at because that's what they had initially wanted and ranked higher.

I'm still waiting for financial aid to come through to see what kind of tuition/aid difference there will be. Hopefully that'll make my decision a bit easier

Remember that Utah will give you IS tuition for years 2-4...

 

[phospho]

Remember that Utah will give you IS tuition for years 2-4...

YES!!! exactly!! and although they still haven't posted the new dollar amounts, i am positive it'll still be much cheaper than instate here...

 

[Steiner]

Thank you both. I think that definitely answers my question. It will increase my chances -- even if by a little bit -- to get into a west coast residency if I go to a west coast school. Yes, I do realize that a lot of people might match in the state they went to medical school at because that's what they had initially wanted and ranked higher.

I'm still waiting for financial aid to come through to see what kind of tuition/aid difference there will be. Hopefully that'll make my decision a bit easier

I don't think I was clear, but it really doesn't matter because the end result is the same. I was saying that people rank programs they believe are more likely to accept them higher. Those same people believe these programs are the ones closer to their med school. I don't think it's completely due to residencies ranking applicants from local medical school higher on their rank list, but that's total speculation. It works out where people end up matching locally, but I think this is more due to medical students not understanding the match than to local bias.

Currently, the match is designed more to the student's favor. The system is designed to place you in the highest spot on your list. If you rank somewhere 1st; they accept 20 residents and you're ranked 20th on their list, you will match there. Even if your 2nd choice ranked you 1st. That's why the advice to rank programs completely on your preference is good advice. If you think you are "guaranteed" a spot at a program, but you have them ranked dead last based on your preference, rank them last. If you fall to your last spot and they ranked you 1st, you'll match there, and if they were already full, the program's lowest ranked person will be knocked off the list.

A lot of people seem to forget this right before they submit their ROL and take into account the perceived interest a program had in them or their perceived likelihood to match there, perhaps based on location.

Like I said, it basically all ends up with people going to residency near where they went to school, so this is a long-winded explanation that has no useful purpose. Go to school near where you want to match because that's what happens.

 

[248934]

If you look at the match results from a particular school, you will see that they are for the most part regional. As others have said before, it is largely due to the personal preference of the students wanting to stay in that particular area for residency.

Location also depends on what particular field you want to do. For instance, if you want to do the direct plastic surgery or IR programs, you may not been able to stay in your medical school area simply because of the lack of programs or fewer number of spots in the area.

If you really want to move to California, you will likely get there eventually. You may not necessarily get your training program of choice, but nonetheless you will make it there.

 

[montessori2md]

Bump.

I was recently accepted to a west coast medical school. I am sick and tired of living here in the midwest (Columbus, OH). I have always wanted to move out west (California, Nevada, Utah, Oregon, etc...)

My two options:

1- Move west right now, i.e. take that west coast school's acceptance offer

2- Stay here in Columbus for medical school and pay cheaper tuition, and then apply to residency in the west coast.

I really don't mind moving right now if I have to or if it puts me at a better advantage come residency time. I'm having trouble finding concrete advice about this. I'm also having trouble believing that a school like Wright State or Ohio State would put me on the same level of competition as a west coast applicant when it comes to matching.

Also, it might help to mention that I'm generally hoping to get into primary care. I am not interested in any of the competitive specialties.

Any opinions/advice?

Listen to njbmd, especially if you're at all serious about primary care, and go to ohio state. Those loans will start talking to you about the time you get your first statement, and what they are saying is NOT pretty.

I'm from Ohio myself, and I empathize w/ your desire to flee, but fleeing to the west coast will be easier w/o a lot of debt.

Also, myself, I wouldn't do Wright State b/c I think Dayton is kind of a hole (sorry to all of you fans out there). Lots more to do in your free time in Columbus.

Use all the extra money you save to travel -go to Europe for the summer or something.

 

[Steiner]

Spanish speaker with a desire to work in a rural area. That's like a golden ticket. You should have no trouble working anywhere you want.

 

[silas2642]

My school's match list is also heavy in in-state match, which I think is attributed to demographics. Most students are from the state, most students attended college in the state, and most students have close family ties in the state. Some people just aren't really into adventure I suppose.

Interestingly, California also retains a lot of their residents who attended med school in the state. Although California has way more prestigious academic programs than most states, the same reasoning probably applies. I personally also plan to gain as much outside experience as I can and hopefully practice in another area, but I haven't absolutely ruled out my state either.

My experience with Californians is that they don't really want to leave California, and those that do have to leave California are trying desperately to get back to California.

 

[Mr hawkings]

My experience with Californians is that they don't really want to leave California, and those that do have to leave California are trying desperately to get back to California.

Well, heres one thats leaving and will probably not try to come back.

 

[amidoinitrite]

Well, heres one thats leaving and will probably not try to come back.

Texas welcomes you.

 

[docscience]

I agree with you both... i guess that's why i was saying that i really don't care what i match in as long as i match in somewhere warm or with no clouds. I know this sounds stupid. The sun came out today and yesterday, but we hadn't seen it for like a week before that...

people are saying i'm crazy if I take any of my acceptances over my OSU acceptance... but for me, it's either wright state or utah at this point... it's wright state if i decide to stay here in ohio, and utah if i decide to get out...

we don't have any mountains here... it's as flat as it gets...

I can totally relate! somewhere warm or with no clouds sounds great! right on phospho!

But I read about your situation and I don't know if I would bank on your geographical location vs. how much you are going to spend.

There are plenty of students from my school who are doing their residencies elsewhere. I think a lot of things keep students at the home school/geography for residency and many of them have been mentioned on this thread: familiarity with the school/hospital, thinking they will get ranked higher here, wives/SO who have jobs that they can't move with, family in the state + having gone to college/grown up here, etc.

I am looking to move after medical school also....but someone on this thread pointed out that I will be laughing as I read this after third year...

Here is to hoping that I won't be interested in something uber competitive...I haven't done rotations, but I am leaning towards medicine, ob/gyn, or FM.

Y'all (midwest/south) think I have a shot at perhaps Louisiana, TX, FL, Southern Cal for those?

Can't wait to be done with 2nd year!

 

[phospho]

I don't think I was clear, but it really doesn't matter because the end result is the same. I was saying that people rank programs they believe are more likely to accept them higher. Those same people believe these programs are the ones closer to their med school. I don't think it's completely due to residencies ranking applicants from local medical school higher on their rank list, but that's total speculation. It works out where people end up matching locally, but I think this is more due to medical students not understanding the match than to local bias.

Currently, the match is designed more to the student's favor. The system is designed to place you in the highest spot on your list. If you rank somewhere 1st; they accept 20 residents and you're ranked 20th on their list, you will match there. Even if your 2nd choice ranked you 1st. That's why the advice to rank programs completely on your preference is good advice. If you think you are "guaranteed" a spot at a program, but you have them ranked dead last based on your preference, rank them last. If you fall to your last spot and they ranked you 1st, you'll match there, and if they were already full, the program's lowest ranked person will be knocked off the list.

A lot of people seem to forget this right before they submit their ROL and take into account the perceived interest a program had in them or their perceived likelihood to match there, perhaps based on location.

Like I said, it basically all ends up with people going to residency near where they went to school, so this is a long-winded explanation that has no useful purpose. Go to school near where you want to match because that's what happens.

Nope, you were quite clear... I just didn't understand you... now i do though, and I think you're right... but then again, they were worried that if they did rank them first, they wouldn't end up matching anywhere.... since they thought that those residency programs were looking for locals...

I can totally relate! somewhere warm or with no clouds sounds great! right on phospho!

But I read about your situation and I don't know if I would bank on your geographical location vs. how much you are going to spend.

There are plenty of students from my school who are doing their residencies elsewhere. I think a lot of things keep students at the home school/geography for residency and many of them have been mentioned on this thread: familiarity with the school/hospital, thinking they will get ranked higher here, wives/SO who have jobs that they can't move with, family in the state + having gone to college/grown up here, etc.

I am looking to move after medical school also....but someone on this thread pointed out that I will be laughing as I read this after third year...

Here is to hoping that I won't be interested in something uber competitive...I haven't done rotations, but I am leaning towards medicine, ob/gyn, or FM.

Y'all (midwest/south) think I have a shot at perhaps Louisiana, TX, FL, Southern Cal for those?

Can't wait to be done with 2nd year!

thank you for understanding me...

P.S. i have two pairs of socks on right now because my toes are freezing in my 74 degree apartment (12 degrees outside)... screw this...