Matching competitive specialty

[cakka298]

Hi all,

I will attend a top 10 medical school in the fall. I am interested in some notoriously competitive specialties.
Will the prestige of my school help me match, or at least compensate somewhat? I want to spend a decent amount of time volunteering in multiple roles. Will I have to cut back significantly on this to focus more on research and Step 1/2?

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[Konkurro]

If step 1 becomes pass fail, then you're golden I'd think as prestige will matter more (at least that seems to be consensus on here) . Though would probs still have to spend time doing research.

 

[cakka298]

If step 1 becomes pass fail, then you're golden I'd think as prestige will matter more (at least that seems to be consensus on here) . Though would probs still have to spend time doing research.

Even though this may help me (unless half my class wants to compete for the same residency seats), I don't believe it should go pass/fail.

So under current circumstances, you're suggesting I should spend less time volunteering and more time becoming competitive for match?
Maybe this is one reason they might recommend p/f step 1

 

[Konkurro]

Even though this may help me (unless half my class wants to compete for the same residency seats), I don't believe it should go pass/fail.

So under current circumstances, you're suggesting I should spend less time volunteering and more time becoming competitive for match?
Maybe this is one reason they might recommend p/f step 1

Yes I would think so that you would have to spend time on research, though how much you would have to sacrifice volunteering depends on your own time management and curriculum demands. But dull disclosure I'm just an incoming med student like you and hopefully others with more experience will also comment

 

[VincentAdultman]

 

[cakka298]

I've read the match outcomes report, noting ~10 research items, volunteer activities. Some work activities. Step 240 - 260 optimal. I guess my question turns into a quantification of "prestige boost."
Which I doubt is easy to quantify.

 

[raiderette]

Volunteering in medical school is nothing like premed. Only volunteer for things you like. Work in a student clinic, advocate for healthcare access, join a student interest group. Research will be more important for most specialities.

 

[watermelon master]

Really? Will the prestige of a top-10 medical school help you get into a competitive specialty?

Is water wet? Will the sun rise tomorrow? Will Harvard grads be taken over (insert lowest ranked school here) even though the Harvard grad has a lower step score?

 

[cakka298]

Really? Will the prestige of a top-10 medical school help you get into a competitive specialty?

Is water wet? Will the sun rise tomorrow? Will Harvard grads be taken over (insert lowest ranked school here) even though the Harvard grad has a lower step score?

I only mean to ask because I believe students should be able to pursue their interests, not lock themselves in their rooms cramming for standardized exams or trying to pump out research to reach x-amount. I would like to donate my time, but according to the match outcome published it looks like I would be better served in my room after x-amount research.
I won't knock this prestige boost, I worked hard to earn it from a lower-ranked"" undergrad. I'm only curious if the compensation from who-you-know would allow me to volunteer more.

 

[AnatomyGrey12]

If you want a competitive specialty then you need to be competitive for it. Period. No your school prestige, while a big boost, isn't going to get you out of having to do research or getting decent enough Step scores for whatever specialty you are talking about.

 

[VincentAdultman]

You want to know what I definitely did not look at during my last semester of college?

Snark aside OP by all means do volunteer. But understand that the competitive fields are going to still want to see good Step One scores, research and stellar LORs. You’ll get a boost from the name of your medical school but it’s not going to compensate for those factors I listed.

 

[ooh a bean]

A big reason why a top 10 med school is top 10 is because of the abundance of research resources at the institution.

Take advantage of these resources, a lot of students at other schools don't have them

 

[Deecee2DO]

A big reason why a top 10 med school is top 10 is because of the abundance of research resources at the institution.

Take advantage of these resources, a lot of students at other schools don't have them

This^ OP listen to this kid

 

[WedgeDawg]

Yes it will be quite helpful especially if your home department is also strong, but you also have to set your application up well aka good step 1, good grades, good research, good letters. You can’t be a terrible applicant, but if you’re average or better, a strong med school name and highly respected home department can def help.

 

[afib123]

How much time will volunteering take you? I volunteer almost every weekend and it takes up max 4-6 hours. If you wish to volunteer more than that, sure go ahead but you have to be more efficient with your studying. Add on a extracurricular activity every week maybe another 2-3 hours. Shouldn't hinder you from studying.
You are in medical school to study the first 2 years, then spend as much time as you can on the wards the last 2 years. If you have any remaining time, feel free to volunteer and be involved in school activities. But those should come first.
This is exactly what making Step 1 p/f is going to do. Make medical school like another undergrad with resume building activities.
Volunteering is great, but medical school is not the time to be volunteering 20 hours a week unless you are that smart and can finish studying quickly. Volunteering in non-clinical activities are an easy way out to feel good and and socialize with friends but do nothing to make me a knowledgeable physician, especially volunteering in activities not related to medicine.
If you want a competitive speciality, you work for it.

 

[swissnational]

OP I’m in the same boat as you — incoming into a top Medical School interested in a very competitive specialty (neurosurgery). I agree big with what @ooh a bean said. The biggest difference(from what I’ve heard) between top 5/top 10 schools and the rest are the resources they have to offer, especially research. Yes volunteering is nice, but research is going to be key to any successful application, as well as stellar recs. Those two should be your main focuses entering med school a long with good grades and of course a step I > 245-250.

 

[Neuronom]

A big reason why a top 10 med school is top 10 is because of the abundance of research resources at the institution.

Take advantage of these resources, a lot of students at other schools don't have them

Spot on.

 

[deleted600623]

Does it matter what type of research you do? I was never into research in undergrad but it was also bench research. I will also be attending a top 10-15 med school but have no idea what I want to go into so I figure I need to make myself as competitive as possible and keep all options open.

 

[Neuronom]

Does it matter what type of research you do? I was never into research in undergrad but it was also bench research. I will also be attending a top 10-15 med school but have no idea what I want to go into so I figure I need to make myself as competitive as possible and keep all options open.

Incoming MD, but I've read that bench research typically requires too much time commitment. Clinical, translational, epidemiological, are easier with a medical education.
Also, looking at specific specialty advice, any type of research helps. Specifically related to the specialty is ideal, maybe for research year or M1-M2, or flex time with accelerated pre-clinical program.
Some smaller specialties are understanding of "late interest," such as ophtho and derm (correct me if I'm wrong). Edit: lots of grammer

 

[LukaDoncicLuk]

"Late interest" = >250 step 1?

 

[mrbreakfast]

To match somewhere competitive you need to (in order)
1) Do well in classes. If you can handle that, then:
2) Do well on boards. If you can handle that, then:
3) Do good research. Actually do something, not just 4th author because you wrote the intro. If you can handle that, then:
4) Network/spend time in OR/whatever will help you get even better letters. If you can handle that, then:
5) Anything else

Where you go does matter in the sense that you might have better access to 1-5, but your access doesn't matter in itself; what you do with it does.

Does it matter what type of research you do?

Yes in the sense that a) certain fields expect you to have done at least some research in the field, and b) in general, interviewers will be less interested in projects the less related the topics are to their own expertise.

A note on bench research: I spent probably 400 hours in a bench lab over a summer/few months of the schoolyear. We didn't publish. That turned into a single line of text on my ERAS CV. Your time is limited, so be careful about dedicating a chunk to pipetting or other activities you will never perform again in your life.

 

[Neuronom]

"Late interest" = >250 step 1?

Haha yes. No, like Ortho -> Derm/Ophtho is where I saw that advice I think. I think those specialties that most students don't have much exposure to without initiative.

 

[cakka298]

Thank you all!

 

[jhamaican]

Your top 10 school will help you.

If you want to match something competitive:

1. step 1 score
2. Med school grades
3. Connections (i.e. research, letters of rec, away rotations)

In no particular order. You will need to have excellence in all 3 areas to have success.

Skip your volunteering. You are playing for keeps and a lifetime career now.

 

[jhamaican]

OP I’m in the same boat as you — incoming into a top Medical School interested in a very competitive specialty (neurosurgery). I agree big with what @ooh a bean said. The biggest difference(from what I’ve heard) between top 5/top 10 schools and the rest are the resources they have to offer, especially research. Yes volunteering is nice, but research is going to be key to any successful application, as well as stellar recs. Those two should be your main focuses entering med school a long with good grades and of course a step I > 245-250.

Just so you know, neurosurgery is not that competitive.

Most competitive things have all 3:

1. money
2. lifestyle
3. prestige

I would argue things like derm and plastics have all 3

Neurosurgery is sorely lacking in #2. Thus it is not as competitive and this is shown in the match statistics (step 1 not that high relatively speaking).

 

[Neuronom]

Just so you know, neurosurgery is not that competitive.

Most competitive things have all 3:

1. money
2. lifestyle
3. prestige

I would argue things like derm and plastics have all 3

Neurosurgery is sorely lacking in #2. Thus it is not as competitive and this is shown in the match statistics (step 1 not that high relatively speaking).

Argue plastics, I've heard the contrary on lifestyle

 

[Dr. Doctor MD]

Just so you know, neurosurgery is not that competitive.

Most competitive things have all 3:

1. money
2. lifestyle
3. prestige

I would argue things like derm and plastics have all 3

Neurosurgery is sorely lacking in #2. Thus it is not as competitive and this is shown in the match statistics (step 1 not that high relatively speaking).

Several things you mentioned I disagree with...

First neurosurgery is just as competitive as Derm/Plastics - Essentially identical step 1 and research. Despite the terrible lifestyle it is still an absolute bloodbath.

Second not all competitive specialties have all three components, in fact I'd argue that no specialty has it perfect in all three.

Third, Derm may have excellent lifestyle, and compensation is good but not exceptional, but I wouldn't say there is much prestige beyond impressing medical students who romanticize competitive specialties. The general public may have a shifting perception of dermatology due to Dr. Pimple Popper or the rise of Instaderms, but the field does not have the "Layperson Prestige" that you see in fields like Cardiology, EM, or Surgery, which the general public tends to fawn over.

I would also argue that no specialty actually has all three, but rather different say (1-10) levels of all three, and most competitive specialties hit lets say >20 or some other arbirary cut-off

Ex.
Ortho (23) - Money 9 Lifestyle 5 Prestige 9
Neurosurg (22) - Money 10 Lifestyle 2 Prestige 10
Plastics (22) - Money 8, Lifestyle 6, Prestige 8
Derm (20) - Money 6, Lifestyle 9, Prestige 5
Optho (20) - Money 6, Lifestyle 9, Prestige 5

vs
Peds (11) - Money 1, Lifestyle 7, Prestige 3
Family (11) - Money 2, Lifestyle 6, Prestige 3
Hospitalist (14) - Money 4, Lifestyle 4, Prestige 6

The numbers are just for fun, but it would be interesting if people agreed on a rubric and I bet the most competitive specialties would be pretty high.

 

[ricksimmonsrafowens]

neurosurgery is not that competitive

Ignore this, pre-clinical students. nsgy is competitive.

 

[chord]

Just so you know, neurosurgery is not that competitive.

Most competitive things have all 3:

1. money
2. lifestyle
3. prestige

I would argue things like derm and plastics have all 3

Neurosurgery is sorely lacking in #2. Thus it is not as competitive and this is shown in the match statistics (step 1 not that high relatively speaking).

50 US seniors out of 260 didn’t match this year so I would disagree.

 

[mrbreakfast]

Just so you know, neurosurgery is not that competitive.
Neurosurgery is sorely lacking in #2. Thus it is not as competitive and this is shown in the match statistics (step 1 not that high relatively speaking).

Whenever someone says something like this, just hop on over to charting outcomes to check. At a Step 1 score range of 221+ and at 231+, NS's match rate is approximately 1% higher than plastics/ortho. According to US seniors/spots (another metric), NS is the 4th most competitive specialty.

Different specialties are competitive for different reasons. I would say derm and plastics are slightly more competitive than other surgical subspecialties but ALL are very competitive. Vascular surgery is extremely competitive despite being generally recognized as having the worst lifestyle of any specialty. You can't just look at mean matched step score. Eg diagnostic rads mean step scores are 240/250, yet you're above a 90% match rate with a 225.

The most competitive subspecialty right now, by far, is IR. Nothing comes even close. You had a better chance of matching to derm with a Step 1 score <240 than matching IR with a 250+.


tl;dr if you are actually interested in NS as a pre-clinical student, the time to start looking into research/making connections/shadowing is now.

 

[swissnational]

Ignore this, pre-clinical students. nsgy is competitive.

Lol I skipped right over it

 

[VincentAdultman]

Lol I thought maybe something had dramatically shifted in the last decade because I was like wtf of course Nsgy is competitive.

 

[Frogger27]

Just so you know, neurosurgery is not that competitive.

Most competitive things have all 3:

1. money
2. lifestyle
3. prestige

I would argue things like derm and plastics have all 3

Neurosurgery is sorely lacking in #2. Thus it is not as competitive and this is shown in the match statistics (step 1 not that high relatively speaking).

What about GI

 

[deleted600623]

Your top 10 school will help you.

If you want to match something competitive:

1. step 1 score
2. Med school grades
3. Connections (i.e. research, letters of rec, away rotations)

In no particular order. You will need to have excellence in all 3 areas to have success.

Skip your volunteering. You are playing for keeps and a lifetime career now.

When you say grades, do you mean clinical grades?

 

[Deecee2DO]

When you say grades, do you mean clinical grades?

Yeah what? preclinical grades intrinsically mean squat lol he must mean clinical grades

 

[deleted600623]

Yeah what? preclinical grades intrinsically mean squat lol he must mean clinical grades

Well I figured he meant clinical grades because some schools (mine included) are P/F in pre-clinical.

 

[Deecee2DO]

Several things you mentioned I disagree with...

First neurosurgery is just as competitive as Derm/Plastics - Essentially identical step 1 and research. Despite the terrible lifestyle it is still an absolute bloodbath.

Second not all competitive specialties have all three components, in fact I'd argue that no specialty has it perfect in all three.

Third, Derm may have excellent lifestyle, and compensation is good but not exceptional, but I wouldn't say there is much prestige beyond impressing medical students who romanticize competitive specialties. The general public may have a shifting perception of dermatology due to Dr. Pimple Popper or the rise of Instaderms, but the field does not have the "Layperson Prestige" that you see in fields like Cardiology, EM, or Surgery, which the general public tends to fawn over.

I would also argue that no specialty actually has all three, but rather different say (1-10) levels of all three, and most competitive specialties hit lets say >20 or some other arbirary cut-off

Ex.
Ortho (23) - Money 9 Lifestyle 5 Prestige 9
Neurosurg (22) - Money 10 Lifestyle 2 Prestige 10
Plastics (22) - Money 8, Lifestyle 6, Prestige 8
Derm (20) - Money 6, Lifestyle 9, Prestige 5
Optho (20) - Money 6, Lifestyle 9, Prestige 5

vs
Peds (11) - Money 1, Lifestyle 7, Prestige 3
Family (11) - Money 2, Lifestyle 6, Prestige 3
Hospitalist (14) - Money 4, Lifestyle 4, Prestige 6

The numbers are just for fun, but it would be interesting if people agreed on a rubric and I bet the most competitive specialties would be pretty high.

When you put it this way Id say plastics wins across the board. Both Income and prestige without sacrificing as much in the lifestyle category as say NS or Ortho. Few of my buddies dads are orthos and they are never home lol

 

[Deecee2DO]

Whenever someone says something like this, just hop on over to charting outcomes to check. At a Step 1 score range of 221+ and at 231+, NS's match rate is approximately 1% higher than plastics/ortho. According to US seniors/spots (another metric), NS is the 4th most competitive specialty.

Different specialties are competitive for different reasons. I would say derm and plastics are slightly more competitive than other surgical subspecialties but ALL are very competitive. Vascular surgery is extremely competitive despite being generally recognized as having the worst lifestyle of any specialty. You can't just look at mean matched step score. Eg diagnostic rads mean step scores are 240/250, yet you're above a 90% match rate with a 225.

The most competitive subspecialty right now, by far, is IR. Nothing comes even close. You had a better chance of matching to derm with a Step 1 score <240 than matching IR with a 250+.


tl;dr if you are actually interested in NS as a pre-clinical student, the time to start looking into research/making connections/shadowing is now.

IR is really that competitive? I know its competitive but the most competitive? DO schools my school included matched a fair amount in IR this year

 

[nimbus]

Volunteering is important for medical school admissions but is of little value for residency match. Not sure why. One can match all the competitive specialties with zero volunteer work. I suppose one can consider time spent doing research as volunteer work.

 

[mrbreakfast]

Yeah what? preclinical grades intrinsically mean squat lol he must mean clinical grades

Preclinical grades matter for AOA and class quartile.

Both Income and prestige without sacrificing as much in the lifestyle category as say NS or Ortho.

It's all relative. Plastics still has to see their post-ops, and does have some call/urgent cases. Not counting call days, my longest days in the hospital were on plastics. Surgeons of all specialties work a lot.

IR is really that competitive? I know its competitive but the most competitive? DO schools my school included matched a fair amount in IR this year

14 DOs matched IR this year. Overall match rate for US seniors was 42%, compared to derm's 76%.

 

[VincentAdultman]

Keep in mind plastics isn’t just cosmetics. They can do a decent amount of trauma-related work (ie flaps) somenof which can be pretty time-consuming.

 

[nimbus]

There can also be a lot of selling, hustling and promotion in plastics that is unique to the specialty. It’s not for everyone.

I work in a level 1 trauma center covered by 1 plastic surgeon. He has no elective cosmetic practice. He is 74 years old and we joke that his block time is 9pm.

 

[Dwan]

IR is really that competitive? I know its competitive but the most competitive? DO schools my school included matched a fair amount in IR this year

IR is a tricky one to interpret with match rates because it's very common to dual apply IR and DR, even among those not completely set on IR. I know someone who applied both and ranked a top tier DR program that has ESIR over less prestigious IR programs, and matched there. They'd show up as a failed match (I think), but probably would have made IR if they wanted. Going directly into IR binds you to a significant amount of IR-specific training without the option to swap to DR-only, and some end up preferring the latter after experiencing it as a resident. I think DR match rates also dropped significantly with the introduction of the direct IR pathway, likely also due to dual applying.

 

[ArdorAyurveda]

Volunteering is important for medical school admissions but is of little value for residency match. Not sure why.

Because research -> drug/medical device development -> profit

 

[PugsAndHugs]

Several things you mentioned I disagree with...

First neurosurgery is just as competitive as Derm/Plastics - Essentially identical step 1 and research. Despite the terrible lifestyle it is still an absolute bloodbath.

Second not all competitive specialties have all three components, in fact I'd argue that no specialty has it perfect in all three.

Third, Derm may have excellent lifestyle, and compensation is good but not exceptional, but I wouldn't say there is much prestige beyond impressing medical students who romanticize competitive specialties. The general public may have a shifting perception of dermatology due to Dr. Pimple Popper or the rise of Instaderms, but the field does not have the "Layperson Prestige" that you see in fields like Cardiology, EM, or Surgery, which the general public tends to fawn over.

I would also argue that no specialty actually has all three, but rather different say (1-10) levels of all three, and most competitive specialties hit lets say >20 or some other arbirary cut-off

Ex.
Ortho (23) - Money 9 Lifestyle 5 Prestige 9
Neurosurg (22) - Money 10 Lifestyle 2 Prestige 10
Plastics (22) - Money 8, Lifestyle 6, Prestige 8
Derm (20) - Money 6, Lifestyle 9, Prestige 5
Optho (20) - Money 6, Lifestyle 9, Prestige 5

vs
Peds (11) - Money 1, Lifestyle 7, Prestige 3
Family (11) - Money 2, Lifestyle 6, Prestige 3
Hospitalist (14) - Money 4, Lifestyle 4, Prestige 6

The numbers are just for fun, but it would be interesting if people agreed on a rubric and I bet the most competitive specialties would be pretty high.

Just out of curiosity, why do you put Hospitalist lifestyle at 4 (below Ortho)?

 

[Dr. Doctor MD]

Just out of curiosity, why do you put Hospitalist lifestyle at 4 (below Ortho)?

No particular reason, it wasn't meant to be terribly accurate.

I'm not really sure exactly how to classify hospitalists as far as lifestyle goes. From what I've seen it tends to be 7 on 7 off, but there are so many combinations and permutations, I'm honestly not sure. For some people hospitalist lifestyle might be amazing, for others it might suck. It's hard to tell. So I'd give it right around the middle. It's not as bad as some surgical subs like Vascular/NeuroSurg/CT etc, but it's not as good as a typical 8-5 outpatient job.

As for ortho I gave it a 5 because it can have a great or terrible lifestyle based on the sub-specialty or specific job. I'm sure there are super busy Ortho trauma physicians who hit 80 hours a week and take q3 call or something horrible like that, but there are also other orthopedic surgeons who operate electively 4 days a week 7am-3pm with a day of clinic, which is pretty good in terms of lifestlye.

Overall I'd say both IM and Ortho can be as good or as terrible as you want in terms of lifestyle so I feel like a middle of the road rating ~5/10 is probably reasonable for both. I wouldn't read too much into the exact numbers I posted. It was more of a thought exercise.

 

[Deecee2DO]

No particular reason, it wasn't meant to be terribly accurate.

I'm not really sure exactly how to classify hospitalists as far as lifestyle goes. From what I've seen it tends to be 7 on 7 off, but there are so many combinations and permutations, I'm honestly not sure. For some people hospitalist lifestyle might be amazing, for others it might suck. It's hard to tell. So I'd give it right around the middle. It's not as bad as some surgical subs like Vascular/NeuroSurg/CT etc, but it's not as good as a typical 8-5 outpatient job.

As for ortho I gave it a 5 because it can have a great or terrible lifestyle based on the sub-specialty or specific job. I'm sure there are super busy Ortho trauma physicians who hit 80 hours a week and take q3 call or something horrible like that, but there are also other orthopedic surgeons who operate electively 4 days a week 7am-3pm with a day of clinic, which is pretty good in terms of lifestlye.

Overall I'd say both IM and Ortho can be as good or as terrible as you want in terms of lifestyle so I feel like a middle of the road rating ~5/10 is probably reasonable for both. I wouldn't read too much into the exact numbers I posted. It was more of a thought exercise.

Also out of curiosity you would put IM (hospitalist) same or higher prestige than Derm and Ophtho? I know its a ballpark but if youre rating it higher there must be some reason to make you think theyre in the same ballpark lol thats wild

 

[VincentAdultman]

there are also other orthopedic surgeons who operate electively 4 days a week 7am-3pm with a day of clinic,

I want that job....

 

[Chibucks15]

Also out of curiosity you would put IM (hospitalist) same or higher prestige than Derm and Ophtho? I know its a ballpark but if youre rating it higher there must be some reason to make you think theyre in the same ballpark lol thats wild

Prestige is whatever somebody else thinks

 

[Gilakend]

Several things you mentioned I disagree with...

First neurosurgery is just as competitive as Derm/Plastics - Essentially identical step 1 and research. Despite the terrible lifestyle it is still an absolute bloodbath.

Second not all competitive specialties have all three components, in fact I'd argue that no specialty has it perfect in all three.

Third, Derm may have excellent lifestyle, and compensation is good but not exceptional, but I wouldn't say there is much prestige beyond impressing medical students who romanticize competitive specialties. The general public may have a shifting perception of dermatology due to Dr. Pimple Popper or the rise of Instaderms, but the field does not have the "Layperson Prestige" that you see in fields like Cardiology, EM, or Surgery, which the general public tends to fawn over.

I would also argue that no specialty actually has all three, but rather different say (1-10) levels of all three, and most competitive specialties hit lets say >20 or some other arbirary cut-off

Ex.
Ortho (23) - Money 9 Lifestyle 5 Prestige 9
Neurosurg (22) - Money 10 Lifestyle 2 Prestige 10
Plastics (22) - Money 8, Lifestyle 6, Prestige 8
Derm (20) - Money 6, Lifestyle 9, Prestige 5
Optho (20) - Money 6, Lifestyle 9, Prestige 5

vs
Peds (11) - Money 1, Lifestyle 7, Prestige 3
Family (11) - Money 2, Lifestyle 6, Prestige 3
Hospitalist (14) - Money 4, Lifestyle 4, Prestige 6

The numbers are just for fun, but it would be interesting if people agreed on a rubric and I bet the most competitive specialties would be pretty high.

FWIW every ortho surgeon I shadowed had a great lifestyle imo. I think depending on your fellowship it could be a much better lifestyle ranking.