Medical School location a factor?

[Mandiblespeaks]

Hello,

First: I post this thread knowing full well my "station in life," and do not presume to know my arse from my elbow so please enlighten me. Thank you.

Situation: I was recently accepted to a decent state school in NY, one I can see myself in. However, there are two other prestigious schools I am waiting to hear back from in Boston and DC. (for sake of clarity they are ranked in the 30's by US news report (ie, Dartmouth, Brown, etc etc). Not as concerned with prestige. What I am asking, how much does the location of a medical school have bearing on where you would be likely accepted for a surgical residency program?

The research I have done:
I dont put much stock into what I read online and Id rather hear from you but this is what I have read.-There are only a few GS programs in MA, and fewer in DC as compared to New York State.
-I am aware that letters of recommendation will carry more weight from someone who is familiar with the programs I would like to apply too and viceversa that residency programs prefer students from schools they are familiar with.

Q:Would attending a more prestigious school in Boston (school does not give honors for first year classes but does have AOA) or in DC (school gives honors for first year classes and has AOA) be more beneficial for me if I wanted to get into a surgical residency in say a major metropolitan area or is it safer to go to the state school in NY that has an established relationship with the residency programs in the state (with far more of them in NY then DC or MA)? I am not AS concerned with the prestige of the residency program but more concerned with making sure I secure a spot.

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[Winged Scapula]

Moving to Pre-Allo Forum...

 

[Law2Doc]

Hello,

First: I post this thread knowing full well my "station in life," and do not presume to know my arse from my elbow so please enlighten me. Thank you.

Situation: I was recently accepted to a decent state school in NY, one I can see myself in. However, there are two other prestigious schools I am waiting to hear back from in Boston and DC. (for sake of clarity they are ranked in the 30's by US news report (ie, Dartmouth, Brown, etc etc). Not as concerned with prestige. What I am asking, how much does the location of a medical school have bearing on where you would be likely accepted for a surgical residency program?

The research I have done:
I dont put much stock into what I read online and Id rather hear from you but this is what I have read.-There are only a few GS programs in MA, and fewer in DC as compared to New York State.
-I am aware that letters of recommendation will carry more weight from someone who is familiar with the programs I would like to apply too and viceversa that residency programs prefer students from schools they are familiar with.

Q:Would attending a more prestigious school in Boston (school does not give honors for first year classes but does have AOA) or in DC (school gives honors for first year classes and has AOA) be more beneficial for me if I wanted to get into a surgical residency in say a major metropolitan area or is it safer to go to the state school in NY that has an established relationship with the residency programs in the state (with far more of them in NY then DC or MA)? I am not AS concerned with the prestige of the residency program but more concerned with making sure I secure a spot.

Agree with WS that this belongs in pre-allo -- the other boards are for folks beyond this point, not to give premeds access to them (otherwise the whole board would be overrun by premeds whose med school application questions, honestly, aren't of interest to anyone other than premeds). That being said, here's my answer.

First, you are muddying the waters by putting "more prestigious" into the question. If your question is simply geography, then the answer is that it has some import, but nothing that cannot be overcome. Program Directors really want two things, (1) someone well trained to be an intern, and (2) someone who will do well on the in-service exams (for surgery, the Absite) and make the program look good. So they tend to pick people who both have solid grades/scores/evals and also people from places they feel train folks well for internship/residency. Now prestige has little to do with either of these things, but familiarity with the program and its graduates has a lot to do with #1. Meaning if the program has taken a handful of folks in the past from school X, and they did well, then school X will be on the residency programs radar in subsequent years. Similarly, if school Y didn't do a good job of training the prior year's grad who went to that residency program, they may not go back to that well again. So you are mostly at the mercy of the folks who came to that residency program before you.

Another issue is that since interview slots are limited, PDs tend to want to only interview and rank people they think will actually come. So if you don't have much of a nexus to a region, it will be a hard sell to convince a PD to use one of his scarce interview slots on you. He probably thinks you papered the nation with applications (easy to do on today's computerized system) and that you wouldn't be planning to go to this program if anything else panned out. So if you've lived your whole life in NY and attended med school in NY, then it will be a hard sell to convince a PD that your dream residency is in Iowa. Not necessarilly impossible, but you are coming from a disadvantage over all the folks with Iowa roots and connections.

Prestige doesn't play as much of a role as you would think -- if you have the board scores and good evals, then to the extent the school name comes into it, it's more a question of whether they are perceived as doing a good job training interns who can jump into the thick of it with minimal training. And again, this will be largely based on PD's personal experiences with those program's alumns. The PD doesn't care that you went to a fancy named place if you aren't making the attendings and chiefs happy with where you are on the very steep learning curve. Some of the "less prestigious" places sometimes have a huge advantage if they do a good job during the clinical years of cranking out ward-ready interns. Some of the "more prestigious" places have a reputation for being very cerebral but not as solid in the "hands-on" stuff. It all depends. The problem is, you really can't glean any of this from US News. And over the next 4 years other crops of alumns are going to graduate and become residents and will either help pave or obliterate paths for you based on how well they perform.

I don't know if this answered your question, but to summarize, location may make a difference if you don't have a nexus. Prestige means less to PDs than experience with alumns (provided the applicant has the stats). If you would be happier in NY go to NY.

 

[Obnoxious Dad]

Congratulate yourself for getting accepted. Well done.

Go to this site and do a search for general residency residencies in New York and go then to the general surgery program websites linked from the basic information page of each "hit". https://freida.ama-assn.org/Freida/user/viewProgramSearch.do

You will figure it out. In many cases the program identifies the residents currently in their program and where they went to medical school. I think you will see some correlation of med school prestige and surgery program prestige but you might not want a malignant med school based general surgery residency any way because they often treat residents like swill.

Here's another website you might get hooked on: http://www.facs.org/residencysearch/position/position.html

You can noodle around and look at the various programs by state.

One thing to remember is that there is such a tremendous shortage of general surgeons you will get a job no matter where you do a residency.

One other thing. I must say that Law 2 Doc has to be the very best writer on this board. No one tops him for clarity and coherence.

 

[Law2Doc]

... I think you will see some correlation of med school prestige and surgery program prestige but you might not want a malignant med school based general surgery residency any way because they often treat residents like swill....

I would be careful on this though -- I doubt as a premed you have any sense of what a prestigious surgery residency program is -- they aren't ranked accurately anyplace, don't really jibe with med school rankings, and it has a ton to do with culture (and as Obnoxious Dad suggests) whether the program is benign versus malignant, which you cannot get from any website.

 

[Parts Unknown]

Hello,

First: I post this thread knowing full well my "station in life," and do not presume to know my arse from my elbow so please enlighten me. Thank you.

Situation: I was recently accepted to a decent state school in NY, one I can see myself in. However, there are two other prestigious schools I am waiting to hear back from in Boston and DC. (for sake of clarity they are ranked in the 30's by US news report (ie, Dartmouth, Brown, etc etc). Not as concerned with prestige. What I am asking, how much does the location of a medical school have bearing on where you would be likely accepted for a surgical residency program?

The research I have done:
I dont put much stock into what I read online and Id rather hear from you but this is what I have read.-There are only a few GS programs in MA, and fewer in DC as compared to New York State.
-I am aware that letters of recommendation will carry more weight from someone who is familiar with the programs I would like to apply too and viceversa that residency programs prefer students from schools they are familiar with.

Q:Would attending a more prestigious school in Boston (school does not give honors for first year classes but does have AOA) or in DC (school gives honors for first year classes and has AOA) be more beneficial for me if I wanted to get into a surgical residency in say a major metropolitan area or is it safer to go to the state school in NY that has an established relationship with the residency programs in the state (with far more of them in NY then DC or MA)? I am not AS concerned with the prestige of the residency program but more concerned with making sure I secure a spot.

Frankly, I think you're splitting hairs with this one. NY, DC, MA, you really aren't going to have a hard time selling yourself between these three. El Paso vs. Milwaukee and maybe you would have something to mull over, but this?

Just go to the school you like and do your best. If you have the goods and put in the time, in about 49 months you will find yourself matched into a solid residency program. Good luck.

 

[thesauce]

Outside of the top 10 medical schools, I don't think prestige plays much of a role in residency admissions. Luckily, GS isn't terribly competitive nowadays (although it's on the rise). With a good board score, decent clinical grades, and solid LORs, you'll be able to go where you want for GS from any of those schools. Definitely look at cost and "fit."

 

[Mandiblespeaks]

I really appreciate your comments. Insightful really.

Law2doc, I read your posts in the "match list" thread. Your posts are partially why I posted this thread in the first place. I couldn't agree more with your assertion that premeds have no idea how to read this lists or how to measure the aptitude of a program. I'll admit before reading through that discussion I was wowed by the program names. I am just a tab bit the wiser now, but only because I am not duped so to speak.

To be honest the prestige of the residency program is not as much a factor for me, but I am certainly concerned with wanting to ensure a position in a program that trains residents well, and has a high pass rate on boards. I apologize if my concern seems premature, but this mentality has served me well so far (which is not very far I know).

What also instigated me to post this thread: When I looked at where students currently in NY state residencies went to medical school a good majority of them came from the SUNY state schools. Take a look at Mount Sinai for one example, while there is an abundant number of students from prestigious universities the other majority seems to be from say Upstate or Buffalo.

In any case, Thank you again for your comments. I am enjoying the links obnoxious dad posted . It is nice to know that GS are not overtly "competitive" for placement but I wonder if that will be the case after I graduate. I like the flexibility is offers, the opportunities to collaborate across the board is enticing. I work in an urgent care clinic and the most exciting parts of my day or doing the simple things like removing staples or wound dressings. Anyhow, take care. Thank you.

 

[Law2Doc]

...but I am certainly concerned with wanting to ensure a position in a program that trains residents well, and has a high pass rate on boards. ...

It's nearly impossible as a premed to know which places "train (future) residents well", and as for having high pass rates -- this battle is won or lost on admissions, not based on anything the school does. Meaning if you are the guy who is going to score 240, you will do so at the top school or the worst school -- it's a very individualized achievement, not school based. ALL med schools cover the same material, and all med students use the same, very limited set of board prep materials, ranging from the same First Aid to the same USMLE World or Qbank. And about 1/4 to 1/2 of all med students don't attend most of their lectures, so really, it's hard to imagine the school provides too much toward folks doing better on the boards (particularly since many folks are off studying on their own after the first month or so). You are going to get what you get wherever you go, provided you go someplace where you will thrive and work hard. So don't waste too much time worrying about the percentage of folks who pass the boards -- a low percentage simply means they didn't admit folks with the right kind of work ethic, not that they trained any worse than any of the other 120 US allo med schools. Truth of the matter is all 125 or so US allo med schools are quite good, cover all the material you need to know on the boards, and give you ample time off during your second summer to study and do well on Step 1. The rest is up to you, regardless of where you attend. This is a journey you run on your own. The real value added of med school tends to occur in the later years, where good rotations and attendings can make your schooling more or less valuable. Someplace with very good practical experiences during rotations (particularly places which are high volume and short staffed so the med students have to earn their keep) and places that require more than one sub-I tend to better prepare you for residency, IMHO.

 

[ChiDO]

It's nearly impossible as a premed to know which places "train (future) residents well", and as for having high pass rates -- this battle is won or lost on admissions, not based on anything the school does. Meaning if you are the guy who is going to score 240, you will do so at the top school or the worst school -- it's a very individualized achievement, not school based. ALL med schools cover the same material, and all med students use the same, very limited set of board prep materials, ranging from the same First Aid to the same USMLE World or Qbank. And about 1/4 to 1/2 of all med students don't attend most of their lectures, so really, it's hard to imagine the school provides too much toward folks doing better on the boards (particularly since many folks are off studying on their own after the first month or so). You are going to get what you get wherever you go, provided you go someplace where you will thrive and work hard. So don't waste too much time worrying about the percentage of folks who pass the boards -- a low percentage simply means they didn't admit folks with the right kind of work ethic, not that they trained any worse than any of the other 120 US allo med schools. Truth of the matter is all 125 or so US allo med schools are quite good, cover all the material you need to know on the boards, and give you ample time off during your second summer to study and do well on Step 1. The rest is up to you, regardless of where you attend. This is a journey you run on your own. The real value added of med school tends to occur in the later years, where good rotations and attendings can make your schooling more or less valuable. Someplace with very good practical experiences during rotations (particularly places which are high volume and short staffed so the med students have to earn their keep) and places that require more than one sub-I tend to better prepare you for residency, IMHO.

We need a L2D "sticky" post where all his words of wisdom in regards to all topics are posted. This way, we can just be like Refer to post 58 of L2D sticky!

 

[Mandiblespeaks]

OK, but I have gleamed from my research is that certain residency programs have volatile differences in the number of students who pass the "ABS?" as compared with other programs. You pose an important point: that during medical school success has everything to do with what I put into it. I find comfort in that, and am also challenged by it.

Correct me if I am wrong, but this does not seem to be the case when comparing how residents do between different programs (post grad). Why would that be? And does my choice of medical school have any bearing on that whatsoever? Based on whats been said I assume not so much.

Again, can't thank you enough for taking the time to discuss this with me. It's an epic decision to make and I prefer to plan long term. Thank you.

 

[shiftingmirage]

med school is 4 years. lots can change in 4 years.
i heard that half the people that go into school with a specialty in mind, change. maybe you are in that half that changes

The school you attend will not bar you from a specialty at a given location. Surgery is not overly competitive. Step 1 average I believe for surg is ~220, the national average. As for a metropolitan location, there are tons of programs located in such an area.

Go to the school you like the most. It may sound elementary, but if you're happy there, you'll probably be more successful in your studies.

Remember you can do away rotations. May be difficult to arrange, but let's say you want to do surgery in NYC, then I suggest you try to do an outside rotation in the city. Hit up the attending for a letter. I'm sure he/she has lots of friends in the city, and their letter will carry more weight to their friends, than a regular letter.

 

[Obnoxious Dad]

OP, if all other things are equal or at least close, go where you get the best financial deal. If you go into general surgery and you are the gunner I think you are, you will probably do a fellowship after your surgery residency that will last two or three years. The consequence of seven or eight years of graduate medical education is that your loan balance will double from the time you graduate from medical school until you start practicing.

 

[Mandiblespeaks]

OP, if all other things are equal or at least close, go where you get the best financial deal. If you go into general surgery and you are the gunner I think you are, you will probably do a fellowship after your surgery residency that will last two or three years. The consequence of seven or eight years of graduate medical education is that your loan balance will double from the time you graduate from medical school until you start practicing.

That is a frightening thought and a good point. I hadn't considered that one. However, I would rather be more in debt having gone to the right school and finding placement in a residency program that accels its residents. Where is that exactly I havent decided yet but I am closer.

I suppose I should be forthright regarding my concerns. Originally I was concerned that attending a state school in the state that I wanted to practice in might actually be beneficial over going to a "prestigous," 30ish ranked school in Boston or DC. I thought this because so many of the residents in the programs I like in NY come from that school. While I have no real way of judging what programs I like and why (as L2D has made me aware of) I want to make my desicion based on facts rather then just fit. Fit for me is more analytical then it probably should be.

The school in DC is Georgetown. Georgetown has honors grading systems in the first two years which I believe helps if you want a surgical residency. It also has AOA. They seem to place quite a number of students in surgical programs after graduation. Interned with a surgeon from Gtwon and have had the school in might sights for some time.

The school in Boston is well, Boston University. There is no honors grading system in the first two years. There is AOA. The school has an even split of students placed in GS residencies as well as GS prelim spots. What does this mean and does is really matters? I really like BU for a number of reasons that have little to do with surgery.

The schoo in NY is Upstate. Unranked. Cheaper. Has AOA and honors grading system I believe. A lot of residencies in NYC take Upstate students it seems. Check Mount Sinai for one such example.

Between these schools, I could see myself at pretty much any of them. I gather from our discussion that any of the schools would be just fine? But I can't help but wonder would going to Upstate, really improve my chances for surgical match in NY state? And does BU's match list raise any red flags?

I want to thank you all again for your insights. Clarity!

ObxDad, I am not your typical gunner. Not competitive with others just with myself really. Just want to give it my best shot. Thanks for all your input.