Medical student without a home program

[autobahn]

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Hey all,
After reading some of these threads, it seems like coming from a school with a home program is an edge in the application process for residency. What's the virtue of simply coming from a school with a home rad onc program? What if you come from a place without a program, have good grades, research, good letters, aoa, etc.? When choosing a medical school, I didn't know that I wanted to do rad onc before I encountered it in medical school, and I certainly didn't know that the lack a home program would hurt me. To me, the fact that a student goes to a school with a home program doesn't actually say anything about that particular student - that's what grades, research and letters are for. How does having a home program say anything about your "commitment to the field"? And if you're wondering, I come from a state school without a home program, so, yes, I am slightly biased.

 

[CNphair]

I came from a state school with no home program. And, yes, I successfully matched. But it would have been much easier with a home program. Why? Exposure. Being present in a department for conferences, research, shadowing, etc is incredibly valuable for forming relationships that can help you match in that department. Look at past match lists. Many people stay at their home programs because programs like to rank known entities. Why gamble on someone new if you have a guy you already like? Recommendation letters they write will also be much more resonant if they worked with you for longer than a 4 week rotation.

Also, having access to residents and young attendings who can help guide you through the rather laborious application process is a huge plus. This is a small field and you can learn a lot about programs just through knowing a few people. In some cases, a private midwest hospital may be a better training environment for Rad Onc than an Ivy league institution. A medical student wouldn't necessarily know this.

It is also difficult to get involved in RO research without a home department. I did plenty of oncology research. But do you know what academic Radiation Oncologists like to talk about on interviews? Radiation Oncology. I assure you that absolutely no one wanted to talk about my project on pediatric chemotherapies. You could actually see their eyes glaze over as I talked about osteonecrosis associated with chronic prednisone...but hey, you can't just ignore the "Tell me about your research question." They asked; I answered. Suckers.

You can definitely match without a home program. But why would you want to if given the choice?

 

[Msrockssocks]

Autobahn,
When I started (at my state school with no home program) I didn't even know what Radiation Oncology was 🙂
3 years later I'm applying to a bunch of programs, excited and hopeful.
Is there an advantage to having a home program? Sure. Like CNphair said, programs like known entities, so if you do have a home program, you certainly have an advantage applying to that one particular residency.
In the application pool at large, however, I don't think having a home program gives you an advantage unless you have used it to get the exposure that CNphair mentioned (research, connections, etc.) By the same coin, if you can find a nearby institution that does have a program, and exhibit your "commitment to the field," there, you can effectively mitigate your "homeless" disadvantage.
My first radiation oncology exposure was at a nearby institution where the (fantastic) residents were very helpful and receptive. While research didn't exactly fall into my lap, I continued to ask around and eventually got on a few projects.
Also never forget that you have the opportunity to do multiple away rotations, make connections, and get letters. Worse case scenario, you could always take a year off and do research somewhere.
If you are strongly convinced that Rad Onc is right for you, stick with it! That's my plan...
Also... never forget that no one has a home court advantage at MSKCC or MDACC. Shapow!