MS2 - chances at top tier IM

[imidazzle92]

Current MS2 at T20 (not in northeast)
- 14 manuscript publications (few cardiology/IM related from gap years, rest are all neurosurgery or neuroscience related from MS1-MS2), few first author. A handful of posters/presentations
- some light volunteering, EC's, nothing substantial
- not sure I'll get AOA (someone with a ton of research output/mostly honors in MS3 in the previous class didn't get it)

Was set on Neurosurgery for the longest time but cardiology was the one specialty that changed my mind. Would really like to match at MGH/BWH/BIDMC (any top IM program in MA or closeby) due to family and desire for an academic career in cardiology.

Q's:
- Is it worth continuing neurosurgery research if I know it'll yield good output over the next 2 years? Or, should I focus on getting involved with research that is more tailored toward IM?
- What's the ideal STEP 2 CK score to aim for?
- Anything else I can do to maximize my chance of matching at top programs with a restrictive geographic preference?

Please don't quote. Thanks

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[Redpancreas]

-Good chances for top tier IM.
-Publications will look good for IM residency, but all in one area will make IM PDs question if you're only applying as a back up. You don't have to find research tailored to IM. 1-2 publications related to Cardiology will be more than enough with your school name.
-250+, but 240s won't kill you.

 

[mrbreakfast]

Top tier IM - particularly the programs you named - are going to be just as competitive as neurosurgery programs. I'm going to disagree with the previous poster and tell you to aim for 260s on step 2 - 21% of IM applicants scored >260 according to NMRP, and scoring in the 240s will land you a below average step 2 score for the specialty overall, let alone top tier. I'd also recommend getting some cardiology research.

You're on pace to be a competitive applicant, but for top tier IM, you're going to be sitting in a room full of applicants who are mostly/all AOA, have 260+ on step, and have high-impact publications. I'd keep working hard and prepare just as if you were still applying to neurosurgery, including multiple away/audition rotations.

 

[AHDCard]

I went through the IM match this year

-Recommend switching to IM / cards related research (so that IM won't be perceived as a backup; will help for cards fellowship application too)
-Per Texas STAR data, mean Step 2 at "T10-15" type IM is ~260+/-5 (for example, at BIDMC my notes were 246/259 for Step1/2 - MGH and Brigham would probably a little higher). Now that Step 2 is the only standardized comparison, I suspect that preparation will go up and the average scores may creep up a bit too.
-other things: clinical rotation grades (try to honor IM and Sub-I in particular), AOA, rec letters
-expect interview invites to be random - I got invites from ~50% of "Top 20" type programs and there's no logic to which programs I got invites to and which I didn't
-aways aren't normally needed for IM, but if you're targeting specific programs I could see them potentially helping? I'd talk to your advisers or any connections at those programs
-geographic and program signals may be better incorporated into the application process when you apply, which could be helpful
-don't forget about places like Yale, BU, Tufts, and NYC programs (NYU, Cornell, Columbia, Mt Sinai) which are great programs and close to Massachusetts

 

[imidazzle92]

I went through the IM match this year

-Recommend switching to IM / cards related research (so that IM won't be perceived as a backup; will help for cards fellowship application too)
-Per Texas STAR data, mean Step 2 at "T10-15" type IM is ~260+/-5 (for example, at BIDMC my notes were 246/259 for Step1/2 - MGH and Brigham would probably a little higher). Now that Step 2 is the only standardized comparison, I suspect that preparation will go up and the average scores may creep up a bit too.
-other things: clinical rotation grades (try to honor IM and Sub-I in particular), AOA, rec letters
-expect interview invites to be random - I got invites from ~50% of "Top 20" type programs and there's no logic to which programs I got invites to and which I didn't
-aways aren't normally needed for IM, but if you're targeting specific programs I could see them potentially helping? I'd talk to your advisers or any connections at those programs
-geographic and program signals may be better incorporated into the application process when you apply, which could be helpful
-don't forget about places like Yale, BU, Tufts, and NYC programs (NYU, Cornell, Columbia, Mt Sinai) which are great programs and close to Massachusetts

Thanks! I'm hoping the aways at those target programs will help me out in interviewing/potentially matching. I'm debating if I should continue the neuro research and add on 1-2 small cardiology projects since the neuro research is going pretty well in my current lab.

 

[NotAProgDirector]

Get an LOR from your NS research mentor that specifically says that you're no longer pursuing NS (in addition to talking about your research, of course)

 

[IM_is_cool_I_guess]

I'll counter some of the previous posters and say that I had a step 1 of 240-245 and a step 2 of 250ish, and matched to top 10 IM. Went to a t20, roughly half H and half HP on clinicals, with more HP than H. Lots of gen med research though. Didn't get any interviews at MGH/BWH/JH/UCSF, but had 4 interviews at the other 6 in the top 10.

 

[Redpancreas]

Top tier IM - particularly the programs you named - are going to be just as competitive as neurosurgery programs. I'm going to disagree with the previous poster and tell you to aim for 260s on step 2 - 21% of IM applicants scored >260 according to NMRP, and scoring in the 240s will land you a below average step 2 score for the specialty overall, let alone top tier. I'd also recommend getting some cardiology research.

You're on pace to be a competitive applicant, but for top tier IM, you're going to be sitting in a room full of applicants who are mostly/all AOA, have 260+ on step, and have high-impact publications. I'd keep working hard and prepare just as if you were still applying to neurosurgery, including multiple away/audition rotations.

Respect the disagreement. Doesn't help OP to aim low. I have through experience seen students attending top tier MDs get the benefit of the doubt, but I guess it depends on which program, etc. Truth lies somewhere in between.

 

[ChordaEpiphany]

Based on matches from my school (well-ranked/respected MD, but not "brand name"), I think people here are overestimating the competitiveness of top IM programs. Not the big 4. Those are intensely competitive. However, OP mentioned they'd be happy with BIDMC. Similar programs in the northeast like Yale and NYC programs (NYU, Cornell, Mount Sinai) are attainable for average students from T20 schools, especially with that level of research output.

The top 20 or so IM programs are very possible for mere mortals. I have plenty of friends who've gone off to places like Duke, UW, WU, UM, UTSW, NU, UCLA, Vandy, Penn, etc... who weren't "knock your socks off" amazing in every category. Everyone is fighting for BWH/MGH/JHH/UCSF, and near perfect applicants can still fail to even get an interview, but the field really opens up beyond there.

Just by the numbers there are ~20,000 US MD seniors in the match, ~4,000 apply IM, and there are ~1,000 spots in T20 residencies. About 1/2 to 1/3 of the residents in T20 programs come from T20 schools, and there are ~20 IM applicants from each T20 school. So if you come from a T20 school, it seems like there is a slot out there for you assuming you don't have red flags or location restrictions. Then the other 2,400 or so mid-tier MD IM applicants are duking it out for the remaining ~500-600 spots. This all passes the eye test. The match list thread shows that nearly all T20 IM applicants wind up in T20 residencies. For mid-tier MD, anywhere from 10-50% of students wind up in T20 residencies.

So basically if you are at a mid-tier MD school, be in the top ~25% of IM applicants, which is probably close to the top 25% of your class. That means Step 1/2 of 240s/250s, some research output, and H in IM/sub-I and H/HP elsewhere. The only places where everyone is 260+/AOA/10+ pubs are the big 4.

 

[Browns99]

-Good chances for top tier IM.
-Publications will look good for IM residency, but all in one area will make IM PDs question if you're only applying as a back up. You don't have to find research tailored to IM. 1-2 publications related to Cardiology will be more than enough with your school name.
-250+, but 240s won't kill you.

I agree that step 2 score of 250 plus is needed......240s is likely to keep you out of those programs that the OP mentioned, so while it may not be detrimental to be in the 240s, but it also won't get you into the very top programs.

 

[aldol16]

Coming from a top program will be an asset for you if you want to match top IM. Research is nice, not essential to have. More important to build relationships with people who are bigwigs at the IM program in your school. Step scores also important so basically just maximize those. Nothing much you can do about the scores other than study your best.

 

[voxveritatisetlucis]

I feel like the geographic range is too small and you may end up having to decide whether you would rather do residency at BMC, Tufts, Umass or a top IM program in a different region.

Obviously you have a very good chance of matching top 10 or 20 IM, but I would say the specific chances at MGH, BWH, BIDMC are still low just due to the randomness of the process. They all seem to like Harvard, JHU, UCSF, and Penn students the best but I’m not sure how much the prestige advantage holds as you go further down in the T20.

I think that this is like a 4.0/525 student asking, “what are the chances I get into Chicago or Northwestern.” The answer would be “pretty low” but high at some T20 school

 

[imidazzle92]

I feel like the geographic range is too small and you may end up having to decide whether you would rather do residency at BMC, Tufts, Umass or a top IM program in a different region.

Obviously you have a very good chance of matching top 10 or 20 IM, but I would say the specific chances at MGH, BWH, BIDMC are still low just due to the randomness of the process. They all seem to like Harvard, JHU, UCSF, and Penn students the best but I’m not sure how much the prestige advantage holds as you go further down in the T20.

I think that this is like a 4.0/525 student asking, “what are the chances I get into Chicago or Northwestern.” The answer would be “pretty low” but high at some T20 school

Yeah this was my thought too. Way too small of a geographic range. Guess I’ll have to find a way to try to minimize the randomness by showing a lot of interest?

Otherwise, I’d be fine with Tufts, Umass, etc. But I think a top IM program would leave more doors open for academic pursuits.

 

[futureapppsy2]

How many of the 14 manuscripts are in cardiology? Are any of them first-author?

 

[voxveritatisetlucis]

Yeah this was my thought too. Way too small of a geographic range. Guess I’ll have to find a way to try to minimize the randomness by showing a lot of interest?

Otherwise, I’d be fine with Tufts, Umass, etc. But I think a top IM program would leave more doors open for academic pursuits.

I’ve heard that aways don’t really help for IM but maybe networking could help. I’m less sure of how this works tbh

 

[imidazzle92]

How many of the 14 manuscripts are in cardiology? Are any of them first-author?

5, 1 is 1st author. no high IF papers.

 

[mrbreakfast]

I’ve heard that aways don’t really help for IM but maybe networking could help. I’m less sure of how this works tbh

I did my medicine prelim year/non-IM residency at a top-tier IM program, and while I'm also not sure how important aways are for IM, the program got a ton of M4s doing audition rotations - more students doing auditions than spots in the intern class, it felt like.

 

[AHDCard]

The top 20 or so IM programs are very possible for mere mortals. I have plenty of friends who've gone off to places like Duke, UW, WU, UM, UTSW, NU, UCLA, Vandy, Penn, etc... who weren't "knock your socks off" amazing in every category. Everyone is fighting for BWH/MGH/JHH/UCSF, and near perfect applicants can still fail to even get an interview, but the field really opens up beyond there.

Like other posters have mentioned, I think the issue here is that the poster wants to evaluate their chances of getting into "T20 programs" in a very specific geographic area, rather any T20 program.

Some back-of-the-envelope calculations using basic probability / combinatorics to illustrate the difference:

Assume that an applicant has a 20% chance of getting an interview from any given T20 program, and that their chance of acceptance post-interview into a given program is 45%. (The latter % is in-line with the % of applicants matching to their top rank across all specialties.)

Assuming that the applicant applies to all T20 programs and ranks all T20s above non T20s, the chance that the applicant will get into a T20 is 84.8%. Those are great chances! But is this 20% interview probability reasonable? Looking at a few match lists, ~60-80% of IM matches at T20 schools are to T20 IM programs. Since medical students in reality don't apply to all 20 programs, nor do they always rank T20s above non T20s, the real % will be somewhat lower than the calculated %. A drop from ~84.8% to ~60-80% seems reasonable to me, so I think 20% is a reasonable probability.

Holding the 20% interview and 45% post-interview acceptance probabilities constant, what are the chances that the applicant gets into one of three specific programs (ie, MGH, BWH, and BIDMC)? Only 24.6% (MUCH lower)! If the applicant broadens their list to 8 programs (ie, +Yale and four NYC programs), the probability of getting into one jumps to 53.0%.

Of course these are approximations - the post interview acceptance probability varies across programs, the interview probability is not uniform (ex: my medical school interviews all home applicants), etc. MGH and BWH will likely have lower probabilities than other T20s, but geographic / signal preferences, family ties, and a customized personal statement could increase probabilities too.

For OP, I would say this:
Mean Step 1/2 for programs in the ~11- 30 range is typically mid 240s/upper 250s +/- a little bit. Given your school pedigree, likely good rec letters, research, etc, you can probably have a little below average scores and still have a very high chance of getting into a T20 somewhere. However, with the exception of your home program, don't count on getting into any individual program or group of a few programs, especially if those groups include MGH/BWH. Higher scores (260s) will increase your chances, and anything beyond that is diminishing returns.

Edit: source for mean step scores was from the Texas STAR data available this past year

 

[ChordaEpiphany]

Yeah this was my thought too. Way too small of a geographic range. Guess I’ll have to find a way to try to minimize the randomness by showing a lot of interest?

Otherwise, I’d be fine with Tufts, Umass, etc. But I think a top IM program would leave more doors open for academic pursuits.

I think you'll find that the cut off for "top academic" pursuits in that area is BIDMC. The next best residency in that immediate area is probably BU/BMC. You'd do fine matching there, but probably you are looking at a mid-tier academic career, not bouncing back up to the top tier/brand name (plenty do match top tier from there, but it's not the norm the way it is at BIDMC/BWH/MGH).

I think the best bet is to establish some relationships there. Look at who from your school has collaborations with Boston area profs in cards OR who are alums of the area with contacts in the Harvard system. Get to know those profs and their connections. Exchange emails. Ideally do some sort of away rotation there, not because the away will help, but because you can work with that prof and get a letter from someone all the PDs actually know.

Like other posters have mentioned, I think the issue here is that the poster wants to evaluate their chances of getting into "T20 programs" in a very specific geographic area, rather any T20 program.

Some back-of-the-envelope calculations using basic probability / combinatorics to illustrate the difference:

Assume that an applicant has a 20% chance of getting an interview from any given T20 program, and that their chance of acceptance post-interview into a given program is 45%. (The latter % is in-line with the % of applicants matching to their top rank across all specialties.)

Assuming that the applicant applies to all T20 programs and ranks all T20s above non T20s, the chance that the applicant will get into a T20 is 84.8%. Those are great chances! But is this 20% interview probability reasonable? Looking at a few match lists, ~60-80% of IM matches at T20 schools are to T20 IM programs. Since medical students in reality don't apply to all 20 programs, nor do they always rank T20s above non T20s, the real % will be somewhat lower than the calculated %. A drop from ~84.8% to ~60-80% seems reasonable to me, so I think 20% is a reasonable probability.

Holding the 20% interview and 45% post-interview acceptance probabilities constant, what are the chances that the applicant gets into one of three specific programs (ie, MGH, BWH, and BIDMC)? Only 24.6% (MUCH lower)! If the applicant broadens their list to 8 programs (ie, +Yale and four NYC programs), the probability of getting into one jumps to 53.0%.

Of course these are approximations - the post interview acceptance probability varies across programs, the interview probability is not uniform (ex: my medical school interviews all home applicants), etc. MGH and BWH will likely have lower probabilities than other T20s, but geographic / signal preferences, family ties, and a customized personal statement could increase probabilities too.

For OP, I would say this:
Mean Step 1/2 for programs in the ~11- 30 range is typically mid 240s/upper 250s +/- a little bit. Given your school pedigree, likely good rec letters, research, etc, you can probably have a little below average scores and still have a very high chance of getting into a T20 somewhere. However, with the exception of your home program, don't count on getting into any individual program or group of a few programs, especially if those groups include MGH/BWH.

Edit: source for mean step scores was from the Texas STAR data available this past year

I see your point and appreciate the analysis. I agree, OP needs to broaden his/her horizons to include NYC and Yale. These are kind of nonsense numbers though, back calculated to come out to realistic chances based on the above discussion and real rates. In reality, the match rates of T20 schools for T20 residencies aren't just a product of combinatorics. They are a product of PDs feeling out who actually wants to be part of the class and who will be a good fit after filtering for minimum stats. This kind of math won't check out in real life because of the ~80% of T20 students who match T20 IM residencies, the majority match regionally. If OP is currently at Mount Sinai or Yale, they'll likely waltz right in Without trying, profs in the Boston area will know their recommenders, or at least have heard of them, and there will be a strong sense of . If they are at Northwestern or UCSD, then their chances at MGH/BWH/BIDMC are lower unless they make a specific effort.

Overall, I think it's all about what I highlighted in your post above + connections. If the paper app looks good, none of it has to be random. If Prof A from UCSD calls up Prof B/PD from BIDMC and says, "Hey, FYI OP really wants your program and has a family reason to need to be there," then OP will wind up there. Less of a guarantee at MGH/BWH, but it's still possible. These people got to where they are by not pissing off powerful colleagues in the field. Ranking your colleague's mentee to match is such a small ask for them.

 

[imidazzle92]

@AHDCard interesting - if I did manage to interview 2 out of the 3 (MGH/BWH/BIDMC) in interviews and only ranked them + all non T20 MA programs I received interviews to, I wonder where I'd end up. I don't think anyone from my school in the past few years has gone to a non-T30 IM program - most either go to our home program (T25) or places like Duke/Emory/Case/Stanford etc -- some UCSF in past years but not many hopkins/MGH/BWH

@ChordaEpiphany guess I'll have to try and leverage any connections I have here to match, but based on what you and the other poster have said, I think I may consider adding in programs that are closeby (i.e., Yale/Cornell) if I manage to get interviews there

Looks like i'll have to study my ass off for Step2 to make sure I get a good score. Step1 is P/F
Thanks for all the insight btw, really helpful

 

[AHDCard]

I see your point and appreciate the analysis. I agree, OP needs to broaden his/her horizons to include NYC and Yale. These are kind of nonsense numbers though, back calculated to come out to realistic chances based on the above discussion and real rates. In reality, the match rates of T20 schools for T20 residencies aren't just a product of combinatorics. They are a product of PDs feeling out who actually wants to be part of the class and who will be a good fit after filtering for minimum stats. This kind of math won't check out in real life because of the ~80% of T20 students who match T20 IM residencies, the majority match regionally. If OP is currently at Mount Sinai or Yale, they'll likely waltz right in Without trying, profs in the Boston area will know their recommenders, or at least have heard of them, and there will be a strong sense of . If they are at Northwestern or UCSD, then their chances at MGH/BWH/BIDMC are lower unless they make a specific effort.

Overall, I think it's all about what I highlighted in your post above + connections. If the paper app looks good, none of it has to be random. If Prof A from UCSD calls up Prof B/PD from BIDMC and says, "Hey, FYI OP really wants your program and has a family reason to need to be there," then OP will wind up there. Less of a guarantee at MGH/BWH, but it's still possible. These people got to where they are by not pissing off powerful colleagues in the field. Ranking your colleague's mentee to match is such a small ask for them.

You're right that the base probabilities are backcalculated, but sensitivity analyses show that any plausible base probability results in the same conclusion: high admissions chances at a "top" program in general; much lower at any one program.

I agree that one can "escape" from the probabilistic regime with geography (but OP does not go to school in the northeast) or with personal connections - if OP has a good application on paper, cultivating relationships with faculty members with personal relationships to IM residency leadership at specific target programs could be helpful. But there's no guarantees. This past cycle, a friend of mine who was a strong applicant (T20 med school, got interviews at several T20 programs) did not get an interview at one particular T20 institution, even though their parent was a longstanding hospitalist at that institution, they had grown up in the surrounding area, and they attended a med school in the same state.

Based on my experience interviewing at about half of the "T20" IM programs (and their corresponding PSTP / research track programs), I also think that the sheer size of categorical IM makes it harder to find and cultivate such a relationship during the limited time that med students have. (IM fellowships, smaller specialties, and IM research track programs are a different story.) Your near-retirement age GI mentor who does liver transplants at a midwestern university hospital is going to be very connected to academic hepatologists and transplant surgeons around the country, but less connected to the new young PD who does primary care at a west coast county hospital. To be fair, the PDs at BWH, MGH, and BIDMC are all deep in their careers and well-connected, but who knows what will happen in a few years? I interviewed at over 20 institutions (and had >30 tracks to rank) and saw many well-known IM programs with frequent PD turnover.

All that said, I think the advice to OP is the same: if you have an average app for your school, you will likely get into *a* top program but don't count on getting into *the* program you want (unless it's your home program); have as strong an app as you can (Step, letters, clinical grades, AOA, research); LoRs or phone calls from faculty at your institution well-known to the leadership at your target institution are great, but my observation is that it's harder to develop those relationships in categorical IM compared to smaller fields.

@AHDCard interesting - if I did manage to interview 2 out of the 3 (MGH/BWH/BIDMC) in interviews and only ranked them + all non T20 MA programs I received interviews to, I wonder where I'd end up. I don't think anyone from my school in the past few years has gone to a non-T30 IM program - most either go to our home program (T25) or places like Duke/Emory/Case/Stanford etc -- some UCSF in past years but not many hopkins/MGH/BWH

If you're an average interviewer, I think you would have a good shot (~>=50%) at ending up at one of the two

 

[Lawpy]

Top tier IM - particularly the programs you named - are going to be just as competitive as neurosurgery programs. I'm going to disagree with the previous poster and tell you to aim for 260s on step 2 - 21% of IM applicants scored >260 according to NMRP, and scoring in the 240s will land you a below average step 2 score for the specialty overall, let alone top tier. I'd also recommend getting some cardiology research.

You're on pace to be a competitive applicant, but for top tier IM, you're going to be sitting in a room full of applicants who are mostly/all AOA, have 260+ on step, and have high-impact publications. I'd keep working hard and prepare just as if you were still applying to neurosurgery, including multiple away/audition rotations.

Whoa wait. How are applicants with high impact publications common even for top programs?

Also OP is at a top school. Aways are overkill.

 

[Lawpy]

I'll counter some of the previous posters and say that I had a step 1 of 240-245 and a step 2 of 250ish, and matched to top 10 IM. Went to a t20, roughly half H and half HP on clinicals, with more HP than H. Lots of gen med research though. Didn't get any interviews at MGH/BWH/JH/UCSF, but had 4 interviews at the other 6 in the top 10.

MGH/BWH/JH/UCSF are only competitive because of how heavily they select for students from their own schools. The only way to have a chance at those places is to establish strong connections with the faculty at those programs

 

[imidazzle92]

Whoa wait. How are applicants with high impact publications common even for top programs?

Also OP is at a top school. Aways are overkill.

Don't think high-impact pubs are that rare but first author ones are pretty rare from what I know. Being mid-author on a high IF pub usually just means you can data collect for a strong PI. I honestly doubt there are many MS1-3's conceiving a study from scratch/spearheading for a Nature/Science level paper. Plenty of MD-PhD's graduate from top programs without first authoring a high IF pub.

 

[Browns99]

MGH/BWH/JH/UCSF are only competitive because of how heavily they select for students from their own schools. The only way to have a chance at those places is to establish strong connections with the faculty at those programs

Where do you come up with this stuff.....MGH/BWH/JH/UCSF are competitive because of the strength of their programs. They would be competitive if they had zero home students apply.

And remember, absolutes are never so, like the adverb "only."

 

[Lawpy]

Where do you come up with this stuff.....MGH/BWH/JH/UCSF is competitive because of the strength of their programs. They would be competitive if they had zero home students apply.

They’re not significantly stronger compared to the rest of the top tier IM programs. The rest of top programs are also really competitive but doesn’t have this extra craziness that those 4 have.

 

[Browns99]

They’re not significantly stronger compared to the rest of the top tier IM programs. The rest of top programs are also really competitive but doesn’t have this extra craziness that those 4 have.

I'm ok with this statement, not so much on the last one about their competitiveness being based only on home applicants applying.

 

[Lawpy]

Don't think high-impact pubs are that rare but first author ones are pretty rare from what I know. Being mid-author on a high IF pub usually just means you can data collect for a strong PI. I honestly doubt there are many MS1-3's conceiving a study from scratch/spearheading for a Nature/Science level paper. Plenty of MD-PhD's graduate from top programs without first authoring a high IF pub.

Coauthoring high impact papers in general is still uncommon. That requires being in good terms with a high powered and well connected PI, and while that’s a lot more likely to happen at top schools, to think many people applying for Big 4 have high impact papers is a huge stretch.

 

[voxveritatisetlucis]

I'm ok with this statement, not so much on the last one about their competitiveness being based only on home applicants applying.

I have noticed that all T30 IM programs on the coasts are more competitive. I will be going to a low tier MD school and in the past we’ve had people match IM at Michigan, Barnes Jewish, Baylor, Northwestern, UChicago, Vanderbilt, Duke but never any of the big names in California (not even UCSD), New York City, Boston etc

 

[imidazzle92]

I have noticed that all T30 IM programs on the coasts are more competitive. I will be going to a low tier MD school and in the past we’ve had people match IM at Michigan, Barnes Jewish, Baylor, Northwestern, UChicago, Vanderbilt, Duke but never any of the big names in California (not even UCSD), New York City, Boston etc

Is your school on one of the coasts? Could be applicant preference.

 

[voxveritatisetlucis]

Is your school on one of the coasts? Could be applicant preference.

no, midwest.

It defintely could be applicant preference but there are plenty of people who match to California and the East coast but usually it’s weaker programs (for example in California: Cedars Sinai, UCLA Harbor, Scripps Mercy/Green, UCLA Olive View, USC, UCI—
in New York: Montefiore, Sinai St. Luke’s, Downstate—in Boston/MA: Tufts, BMC, Umass)


im not even sure if the school will be able to match top tier in Midwest (Mich, Barnes etc.) after pass fail step 1. It will be a lot harder for PD’s to justify taking somebody from ____ lower tier school of medicine than Applicants from Case western, Michigan, WUSTL, Chicago, Northwestern who will be more inclined to apply to all top tiers now that step isn’t limiting factor

 

[Lawpy]

Basically, top tier programs are competitive and Big 4 even more so, but SDN is very severely overexaggerating the competitiveness as with everything else.

 

[ChordaEpiphany]

Don't think high-impact pubs are that rare but first author ones are pretty rare from what I know. Being mid-author on a high IF pub usually just means you can data collect for a strong PI. I honestly doubt there are many MS1-3's conceiving a study from scratch/spearheading for a Nature/Science level paper. Plenty of MD-PhD's graduate from top programs without first authoring a high IF pub.

There are basically 0 MD-only students who first author a Nature/Science paper. Not only are these years-long, full-time endeavors, but even after submission it requires months-to-years of revisions. Even if an MD student did something like this, it wouldn't be out in time for ERAS. It's actually a problem even with MD/PhDs, who submit these papers before starting MS3.

Basic science pubs are a completely different animal. You'd be much more likely to FA a JAMA or Lancet paper. I'm sure there are students who get middle author CNS pubs. Personally I think these are massively overrated, but "PDs can count, but they can't read." I got an email for a 4th author pub last week (basic science, IF ~15) I didn't even know I was on. The level of effort between 1st and middle author is so vast they should honestly go on separate parts of a CV. Also, there is zero difference between effort and talent required for a middle author Nature paper and a middle author Scientific Reports paper.

Where do you come up with this stuff.....MGH/BWH/JH/UCSF are competitive because of the strength of their programs. They would be competitive if they had zero home students apply.

And remember, absolutes are never so, like the adverb "only."

Agree on the absolutes, but PDs do play these games. They want a strong-looking class. They want to be able to tell others they barely went down a single slot on their match list. They want professors at others schools to balk at how their best students still can't crack into these programs. They also get pressure from deans to ensure the school's match list looks good, and that sometimes means taking a borderline candidate from the home med school.

At the end of the day, the match list looks good, the program looks good, and from the outside it looks like there's something superhuman happening in those hallowed walls.

Coauthoring high impact papers in general is still uncommon. That requires being in good terms with a high powered and well connected PI, and while that’s a lot more likely to happen at top schools, to think many people applying for Big 4 have high impact papers is a huge stretch.

Anecdotally, we had an MD/PhD graduate recently with a pretty bad PhD. He published one low impact paper and a high impact review. It was all poor mentorship, the guy was insanely smart and hardworking. My PI actually gathered our entire lab went on a rant about how it was unacceptable to have such a bad PhD. Ironically his exact comments would be considered too unprofessional for this board.

Anyway, he got all Honors and AOA, killed the steps, and matched at a Big 4. Even for MD/PhDs, high impact pubs aren't necessary. They definitely help though.

 

[Lawpy]

Anecdotally, we had an MD/PhD graduate recently with a pretty bad PhD. He published one low impact paper and a high impact review. It was all poor mentorship, the guy was insanely smart and hardworking. My PI actually gathered our entire lab went on a rant about how it was unacceptable to have such a bad PhD. Ironically his exact comments would be considered too unprofessional for this board.

Anyway, he got all Honors and AOA, killed the steps, and matched at a Big 4. Even for MD/PhDs, high impact pubs aren't necessary. They definitely help though.

Mentorship is really the critical factor here and something which these forums don’t appreciate. I also really don’t think the Big 4 is that inaccessible from looking at the match lists of a lot of US MD schools. It’s a lot more situational and nuanced at that level that SDN blanket advice fails pretty severely

 

[ABigChunguss]

Mentorship is really the critical factor here and something which these forums don’t appreciate. I also really don’t think the Big 4 is that inaccessible from looking at the match lists of a lot of US MD schools. It’s a lot more situational and nuanced at that level that SDN blanket advice fails pretty severely

Does the type of research matter for top IM residencies? For example, cardiovascular epidemiology vs. basic science research on heart tissue vs. cardiovascular clinical research.

 

[seeinghowitgoes]

Does the type of research matter for top IM residencies? For example, cardiovascular epidemiology vs. basic science research on heart tissue vs. cardiovascular clinical research.

Depends on your narrative, but generally it doesn’t make a big difference as far as getting into residency.

If you say you want to run a lab, obviously need basic science track record (and probably a PhD). If you want to be 80% research in epi, then you should probably have some quant background (I.e. published things) but field probably doesn’t matter (before getting a k many people publish in whatever their mentors published in, the important thing is just getting some stuff out there to establish a track record). If your narrative is just you care about social justice or healthcare admin, then the research you’ve done would ideally speak to that but because research isn’t how you’ll be buying down your time it doesn’t really matter.

Of course if you know exactly what you want to study (translational research into the epigenetics of aortic stenosis, for example), starting on that work earlier is better for your overall career, not so much because of benefits to getting into a top residency but rather benefits once you apply for a first faculty job. But it’s rare to be so targeted so early in training (even many folks with PhDs going to residency come out with plans to start their labs in something tangentially related to what they got their PhD in).

 

[ABigChunguss]

Depends on your narrative, but generally it doesn’t make a big difference as far as getting into residency.

If you say you want to run a lab, obviously need basic science track record (and probably a PhD). If you want to be 80% research in epi, then you should probably have some quant background (I.e. published things) but field probably doesn’t matter (before getting a k many people publish in whatever their mentors published in, the important thing is just getting some stuff out there to establish a track record). If your narrative is just you care about social justice or healthcare admin, then the research you’ve done would ideally speak to that but because research isn’t how you’ll be buying down your time it doesn’t really matter.

Of course if you know exactly what you want to study (translational research into the epigenetics of aortic stenosis, for example), starting on that work earlier is better for your overall career, not so much because of benefits to getting into a top residency but rather benefits once you apply for a first faculty job. But it’s rare to be so targeted so early in training (even many folks with PhDs going to residency come out with plans to start their labs in something tangentially related to what they got their PhD in).

Would you say the specific type of research doesn't make a big difference even for Top 10 IM or ortho residencies?

 

[seeinghowitgoes]

Would you say the specific type of research doesn't make a big difference even for Top 10 IM or ortho residencies?

Can’t speak to ortho where I imagine it does matter.

For IM, even the top, the other things I wrote apply. So yea doesn’t really matter, the narrative does more.