Nepotism and Family Connections

[charmiedermie]

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[charmiedermie]

So who should do this? Should the editor of JAAD (yes, I checked what you posted) publish something mentioning this? Who is the spokesperson for derm? This application process is real life. We have all learned that in real life, "it's not what you know, it's who you know". This applies to derm. No one is saying that dermatology as a field is somehow exempt from this.

So what is your solution? You think it is right to put out papers concluding how important and predictive Step 1 scores, med school grades, AOA, and research are to being a competent resident and dermatologist even though it may be baloney? Is he lying or not? They both can't be correct.

 

[FIREitUP]

So what is your solution? You think it is right to put out papers concluding how important and predictive Step 1 scores, med school grades, AOA, and research are to being a competent resident and dermatologist even though it may be baloney? Is he lying or not? They both can't be correct.

I understand your frustration, but I don't have a solution. It's hard to publish data about family connections because it's impossible to really know to what extent the connections played a role, since this it is basically all conjecture. Those above metrics (Step 1, AOA, grades, etc.) are objective and tend to predict for competitiveness. That's not to say they are only metrics/determinants of whether someone gets a residency spot.

 

[charmiedermie]

I understand your frustration, but I don't have a solution. It's hard to publish data about family connections because it's impossible to really know to what extent the connections played a role, since this it is basically all conjecture. Those above metrics (Step 1, AOA, grades, etc.) are objective and tend to predict for competitiveness. That's not to say they are only metrics/determinants of whether someone gets a residency spot.

@FIREitUP, did u read his articles? It was referring to derm residency performance and boards post residency not competitiveness to getting in the field in the first place.

 

[doc MD]

Again, I understand life is not fair. It doesn't mean it shouldn't be pointed out. Dral believes nepotism is a 'valid' part of the process no different and is on par with doing research or acing an audition elective. So then the field's company line shouldnt say grades, board scores, AOA, are vital for Derm.

You and anyone else can point it out. It would not do anything. Nepotism is just a stronger LOR and in a way is valid. You have to keep in mind that most programs still want good grades and hence most have step1 cutoffs that varies between programs from 220 to 230, which is well below the overall average score of accept applicants. Having great board scores and AOA gets your application noticed that a LOR or nepotism would not have helped in the first place. It sucks that this is the way it is but college, med school, and residency, all have nepotistic influences.


edit: or maybe you can do something. Last year, an applicant applied and have familial connections with the faculty. We the residency interview them. They had a DUI on their record and gave them the lowest score. The PD asked why and we said, regardless of connections, and ok grades, we could not trust someone that only a few years ago was so irresponsible. Never got in anywhere. There are limits to how far nepotism can take you as well.

 

[tartesos]

So a med student from a brand new medical school with no prominent derm faculty just happens to match at the program that a parent (who is a prominent player in the field and who completed a fellowship)? You think that's just a coincidence? You think maybe, just maybe, having the same last name didn't have any benefit?

I'm sure you got to where you're at by pulling yourself by your bootstraps, etc etc etc, but the reality is clear, nepotism is alive and well in medicine. Some applicants get lucky in that regard. But don't try to deny that the OPs claims are without merit because anyone with an ounce of sense could see that even with a few sentence descriptions, the scenarios are a bit shady.

Nepotism in medicine and in every field has been there since the beginning of time... It is very likely that the credentials of an md whose father is an MD are pretty good, that's logical.
Now to assume someone matched only for their kinship and taking away all merits is also unfair.
Should your kids be punished If they want to pursue medicine for the sake of being politically correct in the future and not be trained in your hospital? ( it's a very likely scenario for all of us in the future. )

It's not fair and I'm sorry for the op, but just think how much more sweeter victory will taste when he matches by his own merits.
Don't give up!

 

[doctor85]

Great discussion! Sounds like nepotism is alive and well even in the pure and unadulterated field of dermatology! But isn't that why we all go after certain faculty members to be our mentors/letter writers but to utilize their connections/power/accomplishments rather than just our own?

And I'd like to give Charmie the award for possibly the nosiest and gutsiest applicant of the year to figure out all the dirty details you managed to uncover and publicize in the opening post of this thread. You are apparently asking much more in-depth questions than I am when the faculty interviewers ask, "So what questions do you have for me?" I usually throw out something generic and just feel happy that I'm at another interview and got a free breakfast.

Go derm.

 

[charmiedermie]

Great discussion! Sounds like nepotism is alive and well even in the pure and unadulterated field of dermatology! But isn't that why we all go after certain faculty members to be our mentors/letter writers but to utilize their connections/power/accomplishments rather than just our own?

And I'd like to give Charmie the award for possibly the nosiest and gutsiest applicant of the year to figure out all the dirty details you managed to uncover and publicize in the opening post of this thread. You are apparently asking much more in-depth questions than I am when the faculty interviewers ask, "So what questions do you have for me?" I usually throw out something generic and just feel happy that I'm at another interview and got a free breakfast.

Go derm.

You're right. someone who is the offspring or spouse of a derm is just like your run of the mill derm applicant who busts their butt getting good grades the first 3 years, acing Step 1, doing research, impressing on audition rotations, getting to know faculty well enough with the hopes they'll write a great letter. Yup both are equal.

Applicants talk about different programs with each other. You must have still been scarfing down breakfast.

 

[charmiedermie]

You and anyone else can point it out. It would not do anything. Nepotism is just a stronger LOR and in a way is valid. You have to keep in mind that most programs still want good grades and hence most have step1 cutoffs that varies between programs from 220 to 230, which is well below the overall average score of accept applicants. Having great board scores and AOA gets your application noticed that a LOR or nepotism would not have helped in the first place. It sucks that this is the way it is but college, med school, and residency, all have nepotistic influences.


edit: or maybe you can do something. Last year, an applicant applied and have familial connections with the faculty. We the residency interview them. They had a DUI on their record and gave them the lowest score. The PD asked why and we said, regardless of connections, and ok grades, we could not trust someone that only a few years ago was so irresponsible. Never got in anywhere. There are limits to how far nepotism can take you as well.

A DUI is considered quite a serious offense, fair or not. That being said your example proves my point. It took a DUI conviction to knock off a nepotistic candidate off your rank list, who had ok grades.

Most med students don't have DUIs - which aren't hard to avoid.

 

[HatsAnd Sunscreen]

You're right. someone who is the offspring or spouse of a derm is just like your run of the mill derm applicant who busts their butt getting good grades the first 3 years, acing Step 1, doing research, impressing on audition rotations, getting to know faculty well enough with the hopes they'll write a great letter. Yup both are equal.

Yes, the former applicants I know that had strong derm connections did every one of those things and had stellar applications. They matched at great programs because they were great candidates and cool people. You seem to be implying that students with dermatologist family members do not work as hard for these positions and are given residency positions without having the same merits as other applicants.

I think that any dermatology faculty/resident would admit that connections are helpful, but having connections is not a substitute for having a strong well balanced application and being a likeable person. I'm not sure if there is a solution or if it is even an issue that needs one. If every program that had ever taken one of these applicants put on the front page of their website "In a previous year we matched an applicant who's father is also a dermatologist", would that really serve a purpose or help applicants better manage the match process?

 

[FIREitUP]

You and anyone else can point it out. It would not do anything. Nepotism is just a stronger LOR and in a way is valid. You have to keep in mind that most programs still want good grades and hence most have step1 cutoffs that varies between programs from 220 to 230, which is well below the overall average score of accept applicants. Having great board scores and AOA gets your application noticed that a LOR or nepotism would not have helped in the first place. It sucks that this is the way it is but college, med school, and residency, all have nepotistic influences.


edit: or maybe you can do something. Last year, an applicant applied and have familial connections with the faculty. We the residency interview them. They had a DUI on their record and gave them the lowest score. The PD asked why and we said, regardless of connections, and ok grades, we could not trust someone that only a few years ago was so irresponsible. Never got in anywhere. There are limits to how far nepotism can take you as well.

I don't know if I agree (though I can't know for sure since I don't have direct experience as you do). I would think that nepotism/family connections could mean the difference of an interview or not in someone with lower scores.

@charmiedermie I'm not familiar with the paper(s) you're referring to. What journal were they published in?

 

[charmiedermie]

I don't know if I agree (though I can't know for sure since I don't have direct experience as you do). I would think that nepotism/family connections could mean the difference of an interview or not in someone with lower scores.

@charmiedermie I'm not familiar with the paper(s) you're referring to. What journal were they published in?

Your example is what I'm talking about as well as Doc MD's example where it took something as serious as a DUI to kick a nepotism candidate off the rank list.

He published them in the JAAD, as I said before.

 

[charmiedermie]

Yes, the former applicants I know that had strong derm connections did every one of those things and had stellar applications. They matched at great programs because they were great candidates and cool people. You seem to be implying that students with dermatologist family members do not work as hard for these positions and are given residency positions without having the same merits as other applicants.

I think that any dermatology faculty/resident would admit that connections are helpful, but having connections is not a substitute for having a strong well balanced application and being a likeable person. I'm not sure if there is a solution or if it is even an issue that needs one. If every program that had ever taken one of these applicants put on the front page of their website "In a previous year we matched an applicant who's father is also a dermatologist", would that really serve a purpose or help applicants better manage the match process?

Forget applicants whose parent is a dermatologist for the moment. I'm talking about those whose parent is an academic dermatologist. They all happened to match bc they're "cool people"?

Stop conflating different scenarios.

 

[HatsAnd Sunscreen]

Forget applicants whose parent is a dermatologist for the moment. I'm talking about those whose parent is an academic dermatologist. They all happened to match bc they're "cool people"?

Stop conflating different scenarios.

Yes, this exact scenario existed my year. Rotated with the child of a well known PD and this individual worked just as hard as the rest of us to get a good letter on that rotation. They also had a great research background, and yes also was a "cool person" which resulted in a good match day. Other than that the interview trail wasn't littered with children of academics. I'm sure there have been instances of favoritism but I'm not convinced that you know enough about the individuals that you have brought up to be able to make the insinuation that they did not bust their butts to achieve their success.

 

[FIREitUP]

Your example is what I'm talking about as well as Doc MD's example where it took something as serious as a DUI to kick a nepotism candidate off the rank list.

He published them in the JAAD, as I said before.

I know, I agree with you dude. I couldn't find the paper but I believe you.

 

[charmiedermie]

I know, I agree with you dude. I couldn't find the paper but I believe you.

Le sigh. One paper is called "Correlation of USMLE Step 1 scores with performance on dermatology in-training examinations". The other is called "Can performance in medical school predict performance in residency? A compilation and review of correlative studies".

 

[charmiedermie]

Yes, this exact scenario existed my year. Rotated with the child of a well known PD and this individual worked just as hard as the rest of us to get a good letter on that rotation. They also had a great research background, and yes also was a "cool person" which resulted in a good match day. Other than that the interview trail wasn't littered with children of academics. I'm sure there have been instances of favoritism but I'm not convinced that you know enough about the individuals that you have brought up to be able to make the insinuation that they did not bust their butts to achieve their success.

We all work hard on rotations to get letters. We all do research. I'm talking about medical school academics and Step scores. If you're the son/daughter/spouse of an academic derm, suddenly the latter 2 doesn't mean much. A non-nepotism candidate wouldn't even be lucky to get an interview. The nepotism tool is a huge shield.

 

[Dral]

I'm not trying to attack you. I know you've been thru the same journey. But for the applicant who has 2 conflicting interviews and has to give up one, you don't think its helpful info to know to be able to go with the program that doesnt pull this stuff and has a higher chance to match there?

Demand for certain scores, grades, etc. are all driven from the top. Applicants aren't the ones doing it.

Fair enough. However, if you were applying next year, would you not apply to OSU, Cleveland Clinic, etc. if you knew these things? What if OSU had three spots and people knew one was 'taken'? Would that change much? In an alternate scenario, maybe OSU only has two spots period and none go to relatives. Would one still apply and interview? Of course. I'm not seeing why knowing this ahead of time really changes what anyone would do except in such very few circumstances.

So let's take the instance of a relative of a big name applying. If it's someone well known and the candidate is just applying everywhere, I guess the 'lowest' person on the would be interview list at a number of programs may get knocked off so the person related to the big name could have an interview mainly because of being related to a big name person. I admit, this kinda sucks. That's a few people that could have had interviews who lose the chance. The candidates would not ever really know, but it still kinda sucks.

In the case of a relative like a wife of faculty at a program who may not be that well known, the wife/candidate probably won't really get that many interviews at other places anyway. So the aforementioned affect probably isn't that big of a deal in this second scenario, other than at their specific program...

Now let's say OSU has 5 spots and Pittsburgh has 5 spots. Someone gets an interview invite at both and the interviews are the same day. However, the candidate knows or has a suspicion that OSU will take someone who is a relative of faculty. They really like OSU better, but in the end decide to go to the Pittsburgh interview because it's one more spot that they have a chance at.

I guess in that scenario it helps to know. But again, how often would that type of scenario really arise? Maybe two rotators at Pittsburgh did really well that year and are high on the list at Pittsburgh. In that case, maybe the candidate above actually has a better chance at OSU since only one spot instead of two are likely to go to someone that's kinda decided ahead of time.

I guess a few times this type of scenario could arise, and it would kinda suck if it did arise, but in the grand scheme of all the things involved in applying Derm, it just doesn't seem like that significant of a problem imo. Sure, it would be nice to be all fair and square, but so few things work that way in real practice.

 

[FIREitUP]

Le sigh. One paper is called "Correlation of USMLE Step 1 scores with performance on dermatology in-training examinations". The other is called "Can performance in medical school predict performance in residency? A compilation and review of correlative studies".

it's because i thought you were talking about another one of the people that you implicitly mentioned in your opening statement.

Anyhow, I don't really see what you're getting so worked up about. it's not really mind blowing that both of the articles correlate performance on step 1 scores with performance derm standardized tests. seems like common sense that someone who is a good test taker would do well on both exams.

 

[charmiedermie]

it's because i thought you were talking about another one of the people that you implicitly mentioned in your opening statement.

Anyhow, I don't really see what you're getting so worked up about. it's not really mind blowing that both of the articles correlate performance on step 1 scores with performance derm standardized tests. seems like common sense that someone who is a good test taker would do well on both exams.

That other person has not written JAAD articles in this area, i believe, that the OSU PD has which was mentioned previously, not just by me.

Are u purposefully not understanding? The correlation of med school exam grades, step 1 score, clinical grades, and AOA were being correlated with derm residency performance in the second article. As mentioned by someone else he also wrote an article on using personality tests, presumably for derm residency. His research interest is in derm residency selection, "specifically the identification of effective predictors of performance during medical school and residency." Do u understand now?

 

[Dral]

One question, is how important is the in service anyway? It is to PDs because presumably it correlates with passing boards. Does it make a better dermatologist in the end? Who knows, I guess.

Anyway, that's sorta OT.

 

[charmiedermie]

One question, is how important is the in service anyway? It is to PDs because presumably it correlates with passing boards. Does it make a better dermatologist in the end? Who knows, I guess.

Anyway, that's sorta OT.

Which is why he did 2 articles: one correlating step 1 to the in service which presumably predicts boards passage and the other article using Step 1, AOA, grades, etc. to predict residency performance. Both together i would think most likely determine competency.

 

[anonperson]

You and anyone else can point it out. It would not do anything. Nepotism is just a stronger LOR and in a way is valid. You have to keep in mind that most programs still want good grades and hence most have step1 cutoffs that varies between programs from 220 to 230, which is well below the overall average score of accept applicants. Having great board scores and AOA gets your application noticed that a LOR or nepotism would not have helped in the first place. It sucks that this is the way it is but college, med school, and residency, all have nepotistic influences.


edit: or maybe you can do something. Last year, an applicant applied and have familial connections with the faculty. We the residency interview them. They had a DUI on their record and gave them the lowest score. The PD asked why and we said, regardless of connections, and ok grades, we could not trust someone that only a few years ago was so irresponsible. Never got in anywhere. There are limits to how far nepotism can take you as well.

Lol! Even with a DUI record this person was able to use their connections to score an interview and it took a united front from the faculty to even not rank the person (or maybe just ranked lowly). The PD even had the temerity to ask why? Hmm, did the PD not even care and was willing to rank this person normally because of the familial connections?

I can be pretty certain that your typical derm applicant who doesn't have mom or dad on faculty would have gotten their applications auto screened, in general.

This is the power of nepotism. It is truly an awesome thing.

 

[Dral]

That is true. With so many superstars applying, any yellow flag is an excuse to not interview someone. A recent DUI is more like a really big red flag.

 

[charmiedermie]

Lol! Even with a DUI record this person was able to use their connections to score an interview and it took a united front from the faculty to even not rank the person (or maybe just ranked lowly). The PD even had the temerity to ask why? Hmm, did the PD not even care and was willing to rank this person normally because of the familial connections?

I can be pretty certain that your typical derm applicant who doesn't have mom or dad on faculty would have gotten their applications auto screened, in general.

This is the power of nepotism. It is truly an awesome thing.

Glad u saw the same. That's why i was surprised doc md used that example. Until faculty drew (what should be obvious) the line, the pd still offered this person an interview and was ready to rank him. He had to actually ask why. THIS is what i am talking about.

But lets just give them the benefit of the doubt, and say it was bc they're cool people, they worked so hard on rotations, its a valid part of the process, or bc their parent is smart their kid is just as smart as them, etc. Bc all the rest of us are lazy.

 

[charmiedermie]

That is true. With so many superstars applying, any yellow flag is an excuse to not interview someone. A recent DUI is more like a really big red flag.

And yet he still got an interview at this program anyway, taking someone else's interview spot when his DUI was in black and white on his ERAS application.

 

[FIREitUP]

That other person has not written JAAD articles in this area, i believe, that the OSU PD has which was mentioned previously, not just by me.

Are u purposefully not understanding? The correlation of med school exam grades, step 1 score, clinical grades, and AOA were being correlated with derm residency performance in the second article. As mentioned by someone else he also wrote an article on using personality tests, presumably for derm residency. His research interest is in derm residency selection, "specifically the identification of effective predictors of performance during medical school and residency." Do u understand now?

I know, I'm not being purposefully dense, I promise. I agree with you. But I don't think we know enough about the applicants who had these ties to say that the author ignored the metrics he found to determine success altogether. Likely these people had decent enough applications that they were not concerned with them not succeeding in residency and knowing someone pushed them over the edge.

 

[charmiedermie]

I know, I'm not being purposefully dense, I promise. I agree with you. But I don't think we know enough about the applicants who had these ties to say that the author ignored the metrics he found to determine success altogether. Likely these people had decent enough applications that they were not concerned with them not succeeding in residency and knowing someone pushed them over the edge.

Right. It's just entirely coincidence he matched from a newly created med school with no derm residency at a program where his father just happens to have a direct connection with the PD there in his area of derm expertise. Of which all his research pubs are with his dad.

 

[doctor85]

Charmie - Look how many fired up posts you've spewed out since opening your account on Sunday. You dislike nepotism and want life to be fair. We get it. You're obviously passionate and persistent enough that I'm sure your app is strong and you'll match. Maybe not at your top program because so-and-so's nephew is going to steal your well-deserved spot, but you'll still be a fine dermatologist.

 

[Dral]

Charmie - Look how many fired up posts you've spewed out since opening your account on Sunday. You dislike nepotism and want life to be fair. We get it. You're obviously passionate and persistent enough that I'm sure your app is strong and you'll match. Maybe not at your top program because so-and-so's nephew is going to steal your well-deserved spot, but you'll still be a fine dermatologist.

/thread

 

[doc MD]

Glad u saw the same. That's why i was surprised doc md used that example. Until faculty drew (what should be obvious) the line, the pd still offered this person an interview and was ready to rank him. He had to actually ask why. THIS is what i am talking about.

But lets just give them the benefit of the doubt, and say it was bc they're cool people, they worked so hard on rotations, its a valid part of the process, or bc their parent is smart their kid is just as smart as them, etc. Bc all the rest of us are lazy.

Faculty split up the applications and can pick from those only 3-5 depending on the number you have to review. Obviously his family member picked up from the pile to get the applicant an interview from their number. It did not necessary go through another filter of review and others did not read it until the day of.

My point is nepotism has some weight as a great LOR. You still need to have a great academic performance (which is subjective to the program you are applying to as well). Just get all your ducks in a row and hope for the best b/c life is unfair.

 

[charmiedermie]

Fair enough. However, if you were applying next year, would you not apply to OSU, Cleveland Clinic, etc. if you knew these things? What if OSU had three spots and people knew one was 'taken'? Would that change much? In an alternate scenario, maybe OSU only has two spots period and none go to relatives. Would one still apply and interview? Of course. I'm not seeing why knowing this ahead of time really changes what anyone would do except in such very few circumstances.

So let's take the instance of a relative of a big name applying. If it's someone well known and the candidate is just applying everywhere, I guess the 'lowest' person on the would be interview list at a number of programs may get knocked off so the person related to the big name could have an interview mainly because of being related to a big name person. I admit, this kinda sucks. That's a few people that could have had interviews who lose the chance. The candidates would not ever really know, but it still kinda sucks.

In the case of a relative like a wife of faculty at a program who may not be that well known, the wife/candidate probably won't really get that many interviews at other places anyway. So the aforementioned affect probably isn't that big of a deal in this second scenario, other than at their specific program...

Now let's say OSU has 5 spots and Pittsburgh has 5 spots. Someone gets an interview invite at both and the interviews are the same day. However, the candidate knows or has a suspicion that OSU will take someone who is a relative of faculty. They really like OSU better, but in the end decide to go to the Pittsburgh interview because it's one more spot that they have a chance at.

I guess in that scenario it helps to know. But again, how often would that type of scenario really arise? Maybe two rotators at Pittsburgh did really well that year and are high on the list at Pittsburgh. In that case, maybe the candidate above actually has a better chance at OSU since only one spot instead of two are likely to go to someone that's kinda decided ahead of time.

I guess a few times this type of scenario could arise, and it would kinda suck if it did arise, but in the grand scheme of all the things involved in applying Derm, it just doesn't seem like that significant of a problem imo. Sure, it would be nice to be all fair and square, but so few things work that way in real practice.

If that scenario were to arise i would choose Pittsburgh so i know im not wasting my time and i should know that, if im rejecting an interview in that scenario at the place i have a better chance at.

 

[Dral]

Correct. If that would ever happen.

 

[Obnoxious Dad]

If one of my children wants to pursue my specialty, I don't see why I shouldn't be able to train them. If they are reasonably competitive and interested, wouldn't my many years of service earn me that right? I should think so. In fact if they didn't select them, I would view that as an unrecoverable slight and start looking into other opportunities.
Derm may be very competitive, but someone with a 225 on the USMLE can learn the material just as well as someone with a 255. It's competitive for many reasons, but mastery doesn't require one to be in the 98th percentile, that's a side effects of the competitiveness of the field. If the reimbursement was cut to Peds levels, the average score would undoubtedly drop and there would still be competent dermatologists being turned out year after year.

I have read at least 10,000 posts on SDN and this is the most galling of the bunch. The position of program director of a residency or fellowship is a public trust. It is not the property of the program director. He or she should choose the best American candidates and not their offspring or some other twit with pull.

I would be the first to admit that selection of residents is an inexact process and that is the fault of medicine in general.However, that doesn't justify selecting your buddy's kids when in your heart you know you are punishing the unconnected.

 

[volcomx]

I have read at least 10,000 posts on SDN and this is the most galling of the bunch. The position of program director of a residency or fellowship is a public trust. It is not the property of the program director. He or she should choose the best American candidates and not their offspring or some other twit with pull.

I would be the first to admit that selection of residents is an inexact process and that is the fault of medicine in general.However, that doesn't justify selecting your buddy's kids when in your heart you know you are punishing the unconnected.

 

[Mad Jack]

I'm just surprised in Derm that it is being done when there are so few people in the specialty where everyone knows everyone. Let those people get their spot outside the match so they don't waste interview spots in places others would have liked to go.

With the all-in policy, this isn't really a viable option anymore.

 

[Mad Jack]

So u think doing audition rotations, working on a research project with an unrelated faculty member who gets to know you, meeting people at other programs in presenting your research, etc. is no different or analogous to being the son/daughter/significant other of a derm attending and the latter is a valid part of the process? I know you don't honestly believe that.

I'm not talking about participation trophies. Don't worry, none of my 'connections' are related to me, but i think ill do fine.

Any degree of networking skill will prove massively important in the selection process. Your ability to make friends in high places is far more important than your academic skills past a certain threshold. And that's completely fair, because that is how life works and is how it will always work. Soft skills are what makes or breaks a career far more than your intellectual or technical ability nine times out of ten.

 

[Mad Jack]

I'm going into a competitive specialty other than derm, but I think my situation fits in here. I went to a different college than my parents to avoid legacy "issues". I'm currently attending a different medical school than my dad. I dislike nepotism on the extreme end (involving unqualified applicants. Like GW Bush and Yale). Having been away from my home state of Hawaii for nearly a decade, I want to return home for residency so I can be with my parents, grandma, cousins, aunts, uncles, and my high school friends. I'm a very competitive applicant, but not the best of the nation. So here's the thing: my dad is part of the residency program and helps decide who gets in. His private practice partner is the director. So what am I supposed to do? Should I apply elsewhere to avoid nepotism issues? The closest program is 3,000 miles across the pacific in California. That's another 6 years I'll be away from my home. Then when I move back, should I not apply to join his private group practice which is the only one on the island? Even if I join a hospital, people will know my dad and know who I am. I'll have an advantage no matter what I do, whether or not I ask for it....whether or not I need it.....

Just another perspective on nepotism...

You should do whatever it takes to get ahead, so long as it's legal. It's your life and you only get to live it once, so make it count and live the best life that you can live. Not seeing your family and home for another few years is in no way worth taking the "high road" on this one. Your father worked hard to earn his current position, and is well within his right to use that position to benefit his children if he so chooses.

 

[Obnoxious Dad]

I'm going into a competitive specialty other than derm, but I think my situation fits in here. I went to a different college than my parents to avoid legacy "issues". I'm currently attending a different medical school than my dad. I dislike nepotism on the extreme end (involving unqualified applicants. Like GW Bush and Yale). Having been away from my home state of Hawaii for nearly a decade, I want to return home for residency so I can be with my parents, grandma, cousins, aunts, uncles, and my high school friends. I'm a very competitive applicant, but not the best of the nation. So here's the thing: my dad is part of the residency program and helps decide who gets in. His private practice partner is the director. So what am I supposed to do? Should I apply elsewhere to avoid nepotism issues? The closest program is 3,000 miles across the pacific in California. That's another 6 years I'll be away from my home. Then when I move back, should I not apply to join his private group practice which is the only one on the island? Even if I join a hospital, people will know my dad and know who I am. I'll have an advantage no matter what I do, whether or not I ask for it....whether or not I need it.....

Just another perspective on nepotism...

You say you don't like nepotism but you are about to exploit it. That's a good one. How do you know there isn't a better candidate who wants to go to Hawaii?

How's this for an idea? Why don't you go some place where you will succeed on merit rather than getting a slot you may not deserve? When you finish residency then you can feel free to piggyback on your father's success. You will at least not be ripping off the federal taxpayers who paid for the residency program. You'll just get a job you didn't really deserve.

 

[Mad Jack]

You say you don't like nepotism but you are about to exploit it. That's a good one. How do you know there isn't a better candidate who wants to go to Hawaii?

How's this for an idea? Why don't you go some place where you will succeed on merit rather than getting a slot you may not deserve? When you finish residency then you can feel free to piggyback on your father's success. You will at least not be ripping off the federal taxpayers who paid for the residency program. You'll just get a job you didn't really deserve.

The taxpayers aren't getting ripped off- they're paying for a physician and getting one. He might even be the best candidate for the job- there's no way of knowing. Just let him do his thing and go home and be happy.

 

[volcomx]

You say you don't like nepotism but you are about to exploit it. That's a good one. How do you know there isn't a better candidate who wants to go to Hawaii?

How's this for an idea? Why don't you go some place where you will succeed on merit rather than getting a slot you may not deserve? When you finish residency then you can feel free to piggyback on your father's success. You will at least not be ripping off the federal taxpayers who paid for the residency program. You'll just get a job you didn't really deserve.

I never said I was going to "exploit" it.

And a slot I don't deserve? You don't even know me. It's not like I'm an underqualified applicant trying to get into plastics at harvard with a 220 Step1. I want to go home because of "fit," not because of prestige or because I need an easy in. I'll be sufficiently qualified when I apply. Above and beyond most, but not all applicants. There will always be someone "better." If I'm qualified enough to get into MGH or Cleveland Clinic, but I choose Hawaii, do I really not deserve it?

I could have a 280 step and 20 first author pubs and I'm sure you'll still rage at me for "exploiting nepotism" to get that oh-so-difficult spot...

 

[HatsAnd Sunscreen]

You say you don't like nepotism but you are about to exploit it. That's a good one. How do you know there isn't a better candidate who wants to go to Hawaii?

How's this for an idea? Why don't you go some place where you will succeed on merit rather than getting a slot you may not deserve? When you finish residency then you can feel free to piggyback on your father's success. You will at least not be ripping off the federal taxpayers who paid for the residency program. You'll just get a job you didn't really deserve.

That is incredibly condescending. It is entirely possible for smart, successful physician parents to have smart, successful medical student children. He should enjoy his interviews and make his rank list in the way that best suits his goals and aspirations and nothing else. Like the rest of us.

 

[Obnoxious Dad]

I never said I was going to "exploit" it.

And a slot I don't deserve? You don't even know me. It's not like I'm an underqualified applicant trying to get into plastics at harvard with a 220 Step1. I want to go to Hawaii because of "fit," not because of prestige or because I need an easy in. I'll be sufficiently qualified when I apply. Above and beyond most, but not all applicants. There will always be someone "better." If I'm qualified enough to get into MGH or Cleveland Clinic, but I choose Hawaii, do I really not deserve it?

I could have a 280 step and 20 first author pubs and I'm sure you'll still rage at me for "exploiting nepotism" to get that oh-so-difficult spot at Hawaii....

Go ahead and let your connections abuse their power. You can then spend the next six years working with people who will know that you got the slot for reasons other than merit. Some of them will believe, like so many of the posters on this thread, that you made the smart move. Other people, who worked for everything they ever attained, will know what you did and think you are a spoiled kid who got everything handed to him. (Let me guess. Your parents picked up the entire college and med school tab.) Those latter people will be pleasant enough to you but they will never respect you.

 

[volcomx]

Go ahead and let your connections abuse their power. You can then spend the next six years working with people who will know that you got the slot for reasons other than merit. Some of them will believe, like so many of the posters on this thread, that you made the smart move. Other people, who worked for everything they ever attained, will know what you did and think you are a spoiled kid who got everything handed to him. (Let me guess. Your parents picked up the entire college and med school tab.) Those latter people will be pleasant enough to you but they will never respect you.

Wow you live up to your username.

So everyone who had some part of their education paid for is a spoiled brat?
Everyone who had their parents help them out in some way had everything handed to them?
Did you pay for your daughters elementary education? High school? Did she pay back the property taxes you paid for her to attend a public school? Did she pay rent when she was a toddler? Did she pay for the food she ate from your fridge?

What if you were the best plumber in town. Your daughter aspires to be a plumber as well. After plumbing school, she wants to come back to her hometown. Would you force her to start her own business and compete with you? Or would you do as 99.9999% of Americans in the same situation do - let her join your business. It used to be respectable to follow in your parents footsteps. Blacksmiths, farmers, woodworkers, etc were all proud to teach their trade to their children, should they wish. Many of our surnames are remnants of that not-so-distant past.


At my med school (a top tier school) there are several students who are the sons and daughters of prominent faculty here. No one I know thinks they got in undeservedly. These are smart and hardworking students. Maybe their parents helped them get into this school in particular. But if they didn't get into this school, they'd be at another top school. So who cares? No one. I'm sure that there are some unqualified students who got in solely because of connections and not because of merit. But those are the exception. At our white coat ceremony, the father and mother faculty got to give their children their white coats. I'd imagine it was a moment of great pride for those parents. If you were their I'd bet you'd be cursing those "spoiled brats."

Don't act like you haven't used any connections, money, or influence to benefit your daughter. To crap on every person in the world to use their connections to benefit their children is ridiculous. You'll end up hating 95% of everyone you meet.

 

[Obnoxious Dad]

My wife and I picked up half of my kid’s undergrad and one third of her med school. Merit scholarships, jobs and loans paid the balance.

My daughter went to a very tough college and majored in chemistry. She had a very competitive MCAT score but because she took the toughest possible road her grade point was a little bit below average for people who got into allopathic medical schools. We also live in a state whose allopathic medical schools give seats away to non-residents just to alleviate the boredom of the faculties of those med schools. As a consequence she had all of the odds stacked against her in spite of great letters of recommendation, foreign language proficiency, math and science talent and significant research credits.

On the flip side I have a friend who recently retired as President of a large university which included a medical school. This guy had turned this institution into a powerhouse and was the most powerful man in his community. My daughter applied to this university’s med school and got a secondary application. Her stats were competitive with the people this institution accepted. I will admit that I looked at our address book and telephone every day and thought about calling my friend to intervene to get her an interview. However, I resisted that temptation even though she would have been heartbroken if she hadn’t gotten into an allopathic med school. I knew calling him would be unethical and I didn’t want to be a sleaze bag. She didn’t get the interview there.

Well my daughter got into another allopathic med school. My friend found about her application to med school in our Christmas letter. Because I didn’t want him to feel uncomfortable I have never broached the subject of her admissions travail with him.

My kid will go through life knowing that it was her talent and hard work that got her into med school, residency and fellowship. When she hits the pillow every night she’ll know she did the right thing.

 

[username456789]

My wife and I picked up half of my kid’s undergrad and one third of her med school. Merit scholarships, jobs and loans paid the balance.

My daughter went to a very tough college and majored in chemistry. She had a very competitive MCAT score but because she took the toughest possible road her grade point was a little bit below average for people who got into allopathic medical schools. We also live in a state whose allopathic medical schools give seats away to non-residents just to alleviate the boredom of the faculties of those med schools. As a consequence she had all of the odds stacked against her in spite of great letters of recommendation, foreign language proficiency, math and science talent and significant research credits.

I would be incredibly embarrassed if my father acted as ultramegadouchey as you. Doubly so if he flaunted it on a public messageboard.

By the way, a "tough college" where she "majored in chemistry" is not the "toughest road possible." It's pretty standard. Making excuse after excuse for her is not doing her any favors, despite what you might think.

I'm happy she was able to get into an allopathic medical school despite her father.

 

[Obnoxious Dad]

I would be incredibly embarrassed if my father acted as ultramegadouchey as you. Doubly so if he flaunted it on a public messageboard.

By the way, a "tough college" where she "majored in chemistry" is not the "toughest road possible." It's pretty standard. Making excuse after excuse for her is not doing her any favors, despite what you might think.

I'm happy she was able to get into an allopathic medical school despite her father.

For your information less than 13% of allopathic med students majored in the physical sciences. Most people take the easy way in with majors like biology or the social sciences. Why take calculus based physics and P Chem. when you can take algebra based physics and ballroom dancing?

How am I making excuses? She got into medical school without connections. She applied and got a great residency at a place where no one knew her prior to the interview. She's a physician. She gets her license next month and she earned it.

I guess you believe that ethics are stupid. I feel sorry for you and sorrier for the people you marry and treat. Are you going to go through life cheating on your spouse and taking advantage of ignorant patients? Is that the smart and undouchey thing to do? Have at it.

 

[username456789]

For your information less than 13% of allopathic med students majored in the physical sciences. Most people take the easy way in with majors like biology or the social sciences. Why take calculus based physics and P Chem. when you can take algebra based physics and ballroom dancing?

How am I making excuses? She got into medical school without connections. She applied and got a great residency at a place where no one knew her prior to the interview. She's a physician. She gets her license next month and she earned it.

I guess you believe that ethics are stupid. I feel sorry for you and sorrier for the people you marry and treat. Are you going to go through life cheating on your spouse and taking advantage of ignorant patients? Is that the smart and undouchey thing to do? Have at it.

I sleep with a different prostitute each week, and irresponsibly prescribe Picato when Efudex would do just as well.

I am your worst nightmare.


[By the way, if you can't spot the numerous excuses you've made on your daughters behalf in your above post, she is very fortunate that she did not ask you to proofread her personal statement for medical school. She might be smarter than you're giving her credit for.]

 

[charmiedermie]

Any degree of networking skill will prove massively important in the selection process. Your ability to make friends in high places is far more important than your academic skills past a certain threshold. And that's completely fair, because that is how life works and is how it will always work. Soft skills are what makes or breaks a career far more than your intellectual or technical ability nine times out of ten.

The topic is nepotism, not actively networking which we all do.

 

[HatsAnd Sunscreen]

For your information less than 13% of allopathic med students majored in the physical sciences. Most people take the easy way in with majors like biology or the social sciences. Why take calculus based physics and P Chem. when you can take algebra based physics and ballroom dancing?

How am I making excuses? She got into medical school without connections. She applied and got a great residency at a place where no one knew her prior to the interview. She's a physician. She gets her license next month and she earned it.

I guess you believe that ethics are stupid. I feel sorry for you and sorrier for the people you marry and treat. Are you going to go through life cheating on your spouse and taking advantage of ignorant patients? Is that the smart and undouchey thing to do? Have at it.

I somehow doubt children would be lying awake at night due to the haunting memories of their parents letting their friends at universities/medical schools/residencies know that their child would be applying that year.

Every year all of these institutions receive applications from many more quality applicants than they could possibly interview, and every year many wonderful applications gets passed over because the selection process is forced to be nit picky and subjective. As a result strong applicants who would be a great fit at the given institution don't even make it through the screening process to get an interview and have a chance prove themselves. If I were a program director I would love to get a phone call with a recommendation from a peer whose opinion and judgement that I trusted and valued. Although, based on the aggressive and demeaning nature of your posts on this medical student forum, I'm not sure "trusted and valued" would describe your judgement.