Non "super desirable" locations to apply to

[Mr.Confused]

I have heard some recommendations of applying to "non desirable" locations for residency....but what is considered non desirable? (looking at gen surgery specifically). Is there an existing thread or forum someone can direct me to? I couldn't find one. A nice list of them would be appreciated. thanks!

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[Xavieous]

The typical reasons why a program would be competitive is things like:

- location in place others want to be at (like Denver, New York City, etc Cities in general are more competitive than suburban, which are more competitive than rural)
- Program notoriety (Mayo, Joh Hopkins, the best university tertiary hospital program in each state)
- Program reputation (well known to have a robust education, lots of xyz procedures, etc)

And in my opinion location where others want to live being the most important reason to make a program competitive.

You can always infer 'non-desirable' programs based on their selection criteria. programs who have overwhelming numbers of applicants will make their selection criteria higher than programs that don't see as many applicants. so once you narrow your selection down to say 100 programs you are interested in, do some research into each program and see what their average scores per applicant is, DO vs MD each year, and you can make a list that way.

 

[lernaeann]

Just as a broad generalization: south/southeast/midwest certain areas of the northeast are "less desirable." Keep in mind though: if you are applying out of your region, you do need to convince these programs to interview/rank you. This is especially more important in the virtual interview landscape (from my experience coming from a very popular region and matching into one of these regions).

 

[Xavieous]

Just as a broad generalization: south/southeast/midwest certain areas of the northeast are "less desirable." Keep in mind though: if you are applying out of your region, you do need to convince these programs to interview/rank you. This is especially more important in the virtual interview landscape (from my experience coming from a very popular region and matching into one of these regions).

truth.

Nothing more convincing than doing a 1 month Sub-I your 4th year and showing interest, enthusiasm, and a humble desire to learn. A decent Sub-I lets you pass an applicant pool of 1000+ people for 10 spots and join an applicant pool of 5-20 people for 10 spots. Just don't make it a 'hail mary' sub-I: "I am ranked 149/150 in my class but sub-I'ed at John Hopkins".

 

[deleted1139416]

truth.

Nothing more convincing than doing a 1 month Sub-I your 4th year and showing interest, enthusiasm, and a humble desire to learn. A decent Sub-I lets you pass an applicant pool of 1000+ people for 10 spots and join an applicant pool of 5-20 people for 10 spots. Just don't make it a 'hail mary' sub-I: "I am ranked 149/150 in my class but sub-I'ed at John Hopkins".

I've heard this go both ways. Applicants get interviews and eventually ranked because they did an audition/SUBI. But I've also heard from many people that this had no effect at that location, or even the opposite effect. Definitely field dependent though - and surgical specialties seems to be in the former category.

 

[sourjoint]

truth.

Nothing more convincing than doing a 1 month Sub-I your 4th year and showing interest, enthusiasm, and a humble desire to learn. A decent Sub-I lets you pass an applicant pool of 1000+ people for 10 spots and join an applicant pool of 5-20 people for 10 spots. Just don't make it a 'hail mary' sub-I: "I am ranked 149/150 in my class but sub-I'ed at John Hopkins".

I'll be a first-year DO student this summer. I would like to know how to achieve these goals in any rotation. Won't the student already be showing a great interest in these programs by choosing to spend a month there in his/her busy 4th-year schedule? What else is expected from them to surpass?

 

[Bluesandstuff]

I'll be a first-year DO student this summer. I would like to know how to achieve these goals in any rotation. Won't the student already be showing a great interest in these programs by choosing to spend a month there in his/her busy 4th-year schedule? What else is expected from them to surpass?

It’s honestly intangible and entirely dependent on your team. Don’t be late, grumpy or cocky but honest one persons enthusiastic is another person annoying so it’s hard to give you a hard blueprint. So yeah there are slight ways to be “better” but by and large all sub-Is are equally diligent. There were one or two sub-Is I rotated across from that just had an it factor like naturally being super inquisitive, super bubbly or super great at procedures but you can’t always fake that stuff for a month.

Be nice to everyone, nurses, techs, always be on and focus on learning.

 

[Xavieous]

I'll be a first-year DO student this summer. I would like to know how to achieve these goals in any rotation. Won't the student already be showing a great interest in these programs by choosing to spend a month there in his/her busy 4th-year schedule? What else is expected from them to surpass?

It is true spending a month there is showing interest, but the program is looking for more than just the volunteering of 1 month of your time. They want to see someone who is a good fit for their program. You'll hear that 'good fit' statement alot, but what does it mean? I'll try to explain it.

First they want to avoid someone with red flags, and believe me those who go into medicine often are eccentric or odd lol. They want to see if you have good social skills, can talk with a patient and talk with other physicians/residents comfortably. This may sound simple but I've seen many medical students and residents in their weakest moment snap at patients, co-residents, shut down in front of attendings, fight with others, and just not handle the fact that they can be wrong. There is a surprising amount of people in medicine who have been 'right' all their life and have a VERY hard time finding humility day to day being told they are wrong and need to keep working on this or that. That is a big deterrent to being appealing and honestly what happens to alot of medical students who a sub-I didn't help. One time arguing with an attending, or snapping at a resident in a 31 day sub-I and that can tarnish your entire reputation. some people can't make do it.

Other things is ability to learn (kinda folds into what is above). if someone is arrogant, can't take criticism they will be very challenging to teach. also if someone is just clueless (there is a few medical students this falls into) and you can tell they don't learn as easily or quickly as their peers. but the latter is much more rare than the former. I'm talking 1% clueless vs 99% inability to take criticism.

finally enthusiasm each day. you want someone who can be down in the trenches with you in residency and bring positivity to the program while still upholding all the other expectations (learning, doing good work, etc). So if a medical student gets grumpy or burnt out doing 80 hours a week for 4 weeks, what will they be like doing 80 hours a week for 3-4 months in a row? this is a bit more intangible but it does make an impression.

those are the things I notice, It is certainly not comprehensive but in my mind if you can avoid those things then you would be considered a 'good fit' for most any program.

 

[sourjoint]

It is true spending a month there is showing interest, but the program is looking for more than just the volunteering of 1 month of your time. They want to see someone who is a good fit for their program. You'll hear that 'good fit' statement alot, but what does it mean? I'll try to explain it.

First they want to avoid someone with red flags, and believe me those who go into medicine often are eccentric or odd lol. They want to see if you have good social skills, can talk with a patient and talk with other physicians/residents comfortably. This may sound simple but I've seen many medical students and residents in their weakest moment snap at patients, co-residents, shut down in front of attendings, fight with others, and just not handle the fact that they can be wrong. There is a surprising amount of people in medicine who have been 'right' all their life and have a VERY hard time finding humility day to day being told they are wrong and need to keep working on this or that. That is a big deterrent to being appealing and honestly what happens to alot of medical students who a sub-I didn't help. One time arguing with an attending, or snapping at a resident in a 31 day sub-I and that can tarnish your entire reputation. some people can't make do it.

Other things is ability to learn (kinda folds into what is above). if someone is arrogant, can't take criticism they will be very challenging to teach. also if someone is just clueless (there is a few medical students this falls into) and you can tell they don't learn as easily or quickly as their peers. but the latter is much more rare than the former. I'm talking 1% clueless vs 99% inability to take criticism.

finally enthusiasm each day. you want someone who can be down in the trenches with you in residency and bring positivity to the program while still upholding all the other expectations (learning, doing good work, etc). So if a medical student gets grumpy or burnt out doing 80 hours a week for 4 weeks, what will they be like doing 80 hours a week for 3-4 months in a row? this is a bit more intangible but it does make an impression.

those are the things I notice, It is certainly not comprehensive but in my mind if you can avoid those things then you would be considered a 'good fit' for most any program.

Thank you for your explanation. So, basically, the motto is to keep your head down, stay personable, don't get scared of being held accountable against constructive criticism, and overall enjoy the ride.

 

[GoSpursGo]

I will say that for competitive specialties (and I would classify anything surgical as competitive, especially for DO students), the idea of a "non-desirable location" is more or less meaningless--the specialty itself is so desirable that people will go literally anywhere in order to get the training. It is much, much more meaningful to look at the roster of current and recent residency classes to see if they have a history of accepting DO students, and even better if from your school. And you yourself need to be "competitive" regardless of which programs you're applying to.

Where this "nondesirable location" idea may be more relevant is for less competitive specialties as a potential landing spot for applicants who have red flags (ie failed comlex/USMLE, remediated a year, etc) and are frankly just looking for a landing spot that will still consider a US MD/DO with some red flags over IMGs.

 

[Xavieous]

Thank you for your explanation. So, basically, the motto is to keep your head down, stay personable, don't get scared of being held accountable against constructive criticism, and overall enjoy the ride.

Pretty much! And work hard in the background (you found out you didn't know something, google it that night and become an expert before the next day). If you can do all that Sub-Is will be your best friend and greatest opportunity to get into programs. All of my Sub-Is (I did 4) they gave me interviews (which is usually an automatic rule if you sub-I somewhere) and were pretty aggressive at trying to get me to go to their programs. My #1 ranked program I got into, partly due to my Sub-I which the program told me later made an impact on their decision. For the program I got into they had 700ish applicants that year for 6 spots.