Hey all, rare poster here, have the morning off so wanted to throw my 2 cents into the ring. Also, I'm a fourth year med student just starting the process so take everything I say with even more of a grain of salt than you would normally with something a stranger on the internet tells you. Most of my information is from speaking with residents, my own program's PD/aPDs, skimming this thread for trends and my own feel of things. You'll notice I throw quotations around any reference to rankings because I abhor rankings. I'm a big proponent of best-fit for a program.
But anyways, I made up a couple "fake applicants" as points of reference.These all assume you come off as a normal somewhat interesting person on interview, come from a top 60ish medical school, and have solid LORs (no singing praises, but no red flags). Don't get me wrong, these things matter (especially the school you come from's reputation and/or it's relation with the program you're applying to), it's just too difficult to make these generic advice bits factoring that in (which is why we have the case by case advice, but I digress).
Also, regardless of which of these you are, it NEVER hurts to tack on a couple safeties. Feces happens.
For the Generic Superstar above, you really don't need to be coming on here asking which of the Big 4 will give you a look. The "top 10" (whatever the heck a subjective statement like that means) are gonna be wheelhouse for you. Nobody should be ranking them for you, or telling you which is the most likely to open doors. You're going to interview at any program you glance at and you should apply broadly to a good number of the top 30 (unless you have some geographic inclination) and figure out for yourself based on how you liked the programs which is the right FIT for you (and maybe check out their fellowship match list if you know already what subspecialty interests you). Regardless where you go, you've shown that you can shine and will probably open your own doors, and you certainly don't need a bunch of internet strangers to remind you of that.
You're an incredibly strong applicant, and interviews at the "Big 4" are within reach, but not quite wheelhouse. You'll get interviews all over and will most likely end up at a solid "top 35" program (top 10-15 if you're lucky, top 50 if you're not). I'd throw 5 or so of the lower end academic programs on there just to be safe (you never know what might happen), but chances are, you're going do great and end up at a solid fellowship program too (in the specialty of your choosing).
If I had to guess I'd imagine you'll end up in a strong academic program, just not necessarily the top 30. You're still going to get a very solid clinical training experience and have fellowship opportunities. You're grandma just won't necessarily know the name of your program. I like to think the bulk of people applying to IM are in this category. You wanna apply to what is cited as the mid to lower end of the academic pool as your wheelhouse with still a very significant shot at matching into the top 50 (and almost certainly interviews at schools typically ranked in the 20-50 range) so certainly have those on there. I would also throw in a couple of the stronger community programs into your list to be safe.
This is where I start to think of the low academic end as a good case scenario, and I'd probably have 5+ community programs on the list. I'd still include a lot of mid-tier academic programs on there, but I think low-tier is the sweet spot with community as the safety.
And then lower than that I would have a good number of community programs on there. I still think everyone applying to IM should apply to a healthy number of "mid-tier" programs because these guys tend to be less OCD about the numbers, and will occasionally take a risk on someone with less than stellar numbers but a strong interview and glowing evals in the MSPE/LORs, especially if they're from someone they know and a program they trust.
I personally don't fit into any of these categories because I have things that are a bit above average on my app and things that are certainly yellow (if not red) flags academically as well. Which is why I think these WAMC threads are tough, because every case is different, but I hope the examples above at least give you an idea (in terms of a starting point) of the ballpark of where I think people will end up (not that my opinion matters).
As mentioned before countless times, this isn't like applying to med school, applying is relatively cheap. Don't sell yourself short, but also DON'T (and this is more important) overestimate yourself. Look at last years
charting the outcomes. You're about to be a doctor, you need to be able to interpret data yourself.
As for the general "tiers" just so you know what I'm referencing above. Again, grain of salt and in NO PARTICULAR ORDER WITHIN THE TIERS (because that's just baseless nonsense IMO). I think going to any of these save maybe the bottom ten or so, would provide a great education.
Top
UCSF
The Brig
MGH
Hopkins
Duke
Penn
Columbia
Michigan
Cornell
UWash
Wash U
BID
UTSW
Northwestern
Vandy (toss-up between here and the one above)
NYU
Mt. Sinai
Emory
Yale
Stanford
UChicago
UAB
Mayo
Baylor
I don't know enough about UCLA and UCSD to put them where they belong.
Middle
Wisconsin
Iowa
UVA
UNC
Pitt
OHSU (although I put it here, I think in terms of how competitive it is, it belongs higher)
Case Western
Brown
Ohio State
Rush
Loyola
MUSC
BU
Tufts
Temple
Jefferson
UMD
Was unsure what to do with Dart
Lower
VCU
Gtown
SUNY Stony Brook
UIC
GW
EVMS
Downstate
Rutgers ?