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Depends on what you mean by low tier. At my low tier, you need AOA to match top tier IM and big 4 is basically unheard of regardless of application
Official Eternal IM WAMC Thread
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Your publications are noteworthy and step 2 great. Low tier no aoa pass in medicine will be tough to overcome.
Would add 10 mid tier programs. You may not even get a look from some of these higher ranked programs based on the institution you’re coming from…
Thanks guys, the thought from the deans was that the publication record would make up for the other deficits. Definitely seems like wishful thinking at this point and I should’ve come here earlier so my signals could have been put to better use. I applied to 35 other mid tier programs because I was worried about this, but given the way signaling has turned out I don’t expect much in way of interviews from them.
Appreciate you guys helping me recalibrate my expectations
Appreciate you guys helping me recalibrate my expectations
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Med School: Upper-Midtier
M1-M2 grades: Pass/Fail; all pass
M3 grades: 5/7 honors, 1 high pass, 1 pass. Honors in IM
M4 grades: TBD
Class rank: 1st quartile
Step 1: Pass
Step 2: 26x
AOA: No (Missed out because I failed one M1 exam. Fail will not show up anywhere on my app as I retook and passed but will not receive AOA).
GHHS: No
Demographics: Asian
Research: 8 publications, 2 posters. 4 first author, two of them in very high impact journals.
Extracurriculars: Nothing too impressive, some clubs and volunteering. My main extracurricular was research lol
LORs: Strong, got letter from IM department chair, research head who is well known in the field, and two others.
Red flags: None
Career goals: Academic IM and Cardiology
Any chance for the top 4/10/20? Would programs like Yale/UCLA/Mt. Sinai/Mayo be targets or reaches?
M1-M2 grades: Pass/Fail; all pass
M3 grades: 5/7 honors, 1 high pass, 1 pass. Honors in IM
M4 grades: TBD
Class rank: 1st quartile
Step 1: Pass
Step 2: 26x
AOA: No (Missed out because I failed one M1 exam. Fail will not show up anywhere on my app as I retook and passed but will not receive AOA).
GHHS: No
Demographics: Asian
Research: 8 publications, 2 posters. 4 first author, two of them in very high impact journals.
Extracurriculars: Nothing too impressive, some clubs and volunteering. My main extracurricular was research lol
LORs: Strong, got letter from IM department chair, research head who is well known in the field, and two others.
Red flags: None
Career goals: Academic IM and Cardiology
Any chance for the top 4/10/20? Would programs like Yale/UCLA/Mt. Sinai/Mayo be targets or reaches?
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Youll likely get multiple interviews from T20s without question. Probs will get T10 interview (wouldnt be surprised). Yale Mayo Sinai UCLA all in your wheelhouse. Big 4 is a toss up the no AOA might hurt you here. Upper mid tier USMD 260+ step 2 no red flags honored almost all M3 and multiple pubs in HI journals with first author aka you are a highly competitive applicant and im sure you know this
Hi everyone! I wanted to get some advice on applying to IM for the 2025-2026 application cycle. I applied only for ophtho residency this match cycle (without submitting ERAS) and went unmatched last week. I am considering doing a research year in ophtho and then dual applying ophtho and IM for the 2025-2026 match cycle.
My stats are as follows:
- US MD 4th year medical student at mid-tier school
- Top 5% of medical school class (honored all 3 years of medical school)
- Junior AOA
- Honored IM, surgery, pediatrics, OBGYN, high passed EM, FM, psych, and neurology, honored 4 ophtho rotations (1 home rotation and 3 aways)
- Step 2 score: 248
- 6 ophtho pubs (1 first author), 7 pulmonology pubs (1 first author), 1 nephro review paper (2nd author), 1 oncology review paper (2nd author)
- The pulmonology pubs were from a top 5 pulmonology program
- 24 oral and poster presentations across ophtho and pulmonology
- Leadership involvements were in ophtho interest groups and volunteer involvements in many student-run free clinics
The questions that I had were:
1. Am I competitive for an academic IM residency program and if yes, would it be a mid-tier or high-tier?
2. If I were to dual apply ophtho and IM for the 2025-2026 residency application cycle, would it increase my chances to match into IM if I SOAP into a preliminary - internal medicine spot vs doing the research year in ophtho?
3. If my goal is to match an academic IM residency, what would be the best way to structure my residency application? Should I leave out any ophthalmology research in the application?
4. How many programs should I apply to given my stats?
5. Can I ask for a research letter for ERAS since the research I did was with physicians?
6. I plan to do a fellowship in GI so what would I need to do now to make myself a competitive applicant for the fellowship considering I have no GI research?
I would also welcome any advice about my next steps in addition to the questions I asked above. Thank you all for your time!
My stats are as follows:
- US MD 4th year medical student at mid-tier school
- Top 5% of medical school class (honored all 3 years of medical school)
- Junior AOA
- Honored IM, surgery, pediatrics, OBGYN, high passed EM, FM, psych, and neurology, honored 4 ophtho rotations (1 home rotation and 3 aways)
- Step 2 score: 248
- 6 ophtho pubs (1 first author), 7 pulmonology pubs (1 first author), 1 nephro review paper (2nd author), 1 oncology review paper (2nd author)
- The pulmonology pubs were from a top 5 pulmonology program
- 24 oral and poster presentations across ophtho and pulmonology
- Leadership involvements were in ophtho interest groups and volunteer involvements in many student-run free clinics
The questions that I had were:
1. Am I competitive for an academic IM residency program and if yes, would it be a mid-tier or high-tier?
2. If I were to dual apply ophtho and IM for the 2025-2026 residency application cycle, would it increase my chances to match into IM if I SOAP into a preliminary - internal medicine spot vs doing the research year in ophtho?
3. If my goal is to match an academic IM residency, what would be the best way to structure my residency application? Should I leave out any ophthalmology research in the application?
4. How many programs should I apply to given my stats?
5. Can I ask for a research letter for ERAS since the research I did was with physicians?
6. I plan to do a fellowship in GI so what would I need to do now to make myself a competitive applicant for the fellowship considering I have no GI research?
I would also welcome any advice about my next steps in addition to the questions I asked above. Thank you all for your time!
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Med School: Mid-tier USMD
M1-M2 grades: Pass/Fail, all pass
M3 grades: 3/7 honors, rest were passes (including IM). Grading scale is based on fixed curves so the top 30% get honors and bottom 30% get P regardless of percentage.
M4 grades: Honored IM sub-I. M4 grades are not based on curves, so the final grade is what the attendings collectively assign.
Class rank: 3rd quartile
Step 1: Pass
Step 2: 258
AOA: No
GHHS: No
Demographics: White male
Research: 2 pubs (both 1st author in high impact journals for their fields), 18 posters (half are from regional/national conferences), 9 research experiences overall.
Extracurriculars: Teaching and community service-related volunteering, 1 unique teaching/MedEd experience.
LORs: 2 deans (both hospitalists), 1 non-dean hospitalist, 1 well known psychiatry attending
Geographic Signaling: Midwest
Red flags: None
Anyone have any suggestions as to which types of programs I should be signaling? I'm interested in Heme/onc so I'd like to go to a program with lots of research opportunities
M1-M2 grades: Pass/Fail, all pass
M3 grades: 3/7 honors, rest were passes (including IM). Grading scale is based on fixed curves so the top 30% get honors and bottom 30% get P regardless of percentage.
M4 grades: Honored IM sub-I. M4 grades are not based on curves, so the final grade is what the attendings collectively assign.
Class rank: 3rd quartile
Step 1: Pass
Step 2: 258
AOA: No
GHHS: No
Demographics: White male
Research: 2 pubs (both 1st author in high impact journals for their fields), 18 posters (half are from regional/national conferences), 9 research experiences overall.
Extracurriculars: Teaching and community service-related volunteering, 1 unique teaching/MedEd experience.
LORs: 2 deans (both hospitalists), 1 non-dean hospitalist, 1 well known psychiatry attending
Geographic Signaling: Midwest
Red flags: None
Anyone have any suggestions as to which types of programs I should be signaling? I'm interested in Heme/onc so I'd like to go to a program with lots of research opportunities
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What programs are you thinking of? Tell us what you want and let us help you sculpt your list, don't rely on internet randos (of which I am one) tell you where you should apply.
Also, the residency application process is relatively cheap and easy so now isn't the time to skimp on apps.
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Thanks for the response! Sorry I should have included more info in my post lol. Ideally I'd like to go to an academic program in the Midwest with lots of research opportunities (since I'm mostly interested in Heme/Onc), so some of the advice I was given from people in the year ahead of me was to "aim high" and signal mostly T20-30 programs with a handful of mid-tier targets. I'm from Chicago so that's my city preference, but I'm open to going anywhere.
My current signal list based on the advice I was given is WashU (gold + LOI lol), UMich (gold), UChicago (gold), Rush, UIC, Ohio State, Tufts, Emory, Case Western, and Brown. Only reason I was thinking WashU for a gold and LOI is because I have personal connections to the area and my LOR writers are close with them - otherwise I don't think I'm competitive for T10. I'm not sure what "tier" of programs I'm realistically competitive for so I'm not sure how exactly to fill the rest of it out. I'm mostly looking to aim as high as I realistically can just for fellowship options, but I know that in reality my app has some holes that make some T20s a reach
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I think your golds are a long shot. You can add Mayo but it would probably be a long shot as well. Places I would add: Loyola, Iowa, Wisconsin, Minnesota, IU, SLU. If you'd consider living in the Southeast than I'd add MUSC and UAB as well. I think you need a few safety-type places (low-end university or community programs) as well.
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Thank you! I'm close with my home program and they said they automatically interview and rank highly all students that come from our program, so they said to treat it like our "floor" and to only apply to places we'd otherwise prefer to go to. It's a mid tier academic program so I'd be comfortable staying here if it comes to it - that was my main thought process with aiming higher than usual with my signals. How would you rate the overall "competitiveness" of my app just so I can get a better gauge of which programs to be signaling and aiming for? I like your suggestions as well
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Your research is definitely a strength. And your Step 2 score is good, though not jaw droppingly so. Your IM grade and class rank are going to hurt you imo, especially at a place like WashU that's going to auto-invite based heavily on things like AOA. I'm not saying you have no chance there; you do and it's certainly worth the application fee. But I'd say your more in the UIC-to-Wisconsin tier than the WashU tier.
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I appreciate that and I definitely agree with that you said. Thank you!
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100% agree here.
No reason not to shoot your shot on WashU, NW, UofC, Michigan and Mayo. But your sweet spot is going to be Wisco, UMinn, Indy, UIC, Rush, Pitt, tOSU, Iowa, Mizzou.
phantasmo
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have read every page from 35 to here. that's ok. you did great and your advice helped many.
arsenal123
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Med School: low-mid tier USMD
M1-M2 grades: Pass/Fail, all pass
M3 grades: no honors, 4/6 high passes (including IM), 2 passes in surgery and OB. Grading scale is essentially top 30-40% honors, bottom 10% pass, everyone else gets high passes.
M4 grades: all pass/fail, none yet
Class rank: unsure but assuming 3rd/4th quartile
Step 1: Pass
Step 2: low 260s
AOA: No
GHHS: No
Demographics: Asian male
Research: 10 pubs published (a few second author, none are case reports), 6 more pubs under review (4 first author), 28 posters/abstracts (all are from national/large regional conferences)
Extracurriculars: Tutoring and community service-related volunteering x 3, 1 unique sports volunteering experience.
Additional Degree: MBA healthcare admin track during med school
LORs: 1 outpatient preceptor, 1 research mentor, 1 from sub-I, chair letter
Geographic Signaling: Midwest, West
Red flags: None
Anyone have any suggestions to my list of programs that I’m planning to signal/any I should add or remove? I'm interested in cardiology so I'd like to go to a program with a history of matching cards
Gold (any 3 from these): USC, UC Irvine, UCSD, Rush, Cedars Sinai
Silver (two from above list and these): UIC, Jefferson, Temple, George Washington, Harbor-UCLA, RWJMS, Loyola, Scripps Green, Kaiser LA, UC Davis/Brown
I am considering Rutgers NJ, Cooper, or USF
Also should add that I'm originally from California
M1-M2 grades: Pass/Fail, all pass
M3 grades: no honors, 4/6 high passes (including IM), 2 passes in surgery and OB. Grading scale is essentially top 30-40% honors, bottom 10% pass, everyone else gets high passes.
M4 grades: all pass/fail, none yet
Class rank: unsure but assuming 3rd/4th quartile
Step 1: Pass
Step 2: low 260s
AOA: No
GHHS: No
Demographics: Asian male
Research: 10 pubs published (a few second author, none are case reports), 6 more pubs under review (4 first author), 28 posters/abstracts (all are from national/large regional conferences)
Extracurriculars: Tutoring and community service-related volunteering x 3, 1 unique sports volunteering experience.
Additional Degree: MBA healthcare admin track during med school
LORs: 1 outpatient preceptor, 1 research mentor, 1 from sub-I, chair letter
Geographic Signaling: Midwest, West
Red flags: None
Anyone have any suggestions to my list of programs that I’m planning to signal/any I should add or remove? I'm interested in cardiology so I'd like to go to a program with a history of matching cards
Gold (any 3 from these): USC, UC Irvine, UCSD, Rush, Cedars Sinai
Silver (two from above list and these): UIC, Jefferson, Temple, George Washington, Harbor-UCLA, RWJMS, Loyola, Scripps Green, Kaiser LA, UC Davis/Brown
I am considering Rutgers NJ, Cooper, or USF
Also should add that I'm originally from California
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Your geographic signaling and your list don't make any sense to me. You have a grand total of 3 midwest programs on your list but 8 Cali and 4 East Coast, why would you signal there?
I don't think there's anything wrong with your list above. I'd probably tack on a few more apps to round it up to 20 total but it seems reasonable.
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Med School: Mid-tier USMD
M1-M2 grades: Pass/Fail, all passed
M3 grades: 4/7 honors, I (including IM). Passed Peds and Near honored OB and Surgery. The grading scale is based on fixed curves, so the top 30% get honors and the bottom 30% get P regardless of percentage.
M4 grades: Have not done Sub-I yet
Class rank: 1st quartile
Step 1: Pass
Step 2: Low 260s
AOA: Invited to apply, Good odds
GHHS: Not announced yet
Demographics: White male
Research: 2 middle author manuscripts published. 1 first-author manuscript accepted to be published in a decent journal. 1 first-author paper anticipated to be accepted before apps are due in a decent journal. Several posters and abstracts with a mix of middle and first author. 2 oral presentations in regional conferences. All related to interests.
Extracurriculars: Some unique volunteering and leadership experiences with regional cancer society and palliative care/hospice volunteering at hospital. Helped implement a QI project on palliative care/hospice patients. Some unique job experiences in undergrad as well
LORs: Should have 2 strong letters from longstanding relationships with mentors, 1 heme-onc and 1 psych. 1 from IM sub I and 1 from IM chair anticipated
Geographic Signaling: East North Central, West North Central, Pacific
Red flags: None
Goals: Heme-onc in academic medicine. Hoping to get insight on my list and advice on how best to use my signals. Would ideally like to end up in California.
List:
UC Irvine
Cedars-Sinai Medical Center (S)
University of California (San Francisco) (S) (Should I gold for best odds or is that a waste?)
University of California Davis Health (S)
Mayo Clinic College of Medicine and Science (Rochester) (S)
UCLA David Geffen School of Medicine/UCLA Medical Center (S)
Washington University/B-JH/SLCH (G)
McGaw Medical Center of Northwestern University (S)
Stanford Health Care-Sponsored Stanford University (G)
University of Chicago (S)
University of California (San Diego) Medical Center (G)
University of Southern California/Los Angeles General Medical Center (USC/LA General) (S)
Rush University Medical Center (S)
University of Iowa Hospitals and Clinics (S)
University of Minnesota
University of Illinois College of Medicine at Chicago (S)
University of Wisconsin Hospitals and Clinics (S)
SSM Health/Saint Louis University School of Medicine
Loyola
Thanks everyone!
M1-M2 grades: Pass/Fail, all passed
M3 grades: 4/7 honors, I (including IM). Passed Peds and Near honored OB and Surgery. The grading scale is based on fixed curves, so the top 30% get honors and the bottom 30% get P regardless of percentage.
M4 grades: Have not done Sub-I yet
Class rank: 1st quartile
Step 1: Pass
Step 2: Low 260s
AOA: Invited to apply, Good odds
GHHS: Not announced yet
Demographics: White male
Research: 2 middle author manuscripts published. 1 first-author manuscript accepted to be published in a decent journal. 1 first-author paper anticipated to be accepted before apps are due in a decent journal. Several posters and abstracts with a mix of middle and first author. 2 oral presentations in regional conferences. All related to interests.
Extracurriculars: Some unique volunteering and leadership experiences with regional cancer society and palliative care/hospice volunteering at hospital. Helped implement a QI project on palliative care/hospice patients. Some unique job experiences in undergrad as well
LORs: Should have 2 strong letters from longstanding relationships with mentors, 1 heme-onc and 1 psych. 1 from IM sub I and 1 from IM chair anticipated
Geographic Signaling: East North Central, West North Central, Pacific
Red flags: None
Goals: Heme-onc in academic medicine. Hoping to get insight on my list and advice on how best to use my signals. Would ideally like to end up in California.
List:
UC Irvine
Cedars-Sinai Medical Center (S)
University of California (San Francisco) (S) (Should I gold for best odds or is that a waste?)
University of California Davis Health (S)
Mayo Clinic College of Medicine and Science (Rochester) (S)
UCLA David Geffen School of Medicine/UCLA Medical Center (S)
Washington University/B-JH/SLCH (G)
McGaw Medical Center of Northwestern University (S)
Stanford Health Care-Sponsored Stanford University (G)
University of Chicago (S)
University of California (San Diego) Medical Center (G)
University of Southern California/Los Angeles General Medical Center (USC/LA General) (S)
Rush University Medical Center (S)
University of Iowa Hospitals and Clinics (S)
University of Minnesota
University of Illinois College of Medicine at Chicago (S)
University of Wisconsin Hospitals and Clinics (S)
SSM Health/Saint Louis University School of Medicine
Loyola
Thanks everyone!
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I think UIC, Rush, Iowa, Wisconsin (to a lesser extent), Davis, UCSD (to a lesser extent) and Cedars Sinai would want you even without a signal, especially if you get AOA. Do you have any interest in West Coast, non-CA programs like OHSU and UWashington? Midwest-wise, I'd consider IU, Case Western, Michigan. But like gutonc I don't have a good feel for this signal stuff. You'll definitely match with that list. Good luck.
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Thank you for the other recommendations and the good luck! I appreciate it. Due to my fiancés preferences, I am not interested in the non-CA west coast programs. Is it a waste to apply to UCSF given I come from a mid tier school?
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If you get AOA your chances go up a good amount. Id say def apply there with AOA yoir app is competitive enough at that point
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Well hopefully I get AOA then haha. Thanks for the reply!
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Yeah I mean youre up against people they interview with 270s all honors from T10 med schools but i think as a USMD 260s strong research more than half honors and AOA you might have a shot. AOA matters at the big 4
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The only absolute guarantee is that if you don't send them an application, you won't get an interview. Apps are cheap. Shoot your shot.
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Agree with this^ just shoot them an app the worst they can say is no
phantasmo
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did you have AOA?
D
deleted1091661
Not sure yet but most likely not
phantasmo
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would prob go for bottom t10-20 and below tier. you have good shot there with signals (hopefully letters are strong, if average not as great odds).
lack of AOA/prestige/some insane factor I think blocks out t4 but others can confirm.
phantasmo
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imo should have a good shot but others should weigh in. i think with right gold placements you can snipe in that tier
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With your step 2 I think it's worth applying to all the top 20, imo you'll probably have more luck with the WashU/Mayo/Yale/UTSW type places than the MGH/JHU/Stanford types but who can say really. The state schools you mentioned should be no problem.
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I've posted in this thread before, but I've got my signal list re-organized so I'm interested to see if anyone has any feedback on it. I'm looking to stay in the midwest, and my long-term goal is Heme/Onc so I'd ideally like to find programs with good research opportunities. Overall I know some of my signals are reaches, but I'm comfortable reaching a little high since my home program (not on this list) has told our class that we're essentially guaranteed a spot in their program if we fail to match elsewhere. I like my home program, so I'm comfortable using it as a safety net to reach a little higher than usual. I'd love some thoughts on this list! Thank you!
As a quick breakdown of my stats:
- USMD (mid-tier), 258, 3 H's in M3 (not IM) and the others were P, 3rd quartile, no AOA/GHHS. All M4 grades (including IM sub-I) are H, 4 strong LORs and 2 are from deans.
- Research: 1 1st author manuscript pub (high impact journal), 2 manuscript pubs under review (likely to be accepted, but the decision will be made before ERAS is submitted), 1 abstract pub, 18 posters (half are from regional or national conferences, other half are local), 9 overall research experiences.
- ECs: handful of teaching/MedEd related experiences (1 is pretty unique), others are community service.
Gold: WashU, UMich, Rush
Silver: Mayo, UChicago, BIDMC, University of Pittsburg, Case Western, Oregon Health and Sciences, Brown University, University of Wisconsin, Boston University, University of Iowa, Ohio State, UIC, University of Cincinnati
As a quick breakdown of my stats:
- USMD (mid-tier), 258, 3 H's in M3 (not IM) and the others were P, 3rd quartile, no AOA/GHHS. All M4 grades (including IM sub-I) are H, 4 strong LORs and 2 are from deans.
- Research: 1 1st author manuscript pub (high impact journal), 2 manuscript pubs under review (likely to be accepted, but the decision will be made before ERAS is submitted), 1 abstract pub, 18 posters (half are from regional or national conferences, other half are local), 9 overall research experiences.
- ECs: handful of teaching/MedEd related experiences (1 is pretty unique), others are community service.
Gold: WashU, UMich, Rush
Silver: Mayo, UChicago, BIDMC, University of Pittsburg, Case Western, Oregon Health and Sciences, Brown University, University of Wisconsin, Boston University, University of Iowa, Ohio State, UIC, University of Cincinnati
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Why waste a gold (or any signal) on Rush?
To the point of "guaranteed a spot if you don't match elsewhere", the only way to your home program can do this is to rank all of the IM applying students within the top X spots on their list (where X is the number of spots they have in the intern class). I'm not saying they won't do this, but I wouldn't personally believe that for a second.
Your list is fine. You'd do well to add another 5-10 programs IMO (off the top of my head, based on your apparent geographic bias - Indy, UMinn, NW, CCF, MGH are a few to consider).
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What you described is what the PD pretty much said to me about how they rank their home students (and some residents backed it up), but yeah you're right, I def shouldn't put TOO much stock into it. Thank you for that advice though! What would you recommend I give a gold to over Rush? Also some of those other programs you mentioned are ones I'm planning on applying to without signaling (CCF, Indy, UMinn). Do you think I should replace any of my current signals with any of those?
hi! just starting to make a list so mainly looking for recs re: program tiers to focus on
Med School: T5 USMD
M1-M2 grades: Pass/Fail, all pass
M3 grades: Pass/Fail, all pass
M4 grades: none yet, just P/F electives. Have graded IM and subspecialty sub-I's upcoming and prioritizing honoring both
Class rank: none at school
Step 1: Pass
Step 2: mid 260s
AOA: none at school
GHHS: none at school
Demographics: URM female
Research: extremely lacking, have never been much of a research person and had life circumstances in med school that were more of a priority. 1 second author pub from undergrad, 1 poster from med school (local), potentially submitting subspecialty case report this summer. 1 ongoing project in neuro that won't yield submissions before apps go in
Extracurriculars: Co-founder of two affinity and community outreach groups, underserved pop clinic volunteering, DEI curriculum work, coordinated a couple of electives and interest groups, 1 artistic endeavor
Geographic Signaling: West
Red flags: None
thank you!!
Med School: T5 USMD
M1-M2 grades: Pass/Fail, all pass
M3 grades: Pass/Fail, all pass
M4 grades: none yet, just P/F electives. Have graded IM and subspecialty sub-I's upcoming and prioritizing honoring both
Class rank: none at school
Step 1: Pass
Step 2: mid 260s
AOA: none at school
GHHS: none at school
Demographics: URM female
Research: extremely lacking, have never been much of a research person and had life circumstances in med school that were more of a priority. 1 second author pub from undergrad, 1 poster from med school (local), potentially submitting subspecialty case report this summer. 1 ongoing project in neuro that won't yield submissions before apps go in
Extracurriculars: Co-founder of two affinity and community outreach groups, underserved pop clinic volunteering, DEI curriculum work, coordinated a couple of electives and interest groups, 1 artistic endeavor
Geographic Signaling: West
Red flags: None
thank you!!
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Youll match in the T20 definitely. The T10 likely. The Big 4 lack of research and AOA might be a barrier. URM F T5 med school with 260+ S2 is an extremely competitive profile that will get you snatched up by many of the T20 programs
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Agree 100% that your CV makes you competitive just about anywhere at this point. Now what you need to think about is what you want your career and training to look like and what programs will help you be successful in getting there. Matching at Duke or Stanford or U Chicago or Hopkins won't do anything for you if it's not a place you can thrive.
WAMC_Throwaway
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Med School: T30 USMD
M1-M2 grades: P/F, all P
M3 grades: All H
M4 grades: All H
Class rank: n/a
Step 1: Pass
Step 2: 265
AOA: Probably not
GHHS: No
Demographics: White male
Research: 13 publications (9 1st author), 4 posters. Strong journals but in somewhat niche discipline (bioethics)
Extracurriculars: Enough to talk about in interviews, but pretty unremarkable. Stronger service than leadership. Full-tuition scholarship to my medical school (I don’t know if that means anything for residency applications)
LORs: Probably somewhat generic but strong. 1x IM subspecialty, 1 AI, 1 MICU
Geographic Signaling: Southeast, New England, deciding between Midwest vs Mid-Atlantic for 3rd.
Red flags: None
Goals: Academic program, interested in heme/onc or palliative care, though pretty open to other specialties.
Questions: My overall impression was that my research should carry my application, but my school’s advising has tempered my expectations somewhat, on the basis that I don’t have AOA or gold humanism. Trying to figure out if I’m being unrealistic with my list.
Programs
Reaches (5): MGH, BWH, Duke, UPenn, WashU
Target (7): Vanderbilt, Northwestern, UChicago, BIDMC, UPMC, Emory, UNC
Safeties (3): Wake Forest, UVA, Georgetown
I’ve been treating the 15 signals as a soft cap, but looking for suggestions on other programs to consider adding, even though it seems low-yield to apply to programs without signaling.
M1-M2 grades: P/F, all P
M3 grades: All H
M4 grades: All H
Class rank: n/a
Step 1: Pass
Step 2: 265
AOA: Probably not
GHHS: No
Demographics: White male
Research: 13 publications (9 1st author), 4 posters. Strong journals but in somewhat niche discipline (bioethics)
Extracurriculars: Enough to talk about in interviews, but pretty unremarkable. Stronger service than leadership. Full-tuition scholarship to my medical school (I don’t know if that means anything for residency applications)
LORs: Probably somewhat generic but strong. 1x IM subspecialty, 1 AI, 1 MICU
Geographic Signaling: Southeast, New England, deciding between Midwest vs Mid-Atlantic for 3rd.
Red flags: None
Goals: Academic program, interested in heme/onc or palliative care, though pretty open to other specialties.
Questions: My overall impression was that my research should carry my application, but my school’s advising has tempered my expectations somewhat, on the basis that I don’t have AOA or gold humanism. Trying to figure out if I’m being unrealistic with my list.
Programs
Reaches (5): MGH, BWH, Duke, UPenn, WashU
Target (7): Vanderbilt, Northwestern, UChicago, BIDMC, UPMC, Emory, UNC
Safeties (3): Wake Forest, UVA, Georgetown
I’ve been treating the 15 signals as a soft cap, but looking for suggestions on other programs to consider adding, even though it seems low-yield to apply to programs without signaling.
All clinical honors and a strong publication record should get you pretty far. Given your regional preferences, you could consider adding BU, Tufts, Brown, Jefferson, Michigan, Wisconsin, Ohio State, Case Western.
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Just apply to the T40 youll match within the top 10-20. Your only reaches really are the Big 4 (MGH BWH JHH UCSF) without AOA
Med School: Mid-tier USMD in the Midwest
M1-M2 grades: All H
M3 grades: H in IM, Surgery, Peds, ObGyn, HP in neuro, psych and FM
M4 grades: All H (including acting internship in IM), except for EM, which was HP
Class rank: top 5%
Step 1: Pass
Step 2: 248
AOA: Yes (Junior)
GHHS: No
Demographics: White male
Research: 14 publications, 2 as first author, 9 publications on IM subspecialties, 5 on non-IM subspecialties
Extracurriculars: Involvement in student-run free clinics while a medical student, working with the underserved and many teaching initiatives I designed myself
LORs: 1 department letter, 1 head of the department at a VA hospital associated with my medical school letter, 1 acting internship in internal medicine letter, 1 research in subspeciality in IM (at T5 medical school) letter (I have been involved with this research team for almost 10 years)
Geographic Signaling: New England, Middle Atlantic, East North Central
Red flags:
1. Graduated from medical school in 2025 and applied to a surgical subspeciality and did not match, and on my transcript, I have 4 electives (4 months in total) of home and away rotations for this speciality
2. Currently doing a clinical position/research year in that subspeciality, but realized I like IM more and will not be applying for that surgical subspeciality a second time around and will only be applying IM
Goals: Academic program, interested in cardio, GI, or heme-onc fellowship (likely the former 2 for now)
Programs:
1. MGH
2. Brigham
3. Mayo Clinic College of Medicine and Science (Rochester) Program
4. University of Michigan Program
5. University of Pennsylvania Health System Program
6. NYU Grossman School of Medicine Program
7. McGaw Medical Center of Northwestern University Program
8. Icahn School of Medicine at Mount Sinai (Mount Sinai Hospital) Program
9. Beth Israel Deaconess Medical Center Program
10. University of Chicago Program
11. Cleveland Clinic Foundation Program
12. Yale-New Haven Medical Center Program
13. UPMC Medical Education Program
14. New York Presbyterian Hospital (Cornell Campus) Program
15. Pennsylvania Hospital of the University of Pennsylvania Health System Program
16. Ohio state
17. Boston University Medical Center Program
18. Rush University Medical Center Program
19. Case Western Reserve University/University Hospitals Cleveland Medical Center Program
20. Sidney Kimmel Medical College at Thomas Jefferson University/TJUH Program
21. Henry Ford Health/Henry Ford Hospital Program
22. University of Cincinnati Medical Center/College of Medicine Program
23. University of Wisconsin Hospitals and Clinics Program
24. Tufts Medical Center Program
25. Icahn School of Medicine at Mount Sinai (Morningside/West) Program
26. University of Rochester Medical Center Program
27. University of Minnesota Program
28. Temple University Hospital Program
29. Cook County
30. Indiana University School of Medicine Program
31. Rhode Island Hospital/Brown University Health Program
32. University of Illinois College of Medicine at Chicago Program
33. Detroit Medical Center/Wayne State University Program
34. Loyola University Medical Center Program
35. Rutgers Health/New Jersey Medical School Program
36. Zucker School of Medicine at Hofstra/Northwell Program
37. University of Connecticut Program
38. Jacobi Medical Center/Albert Einstein College of Medicine Program
39. UMass Chan Medical School Program - Worcester"
40. Dartmouth-Hitchcock/Mary Hitchcock Memorial Hospital Program
41. Stony Brook Medicine/University Hospital Program
42. Medical College of Wisconsin Affiliated Hospitals Program
43. Penn State Milton S Hershey Medical Center Program
44. University at Buffalo Program
45. Lahey Clinic Program
46. University of Vermont Medical Center Program
47. Maine Medical Center Program
48. SUNY Upstate Medical University Program
49. UMass Chan - Baystate Program
50. Cooper Medical School of Rowan University/Cooper University Hospital Program
51. Bridgeport Hospital/Yale University Program
52. Geisinger Health System (Danville) Program
53. Yale-New Haven Medical Center (Waterbury) Program
54. Nuvance Health Consortium (Norwalk Hospital/Yale University) Program
55. Albany Medical Center Program
56. Hackensack University Medical Center Program
57. Montefiore Medical Center/Albert Einstein College of Medicine (New Rochelle) Program
58. New York Medical College (Metropolitan) Program
59. Mount Auburn Hospital Program
60. St Elizabeth's Medical Center Program
61. Hackensack University Medical Center/Englewood Hospital and Medical Center Program
62. Greenwich Hospital/Yale University Program
63. MetroWest Medical Center Program
64. Mass General Brigham/Salem Hospital Program
65. Quinnipiac University Frank H. Netter MD School of Medicine/St VIncent's Medical Center Program
66. Berkshire Medical Center Program
Questions:
1. Is the current program list I have below reasonable, and what is a good number of IM programs to apply for in general? If not reasonable, what modifications should be made?
2. I am from the Northeast and would prefer to be in MA for residency, but am open to being in nearby states; therefore, which programs should I send gold and silver signals to?
3. Will the red flags I mentioned hamper me from matching into a strong academic IM program?
Thank you very much in advance!
M1-M2 grades: All H
M3 grades: H in IM, Surgery, Peds, ObGyn, HP in neuro, psych and FM
M4 grades: All H (including acting internship in IM), except for EM, which was HP
Class rank: top 5%
Step 1: Pass
Step 2: 248
AOA: Yes (Junior)
GHHS: No
Demographics: White male
Research: 14 publications, 2 as first author, 9 publications on IM subspecialties, 5 on non-IM subspecialties
Extracurriculars: Involvement in student-run free clinics while a medical student, working with the underserved and many teaching initiatives I designed myself
LORs: 1 department letter, 1 head of the department at a VA hospital associated with my medical school letter, 1 acting internship in internal medicine letter, 1 research in subspeciality in IM (at T5 medical school) letter (I have been involved with this research team for almost 10 years)
Geographic Signaling: New England, Middle Atlantic, East North Central
Red flags:
1. Graduated from medical school in 2025 and applied to a surgical subspeciality and did not match, and on my transcript, I have 4 electives (4 months in total) of home and away rotations for this speciality
2. Currently doing a clinical position/research year in that subspeciality, but realized I like IM more and will not be applying for that surgical subspeciality a second time around and will only be applying IM
Goals: Academic program, interested in cardio, GI, or heme-onc fellowship (likely the former 2 for now)
Programs:
1. MGH
2. Brigham
3. Mayo Clinic College of Medicine and Science (Rochester) Program
4. University of Michigan Program
5. University of Pennsylvania Health System Program
6. NYU Grossman School of Medicine Program
7. McGaw Medical Center of Northwestern University Program
8. Icahn School of Medicine at Mount Sinai (Mount Sinai Hospital) Program
9. Beth Israel Deaconess Medical Center Program
10. University of Chicago Program
11. Cleveland Clinic Foundation Program
12. Yale-New Haven Medical Center Program
13. UPMC Medical Education Program
14. New York Presbyterian Hospital (Cornell Campus) Program
15. Pennsylvania Hospital of the University of Pennsylvania Health System Program
16. Ohio state
17. Boston University Medical Center Program
18. Rush University Medical Center Program
19. Case Western Reserve University/University Hospitals Cleveland Medical Center Program
20. Sidney Kimmel Medical College at Thomas Jefferson University/TJUH Program
21. Henry Ford Health/Henry Ford Hospital Program
22. University of Cincinnati Medical Center/College of Medicine Program
23. University of Wisconsin Hospitals and Clinics Program
24. Tufts Medical Center Program
25. Icahn School of Medicine at Mount Sinai (Morningside/West) Program
26. University of Rochester Medical Center Program
27. University of Minnesota Program
28. Temple University Hospital Program
29. Cook County
30. Indiana University School of Medicine Program
31. Rhode Island Hospital/Brown University Health Program
32. University of Illinois College of Medicine at Chicago Program
33. Detroit Medical Center/Wayne State University Program
34. Loyola University Medical Center Program
35. Rutgers Health/New Jersey Medical School Program
36. Zucker School of Medicine at Hofstra/Northwell Program
37. University of Connecticut Program
38. Jacobi Medical Center/Albert Einstein College of Medicine Program
39. UMass Chan Medical School Program - Worcester"
40. Dartmouth-Hitchcock/Mary Hitchcock Memorial Hospital Program
41. Stony Brook Medicine/University Hospital Program
42. Medical College of Wisconsin Affiliated Hospitals Program
43. Penn State Milton S Hershey Medical Center Program
44. University at Buffalo Program
45. Lahey Clinic Program
46. University of Vermont Medical Center Program
47. Maine Medical Center Program
48. SUNY Upstate Medical University Program
49. UMass Chan - Baystate Program
50. Cooper Medical School of Rowan University/Cooper University Hospital Program
51. Bridgeport Hospital/Yale University Program
52. Geisinger Health System (Danville) Program
53. Yale-New Haven Medical Center (Waterbury) Program
54. Nuvance Health Consortium (Norwalk Hospital/Yale University) Program
55. Albany Medical Center Program
56. Hackensack University Medical Center Program
57. Montefiore Medical Center/Albert Einstein College of Medicine (New Rochelle) Program
58. New York Medical College (Metropolitan) Program
59. Mount Auburn Hospital Program
60. St Elizabeth's Medical Center Program
61. Hackensack University Medical Center/Englewood Hospital and Medical Center Program
62. Greenwich Hospital/Yale University Program
63. MetroWest Medical Center Program
64. Mass General Brigham/Salem Hospital Program
65. Quinnipiac University Frank H. Netter MD School of Medicine/St VIncent's Medical Center Program
66. Berkshire Medical Center Program
Questions:
1. Is the current program list I have below reasonable, and what is a good number of IM programs to apply for in general? If not reasonable, what modifications should be made?
2. I am from the Northeast and would prefer to be in MA for residency, but am open to being in nearby states; therefore, which programs should I send gold and silver signals to?
3. Will the red flags I mentioned hamper me from matching into a strong academic IM program?
Thank you very much in advance!
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It is 40-50 programs too long. But it's your money.
Signaling is stupid. I know you have to do it, but I have no other comments.
Only if your LORs and PS don't adequately explain your change of heart and switch to IM. IM programs are generally quite open to people who initially wanted something else but decided later in med school (or even after) that IM was a better choice for them. But nobody wants to be your backup just because you didn't match.
Thank you for your response! I had a few follow-up questions:
1. How should I modify the program list to include 20-25 programs considering my stats? What programs should be included?
2. How much of the PS should explain the specialty switch?
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You're a top IM candidate. Spend 15-20 apps on Top X programs and another 10-20 on mid-tiers. You don't need to go bottom feeding.
1 paragraph. No more, no less.
I appreciate you getting back to me in a timely manner and for your kind words regarding my candidacy! Here is my refined program list per your suggestion:
Top 20 programs:
1. University of Michigan
2. Icahn School of Medicine at Mount Sinai (Mount Sinai Hospital) Program
3. UPenn
3. UChicago
4. Cleveland Clinic
5. UPMC Medical Education Program
6. New York Presbyterian Hospital (Cornell Campus) Program
7. Ohio State
8. Boston University
9. Case Western Reserve University
10. Thomas Jefferson University
11. Henry Ford
12. UCincinnati
13. University of Rochester
14. Tufts
15. Temple
16. Mayo
17. NYU
18. Northwestern
19. Rush
20. Uni Wisconsin
Mid tier 20 programs:
1. Cook County
2. Indiana
3. Brown
4. U Illinois
5. DMC/Wayne State
6. Loyola
7. Rutgers
8. Hofstra
9. UConn
10. Albert Einstein
11. UMass Worcester
12. UMass Baystate
13. Dartmouth
14. Stony Brook
15. Penn State
16. University of Vermont
17. Main medical center
18. Cooper
19. Albany Medical Center
20. Icahn School of Medicine at Mount Sinai (Morningside/West) Program
Is this a good list of programs to feel safe matching?
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It's a weird list for someone who wants to stay in MA and doesn't have the HMS programs on it. Cook County, Albany, Cooper, Maine and Morningside West are superfluous. As are Baystate and Hofstra. Not sure which "U Illinois" program you're talking about, I assume UIC, but Rush is a better program if you want to be in Chicago.
If you feel like you need 40 on your list, UMinn, Iowa, WashU, UNC, Vandy, Duke, Hopkins/Bayview, JHU (why not?) and the HMS programs are all ones to consider.
I appreciate the feedback! I did not include the HMS programs as their residency class in IM are mostly from top tier MD schools and the average step 2 is likely higher than mine. What are your thoughts on this?
As for this statement "Cook County, Albany, Cooper, Maine and Morningside West are superfluous. As are Baystate and Hofstra.", would it be safe to remove these programs if the goal is stay in MA?
Lastly, to address "If you feel like you need 40 on your list, UMinn, Iowa, WashU, UNC, Vandy, Duke, Hopkins/Bayview, JHU (why not?) and the HMS programs are all ones to consider.", I did not include most of these programs as they were outside of my geographic preferences (Northeast, middle Atlantic and midwest). Do you think that it's fine to apply to these top tier places outside of my geographic preference?
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You definitely won't match at the HMS programs if you don't apply.
I mean, only one of those programs is in MA, so....
NE - HMS programs
Midwest - UMinn, Iowa, WashU
Mid-Atlantic - JHU, Bayview, UNC, Duke
Vandy is pretty much the only place outside of your professed geographic preference...and just barely.
Thank you kindly for your comments! I modified the list incorporating some of the suggestions you mentioned. I decided to only include programs within the geographic preferences, which are New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont), Middle Atlantic (New Jersey, New York, Pennsylvania), East North Central (Illinois, Indiana, Michigan, Ohio, Wisconsin).
Here is the list of 40 programs with follow-up questions below the list:
A. Gold signal (3 programs):
- Boston University Medical Center Program
- Tufts Medical Center Program
- Brigham and Women’s Hospital
B. Silver signal (12 programs):
- Brown/Rhode Island Hospital
- Sidney Kimmel Medical College at Thomas Jefferson University/TJUH Program
- UConn
- UMichigan
- UMass - Worcester
- Wayne State/DMC
- Dartmouth
- Icahn School of Medicine at Mt. Sinai
- Henry Ford Detroit
- Rutgers
- New York Presbyterian (Cornell Campus)
- University of Pittsburgh
C. No signal (25 programs):
- Maine Health
- Case Western Reserve University/University Hospitals Cleveland Medical Center Program
- Cleveland Clinic Foundation Program
- Cooper Medical School of Rowan University/Cooper University Hospital Program
- Icahn School of Medicine at Mount Sinai (Morningside/West) Program
- Indiana University School of Medicine Program
- Loyola University Medical Center Program
- MGH
- Beth Israel Deaconess Medical Center
- Mayo Clinic College of Medicine and Science (Rochester) Program
- McGaw Medical Center of Northwestern University Program
- NYU Grossman School of Medicine Program
- Penn State Milton S Hershey Medical Center Program
- Pennsylvania Hospital of the University of Pennsylvania Health System Program
- Rush University Medical Center Program
- UMass Chan Baystate
- University at Buffalo Program
- University of Chicago Program
- University of Cincinnati Medical Center/College of Medicine Program
- University of Wisconsin Hospitals and Clinics Program
- University of Pennsylvania Health System Program
- Yale-New Haven Medical Center Program
- Ohio State
- University of Rochester Medical Center Program
- University of Minnesota Program
Follow-up questions:
1. What is your opinion of this list?
2. For academic institutions outside of the geographic preferences that you alluded to, such as Iowa, WashU, JHU, Bayview, UNC, Duke, Vanderbilt, is it still worth applying to (these programs will see that I did not include their region as a geographic preference)?
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