overcoming regional bias?

[hyperchicken]

Hello everyone!

I’m a first year med student at a US med school. I came into med school with an interest in pathology, and I’m thinking about doing a post sophomore fellowship. I’m ultimately interested in getting a residency in another region of the US. But currently my curriculum vitae is very “local.” I’m going to my state school—which is the same school I went to for undergrad, and I’ll most likely be doing a summer research fellowship at my school (applied for a few national fellowships at other schools, but no luck).
My school also offers a post sophomore fellowship pathology, but I was wondering if it would be better for my goals if I tried to apply to post sophomore fellowships at other schools in different states just to open a few more doors nationally. I definitely saw a lot of regional bias during the med school interview trail in terms of who was invited to interview, a few interviewers even asked my why I applied to school X when I have no ties to the region, and looked at me rather skeptically when I answered them (did not get accepted to these school either ).

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[Pathologee]

Nah do the PSF at your school. You wont have to move, you are already familiar with the area and you will have enough to learn and adjust to while there.

If you move away you will have to spend money everytime you come home. When you interview, just make sure you tell people that you want the best training possible and location doesn't matter.

Hello everyone!

I’m a first year med student at a US med school. I came into med school with an interest in pathology, and I’m thinking about doing a post sophomore fellowship. I’m ultimately interested in getting a residency in another region of the US. But currently my curriculum vitae is very “local.” I’m going to my state school—which is the same school I went to for undergrad, and I’ll most likely be doing a summer research fellowship at my school (applied for a few national fellowships at other schools, but no luck).
My school also offers a post sophomore fellowship pathology, but I was wondering if it would be better for my goals if I tried to apply to post sophomore fellowships at other schools in different states just to open a few more doors nationally. I definitely saw a lot of regional bias during the med school interview trail in terms of who was invited to interview, a few interviewers even asked my why I applied to school X when I have no ties to the region, and looked at me rather skeptically when I answered them (did not get accepted to these school either ).

 

[deleted314957]

you get a decent step 1 any you can go to pretty much anywhere

 

[hyperchicken]

you get a decent step 1 any you can go to pretty much anywhere

haha, I guess I'm trying to come up with the best "plan B" in case I don't get a great step 1. I'll probably stick with my home school PSF (I've basically been accepted to it after informally chatting with the department head), but I'll perhaps apply to a few "long shot" PSFs like Stanford and see if I get in.

 

[2121115]

My advice is to go to a different region of the country for the PSF. You won't regret it, and it may even open doors for you. Yes, it will probably cost you some extra $$. But you are in your 20's and free, and you've already gone to the same place for undergrad and med school. Just go for it. Pick an academic environment you don't know much about and go experience it. In the end it will at least give you something unusual to talk about at interviews. And it may even open a few doors for you. Pathology is a small world, and connections matter - even a good word from across the country can help you. You never know.

 

[2121115]

you get a decent step 1 any you can go to pretty much anywhere

^^^ this ^^^^


This is the number 1 most important factor in pathology residency applications, for better or worse.

 

[Enkidu]

What is a good enough step 1 score to go to a top tier program?

 

[mlw03]

240 gets you noticed. 250 and up is very strong.

 

[Enkidu]

240 gets you noticed. 250 and up is very strong.

So, assuming that you have a 250 and have no red flags on your application - programs like BWH, MGH, UCSF will consider you to be a strong applicant? Is this even the case if you don't have any publications?

 

[gbwillner]

So, assuming that you have a 250 and have no red flags on your application - programs like BWH, MGH, UCSF will consider you to be a strong applicant? Is this even the case if you don't have any publications?

This thread is getting ridiculous.

#1- don't do a post-sophmore fellowship. It's a complete waste of time. Do a few rotations in surgical pathology (or clinical, of that's your thing), and make sure you like it. Path overall isn't that competitive. If you are from a small school and want to go to MGH and no other place- a PSF probably isn't going to do much of anything for your application, not compared to being AOA, having a high Step 1-2 score, etc. That program will only let in 12 applicants from the whole country- why will they select you? You need to apply broadly, is basically what I'm saying. Maybe you impress someone there, and wonder later how you got so high on their rank list.

#2. You will be considered a "strong applicant" depending on a lot of factors. A high Step 1 score can get you noticed (and meet certain threshold requirements), but by itself in NOT sufficient to get you into a "top" program. There are a lot of factors- how well do you interview? Are you likable? Are you visibly pregnant when you visit? Do you seem like a hard worker? These are all more important than Step 1 scores once you get an interview. If you are on a research track, then your mentor and publications are all FAR more important that Step 1 score. The interview skills are still essential.

 

[hyperchicken]

This thread is getting ridiculous.

#1- don't do a post-sophmore fellowship. It's a complete waste of time. Do a few rotations in surgical pathology (or clinical, of that's your thing), and make sure you like it. Path overall isn't that competitive. If you are from a small school and want to go to MGH and no other place- a PSF probably isn't going to do much of anything for your application, not compared to being AOA, having a high Step 1-2 score, etc. That program will only let in 12 applicants from the whole country- why will they select you? You need to apply broadly, is basically what I'm saying. Maybe you impress someone there, and wonder later how you got so high on their rank list.

#2. You will be considered a "strong applicant" depending on a lot of factors. A high Step 1 score can get you noticed (and meet certain threshold requirements), but by itself in NOT sufficient to get you into a "top" program. There are a lot of factors- how well do you interview? Are you likable? Are you visibly pregnant when you visit? Do you seem like a hard worker? These are all more important than Step 1 scores once you get an interview. If you are on a research track, then your mentor and publications are all FAR more important that Step 1 score. The interview skills are still essential.

Hi, OP here. I myself am not worried so much about getting into a "top program," but ALL SDN threads seem to degenerate into this kind of discussion..haha...I'm starting to become jaded to the term. I might also apply to year long research fellowships after second year...especially if the project I'm working on over the summer turns out to be interesting, this might be a better use of my time than the PSF.

 

[deleted314957]

Hi, OP here. I myself am not worried so much about getting into a "top program," but ALL SDN threads seem to degenerate into this kind of discussion..haha...I'm starting to become jaded to the term. I might also apply to year long research fellowships after second year...especially if the project I'm working on over the summer turns out to be interesting, this might be a better use of my time than the PSF.

as you should become jaded. don't commit yourself to a "big name". you have to be happy geographically, socially, professionally, etc. and it is a different mix with everyone. certainly avoid glaring red flags but beyond that keep an open mind. you don't need a huge place with 60,000 surgicals (you may well just end up grossing a s***load of them and little else).

 

[Sulfinator]

#1- don't do a post-sophmore fellowship. It's a complete waste of time. Do a few rotations in surgical pathology (or clinical, of that's your thing), and make sure you like it. Path overall isn't that competitive.

I agree. Overall, I think you are better off saving yourself a year and not doing a PSF. It's not a terrible idea, but is probably not worth an extra year of your time.

 

[Euchromatin]

#1- don't do a post-sophmore fellowship. It's a complete waste of time. Do a few rotations in surgical pathology (or clinical, of that's your thing), and make sure you like it. Path overall isn't that competitive.

Agree with above. A couple of month-long elective rotations should be more than adequate for most people to decide if they really want to do pathology or not, as well as giving them an opportunity to get letter(s) from attending staff pathologist(s). If you have some particular part of the country or program that you really want to go to, try to set up one of your rotations there. I don't think that taking an entire year off to work on a research project is necessary either (unless you are dead set on working at a super hard core academic place and want to do a lot of research when you are out in practice).

 

[KCShaw]

See the other recent/current PSF thread too.

Medical schools, particularly admissions, are weird and somewhat unpredictable. Chances are that another interviewer the same days you were interviewing would have thought how cool it was that you were trying to expand your horizons by applying out-of-region -- whatever that means these days. It's (probably) not like you had to take a wagon for 2 weeks then wait again for the river to go down in order to cross to get to the interview, nor likely that you would make that commute "daily" to classes. To be somewhat fair, some schools may have a funding mandate to prefer locals in the hope that they will somehow stay and become local practitioners if they don't have to move "out-of-region" for medical school; I'm pretty sure that's a failed concept, but I confess I don't have the data to support that mild mockery. That said, I don't know of anyone who ran into a similar problem when it came to pathology residency -- I don't think there are any programs out there specifically looking for locals who will stay local as attending pathologists. If you like the thought of moving and broadening your horizons while you still can, I encourage you to do so.. I just don't think it will have anything to do with a competitive edge when it comes to residency applications.

 

[hyperchicken]

Thanks to everyone for the replies. I'm thinking about doing a few away rotations in pathology in 3rd or 4th year (3rd year is probably more preferable in order to get rec letters, am I correct?). In general, are away rotations competitive in the sense that they only take a few students per program a year, or is it more like if you express an interest in a particular program, you'll eventually get a chance to rotate through it? (I am aware there is probably massive variation among different programs, but if anyone could give their personal experience) Should I just have a few schools in mind for away rotations, or should I apply broadly?

 

[KCShaw]

I would try to do rotations in fields you are pretty sure you like at least early enough to pick their brains and hopefully get a decent letter of recommendation from them prior to residency interview season.

For getting a rotation spot, as you acknowledge this is widely variable. Some brand name programs may pretend to not even have a rotation option because they get so many calls and emails. Others you could flick a booger at and get -asked- to rotate there. I would suggest starting early and aiming for a few programs that you think trip your trigger, leaving enough time to cast a wider net if those don't pan out in a reasonable time. I also think anyone with a local pathology program should try to rotate locally, early, because those local contacts can be a great first point of contact as time goes on.

 

[hyperchicken]

I would try to do rotations in fields you are pretty sure you like at least early enough to pick their brains and hopefully get a decent letter of recommendation from them prior to residency interview season.

For getting a rotation spot, as you acknowledge this is widely variable. Some brand name programs may pretend to not even have a rotation option because they get so many calls and emails. Others you could flick a booger at and get -asked- to rotate there. I would suggest starting early and aiming for a few programs that you think trip your trigger, leaving enough time to cast a wider net if those don't pan out in a reasonable time. I also think anyone with a local pathology program should try to rotate locally, early, because those local contacts can be a great first point of contact as time goes on.

By starting "early" do you mean I should start looking around during second year for third year away rotations? (assuming I don't take a year off after second year, I will really have no break between second and third year). I'd most likely want to first rotate at my school's path dept so I can learn the ropes a bit better.

 

[BrainPathology]

You can expect to make 100-250k in your first year of practice and some substantially higher number than that in your last year. Considering no-one who hasn't done a PSF has a difficult time getting into a good program if they have a good application otherwise you should ask if it's worth it to basically pay six figures to train longer for something that is unnecessary.

What would be worth that future year of earning power? The fact that you're asking on here makes me assume you don't want to take it for some reason that is compelling regardless of its use getting into a program such as wanting the year to make sure you actually want to do pathology. Or having a very strong draw toward an attending you think could help your career or you just love working with. Or wanting to take an extra year to sync up with a partner so you can do couples match or some other reason. The research you mention could potentially be a compelling reason to do an extra year if you think the experience will help your career either objectively or subjectively enough that you want it.

The bottom line though is that I don't think you need it. I saw a great deal of regional bias in my medical school interviews as well but that was more pronounced at state schools than private ones. Questions were much much less frequent on the residency interview trail and were mostly along the lines of how did you hear about us from way out where you're training, not to try to weed me out but because they were genuinely curious about what path I had taken that lead to my interview that day.

 

[twentyone]

#2. You will be considered a "strong applicant" depending on a lot of factors. A high Step 1 score can get you noticed (and meet certain threshold requirements), but by itself in NOT sufficient to get you into a "top" program. There are a lot of factors- how well do you interview? Are you likable? Are you visibly pregnant when you visit? Do you seem like a hard worker? These are all more important than Step 1 scores once you get an interview. If you are on a research track, then your mentor and publications are all FAR more important that Step 1 score. The interview skills are still essential.

???

 

[gbwillner]

???

Seriously, you don't think that's pretty much an automatic fail on your interview day??? It tells staff that as soon as you start residency, you'll take a month off or more, forcing everyone else to do your work for you. At best it means that when day care calls you 10x per year that your kid is sick you will have to force people to cover you when you stay home that day AND the following day (unless you are lucky enough to have someone to do it for you). At worst, it means you decide you want to stay home and quit residency, and there is no way for the program to recover from that.

Maybe at low volume places this isn't a big deal. But at high volume places this is a risk every PD will think about. They could take the pregnant woman with all these risks, or the non-pregnant one with none of those risk. Who would you take????

 

[twentyone]

Seriously, you don't think that's pretty much an automatic fail on your interview day??? It tells staff that as soon as you start residency, you'll take a month off or more, forcing everyone else to do your work for you. At best it means that when day care calls you 10x per year that your kid is sick you will have to force people to cover you when you stay home that day AND the following day (unless you are lucky enough to have someone to do it for you). At worst, it means you decide you want to stay home and quit residency, and there is no way for the program to recover from that.

Maybe at low volume places this isn't a big deal. But at high volume places this is a risk every PD will think about. They could take the pregnant woman with all these risks, or the non-pregnant one with none of those risk. Who would you take????

Pathetic. I expect this kind of BS on pre-allo, I guess it suprised me here. Maybe it shouldn't have.

If you are "visibly" pregnant on your interview day, I think you would not still be on maternity leave in July, if I'm remembering the basic time frames of human gestation....We also don't schedule people who are actually on maternity leave for a busy surgical rotation, so that argument really doesn't hold up- no one has to cover for the absentee mother or anything.

 

[gbwillner]

Pathetic. I expect this kind of BS on pre-allo, I guess it suprised me here. Maybe it shouldn't have.

If you are "visibly" pregnant on your interview day, I think you would not still be on maternity leave in July, if I'm remembering the basic time frames of human gestation....We also don't schedule people who are actually on maternity leave for a busy surgical rotation, so that argument really doesn't hold up- no one has to cover for the absentee mother or anything.

There are laws protecting women from discrimination of this type, which is why you are not allowed to ask applicants if they are pregnant or planning to become pregnant. Those laws are there because people will make these exact assumptions.

You are right of course, depending on when you interview that the pregnancy will be over. But you really think PDs (in general, of course) would NOT factor it in to their decision????

 

[twentyone]

I am optimistic in general, but I expect PDs a) are grown-ups and b) value women in the workplace. So no, I don't think it factors into their decisions.

 

[BrainPathology]

I am optimistic in general, but I expect PDs a) are grown-ups and b) value women in the workplace. So no, I don't think it factors into their decisions.

It would factor to some I'm sure.. not that that would be right. And I doubt it would effect 'whether' someone would be ranked.. but possibly 'where' they would be on the list. And you never know it might actually HELP if a program director that was given a difficult time of it during their own children's early days interviews you it may actually bump them a spot or two up on the list.

From my residents reactions to interviewees I'd be more wary of wearing visibly bright orange or black nail polish. Those were automatic "she's unprofessional" reactions from them. (I assume male with these colors would be reacted to similarly)

 

[lipomas]

Be carefuly about interpreting "bias" from the wrong perspective. The main reason there are so many local people interviewing at programs and med schools is that that's who applies. Students are more likely to consider local factors as important than med schools and residencies are.

 

[KCShaw]

Some things may have more sub or semi-conscious influence than others, and just like "taking offense" at something is an individual thing, so can many biases be. There's no point being completely naive about that, other than to apply the old claim that ignorance is bliss.

Some people probably intentionally did not pursue having children while in residency, while others intentionally had a couple of kids -- either perspective could influence the impression of a person. Some people grew up in an isolated conservative atmosphere, or whatever, and that probably influences their perceptions of someone's choice of makeup or nail polish or language or music...etc. Others had a bad experience with tall people. For the most part I really wouldn't worry about it -- most such influences are subtle and largely overridden by the conscious brain I think (or choose to assume). Be yourself and you're more likely to end up in a place that suits you.

 

[hyperchicken]

What would be worth that future year of earning power? The fact that you're asking on here makes me assume you don't want to take it for some reason that is compelling regardless of its use getting into a program such as wanting the year to make sure you actually want to do pathology. Or having a very strong draw toward an attending you think could help your career or you just love working with. Or wanting to take an extra year to sync up with a partner so you can do couples match or some other reason. The research you mention could potentially be a compelling reason to do an extra year if you think the experience will help your career either objectively or subjectively enough that you want it.

I guess I was posting because I want to figure out if a PSF was the best way to "sell" the fact that I'm interested in pathology to residency programs around the country, but yes, I also wasn't sure if I want to waste a year. I pretty sure I could get good rec letters if I do a few rotations (here and away) during third year. As of now, I'll probably only take a year off if I want to continue on with the research I'll be doing.

Seriously, you don't think that's pretty much an automatic fail on your interview day??? It tells staff that as soon as you start residency, you'll take a month off or more, forcing everyone else to do your work for you. At best it means that when day care calls you 10x per year that your kid is sick you will have to force people to cover you when you stay home that day AND the following day (unless you are lucky enough to have someone to do it for you). At worst, it means you decide you want to stay home and quit residency, and there is no way for the program to recover from that.

Maybe at low volume places this isn't a big deal. But at high volume places this is a risk every PD will think about. They could take the pregnant woman with all these risks, or the non-pregnant one with none of those risk. Who would you take????

Hmmm, this is an attitude that I'm afraid of. I am a woman (though not pregnant) and a non traditional student (27 going on 28 next week)...I may eventually want to pass my genes on before I hit menopause (stupid menopause)...and given my age (remember, I'm only a first year med student) it might be best to have a child sometime during residency. Luckily, I do have a "stay at home" husband, who works from home and would be willing to do his share to help raise the child. I sort of blame the culture for the situations above, we almost expect the mother to bear most of the responsibility for raising the child and the men were historically given a "free pass" to work until they drop (at the expense of getting to know/raising their children).

 

[pathstudent]

I guess I was posting because I want to figure out if a PSF was the best way to "sell" the fact that I'm interested in pathology to residency programs around the country, but yes, I also wasn't sure if I want to waste a year. I pretty sure I could get good rec letters if I do a few rotations (here and away) during third year. As of now, I'll probably only take a year off if I want to continue on with the research I'll be doing.





Hmmm, this is an attitude that I'm afraid of. I am a woman (though not pregnant) and a non traditional student (27 going on 28 next week)...I may eventually want to pass my genes on before I hit menopause (stupid menopause)...and given my age (remember, I'm only a first year med student) it might be best to have a child sometime during residency. Luckily, I do have a "stay at home" husband, who works from home and would be willing to do his share to help raise the child. I sort of blame the culture for the situations above, we almost expect the mother to bear most of the responsibility for raising the child and the men were historically given a "free pass" to work until they drop (at the expense of getting to know/raising their children).

Don't do the PSF. Don't do a year of research. You will match in pathology and likely at a good to great place. Have your baby whenever you are ready.

 

[2121115]

I guess I was posting because I want to figure out if a PSF was the best way to "sell" the fact that I'm interested in pathology to residency programs around the country...

There is no need. Pathology is not competitive. They will be selling you on coming there, not the other way around.

 

[gbwillner]

Hmmm, this is an attitude that I'm afraid of. I am a woman (though not pregnant) and a non traditional student (27 going on 28 next week)...I may eventually want to pass my genes on before I hit menopause (stupid menopause)...and given my age (remember, I'm only a first year med student) it might be best to have a child sometime during residency. Luckily, I do have a "stay at home" husband, who works from home and would be willing to do his share to help raise the child. I sort of blame the culture for the situations above, we almost expect the mother to bear most of the responsibility for raising the child and the men were historically given a "free pass" to work until they drop (at the expense of getting to know/raising their children).

You can definitely have a child in residency. I would just wait until you match to get pregnant. Once you're in, no one is going to want to see you go. If possible, I would try to plan ahead, and have the child during 3rd year. You're no longer working quite as hard (or may be on CP electives), and may already have your fellowship lined up.

There is never going to be a "good" time to have kids in the medical field- there is only going to be the "best time" given your particular career constraints.

 

[BrainPathology]

You're in the very enviable position of having a partner who can stay home and help with raising any children you have. I wouldn't even worry about when. Just plan carefully and do it when you're ready. You have advantages and options few others have. Is there any reason why it's assumed that having kids during the 3rd and 4th year of medical school is ruled out? Not just for the OP but everyone in general. It seems like you may have just as much extra time if you plan correctly to do it then as well making it a little easier during residency (of course if you want multiple children this must complicate it).