Path to competitive residencies....

[JJMrK]

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how about the compeptive ones dermatology or anethesiology or pathology? cause i like pathology lol.

AFAIK pathology in general is not terribly competitive.

 

[loljkttyl]

how about the compeptive ones dermatology or anethesiology or pathology? cause i like pathology lol.

AVERAGE STEP 1 BOARD SCORES:
Dermatology: 242 (very competitive)
Pathology: 227 (average)
Anesthesiology: 224 (average)

Source: www.nrmp.org/data/chartingoutcomes2009v3.pdf

 

[ButImLETired]

There's a lot of factors and not all of them are in your control. The med school you attend, though, if you have multiple options, IS one of the few things in your control. Depending on what programs you're targeting, it could make a difference but as I said before, it's less important than putting yourself in a position to succeed. I would note however, that the vast majority of posters who are saying that your med school doesn't matter are attending unranked schools... Jus' saying...

Absolutely. And this is a key point people don't often mention: IT DEPENDS. If you're going into something really research-intensive like rad/onc, going to a research powerhouse is far more useful than if you were trying to get an FM position. If you want to work at an intense, high-paced gunshot mecca, coming from an ivory tower place like Stanford might not be as helpful. And so on. To complicate matters, there are some high-ranked places that are known to have "weaker" clinicals than others, whether it's because the residents are overworked and unwilling to teach, or because clinicals are just not their focus, or their curriculum doesn't prepare you for them enough (I can think of at least 2 I was advised not to go to, but I won't mention them to avoid a flame war). You probably wouldn't know that you're in that kind of school until it's too late, unless you have the ear of some knowledgeable doctors in academia. And finally, mentorship is important, so a med school that has a really fantastic, say, pediatrics department with great teachers (this is key! No point in being in the best department in the world if they're unwilling to teach you) and influential people to write your LORs will be more helpful than one in which all you could do was run samples to the lab or no one knows who your teachers are.

So yeah, moral of the story: it depends. In general prestige will help you and won't hurt you, while lack thereof will require you to do all the hard work yourself (keep your grades up so you can do fancy away rotations, stuff like that) without a leg-up from the name of the school. But it's certainly not the be-all and end-all of medicine, and the extent to which your school's name helps you or hinders you won't really become apparent until you're in the middle of it.

 

[drizzt3117]

Absolutely. And this is a key point people don't often mention: IT DEPENDS. If you're going into something really research-intensive like rad/onc, going to a research powerhouse is far more useful than if you were trying to get an FM position. If you want to work at an intense, high-paced gunshot mecca, coming from an ivory tower place like Stanford might not be as helpful. And so on. To complicate matters, there are some high-ranked places that are known to have "weaker" clinicals than others, whether it's because the residents are overworked and unwilling to teach, or because clinicals are just not their focus, or their curriculum doesn't prepare you for them enough (I can think of at least 2 I was advised not to go to, but I won't mention them to avoid a flame war). You probably wouldn't know that you're in that kind of school until it's too late, unless you have the ear of some knowledgeable doctors in academia. And finally, mentorship is important, so a med school that has a really fantastic, say, pediatrics department with great teachers (this is key! No point in being in the best department in the world if they're unwilling to teach you) and influential people to write your LORs will be more helpful than one in which all you could do was run samples to the lab or no one knows who your teachers are.

So yeah, moral of the story: it depends. In general prestige will help you and won't hurt you, while lack thereof will require you to do all the hard work yourself (keep your grades up so you can do fancy away rotations, stuff like that) without a leg-up from the name of the school. But it's certainly not the be-all and end-all of medicine, and the extent to which your school's name helps you or hinders you won't really become apparent until you're in the middle of it.

If with your point about schools not giving good clinical training you're talking about Stanford, I've heard the same thing but it certainly doesn't affect their match results even if it's true. Recently one of our clinical course directors was asked to spend a week at Stanford as they are figuring out how to revamp their curriculum. People say the same thing about UCLA at times but it doesn't seem to affect how their students match either. UCSD is supposed to have the best clinical training in med school in California and empirically their students don't match better than ones from the higher ranked schools in CA.

I think no matter how well you are trained clinically as a med student, it's going to be an adventure when you're an intern. My brother had a ton of good clinical experience in his field of interest prior to starting residency, on his surgical sub-I, his attendings and residents let him manage patients with minimal supervision, but when he had to do it as an intern, it was totally different, and much of it was simply the flow, load of patients, interactions with the nursing staff, feeling of responsibility, and overwhelming amount of paperwork and figuring out how to get things done efficiently. There's going to be a steep learning curve no matter what pretty much, unless you're one of those people who was a PA or DNP prior to med school.

Regarding the whole prestige thing, I agree with you with the reasons, hardcore academic programs want people who are going to be very productive at research and interact with top people in the field, and for the most part, they're going to be at top programs. There's some exceptions of course... one relevant one in my particular case is that a school might be rated moderately in the overall research rankings and be a powerhouse in a specific field, in which case it's not just about the rankings. That said, it's rare for a school outside the top 40 NIH to be a top 5 powerhouse in a specific program, the only example I can think of off the top of my head is Miami in Optho and even then it's ranked like 42 in NIH funding.

 

[ButImLETired]

If with your point about schools not giving good clinical training you're talking about Stanford, I've heard the same thing but it certainly doesn't affect their match results even if it's true. Recently one of our clinical course directors was asked to spend a week at Stanford as they are figuring out how to revamp their curriculum. People say the same thing about UCLA at times but it doesn't seem to affect how their students match either. UCSD is supposed to have the best clinical training in med school in California and empirically their students don't match better than ones from the higher ranked schools in CA.

I think no matter how well you are trained clinically as a med student, it's going to be an adventure when you're an intern. My brother had a ton of good clinical experience in his field of interest prior to starting residency, on his surgical sub-I, his attendings and residents let him manage patients with minimal supervision, but when he had to do it as an intern, it was totally different, and much of it was simply the flow, load of patients, interactions with the nursing staff, feeling of responsibility, and overwhelming amount of paperwork and figuring out how to get things done efficiently. There's going to be a steep learning curve no matter what pretty much, unless you're one of those people who was a PA or DNP prior to med school.

Regarding the whole prestige thing, I agree with you with the reasons, hardcore academic programs want people who are going to be very productive at research and interact with top people in the field, and for the most part, they're going to be at top programs. There's some exceptions of course... one relevant one in my particular case is that a school might be rated moderately in the overall research rankings and be a powerhouse in a specific field, in which case it's not just about the rankings. That said, it's rare for a school outside the top 40 NIH to be a top 5 powerhouse in a specific program, the only example I can think of off the top of my head is Miami in Optho and even then it's ranked like 42 in NIH funding.

I actually wasn't really talking about Stanford, but I've heard the same thing about them. And it's absolutely true, their match is still remarkable. However, if you'll notice no one really goes to the L.A. County's and Detroits of the world- mostly they stick with the other ivory towers out there. I'm guessing too that the Stanford name carries you pretty far when you're applying to do away rotations, so if they do want to get more urban medical training, I'm sure they can do so pretty easily.

 

[drizzt3117]

I actually wasn't really talking about Stanford, but I've heard the same thing about them. And it's absolutely true, their match is still remarkable. However, if you'll notice no one really goes to the L.A. County's and Detroits of the world- mostly they stick with the other ivory towers out there. I'm guessing too that the Stanford name carries you pretty far when you're applying to do away rotations, so if they do want to get more urban medical training, I'm sure they can do so pretty easily.

I mean, last I heard, 2/3 or more of their class does a research year, clearly they're targeting people going into academic medicine, they even have a question on their secondary asking you to list your publications... haha.

That said, it all really depends on interests. I'm interested in going into the most research heavy and competitive fellowship track of a very research heavy residency, so going to a top academic residency really helps. Even in some very competitive residencies where research is quite important (orthopedics, for example) though, top people in the field come out of community programs. Arguably the best orthopedic surgeon at our institution (and the one that I actually chose to do my own pretty complicated ORIF) went to a urban track community residency, so like I said, it just depends!

 

[feipar]

AVERAGE STEP 1 BOARD SCORES:
Dermatology: 242 (very competitive)
Pathology: 227 (average)
Anesthesiology: 224 (average)

Source: www.nrmp.org/data/chartingoutcomes2009v3.pdf

Can someone please explain how med school grads are advised in terms of selecting preferred specialities for the match? Based on the chart in the above file, it appears that 80% of graduating US seniors get into their preferred specialty. That seems quite high. However, the positions available offered per specialty various greatly. Is the reason for this basically that competitive specialties have cut offs for USMLE step 1 that MUST be met (explicitly or implicitly) or the applicant won't be considered at all? Thanks.

 

[drizzt3117]

Can someone please explain how med school grads are advised in terms of selecting preferred specialities for the match? Based on the chart in the above file, it appears that 80% of graduating US seniors get into their preferred specialty. That seems quite high. However, the positions available offered per specialty various greatly. Is the reason for this basically that competitive specialties have cut offs for USMLE step 1 that MUST be met (explicitly or implicitly) or the applicant won't be considered at all? Thanks.

Many schools have a career services department that counsels you when you apply to residency. They will "strongly suggest" you not apply for a residency you aren't competitive for. There's a lot of self-selection going on. People don't want to waste time doing ERAS to get no interviews. Someone might "prefer" PRS but if they have a 201 on the boards, they aren't getting it, so they'll probably figure out something else to do.

 

[coolnad17]

It seems like research/publications, work experience, and volunteer experience are some of the factors residency programs look at.

(source: http://www.nrmp.org/data/chartingoutcomes2009v3.pdf)

Which of these things can carry over from undergrad? Are you supposed to list your work/volunteer/research experience from undergrad as well. Only research from undergrad? Nothing from undergrad?

Most people matching to Dermatology residencies had 5 or more publications/abstracts...how does one even do that in a period of 3 years?

 

[drizzt3117]

IIRC, it counts research experiences, which is an abstract, poster, or publication, which is pretty easy to get. A poster or presentation is two research experiences with the way they count it IMMSMC.

FWIW this year I will have ~20 research experiences (8 accepted abstracts, 3 posters, 4 presentations, 5 pubs) It's doable just requires good time management.

It seems like research/publications, work experience, and volunteer experience are some of the factors residency programs look at.

(source: http://www.nrmp.org/data/chartingoutcomes2009v3.pdf)

Which of these things can carry over from undergrad? Are you supposed to list your work/volunteer/research experience from undergrad as well. Only research from undergrad? Nothing from undergrad?

Most people matching to Dermatology residencies had 5 or more publications/abstracts...how does one even do that in a period of 3 years?

 

[coolnad17]

IIRC, it counts research experiences, which is an abstract, poster, or publication, which is pretty easy to get. A poster or presentation is two research experiences with the way they count it IMMSMC.

FWIW this year I will have ~20 research experiences (8 accepted abstracts, 3 posters, 4 presentations, 5 pubs) It's doable just requires good time management.

If you don't mind me asking, how many hours per week do you spend in the lab? Just trying to get an idea of what it takes. Do you work with multiple PI's in multiple labs...or just one? Is it easier to do research while in years 1 and 2 compared to years 3 and 4?

Also, does nothing from undergrad count towards your residency application?

Thanks very much for all your responses and help.

 

[drizzt3117]

If you don't mind me asking, how many hours per week do you spend in the lab? Just trying to get an idea of what it takes. Do you work with multiple PI's in multiple labs...or just one? Is it easier to do research while in years 1 and 2 compared to years 3 and 4?

20-30 average, sometimes a lot more. When I was trying to get two papers and two abstracts done in a week I put in about 90 that one week. I don't go to class, except for required small groups so that helps in terms of time. I'm actually in Stockholm right now for a conference.

Also, does nothing from undergrad count towards your residency application?

Thanks very much for all your responses and help.

It does, but it's not as important as stuff you did during med school for the most part, unless you have a PhD or research masters before med school.

 

[Cleavername]

20-30 average, sometimes a lot more. When I was trying to get two papers and two abstracts done in a week I put in about 90 that one week. I don't go to class, except for required small groups so that helps in terms of time. I'm actually in Stockholm right now for a conference.



It does, but it's not as important as stuff you did during med school for the most part, unless you have a PhD or research masters before med school.

so how do you keep up with classes lol.

 

[drizzt3117]

so how do you keep up with classes lol.

At our school (and a lot of schools) you get a binder full of pages for each block (~400 pages per class per 3 weeks) and the vast majority of what they're going to test is in there. What isn't in there is usually either covered in mandatory small groups or in the powerpoints from lecture. Some people watch lecture or attend but I don't find it useful so I just memorize and understand the course materials and supplement it by browsing the powerpoints before the exam and reviewing the small group answers.

 

[coolnad17]

20-30 average, sometimes a lot more. When I was trying to get two papers and two abstracts done in a week I put in about 90 that one week.

If you don't mind me asking, do you get paid for your research time during the year or do you volunteer your time?

Also, how did you go about choosing a suitable PI? Any suggestions...?

 

[causalinference]

Can someone elaborate on what kind of letters are required for residency applications? Do these letters come from the attendings who supervised your rotations or what?

 

[drizzt3117]

If you don't mind me asking, do you get paid for your research time during the year or do you volunteer your time?

I'm funded by the NIH and other sources to do research, which includes pretty good salary support.

Also, how did you go about choosing a suitable PI? Any suggestions...?

in my case, like most things, through connections. However, you'll have ample exposure to lots of faculty doing great research during med school. Don't hesitate to talk to your teachers about research or to ask who might be good to approach that would be a good mentor.

 

[drizzt3117]

Can someone elaborate on what kind of letters are required for residency applications? Do these letters come from the attendings who supervised your rotations or what?

People who you've interacted with in a clinical or research setting are typically what residency programs are interested in.

 

[coolnad17]

I'm funded by the NIH and other sources to do research, which includes pretty good salary support.

Would you/anyone happen to know what the norm is? I'm sure not everyone receives this kind of funding.

So normally, do students doing research during med school get paid for their time...or is it mostly voluntary?

Thanks once again.

 

[drizzt3117]

Would you/anyone happen to know what the norm is? I'm sure not everyone receives this kind of funding.

If you do research and are productive (publishing), you can get funded.

So normally, do students doing research during med school get paid for their time...or is it mostly voluntary?

Most people will get paid for research between years 1-2. Our school gives you about $500 per week.

 

[coolnad17]

If you do research and are productive (publishing), you can get funded.

Most people will get paid for research between years 1-2. Our school gives you about $500 per week.

Thanks once again. Hope Sweden is treating you well.

 

[TexasPhysician]

There's a lot of factors and not all of them are in your control. The med school you attend, though, if you have multiple options, IS one of the few things in your control. Depending on what programs you're targeting, it could make a difference but as I said before, it's less important than putting yourself in a position to succeed. I would note however, that the vast majority of posters who are saying that your med school doesn't matter are attending unranked schools... Jus' saying...

I guess if you only want to match Dermatology at Harvard, then yes.....every little thing matters. Otherwise, it just isn't that hard to match into whatever field you want.

 

[Cleavername]

I guess if you only want to match Dermatology at Harvard, then yes.....every little thing matters. Otherwise, it just isn't that hard to match into whatever field you want.

can u transfer in med school lol? after like 1 year or so?

 

[ButImLETired]

can u transfer in med school lol? after like 1 year or so?

Not really. You theoretically can only transfer after second year, and it's VERY rare. Med schools already accept as many people as they can fit, and having an extra person is basically not doable. So, you're relying on people who dropped out, and those are pretty rare. Then you compound the fact that most med schools plainly do not accept transfers, because they can't rely on the fact that you're trained the way their other students are. Finally, even if you can find a program that accepts transfers, 1) it's probably not one of the super high-ranked schools, and 2) they generally only accept people with extenuating circumstances (your wife lives across the country and just had a baby, your parents who live elsewhere need you to help them, etc) and/or Carib students who want to be in the US and have great grades.

So yeah, on a practical level, no.

 

[drizzt3117]

I guess if you only want to match Dermatology at Harvard, then yes.....every little thing matters. Otherwise, it just isn't that hard to match into whatever field you want.

Tell that to the 26.9% of people who applied to Derm and didn't match, the 29.2% of people who didn't match into Plastics, and the ~18% of people who didn't match into Neurosurgery, ENT, or Orthopedics. There's a lot of self-selection going on and most of the applicants are the cream of the crop of US seniors...

Source: http://www.nrmp.org/data/resultsanddata2009.pdf

IMO it's so ridiculous when people keep telling incoming M1s they can match into whatever they want when it's just not true.

 

[TexasPhysician]

Tell that to the 26.9% of people who applied to Derm and didn't match, the 29.2% of people who didn't match into Plastics, and the ~18% of people who didn't match into Neurosurgery, ENT, or Orthopedics. There's a lot of self-selection going on and most of the applicants are the cream of the crop of US seniors...

Source: http://www.nrmp.org/data/resultsanddata2009.pdf

IMO it's so ridiculous when people keep telling incoming M1s they can match into whatever they want when it's just not true.

The problem is no one can see the full applications of everyone who applied. IMO its ridiculous for you to tell people they can't match well without stellar scores.

I go to a state school with a HEAVY primary care emphasis. We have 140 people in our class.
5 matched Derm, including at IVY programs
4 matched ENT
5 matched ortho

That is 10% of my class in just a few highly competitive fields, and you want to believe they were all top students? Not even half of that were top 20% in the class. I didn't even begin listing off our matches for uro, neurosurg, rads, etc. Many of our AOA students are in primary care.

Someone not to be named in that 14 even had comments on his/her application that said something similar to "does not work well with others".

Someone else that matched a surgical subspecialty at a top 20 program was in the bottom 10% of our class and had marks on his/her application.

Sure it is tougher to match into a competitive field with low scores and/or red flags on your transcript, but it is VERY possible.....even from public state schools...🙄.

Most of my friends got their #1 choice in field and residency spot, and I can guarantee that because I knew their rank order list before match day (they wouldn't have been able to lie come match day).

In no way am I trying to brag about my class.....I think most US MD schools would have similar results. If a small state school like mine (probably not even considered in the top 5 med schools in the state in prestige) can match students at the bottom of the class into competitive fields, surely top schools like drizzt3117's can do ok. 😀

 

[Pedie Packs]

Tell that to the 26.9% of people who applied to Derm and didn't match, the 29.2% of people who didn't match into Plastics, and the ~18% of people who didn't match into Neurosurgery, ENT, or Orthopedics. There's a lot of self-selection going on and most of the applicants are the cream of the crop of US seniors...

Source: http://www.nrmp.org/data/resultsanddata2009.pdf

IMO it's so ridiculous when people keep telling incoming M1s they can match into whatever they want when it's just not true.

I think a more telling stat would be looking at the roughly 20 to 25 percent who didn't match in these competitive specialties and seeing what school they came from.

 

[Pedie Packs]

At the unranked state schools that I am considering, people are matching into these specialties. Some even at prestigious institutions (though the point was brought up that prestige =/= a great residency due to malignant programs). My point is that I'm going to go into M1 believing I can match into any specialty if I put in great work. What's your reason for saying otherwise?

 

[drizzt3117]

Anecdotal info is nice, I prefer hard #s though, the average step for plastics is 243, I don't have the #s on hand for the other specialties but IIRC, they're 235 or higher for all the ones I mentioned. As that's about a standard deviation or more above the national average for step, I'd say they have good stats. You'll find similar info for % AOA in each specialty, etc.

It's nice that your friends matched into what they wanted. Even in competitive specialties most people are getting in, but there's still a good amount of people who do not. 1/4 to 1/3 of applicants not matching AT ALL is not a trivial amount, never mind their first choice, or where they wanted to go but didn't interview.

My point is that it's an unpredictable process and everything matters. You don't know exactly what a given PD is looking for, all you can do is put yourself in the best position to succeed.

The problem is no one can see the full applications of everyone who applied. IMO its ridiculous for you to tell people they can't match well without stellar scores.

I go to a state school with a HEAVY primary care emphasis. We have 140 people in our class.
5 matched Derm, including at IVY programs
4 matched ENT
5 matched ortho

That is 10% of my class in just a few highly competitive fields, and you want to believe they were all top students? Not even half of that were top 20% in the class. I didn't even begin listing off our matches for uro, neurosurg, rads, etc. Many of our AOA students are in primary care.

Someone not to be named in that 14 even had comments on his/her application that said something similar to "does not work well with others".

Someone else that matched a surgical subspecialty at a top 20 program was in the bottom 10% of our class and had marks on his/her application.

Sure it is tougher to match into a competitive field with low scores and/or red flags on your transcript, but it is VERY possible.....even from public state schools...🙄.

Most of my friends got their #1 choice in field and residency spot, and I can guarantee that because I knew their rank order list before match day (they wouldn't have been able to lie come match day).

In no way am I trying to brag about my class.....I think most US MD schools would have similar results. If a small state school like mine (probably not even considered in the top 5 med schools in the state in prestige) can match students at the bottom of the class into competitive fields, surely top schools like drizzt3117's can do ok. 😀

 

[drizzt3117]

At the unranked state schools that I am considering, people are matching into these specialties. Some even at prestigious institutions (though the point was brought up that prestige =/= a great residency due to malignant programs). My point is that I'm going to go into M1 believing I can match into any specialty if I put in great work. What's your reason for saying otherwise?

I think it's possible for anyone from any program to match anywhere, it's simply a matter of probability, and that people need to temper their expectations accordingly.

 

[ButImLETired]

Generalized data on school prestige for matched/unmatched applicants in each specialty can be found in the report linked in post #62.

The ranks are determined by NIH funding, but it's a start.

Here's the relevant quote:

"Radiation Oncology had the highest percentage of matched U.S. seniors who were graduates of a medical school with the highest NIH funding. Plastic Surgery, Dermatology, Neurological Surgery, and Transitional Year also had higher percentages of matched applicants from those schools compared to the other specialties. For all specialties except Internal Medicine/Pediatrics and Physical Medicine and Rehabilitation, smaller percentages of seniors who did not match to their preferred specialty were graduates of a medical school with the highest NIH funding compared to seniors who matched."

Note: they looked at the grads of the top 40 NIH schools so it's still a pretty big group.


Btw koko, congrats on the acceptance!!

 

[TexasPhysician]

Here's the relevant quote:

"Radiation Oncology had the highest percentage of matched U.S. seniors who were graduates of a medical school with the highest NIH funding. Plastic Surgery, Dermatology, Neurological Surgery, and Transitional Year also had higher percentages of matched applicants from those schools compared to the other specialties. For all specialties except Internal Medicine/Pediatrics and Physical Medicine and Rehabilitation, smaller percentages of seniors who did not match to their preferred specialty were graduates of a medical school with the highest NIH funding compared to seniors who matched."

Note: they looked at the grads of the top 40 NIH schools so it's still a pretty big group.

Hard to imagine some of the numbers being statistically significant when I can't remember anyone from my school who even "applied" to rad onc.....much less got rejected/accepted.

You are looking at very small fields (hence the competition) where very limited numbers of people apply.

 

[TexasPhysician]

Anecdotal info is nice, I prefer hard #s though, the average step for plastics is 243, I don't have the #s on hand for the other specialties but IIRC, they're 235 or higher for all the ones I mentioned. As that's about a standard deviation or more above the national average for step, I'd say they have good stats. You'll find similar info for % AOA in each specialty, etc.

It's nice that your friends matched into what they wanted. Even in competitive specialties most people are getting in, but there's still a good amount of people who do not. 1/4 to 1/3 of applicants not matching AT ALL is not a trivial amount, never mind their first choice, or where they wanted to go but didn't interview.

My point is that it's an unpredictable process and everything matters. You don't know exactly what a given PD is looking for, all you can do is put yourself in the best position to succeed.

The NBME match statistics (same as someone already posted on here) shows that people match Derm with <200 on USMLE's. Obviously you are statistically more likely to match with a 270. I'm not argueing that.

A flaw with the NBME match stats (since you like stats) is that it takes into account what your "1st choice" residency is only.

"For the purposes of this report, match success is defined as a
match to the specialty of the applicant's first-ranked program,
because that is assumed to be the specialty of choice. Lack of
success includes matching to another specialty as well as failure
to match at all. No distinction was made based on whether​

applicants matched to their first, second, third, or last choice."

So if an applicant has a 270 Step 1 score and only ranks 2 Derm programs due to location/family/etc and matches at their 3rd choice say in Internal Medicine, it is considered a failed attempt to match Derm. Such things happen quite often. I would argue that this is the applicant's fault in not matching Derm - not enough programs were ranked. If you have lower stats, you just need to apply more broadly than others.

To give an example, a classmate of mine ranked 2 programs in ENT and failed to match. It will show up on the next NBME match statistics publication that someone with 250+ step scores and junior AOA (top 4 people in the class) failed to match ENT. Other people with <200 step scores matched because they were more flexible.

This is why I advise people to apply in whatever field they want. If you have poor scores, maybe apply everywhere. You may end up in a less-than-ideal location, but you may get into the field of your dreams because many applicants are limited geographically.

 

[drizzt3117]

I don't know what you're trying to argue.

1) If you go to a lower ranked school you'll have lower chances to match into the most competitive specialties, according to the article we're all quoting.

2) If you have lower scores, you'll have a lower chance of matching into top specialties.

3) People match into all specialties from all schools but they have a higher chance of matching into the most competitive programs in ALL specialties but especially the most competitive specialties in all fields.

I think most people would agree with these statements, and if not, the data certainly bears it out. I posted a list of top 3 programs in three competitive residencies (Radiology, Optho, Neurosurgery) and 73% of the people in the last 4 years in those residencies were from top 25 programs, 51% were from top 10 programs. I don't really know what to tell you if you don't think going to a top program is going to help you when applying to the top programs in competitive residencies.

The NBME match statistics (same as someone already posted on here) shows that people match Derm with <200 on USMLE's. Obviously you are statistically more likely to match with a 270. I'm not argueing that.

A flaw with the NBME match stats (since you like stats) is that it takes into account what your "1st choice" residency is only.

"For the purposes of this report, match success is defined as a
match to the specialty of the applicant’s first-ranked program,
because that is assumed to be the specialty of choice. Lack of
success includes matching to another specialty as well as failure
to match at all. No distinction was made based on whether​

applicants matched to their first, second, third, or last choice."

So if an applicant has a 270 Step 1 score and only ranks 2 Derm programs due to location/family/etc and matches at their 3rd choice say in Internal Medicine, it is considered a failed attempt to match Derm. Such things happen quite often. I would argue that this is the applicant's fault in not matching Derm - not enough programs were ranked. If you have lower stats, you just need to apply more broadly than others.

To give an example, a classmate of mine ranked 2 programs in ENT and failed to match. It will show up on the next NBME match statistics publication that someone with 250+ step scores and junior AOA (top 4 people in the class) failed to match ENT. Other people with <200 step scores matched because they were more flexible.

This is why I advise people to apply in whatever field they want. If you have poor scores, maybe apply everywhere. You may end up in a less-than-ideal location, but you may get into the field of your dreams because many applicants are limited geographically.

 

[ButImLETired]

Hard to imagine some of the numbers being statistically significant when I can't remember anyone from my school who even "applied" to rad onc.....much less got rejected/accepted.

You are looking at very small fields (hence the competition) where very limited numbers of people apply.

Hmm I'm not sure why you're arguing with me. I just posted something from the charting outcomes thing. Take it up with them...

Also, I don't think anyone is arguing in absolutes here. Of course, you can match anywhere from anywhere. But the data shows that you're statistically more likely to match into one of the most competitive specialties if you go to a "prestigious" school. To argue against those statistics using anecdotal evidence really doesn't make any sense.

 

[235788]

Urology is the way... Read into it.

-If you want to coach your sons sport teams, not get divorced, and still live well. Just remember, almost everything can wait until the morning.

 

[ButImLETired]

Urology is the way... Read into it.

-If you want to coach your sons sport teams, not get divorced, and still live well. Just remember, almost everything can wait until the morning.

You truly couldn't pay me enough money or give me enough hours off to do urology.

 

[drizzt3117]

You truly couldn't pay me enough money or give me enough hours off to do urology.

urology IS pretty sweet, my brother is a PGY-3 in urology and he gets to use the da vinci robots all the time! Fun!

 

[coolnad17]

Hmm I'm not sure why you're arguing with me. I just posted something from the charting outcomes thing. Take it up with them...

Also, I don't think anyone is arguing in absolutes here. Of course, you can match anywhere from anywhere. But the data shows that you're statistically more likely to match into one of the most competitive specialties if you go to a "prestigious" school. To argue against those statistics using anecdotal evidence really doesn't make any sense.

I'm not trying to argue the prestige issue here...i'm sure it plays a role.

Anyway, to summarize, the data show that a higher percentage of people matching to some of the more competitive residencies are from the top 40 NIH funded schools.

However, is this really correlated to prestige or is it just a function of the amount of research going on at particular institutions? Research publications seem to be an important factor for the competitive specialties. If an institution is receiving a lot of NIH funding, it may imply that its students and faculty are more involved in research compared to those not on the NIH top-40, which puts the students in a better position to match to more competitive specialties.

Just a thought....

By the way, thanks for everyone who has contributed to this thread. I've definitely learned a lot.

 

[drizzt3117]

The two things go hand in hand. Schools are "prestigious" because they have prestigious faculty who have made amazing scientific discoveries.

I'm not trying to argue the prestige issue here...i'm sure it plays a role.

Anyway, to summarize, the data show that a higher percentage of people matching to some of the more competitive residencies are from the top 40 NIH funded schools.

However, is this really correlated to prestige or is it just a function of the amount of research going on at particular institutions? Research publications seem to be an important factor for the competitive specialties. If an institution is receiving a lot of NIH funding, it may imply that its students and faculty are more involved in research compared to those not on the NIH top-40, which puts the students in a better position to match to more competitive specialties.

Just a thought....

By the way, thanks for everyone who has contributed to this thread. I've definitely learned a lot.

 

[ButImLETired]

urology IS pretty sweet, my brother is a PGY-3 in urology and he gets to use the da vinci robots all the time! Fun!

I rest my case. I couldn't do it. I hate everything surgical (I feel like a mechanic, and I don't like a lot of the personalities in surgery), think the pelvis is both boring and totally gross, and couldn't look at ED and weird urinary issues all day. Noooo thank you.

I'm not trying to argue the prestige issue here...i'm sure it plays a role.

Anyway, to summarize, the data show that a higher percentage of people matching to some of the more competitive residencies are from the top 40 NIH funded schools.

However, is this really correlated to prestige or is it just a function of the amount of research going on at particular institutions? Research publications seem to be an important factor for the competitive specialties. If an institution is receiving a lot of NIH funding, it may imply that its students and faculty are more involved in research compared to those not on the NIH top-40, which puts the students in a better position to match to more competitive specialties.

Just a thought....

By the way, thanks for everyone who has contributed to this thread. I've definitely learned a lot.

Absolutely. Which is another reason why going to a prestigious school if you have no interest in academia or research is kind of pointless. That's their main strength, really. Of course you can get tons of research experience elsewhere (Drizz is proof positive of that) but the top schools generally expect you to have some research done or straight up force you to do it.

But I mean, all of these things are related: schools become prestigious because their faculty is at the forefront of medical innovations, i.e. they have a lot of research. So they get a ton of NIH money, other schools' faculty knows them, and the schools rise through the ranks. That academic spirit trickles down to the med students, who are accepted because of their own academic interests and who do research while they're there. Residency directors in equally academic "prestigious" residencies accept these kids and they find that they're best equipped for academia because they already have experience in that environment, and the school they come from rises in the ranks again because of higher residency director scores. And so on. All of this stuff is inter-related.

 

[TexasPhysician]

Hmm I'm not sure why you're arguing with me. I just posted something from the charting outcomes thing. Take it up with them...

Also, I don't think anyone is arguing in absolutes here. Of course, you can match anywhere from anywhere. But the data shows that you're statistically more likely to match into one of the most competitive specialties if you go to a "prestigious" school. To argue against those statistics using anecdotal evidence really doesn't make any sense.

Ok Ill send them an email right now...🙄

 

[TexasPhysician]

I don't know what you're trying to argue.

1) If you go to a lower ranked school you'll have lower chances to match into the most competitive specialties, according to the article we're all quoting.

2) If you have lower scores, you'll have a lower chance of matching into top specialties.

3) People match into all specialties from all schools but they have a higher chance of matching into the most competitive programs in ALL specialties but especially the most competitive specialties in all fields.

I think most people would agree with these statements, and if not, the data certainly bears it out. I posted a list of top 3 programs in three competitive residencies (Radiology, Optho, Neurosurgery) and 73% of the people in the last 4 years in those residencies were from top 25 programs, 51% were from top 10 programs. I don't really know what to tell you if you don't think going to a top program is going to help you when applying to the top programs in competitive residencies.

What was the article that showed top NIH research programs have a better chance of matching students into competitive fields?

Your bolded statement shows that more people from top NIH programs apply - not that they have a better chance. I'd like to read the article that shows that they are statistically more likely to match and see how they came to this conclusion.

 

[coolnad17]

But I mean, all of these things are related: schools become prestigious because their faculty is at the forefront of medical innovations, i.e. they have a lot of research. So they get a ton of NIH money, other schools' faculty knows them, and the schools rise through the ranks. That academic spirit trickles down to the med students, who are accepted because of their own academic interests and who do research while they're there. Residency directors in equally academic "prestigious" residencies accept these kids and they find that they're best equipped for academia because they already have experience in that environment, and the school they come from rises in the ranks again because of higher residency director scores. And so on. All of this stuff is inter-related.

The two things go hand in hand. Schools are "prestigious" because they have prestigious faculty who have made amazing scientific discoveries.

Makes a lot of sense.

 

[drizzt3117]

What was the article that showed top NIH research programs have a better chance of matching students into competitive fields?

Your bolded statement shows that more people from top NIH programs apply - not that they have a better chance. I'd like to read the article that shows that they are statistically more likely to match and see how they came to this conclusion.

We just talked about it, it's the NRMP charting outcomes.

As far your other point, it's self selection, it's naive to assume that people from low ranked schools just don't want to go to higher ranked programs. They either didn't apply because they didn't think they were competitive, didn't get an interview, or didn't match. I'm not super familiar with the average scores for residencies other than radiology, I haven't researched them to that degree, but the last numbers I saw were ~255-260 for UM/USCF and probably similar #s for MGH, MIR, etc. That's 20-25 points higher than the mean for radiology ~235, or more than one standard deviation. That and almost everyone at those programs is from top schools. Draw your own conclusions.

 

[TexasPhysician]

I rest my case. I couldn't do it. I hate everything surgical (I feel like a mechanic, and I don't like a lot of the personalities in surgery), think the pelvis is both boring and totally gross, and couldn't look at ED and weird urinary issues all day. Noooo thank you.




Absolutely. Which is another reason why going to a prestigious school if you have no interest in academia or research is kind of pointless. That's their main strength, really. Of course you can get tons of research experience elsewhere (Drizz is proof positive of that) but the top schools generally expect you to have some research done or straight up force you to do it.

But I mean, all of these things are related: schools become prestigious because their faculty is at the forefront of medical innovations, i.e. they have a lot of research. So they get a ton of NIH money, other schools' faculty knows them, and the schools rise through the ranks. That academic spirit trickles down to the med students, who are accepted because of their own academic interests and who do research while they're there. Residency directors in equally academic "prestigious" residencies accept these kids and they find that they're best equipped for academia because they already have experience in that environment, and the school they come from rises in the ranks again because of higher residency director scores. And so on. All of this stuff is inter-related.

I agree that if your goal is academia, a higher NIH school will better serve you.

 

[drizzt3117]

Absolutely. Which is another reason why going to a prestigious school if you have no interest in academia or research is kind of pointless. That's their main strength, really. Of course you can get tons of research experience elsewhere (Drizz is proof positive of that) but the top schools generally expect you to have some research done or straight up force you to do it.

But I mean, all of these things are related: schools become prestigious because their faculty is at the forefront of medical innovations, i.e. they have a lot of research. So they get a ton of NIH money, other schools' faculty knows them, and the schools rise through the ranks. That academic spirit trickles down to the med students, who are accepted because of their own academic interests and who do research while they're there. Residency directors in equally academic "prestigious" residencies accept these kids and they find that they're best equipped for academia because they already have experience in that environment, and the school they come from rises in the ranks again because of higher residency director scores. And so on. All of this stuff is inter-related.

I think going to a research intensive school is a big plus.

Here's a list of the NIH awards for 2009:
http://www.sendspace.com/file/fnclxk

My departments (radiology/medical physics) had almost 9 million dollars in funding, which helps a lot because there's just a lot of resources to make things happen. You'll find that there's a pretty big difference in terms of simply funding for things between schools. There are 30 grad students here in Sweden from my school's medical physics and radiology departments. You're not going to see that at random schools that don't do a lot of research.

 

[TexasPhysician]

We just talked about it, it's the NRMP charting outcomes.

As far your other point, it's self selection, it's naive to assume that people from low ranked schools just don't want to go to higher ranked programs. They either didn't apply because they didn't think they were competitive, didn't get an interview, or didn't match. I'm not super familiar with the average scores for residencies other than radiology, I haven't researched them to that degree, but the last numbers I saw were ~255-260 for UM/USCF and probably similar #s for MGH, MIR, etc. That's 20-25 points higher than the mean for radiology ~235, or more than one standard deviation. That and almost everyone at those programs is from top schools. Draw your own conclusions.

That's the problem. The NRMP data says nothing about higher NIH schools being any better at sending its students to competitive fields. I've read it.

State schools will on the whole send more students to primary care. State schools and other non-NIH ranked schools accept different types of students than Top 25 programs for the most part. There is a huge majority of my class that WANTS to practice in the middle of nowhere. You can't do a residency in plastic surgery and make a living in a town of 5,000 people. There aren't enough patients.

We have a dozen people I know that want to persue wilderness medicine training (almost 10% of my class).

On the other hand, more people from Top 25 programs will be geared towards academia, research, and competitive fields that will thrive in urban environments.

Its not that Top 25 programs are any better at getting students into competitive fields, but they do have a LOT more that apply. Hence the numbers you mention, and why my state school's numbers (although anecdotes) fall right in line with your data.

Neurosurgery 1/1 matched
Derm 5/5 matched
Ophtho 2/3 matched
Urology 3/3 matched
ENT 4/4 matched

When you find an article that states NIH schools are better at sending students to competitive fields, let me know.

 

[drizzt3117]

The NRMP data said that students from top 40 schools are more like to match into Derm, Plastics, Rad Onc, and Neurosurgery, which are the four most competitive specialties by board scores. We just discussed this.

That's the problem. The NRMP data says nothing about higher NIH schools being any better at sending its students to competitive fields. I've read it.

State schools will on the whole send more students to primary care. State schools and other non-NIH ranked schools accept different types of students than Top 25 programs for the most part. There is a huge majority of my class that WANTS to practice in the middle of nowhere. You can't do a residency in plastic surgery and make a living in a town of 5,000 people. There aren't enough patients.

We have a dozen people I know that want to persue wilderness medicine training (almost 10% of my class).

On the other hand, more people from Top 25 programs will be geared towards academia, research, and competitive fields that will thrive in urban environments.

Its not that Top 25 programs are any better at getting students into competitive fields, but they do have a LOT more that apply. Hence the numbers you mention, and why my state school's numbers (although anecdotes) fall right in line with your data.

Neurosurgery 1/1 matched
Derm 5/5 matched
Ophtho 2/3 matched
Urology 3/3 matched
ENT 4/4 matched

When you find an article that states NIH schools are better at sending students to competitive fields, let me know.

 

[skeptic29]

This question may be a little off topic, but to all the medical students... what kinds of textbooks do you use in medical school? I was just looking at the curriculum of some schools and I see something like Medfoundations Block 1 during the first four months of first year when you're doing biochem, cell bio, immuno, and some other stuff together. It just seems like a lot of information to cram into four months of instruction. Are the textbooks more detailed/comprehensive than the ones you used in college? Because I've taken these courses as an undergraduate and I was just trying to get a sense of how different they are.