Feb 14, 2013
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I was wondering if I could get some help with ranking. I am an MD senior applying to Path this year and I'd consider myself an average candiate. I am worried about two problems, one is comparing prestige vs. happiness and the other is ranking programs close to home vs far away if it means sacrificing better programs farther away. I am very much aware of the issue with the job market and people on here talk about the crappy programs. And I know my questions aren't necessarily original, but I wanted to get a fresh perspective. So here are my questions if anyone can help.............


1. Fellowship: Can a fellowship at an impressive institution make a difference for jobs if the candiate went to an average residency? It seems like there are plenty of fellowships out there so I am thinking even if I go a less desirable program, if I work hard, try to publish, etc do you think it is possible to secure a good fellowship?

2. In relation to question to #2 it seems to me that a fellowship in something like FP or Transfusion medicine would make more a difference in helping one's career to differeniate into something marketable compared to something like a general Surg Path fellowship which is really just an extension of residency. Obviously it will help you more if you went to a top notch program for any job, but does it matter less for a fellowship such as FP?

3. Unmatched programs: So if I am reading NRMP stats from last year correctly it appears as though a lot of spots went unmatched at well known programs/well known hospitals such as Duke, UVM, Columbia, UF-Shands, MCW, etc. Does anyone know if these programs filled in the scramble? I can rank 13 programs, but only 5-6 are at well known places so I am wondering if it would be in my best interest to only rank 6 and if I go unmatched try for the SOAP. I know this sounds crazy in other fields, but since there are so many spots open in Path it seems like it is possible to Scramble into a decent program. Any residents here have experience this? Do these prorams just take the same approach and only rank high quality applicants? If you have residents that scrambled, are they good?


Thanks in advance for the help. My adviser at school has been willing to help but he seems out of touch with the current enviroment.
 

TMZ2007

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My general feeling about prestige from going to meetings and talking to other residents and fellows looking for jobs is that unless you plan on going into strictly academic practice at a big-name place, it's not *that* important. Things that seem to matter more include (in no particular order): be smart/have a good eye, be able to talk coherently with clinicians and get along with the staff, get good references during your training, and have the specific expertise the job requires. A lot of the job connections that your last training program has will be concentrated in the region where it is located, so try to get a residency and/or fellowship where you'd ideally like to put down roots.
 

mlw03

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I don't think too many people cared where I was in residency as I was applying for FP, so long as I could pass the AP boards. For a job in FP, no one gives two poops where you did residency, since path residency has virtually nothing to do with FP practice. They will care where you did fellowship a bit, but there are no bad programs. If you can stand living in one of those cities, I do think the big 4 in FP are worth trying to go to. Heck, about 1/3 of all FPs in North America come from one of those programs anyway.
 

Euchromatin

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1. Fellowship: Can a fellowship at an impressive institution make a difference for jobs if the candiate went to an average residency? It seems like there are plenty of fellowships out there so I am thinking even if I go a less desirable program, if I work hard, try to publish, etc do you think it is possible to secure a good fellowship?

2. fellowship in something like FP or Transfusion medicine compared to something like a general Surg Path fellowship

3. Unmatched programs
1. Yes - I am a resident at a program that is NOT one of those 10-20 "big name" places everyone on this board is always harping about (although I think I'm getting great training and would definitely consider my program to be better than average). I was able to secure a desirable, competitive fellowship. I think doing an impressive audition rotation was the key factor for me.

2. This entirely depends upon what you want to go into. I would NOT suggest that anyone do a forensics fellowship unless you actually want to do FP. If you are trying to get a private practice job where all the partners have mixed AP and CP duties, I think that a specific fellowship that would give you an area of expertise (i.e. cyto, heme, a surg path subspecialty, transfusion, chemistry, etc.) would probably be more marketable than a generic "surg path" fellowship.

3. I, personally, would probably not be comfortable doing what you are suggesting unless some of the places I had interviewed at were really awful and I was considering not ranking them anyway. Also, I have a hunch that many of the bigger name places that had unfilled positions during last year's match are probably going to interview and rank more applicants this year to make sure it doesn't happen again. Even if the candidate they got in the scramble turned out to be okay, having unfilled spots in the match is a stigma that makes the program look less desirable.
 

KCShaw

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Most employers I think look at "you" more than whether you have a brand name background per se. Those that are influenced by a brand name will probably focus more on the most recent place you trained at, usually your fellowship. Feel free to aim high, so to speak, but especially for residency don't sell your soul for a label. Then search and apply early for a reputable fellowship that you think suits you.

Highly specific fellowships, like FP or anything CP, are great if that's exactly what you want to do, but will limit your options in a way that doing a selective (GI, etc.) or general surgpath fellowship won't.

I wouldn't exactly count on the scramble. Some programs are large enough that they're willing to leave a couple of spots open rather than rank everyone they see or bother with the hassle of the scramble. I've seen this play out. They -might- look at those who try to scramble in, but they may ultimately be quite happy to dump more work on their existing residents in order to maintain their exclusivity, knowing there are still enough bodies to handle the service work. They may have a "critical minimum number" in mind, but some would rather appear exclusive than full -- which doesn't work for everyone.
 
OP
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Feb 14, 2013
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Thank you to everyone for your replies. This information is very useful and has helped me put my list together. I did not consider unmatched programs simply putting more work on existing residents. Thank you again!