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"Reputation" as a means to get into a "top" residency

altblue

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Just an applicant, but I get the impression that a comprehensively strong app from a low-tier MD program can get you into a competitive surgical residency (subspecialty?). When you're from a more prestigious med-school though, you might have more lee-way for each of these components like Step 1 or clinical grades, which might be more critical for borderline applicants.
 
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Provided you do well and get the requisite Step 1 score, does it make a big difference what medical school you go to, top 20 vs mid tier in regards to getting into competitives surgical residencies?
In general, yeah, but it's not an absolute. If you go to U KS, you can still match at a JHU residency.
 
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gonnif

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PreMedMissteps

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Provided you do well and get the requisite Step 1 score, does it make a big difference what medical school you go to, top 20 vs mid tier in regards to getting into competitives surgical residencies?


JMHO, but it appears that the residency directors of top programs favor applicants that are from SOMs that have MSTP programs. Perhaps because those SOMs are perceived as being more research-oriented, cutting edge? They seem to be more familiar with those SOMs. I think that there are about 40 SOMs with MSTP. So if you’re looking for a number, maybe the top 50 meds?
 

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JMHO, but it appears that the residency directors of top programs favor applicants that are from SOMs that have MSTP programs. Perhaps because those SOMs are perceived as being more research-oriented, cutting edge? They seem to be more familiar with those SOMs. I think that there are about 40 SOMs with MSTP. So if you’re looking for a number, maybe the top 50 meds?

It's not that PDs prefer MSTP oriented schools and applicants, it's that for top programs a majority of the applicants are likely coming from MSTP and research heavy (i.e. top ranked schools) and if they've historically had good students from said schools then they'll tend to accept students from that school because they know they are good clinically for their program. It's hard to break into a program when you're the first coming from your school since they don't know the quality.
 
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It's not that PDs prefer MSTP oriented schools and applicants, it's that for top programs a majority of the applicants are likely coming from MSTP and research heavy (i.e. top ranked schools) and if they've historically had good students from said schools then they'll tend to accept students from that school because they know they are good clinically for their program. It's hard to break into a program when you're the first coming from your school since they don't know the quality.
That reminds me that med schools are feeders to residency programs in the same way that UG schools are feeders to med schools. As my learned colleague has pointed out, the graduates are a known quantity.
 
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aldol16

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Yes, it matters, but no, it doesn't matter to the extent that it can cover up big weaknesses in your app. You don't have to take anyone's work for it. Take a look at the top residency programs in whatever you want to go into. Every program will have a resident page with where they all went to school. You'll find that at the top, which tend to be highly academic programs, there is a huge overrepresentation of people from top medical schools. That isn't a coincidence.
 
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Would the reputation influence be as important when choosing between a mid-tier and low-tier school, or at that point would it be more advisable to choose a school based on other factors?
Depends on the other factors and if you are legitimately at top 10% type student and frankly the odds are most posters here are not
 
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Would the reputation influence be as important when choosing between a mid-tier and low-tier school, or at that point would it be more advisable to choose a school based on other factors?

No, quite the opposite. There have been data presented in this forum over the years that indicate the only schools that may confer a significant advantage are the top 5-ish (e.g Harvard, Hopkins, Stanford, etc.). Below that and it gets virtually impossible to tease out school name from the myriad other factors that make someone competitive in the residency match.

Ultimately this debate is rather silly, as there aren't may applicants who are sweating a choice between Stanford and North Dakota.
 
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PreMedMissteps

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Would the reputation influence be as important when choosing between a mid-tier and low-tier school, or at that point would it be more advisable to choose a school based on other factors?


Unless there are serious reasons not to, pick the best school you get into.

I was looking over the multi-year residents list at my daughter’s top program. It’s a who’s who listing of UCSF, Stanford, Harvard, Yale, JHU SOM grads. There are about 10-20% of grads from non-elite med schools, but they’re not from low-tier meds either. Their med schools are more like top 50. Interesting though, there are 3 from med schools outside the US (not Caribbean!!! Lol ).

I still think it’s significantly stats-driven, along with research opps, LORs, grades.

Of course those who attended Harvard-like med schools are going to be more likely 250+ scoring Step students than those who attended low tier SOMs. This is what these elite school students do...spank standardized tests and excel at academics. But since there are students from med schools like University of IL Chicago included, it can be safely assumed that students like that had impressive stats too.
 

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Unless there are serious reasons not to, pick the best school you get into.

I was looking over the multi-year residents list at my daughter’s top program. It’s a who’s who listing of UCSF, Stanford, Harvard, Yale, JHU SOM grads. There are about 10-20% of grads from non-elite med schools, but they’re not from low-tier meds either. Their med schools are more like top 50. Interesting though, there are 3 from med schools outside the US (not Caribbean!!! Lol ).

I still think it’s significantly stats-driven, along with research opps, LORs, grades.

Of course those who attended Harvard-like med schools are going to be more likely 250+ scoring Step students than those who attended low tier SOMs. This is what these elite school students do...spank standardized tests and excel at academics. But since there are students from med schools like University of IL Chicago included, it can be safely assumed that students like that had impressive stats too.

The average reported Step 1 at Hopkins is a 235 iirc and Harvard is around the same area. Match list speak for themselves.
 
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The average reported Step 1 at Hopkins is a 235 iirc and Harvard is around the same area. Match list speak for themselves.

Columbia's was lower 240s but went down a little to the upper 230s last year. Could just be random variation. I think we consistently have pretty stacked match lists regardless. I also think that step matters overall less than people hype it up to matter, especially coming from a brand name school.

And for all you premeds out there, average step score is probably the absolute worst way you can choose a medical school so pls don't do that. Just wanted to make sure that was said in this thread for everyone thinking it.
 
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PreMedMissteps

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The average reported Step 1 at Hopkins is a 235 iirc and Harvard is around the same area. Match list speak for themselves.


Still, their averages are probably about 10+ pts higher than mid and low tiers.

There are very strong students at every med school. There is a greater concentration at the likes of JHU and Harvard.

Isn’t there a link for average step scores per school?
 

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Still, their averages are probably about 10+ pts higher than mid and low tiers.

There are very strong students at every med school. There is a greater concentration at the likes of JHU and Harvard.

Isn’t there a link for average step scores per school?

See, I'm super skeptical of this kind of argument. I'm willing to wager that what sets students at HMS/Hopkins and Co. from their peers at academically comparable institutions (virtually any other school in the T20 tbqh) on paper during the Match process is the names at the bottom of their recommendation letters and who is making phone calls on their behalf or answering the phone when program directors call.
 
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Mad Jack

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See, I'm super skeptical of this kind of argument. I'm willing to wager that what sets students at HMS/Hopkins and Co. from their peers at academically comparable institutions (virtually any other school in the T20 tbqh) on paper during the Match process is the names at the bottom of their recommendation letters and who is making phone calls on their behalf or answering the phone when program directors call.
That and the research opportunities
 
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WedgeDawg

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See, I'm super skeptical of this kind of argument. I'm willing to wager that what sets students at HMS/Hopkins and Co. from their peers at academically comparable institutions (virtually any other school in the T20 tbqh) on paper during the Match process is the names at the bottom of their recommendation letters and who is making phone calls on their behalf or answering the phone when program directors call.

Also the whole known product thing when it comes to clinical skills, knowledge base, expectations, etc
 
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That and the research opportunities

True. The quality and quantity of high impact research happening at the very top institutions is difficult to compare with even similarly ranked institutions. This is for MSTP, but to some degree it reflects on the opportunities available to MD students as well but the average number of publications (not presentations, abstracts, etc. but refereed pubs) at a certain T5 school was 15, with average number of first author being 7. The next highest number outside of the T5 I can recall was 6 at another school in the T10.
 
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WedgeDawg

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True. The quality and quantity of high impact research happening at the very top institutions is difficult to compare with even similarly ranked institutions. This is for MSTP, but to some degree it reflects on the opportunities available to MD students as well but the average number of publications (not presentations, abstracts, etc. but refereed pubs) at a certain T5 school was 15, with average number of first author being 7. The next highest number outside of the T5 I can recall was 6 at another school in the T10.

It also can be specialty dependent for us MD only kids
 
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Lucca

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I dont say any of this to promote fatalism...where you go to school is not the ultimate determinant of what career options you'll have. But there's a longrunning myth that students at top schools are somehow intrinsically better than those elsewhere and I think that's just largely false and people are afraid to admit it because it betrays our illusions of meritocracy.
 
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WedgeDawg

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I dont say any of this to promote fatalism...where you go to school is not the ultimate determinant of what career options you'll have. But there's a longrunning myth that students at top schools are somehow intrinsically better than those elsewhere and I think that's just largely false and people are afraid to admit it because it betrays our illusions of meritocracy.

I mean Columbia accepted me so this is just patently untrue...
 
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smq123

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I dont say any of this to promote fatalism...where you go to school is not the ultimate determinant of what career options you'll have. But there's a longrunning myth that students at top schools are somehow intrinsically better than those elsewhere and I think that's just largely false and people are afraid to admit it because it betrays our illusions of meritocracy.

I think that people are unwilling to admit it because a) it betrays our illusions of meritocracy (as you said), but also because b) for people who are going to these top tier schools, and spending exorbitant amounts of money, you have to justify it to yourself somehow. And the easiest way to justify it is to say, "Well, I'm investing in my future because I'll match better coming out of Harvard than I will coming out of Generic State school."

It's all a gamble at the end of the day, which is part of the problem. You might go into medical school (or even go into residency) convinced that you want to do derm or rad onc or neurosurgery or that you want to be chairman of cardiology at JHU someday. And in those cases, yes, going to a big name school might help you. But what if you don't? What if you come out of medical school and/or residency, realizing that you're perfectly happy being an internal medicine hospitalist in a small no-name community hospital that treats you well and lets you spend lots of time with your spouse and kids? Did you spend all that money for nothing? It's a tough call.

I would encourage all med students, no matter what their future goals are, to think about cost. No, it's not sexy and it's not as exciting as poring over match list and comparing Step 1 scores, but from experience - DEBT TRAPS YOU. It traps you in bad jobs, it traps you in medicine even if you want to take a break and do something different, and it can strain your marriage if you're not careful. Yes, it's very easy to say "Just keep living like a resident for the first five years of your attending life!," but it is extremely hard to do in practice. It gets harder if you have a spouse and kids who may not understand that yes, Mommy/Daddy is making a lot more money now but we can't spend anymore because we have to pay back that vicious dominatrix (Sallie Mae or Wells Fargo or whoever) first.
 
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gonnif

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No, quite the opposite. There have been data presented in this forum over the years that indicate the only schools that may confer a significant advantage are the top 5-ish (e.g Harvard, Hopkins, Stanford, etc.). Below that and it gets virtually impossible to tease out school name from the myriad other factors that make someone competitive in the residency match.

Ultimately this debate is rather silly, as there aren't may applicants who are sweating a choice between Stanford and North Dakota.
To expand on this

1) residency selection relies much more on small group dynamics, direct connection, networking, recommendation, and similar.
2) reputation of the overall medical school is not as nearly important as is reputation of the specialty department or program within a school. Residencies care about how good the dept of medicine or the orthopedics is, not the overall prestige of the school
3) similarly, links/history between residency and school department matter. If the school has previously sent high quality graduates to the residency program before, it is likely that would help future applicants from that medical school.
4) recommendations and deans letter matter greatly, especially those where a professional link exists between the residency program director or staff and the medical school faculty. Remember a medical school depends on its reputation to place people and will not extend letters to those students who are subpar for program or speciality. This is where “self-selection” for programs or specialty takes place.
5) even residency is a training position, it is a job and selection is based in a large part based on how you will work with the team. As such, audition rotations play a large part in residency selection.
6) having said all of the above, except for very, very few accepted medical school applicants, it makes almost no sense to consider residency selection as a major factor in selecting which medical school to attend. About half of all acceptees get a single offer of acceptance. Additionally, a large fraction of entering medical school students change specialties from M1 to M4.
7) for data on this, see the NRMP Program Directors survey as well as AAMC matriculating and graduate student surveys
 
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southpaw3

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Unless there are serious reasons not to, pick the best school you get into.

I don't want to get in the middle of this in-depth discussion, but I did want to respond back to this specific statement because this is exactly where my question lies... Is the "best" school the school with the highest ranking/highest step scores, or is it the school where an individual thinks they will be the most successful (academically, emotionally, socially, professionally, etc.)? I'm personally inclined to choose the latter despite that being quantitatively the wrong choice.
 

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I don't want to get in the middle of this in-depth discussion, but I did want to respond back to this specific statement because this is exactly where my question lies... Is the "best" school the school with the highest ranking/highest step scores, or is it the school where an individual thinks they will be the most successful (academically, emotionally, socially, professionally, etc.)? I'm personally inclined to choose the latter despite that being quantitatively the wrong choice.

Definitely not the school with the highest step scores. Definitely not the highest ranking.

You should pick the school with the highest combination of career opportunities, fit, location, cost, and reputation in no particular order. In what order those matter to you depends on you as an individual and your goals. If you want to do your residency at one of the Harvard hospitals, it will help to go to Harvard. If you want to live near natural beauty and be outside in your free time then live somewhere that lets you do that. If your number one priority is to graduate with as little debt as possible and you have two reasonable choices but one is much cheaper then do that.

There are no objective answers. Only subjective ones.
 
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gonnif

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There are no objective answers. Only subjective ones.

The answers are objective; it is the importance and weight of factors to consider and frame of reference for each student that varies. It is up to each acceptee to define their requirements.
 
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