Residency at the Same Place as Medical School?

[SirOmin0uS]

Hi everyone. I just wanted to ask about this topic. From what I've heard from others, a large percentage of many med school classes (say Harvard, for example) end up doing residency at that same school (Harvard).

So is this a situation where a given school's residency programs gives preference to med students from that same school? People seem to continually say that the med school you attend is not that important when it comes to residency, but I'm a little confused as to whether or not that's true given this situation.

I get the (quite possibly wrong) impression that if you do reasonably well at your medical school, you will have a pretty good chance of being able to do residency at that same institution. In which case it seems that the medical school you attend is in fact very important - if Harvard med school is to a certain degree a ticket to Harvard residency - assuming reasonably good performance , etc?

Any ideas on this topic? I'm definitely not clear on it at all.

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[Law2Doc]

Hi everyone. I just wanted to ask about this topic. From what I've heard from others, a large percentage of many med school classes (say Harvard, for example) end up doing residency at that same school (Harvard).

So is this a situation where a given school's residency programs gives preference to med students from that same school? People seem to continually say that the med school you attend is not that important when it comes to residency, but I'm a little confused as to whether or not that's true given this situation.

I get the (quite possibly wrong) impression that if you do reasonably well at your medical school, you will have a pretty good chance of being able to do residency at that same institution. In which case it seems that the medical school you attend is in fact very important - if Harvard med school is to a certain degree a ticket to Harvard residency - assuming reasonably good performance , etc?

Any ideas on this topic? I'm definitely not clear on it at all.

Your last sentence is an understatement. A couple of places (by no means most) do give strong preference to their own. And by strong preference, I mean a few more people from the home school, not that everyone who wants to stay can (as you seem to imply). These places are spread out around the rankings -- not just the top schools, although a couple of top schools do have this reputation. And these biases are not necessarilly going to be the same in all specialties, so if eg a school likes its own in IM, that doesn't mean that eg its ED residency doesn't get most of its residents via a totally different route.

But, depending on the specialty, you generally need to do more than "reasonably well" regardless. I wouldn't call any school a "ticket to its residency" -- if you are lackluster while folks at other schools do well and have much higher board scores, they (or one of your classmates) will take "your" home school spot. The advantage of applying to your own school is that the residency directors know those students best. But away rotations help erode this bias, and there are always some students who actually hurt their chances by being too well known. No school is in a rush to get people just for the continuation of school name and nothing else. They want the best -- want their program to be national known for high board scores, stringent standards, and high levels of competition. So no school is going to take the bottom of its class with low board scores over the top of someone else's with top numbers. And staying out of the bottom of a med school class is an impossible mission for half of all med students (most of whom were A students in college).

So what I am saying is If you think you can ever coast in medicine quit now -- you are setting yourself up for a bad fall. If you think -- if I can get into X med school I am set, you are doomed. No school is going to take you for residency just because they took you for med school. You are never set. You get into X med school so you can work as hard as you can in hopes to maybe get looked at by X's or Y's residency in an A or B specialty. And then you might have to keep working as hard as possible to subspecialize, get a fellowship. And then on to practice where you start at the bottom and always have to impress.

So bottom line is that no residency door is closed to you regardless of where you go, and no door stays open for you just because you pick a certain med school. You still have to put up the goods. You might have a leg up if you do really well (and "might" is the operative word here) -- you may be applying for 10 spots instead of 6 thanks to the home field advantage (their desire to accept a few more from within). But if you think you are getting a ticket to anything besides many hours of intense studying by picking a med school, you are SOL.

 

[AmoryBlaine]

To add to Law2Doc's comments, sometimes residency programs are kind of reflective of the med school philosophy as well.

I know that at my home institution, the IM program takes alot of our medical students (up to 40%). Many, many IM faculty are grads of the medical school so the "attitude" sort of persists into the program. If you really, really love the school, chances are you will fit well with the residency.

Conversely I was talking to a resident at a competitive EM program attached to a prestigious school the other day. She made the comment that in the last few years the residency had only taken like 2 grads from the med school.

Harvard is Harvard, they are not going to be heavily recruiting from outside the big-name medical schools.

 

[Zippership]

I'd also like to add that Harvard happens to have three huge teaching hospitals and multiple other affiliates, so there are many residency spots, and only 166 students in the class. Large portions of the class are going to want to match into other specialties and other areas of the country, so the amount of students from HMS trying to match at Harvard in an individual specialty at a particular institution is relatively low. As such, I've heard that if you are looking to match into a noncompetitive specialty with a huge residency program like internal medicine, the spot is essentially yours if you want it provided that you don't botch medical school. Also, certainly, factors like clerkship grades and board scores are crucially important, but connections matter a lot in residency programs, and it helps enormously if the chief of whatever specialty you're matching into knows your name and can appropriately judge the quality of your work. I should also add that many students at top schools get their choice of noncompetitive residency programs and a large part of why people stay at a school where they could easily leave and go to another top program is a sense of familiarity as AmoryBlaine was saying.

 

[maestro1625]

I'd also like to add that Harvard happens to have three huge teaching hospitals and multiple other affiliates, so there are many residency spots, and only 166 students in the class. Large portions of the class are going to want to match into other specialties and other areas of the country, so the amount of students from HMS trying to match at Harvard in an individual specialty at a particular institution is relatively low. As such, I've heard that if you are looking to match into a noncompetitive specialty with a huge residency program like internal medicine, the spot is essentially yours if you want it provided that you don't botch medical school. Also, certainly, factors like clerkship grades and board scores are crucially important, but connections matter a lot in residency programs, and it helps enormously if the chief of whatever specialty you're matching into knows your name and can appropriately judge the quality of your work. I should also add that many students at top schools get their choice of noncompetitive residency programs and a large part of why people stay at a school where they could easily leave and go to another top program is a sense of familiarity as AmoryBlaine was saying.

true, but you're also forgetting that all 166 graduates end up doing Derm...

 

[Aynsl156]

Not true. There are exactly three metric tons of global health gunners at HMS.

 

[SirOmin0uS]

Thanks for the advice - no real need for the hostility though. I openly said I was just looking for clarification...I wasn't giving any indication that I was "planning to screw around in medical school" or whatever you're implying.

I guess the bottom line is that a friend of mine currently going to HMS says something like 30-40% of the medical students continue residency at Harvard. If that is in fact true, clearly there is a huge preference for Harvard medical students (and my statement about doing "reasonably well" would certainly be apt in that case - basically top 30-40% of the class is what I'd consider "reasonably well"...not the top 2% or something). Again, this is just what I was told so you don't need to insult me if it isn't true - I just wanted to get clear on the facts one way or the other.

 

[MassTransport]

Don't worry about it, sometimes people here are on edge, myself included. I think Harvard might be a special case since it's F'in Harvard.

Wouldn't there be a bias for residency programs in the same med school, since you do the bulk of your rotations in locations that host them and have conceivably made contacts?

 

[jdh71]

Hi everyone. I just wanted to ask about this topic. From what I've heard from others, a large percentage of many med school classes (say Harvard, for example) end up doing residency at that same school (Harvard).

So is this a situation where a given school's residency programs gives preference to med students from that same school? People seem to continually say that the med school you attend is not that important when it comes to residency, but I'm a little confused as to whether or not that's true given this situation.

I get the (quite possibly wrong) impression that if you do reasonably well at your medical school, you will have a pretty good chance of being able to do residency at that same institution. In which case it seems that the medical school you attend is in fact very important - if Harvard med school is to a certain degree a ticket to Harvard residency - assuming reasonably good performance , etc?

Any ideas on this topic? I'm definitely not clear on it at all.

Most residencies like to keep student's (most programs save a certain number of spots) from the medical school - especially for highly competitive specialties. So yes, in that sense it can be helpful to be at Havard or Stanford for instance, but if you're a top student, you're a top student and have a shot anywhere.

 

[PeepshowJohnny]

I just want to strike the idea that getting into a good medical school is going to make your life in any way easier.

No matter where you go to med school, it's a neverending series of summits you have to climb. You'll never really have "made it". From first year grades, to Step 1, to clinical grades, to Step 2, to the match...getting into a good med school is a big step, but it's not the only step.

If you get into a big time med school, you're just going to have to compete that much harder to have a respectable class rank. Not to say you're a slacker or anything, but a good med school doesn't necessarilly put you on any kind of fast track to the easy life.