Residency location question

[Gabby]

Sorry to post here as someone just starting med school, but you guys know way more than the pre-allo folks about residency. I've been accepted to med school out West, but I want to do residency and practice in the northeast, most likely New England. One of my friends who's a second year said that it's extremely hard to land a residency somewhere you haven't been before and that she would reapply to schools in the northeast next year. That sounds way too drastic to me. Is she right? The schools I've been accepted to -- one is allopathic and one is osteopathic. I really didn't like the allo school so I think I'm going to the osteopathic, if that makes any difference.

Any advice?

---

Members don't see this ad.

 

[NotAProgDirector]

Sorry to post here as someone just starting med school, but you guys know way more than the pre-allo folks about residency. I've been accepted to med school out West, but I want to do residency and practice in the northeast, most likely New England. One of my friends who's a second year said that it's extremely hard to land a residency somewhere you haven't been before and that she would reapply to schools in the northeast next year. That sounds way too drastic to me. Is she right? The schools I've been accepted to -- one is allopathic and one is osteopathic. I really didn't like the allo school so I think I'm going to the osteopathic, if that makes any difference.

Any advice?

As an allo MD grad, you'll be able to apply anywhere you want in the US and do fine. Some specialties with very few spots can be hard to land if you are geographically limited, but if by NE you mean anything north and east of NYC, you'll be fine.

As a DO grad, you might find your options more limited, although DO grads have their own residencies as options also. if you're interested in primary care / internal medicine / FP then it probably doesn't matter. But, you should seriously consider the allo school. It will clearly leave more paths open to you going forward.

So:
1. Don't be foolish -- you got into medical school. Don't let this go trying for another medical school (other than for financial reasons)
2. In general, the allo MD program is the better choice unless there are extenuating circumstances or you are certain you are interested in primary care / low competitive fields.

 

[Winged Scapula]

I agree with apd; your choices are less limited by the MD program.

In short, your second year friend is being overly dramatic when she says its "extremely hard" to get a residency outside of where you went to medical school. Truth be told, New England while lovely, isn't the competitive residency milieu that California is. The location of your medical school isn't any where near the top of factors looked at when residency programs look at potential candidates. What IS important to some is where you want to end up as some programs have missions to train physicians who want to stay local.

To give up a medical school position on the rare chance that you might have some trouble matching in New England is foolish IMHO. Just because you got in this year, doesn't mean you will necessary get a position next year.

 

[DarthNeurology]

Sorry to post here as someone just starting med school, but you guys know way more than the pre-allo folks about residency. I've been accepted to med school out West, but I want to do residency and practice in the northeast, most likely New England. One of my friends who's a second year said that it's extremely hard to land a residency somewhere you haven't been before and that she would reapply to schools in the northeast next year. That sounds way too drastic to me. Is she right? The schools I've been accepted to -- one is allopathic and one is osteopathic. I really didn't like the allo school so I think I'm going to the osteopathic, if that makes any difference.

Any advice?

You can easily get a residency position in the northeast as there are a ton of residency programs and *a lot* are not competitive, they will take an allo grad with average board scores in a heartbeat. If you do well in medical school, i.e. high board scores and good clinical evals then that will help you get the residency you want . . .

Now, of course you may change your mind about what specialty. Say if you are appylying for dermatology then you would apply all over and might have to go to even a southern program, no big deal as you can always move back to the northeast after you do residency.

You friend gave you horrible advice if you have an allo spot then do it . . . DO is just as good an education as far as I know BUT the reputation in some circles, probably mostly in the northeast ironically for you, is that DO students couldn't get an allopathic spot and went to DO school and the whole OMM is viewed as quakery by a lot, there are a lot of average IM programs in the northeast that don't touch DO grads. I would go allo and do as good as you.

Most residents at any given program did NOT do medical school there and a lot of people move after medical school to go to residency elsewhere. You can do an "audition rotation" at the northeast program of your choice and many do this to show them you are good for them.

But seriously, there are some middle of the road northeast IM programs, and they are pretty much middle of the road nationwide, who have a lot of northeastern medical students because students in that region want to stay there and so apply there. But if you have higher board scores and better LORs and clinical grades then you will get offered plenty of spots. It isn't favortism, there are a lot of people who don't like the northeastern culture at all and wouldn't want to go there for residency at all.

Major reasons:

1. Many urban areas in northeastern towns in MA, NY and PA are way overpriced in terms of housing.

2. Transportation is horrible, the northeastern corridor highway system is a mess, subways are good but only if you like taking them, it is impossible to park anywhere as everything was built when there were horses and carriages and roads and tons of buildings in downtown areas don't have parking lots and roads are too narrow.

3. Nothing much to do and nothing very culturally interesting. Sure there are museums and stuff like in the northeast, but there aren't the range of opportunities available in southern areas and I think there is a more diverse and friendly populations in the southern states and northwest.

4. Weather absolutely sucks in the northeast. Who wants to put up with snow storms? My apologies for those who "need snow", I don't feel a need to shovel the gunk of my car every day after it snows.

5. The population center of the U.S. is moving south and west, I think it is Missourri or something now, more and more a lot of the intellectual and cultural centers of the US will move towards the west and south. After medical school and residency for you more people will probably have moved away from the northeastern states, eventually they will be uninhabitable due to rising water secondary to global warming, maybe not in your lifetime, but the trend is clear.

6. There is a subset of northeastern personality of attendings which involves basically purposely not being nice to subordinates and sort of struggling with issues that are very simple and holding endlessly meetings to eat up people's time. If you aren't from the northeast then you are at a disadvantage perhaps with some attendings.

 

[jennyboo]

One of my friends who's a second year said that it's extremely hard to land a residency somewhere you haven't been before and that she would reapply to schools in the northeast next year.

That's ridiculous. Start medical school. Go with the allopathic school (unless you feel called strongly to be a DO).

 

[Gabby]

Thank you guys for setting me straight!! My friend had me worried and I didn't know what to think. Unfortunately, the allo school isn't going to work out for me. I just didn't like the school, but more importantly, my fiance and I are planning our wedding (hopefully for the summer after first year) and he can't move to the allo school location for job purposes. The DO school is in a much better location for his career. So it's either the DO school and stay together or the allo school and long distance relationship for four years (he's on the east coast so it would be quite a distance, not conducive to weekend visits).

Do you think DO would limit me severely in the northeast? Right now, I'm interested in either PM&R, peds, or psych. If my plans change and I become interested in something more competitive, I guess I'll have to be geographically flexible, but as of now, are those programs overly competitive for a DO grad looking to settle down in New England?

 

[Ludicolo]

As a DO, you should have no difficulty trying to match into PM&R, northeast location or otherwise. To give you a frame of reference, the department chair of PM&R at Harvard/Spaulding rehab is a DO. Can't speak for peds or psych but neither specialty is ultracompetitive.

 

[dragonfly99]

DO should be fine for peds or psych, and actually might be helpful for PM and R (due to the extra musculoskeletal training vs. most MD programs). However, in general MD schools give you more options in terms of residency. Personally, I would have probably taken the MD admission, but you seem to have reasons that are good for your situation that explain why you want the DO school. Definitely your friend gave you bad advice...take one of the med school admissions and do NOT wait another year to go to med school.

What Darth says about some of the stereotypes about DO's in certain geographic regions is true, though, so you likely wouldn't be able to get a residency in an allopathic hospital in stuff like a surgical specialty, dermatology, radiology, etc. and maybe not even stuff like ER or anesthesia. You may want to check which/how many DO hospitals are in the New England area, just to make sure you won't be severely limited on where you can apply, though you can apply allopathic in most of the less competitive specialties like psych and peds,and probably not have a problem getting in somwhere unless you strongly want to go somewhere like Harvard for your pediatrics, etc.

Some of what Darth said about the northeast is a little exaggerated and over the top, though I def. agree with him about the snow...LOL!

 

[Gabby]

Thank you so much guys for the great advice! I'm so glad I asked.

 

[jennyboo]

Do you think DO would limit me severely in the northeast? Right now, I'm interested in either PM&R, peds, or psych. If my plans change and I become interested in something more competitive, I guess I'll have to be geographically flexible, but as of now, are those programs overly competitive for a DO grad looking to settle down in New England?

It does limit you. You probably won't get the cream-of-the-crop pediatrics residency at CHOP in Philadelphia or Children's in Boston. You probably will be able to get a residency in pediatrics at a lesser-known program in the big cities, or in a smaller city. So you will be able to train in pediatrics, no problem.

Probably similar with psych. I don't know much about PM&R but I'm guessing many programs will accept a DO.

What will be significantly limited by a DO degree: Any specialty which requires training at large tertiary academic centers -- namely, all the subspecialties. Radiology, dermatology, various types of surgery, anesthesiology, EM. Many of these residencies exist only in big hospitals and big cities, and some of the big-city, big-hospital programs may simply filter the DOs out of the interview process for residencies (you can apply, but chances are you won't get invited to an interview).