Residency Program Competitiveness

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Being, in fact, a med student, I think I can be of help!

What I hear from my peers is, generally, that the Ivies are at the top (and are thought of as the "best," whether that's true or not). After that, most other programs seem relatively the same with the only major difference being location - aka NYC programs>>>east oshkosh univ program. We kind of just assume that every program everywhere gets a metric gazillion apps, which may or may not be true.

The caveat to all this is that if one of us is, ahem, a little under-performing, all of that is moot and one ought to apply more to lower-end programs.

Hope this helps.
 
For me it is coming up on a decade since I went through the match, but I think people draw/drew a sense of what programs are competitive from:

-Doximity and to a lesser extent US News rankings (though I don't think the Doximity rankings were around when I applied)
-SDN reviews and discussion
-The prestige of the associated medical school (see Ivies comment above)
-The seeming quality of current residents (if that can be determined in any way from the program's website)
-Talking with peers, recent graduates from one's medical school, and others on the interview trail
-Looking at the number of famous faculty or the volume of research coming from a program
-If you make it to the interview stage, how impressive are the faculty, the current residents, the program overview, the applicants sitting in the room with you, the city. Do people seem excited about the place?

Some factors that get tossed around on SDN such as "how low on the rank list the program had to go" I wouldn't even begin to know how to find, and I think applying students don't either.
 
As a medical student, I used Doximity and US News & World Report rankings as a first pass. I soon discovered that the rankings have nothing to do with the quality of the clinical training though.

Doximity rankings for psychiatry departments and residency programs are based entirely on reputation, as determined by a survey of Doximity members. There are no objective criteria; it is literally a popularity contest. Furthermore, very few people actually bother to vote in this thing. Therefore it is possible to change the rankings significantly just by convincing a small number of people to join Doximity and vote for a particular program.

The dept chairs have now figured this out and are waging get-out-the-vote efforts among their faculty and alumni, with Doximity registration drives, voting pizza parties, and such. The result is that the Doximity rankings largely reflect the relative success of this effort. I'd ignore them entirely. Honestly US News is a better source, at least they include some kind of objective data.
 
Very difficult topic to answer because the answer is usually "it depends." That "depends" part considers a lot of factors including what your personal career goals are, how much you value academic/research settings vs. purely clinically focused environments, what type of personalities you learn best from, and if you want to pursue fellowship or not.
 
By competitiveness, I’ll assume you mean difficulty in matching, not prestige.

This can vary from year to year as well. I wouldn’t consider my program Top 25 in prestige, but some years it will be top 15 in that you’ll need step 1 of 240+ to stand a chance.

The “name” is less important come residency time. Just by graduating, you’ll have access to good jobs. More and more people thus ignore the name and choose a residency for other reasons.

Anything California is disproportionately more competitive than it would be outside of Cali. Many residents are Cali or bust when they could match 9 of 10 Ivies.

NYC is also disproportionately more competitive. Terrible programs can draw good residents. It’s all in the location.

Access to fellowships. Programs with your desired fellowship pre-residency will generally get a boost. People don’t like moving for 1 year if they can avoid it.

The schedule can play a huge role. More lifestyle friendly programs will draw strong applicants. Less call = more competitive.

Almost anything Harvard is quite competitive.

Something close to a nice beach outside of Cali also gets a boost.

Now I’d start looking at Ivy programs. An average US MD can likely match at a Ivy if not picky about which one. There is just few people that care about this.

Beyond that, people will choose based on their desired research, proximity to family, proximity to spouse’s work options, etc.

Overall name doesn’t mean a lot.
 
Can't add anything to pre-interview rankings that people suggested above, but one question/consideration that helped me a lot is "How prepared are residents to be practice independently as attendings directly after graduating?". While it did garner the usual boilerplate positive responses from many people, I actually had multiple instances where there was hesitation or outright negative responses from current residents/attendings that helped inform my conceptualization of the quality of the training.

One example of this is when I interviewed at multiple programs all under the umbrella of a large hospital system and received a lot more positive feedback about the "secondary" programs vs the "main" program (and this has subsequently been shown to be true).

Hope this helps!
 
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How competitive are programs in Utah, Oregon, Washington state, Arizona, and New Mexico

Looking to go somewhere with mountains and isn't too snowy. Not interested in CA
 
WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) prefer their own as part of an initiative to address a shortage of physicians in these states. These med schools are around 96% WWAMI residents. Residencies fall into this shadow.
 
How competitive are programs in Utah, Oregon, Washington state, Arizona, and New Mexico

Looking to go somewhere with mountains and isn't too snowy. Not interested in CA
I believe Univ of Utah, Univ of Washington, and OHSU are all very competitive. Maybe OHSU somewhat less so. With Utah you've got the mountains and when I interviewed a very friendly atmosphere. UW and OHSU you get to live in cultured metropolitan areas with a lot of outdoor activities, near water, and it barely snows. UW also has a Boise Track and Billings track which you do 2 years in Seattle, then 2 years in the other city (these are easier tracks to match into but you won't be in Seattle for 4 years).

I think the residency in Spokane WA and Corvallis OR are less competitive because they aren't attached to academic programs (without the research or high profile faculty of an academic center) but are still in nice areas in regards to outdoor activities. Corvallis would be less snowy than Spokane.
 
How competitive are programs in Utah, Oregon, Washington state, Arizona, and New Mexico

Looking to go somewhere with mountains and isn't too snowy. Not interested in CA

Washington and Oregon are fairly competitive. Utah and New Mexico are good programs that are under appreciated. Utah more competitive than NM. I’d put Arizona as not very competitive.
 
Thank you all for your answers!

What about the competitiveness of
  • Mayo Clinic
  • University of Minnesota
  • Medical College of Wisconsin
  • UW-Madison
  • Tulane
  • LSU - New Orleans
Not too interested on the east coast or in the south...hoping to go somewhere with a forensics fellowship or close to a forensics fellowship. Mayo Clinic is in Rochester, wouldn't mind going there for residency and then going to Minneapolis for a forensics fellowship (1-1.5 hour drive)

I'm asking because I don't feel the need to go to the most competitive program, I'm just more interested in being in a city that I actually want to live in, ya know?
 
Thank you all for your answers!

What about the competitiveness of
  • Mayo Clinic
  • University of Minnesota
  • Medical College of Wisconsin
  • UW-Madison
  • Tulane
  • LSU - New Orleans
Not too interested on the east coast or in the south...hoping to go somewhere with a forensics fellowship or close to a forensics fellowship. Mayo Clinic is in Rochester, wouldn't mind going there for residency and then going to Minneapolis for a forensics fellowship (1-1.5 hour drive)

I'm asking because I don't feel the need to go to the most competitive program, I'm just more interested in being in a city that I actually want to live in, ya know?
Mayo - moderately/middle of the road competitive. Hope you like to wear suits.

UofM - pretty competitive

UofWisconsin - pretty competitive

MCW - Milwaukee program is probably on par with Mayo competition-wise, the other programs are less competitive.

Tulane/LSU -can’t really comment.

Also, if those are the regions you’re interested I would suggest considering HCMC as well.
 
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Being, in fact, a med student, I think I can be of help!

What I hear from my peers is, generally, that the Ivies are at the top (and are thought of as the "best," whether that's true or not). After that, most other programs seem relatively the same with the only major difference being location - aka NYC programs>>>east oshkosh univ program. We kind of just assume that every program everywhere gets a metric gazillion apps, which may or may not be true.

The caveat to all this is that if one of us is, ahem, a little under-performing, all of that is moot and one ought to apply more to lower-end programs.

Hope this helps.
What is underperforming?
 
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