Schools vs. Residency Options

[millepora]

I wasn't sure if this was pre-med question or not, but I figured medical school students would be more informed on this.

Hypothetical, since I do not have any options currently...

If someone were to have an option of 'good school' vs. 'not so good, but US school', and you were interested in a competitive residency such as Orthropedics, ENT, etc, and you were in the middle of your medical school class (average intellegence). At 'good school' you would be competing against a brighter class of students, but 'good school' is known to be a better school with better residency options. On the otherhand, at 'not so good school', would probably be a lot of the opposite.

Which do you think would be the better situation to be in?

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[AdmiralChz]

Ugh to threads like this. First off - do not be suckered into looking at rankings. It all depends on WHERE you want to do your residency (i.e. if you want one in New England - go to a school in that area, if you want on in the South, go to one in that area). There is quite a bit of self selection here. The main fact is this - EVERY US Allopathic School is considered a decent program (an MD is an MD in all 50 states!). All US Allopathic schools have people well above "average intelligence" as you defined it - the responsibility is on you no matter where you go to shoot for what you want. This is medical school - it is hard enough to get in the first place. You won't have many classmates with below "average" intelligence!

Contrary to SDN belief, there is no "bad" MD schools in the US - as long as you do well, have good board scores, etc... you shouldn't have an issue doing what you want to.

 

[Greonis]

If someone were to have an option of 'good school' vs. 'not so good, but US school', and you were interested in a competitive residency such as Orthropedics, ENT, etc, and you were in the middle of your medical school class (average intellegence).

It is silly to assume that one's position in the class is directly related to their intelligence. There are several other factors that should be taken into account...

 

[bad virus]

It is silly to assume that one's position in the class is directly related to their intelligence. There are several other factors that should be taken into account...

Do we always have to nitpick? Just answer the question, and If you don't know, then ignore.

 

[Law2Doc]

I wasn't sure if this was pre-med question or not, but I figured medical school students would be more informed on this.

Hypothetical, since I do not have any options currently...

If someone were to have an option of 'good school' vs. 'not so good, but US school', and you were interested in a competitive residency such as Orthropedics, ENT, etc, and you were in the middle of your medical school class (average intellegence). At 'good school' you would be competing against a brighter class of students, but 'good school' is known to be a better school with better residency options. On the otherhand, at 'not so good school', would probably be a lot of the opposite.

Which do you think would be the better situation to be in?

Two flaws in your thinking--You are assuming things that don't pan out in reality.
(1) The range of abilities in the top school versus a lower ranked school isn't that vast. Med schools do a great job of weeding out all the substandard applicants and the result is that you end up with basically A students at the top schools and A-/B+ students at the lesser ranked ones. Not enough of a difference that you can expect to be substantially more highly ranked at one school versus another. You will probably be at about the same percentage of the class at either. It is a very undergrad form of thinking to believe you would be at the bottom of the class at the top school but somehow at the top at a lower one. It comes from years of being in classes with B and C students. But these folks don't get into med school at either end of the spectrum, so you are going to be competing with a tighter grouping of smarter people.
Also, some of the A student types don't stay that way in med school (a lot of people who got A's in college without really trying find that that method doesn't work at all in med school) and many of the B+ crowd improves once they are studying something they perceive as more interesting. There isn't a good correlation between how you did in undergrad and where you end up in your med school class, at any school. There will be nearly as many college A students in the bottom of most med school classes as top.
(2) more importantly, the most important factor in deciding if you are going to get a more competitive residency is Step 1, which is a standardized test, taken by everyone regardless of school. So you will still be competing with the folks from the top schools on the one factor that really counts most to, say, an ortho residency.

So the short answer is to go where you think you will be happy and do well. And I mean doing well independent of whoever else is in your school. This isn't a team sport -- you will get through med school and into a residency by your own efforts, relatively independent of whom your classmates were or what your school name is. It's only about your own accomplishments.

 

[millepora]

Here is where my reasoning comes from, but feel free to correct it.

If I were to compare two schools such as Meharry and Columbia.

The average applicant matriculating into Meharry has a 22 MCAT and a 3.1 GPA.

The average applicant matriculating into Columbia has a 35 MCAT and a 3.8 GPA.

The AAMC has done a lot of studies that say your ability to do well on the MCAT correlates to your ability to do well on the boards, so if those statistics were right I guess it would be obvious which schools have better boards (of course with the exception of the deviations listed above).

When you compete for residencies doesn't most of the emphasis get put on how well you do on your boards? Then the minority of the emphasis gets put on whether you are pass or pass w/ honors?

What I don't know is, are you mostly competing with your classmates for slots (since most MD schools has certain residency slots set up for their graduates)? Are you competing with every other medical school graduate equally for that slot?

 

[Law2Doc]

Here is where my reasoning comes from, but feel free to correct it.

If I were to compare two schools such as Meharry and Columbia.

The average applicant matriculating into Meharry has a 22 MCAT and a 3.1 GPA.

The average applicant matriculating into Columbia has a 35 MCAT and a 3.8 GPA.

The AAMC has done a lot of studies that say your ability to do well on the MCAT correlates to your ability to do well on the boards, so if those statistics were right I guess it would be obvious which schools have better boards (of course with the exception of the deviations listed above).

When you compete for residencies doesn't most of the emphasis get put on how well you do on your boards? Then the minority of the emphasis gets put on whether you are pass or pass w/ honors?

What I don't know is, are you mostly competing with your classmates for slots (since most MD schools has certain residency slots set up for their graduates)? Are you competing with every other medical school graduate equally for that slot?

A quick google search suggests that the Meharry numbers are actually higher than you have presented. But regardless, you again have to remember that folks with lower than a B average aren't really getting into most med schools, and so if you really think you are going to be in the top of one med school and the bottom of another, you are underestimating the range in caliber (things are very different when you get to med school where all of the folks with "gentleman's C's" who made you look so good the past 4 years have been truncated out of the applicant pool), and ignoring my comment that you would still have to compete with the Harvard folks on Step 1, which is what counts far far far more for residency than your med school rank anyhow.

 

[DrJD]

In large part what Law2doc and others have said above is true... HOWEVER, there are some specialties that care more about the prestige of the medical school than others. If you are serious about a competitive specialty speak with some people in the field to find advice. I've been able to get good advice from people on SDN in the specialty forums at the bottom of the main forum screen.

Prestige is not rankings though... It is history, and just plain prestige. For 99% of the specialties it won't matter, but just double check about the one you are going for incase it is in the 1% that do care. Good luck!

 

[ChubbyChaser]

I would think that probably the biggest plus that youll get at Columbia over meharry is research opportunities and an opportunity to get a LOR from a big name professor.

 

[Law2Doc]

In large part what Law2doc and others have said above is true... HOWEVER, there are some specialties that care more about the prestige of the medical school than others. ...

I think the OP's post contains less of a focus on the prestige of the school name and more a focus on the competition with his classmates. My posts above suggest that OP is in for a shocker if he thinks he is deciding between being average at one school and top dog at another. Most of the people who ask this kind of question tend to badly overestimate themselves and will end up treading water at either place. My point is that being average with average steps does not get you the most competitive residency slots. Doesn't matter if you go to a top school or a bottom. And great evals and great steps will put you in line for a competitive residency regardless of where you attend med school. Folks in pre-allo put way too much weight on the school's prestige, which I suppose is understandable because to some extent COLLEGE works that way. So they are extrapolating what they know from undergrad to what they THINK they know about residency selection.

I agree with the above comment that for 99% of the specialties it won't matter. I would suggest that even for that last 1%, the prestige only matters if you happen to already be in the upper X% of applicants in terms of stats an boards. The truth of the matter is that if you have so much in common with other applicants that they have to get to your school name to decide who to take, you already failed in terms of winning them over in away rotations, etc. You should never be in an "everything else being equal" situation with another applicant. Doesn't happen.

The one thing that does happen is some programs like to take their own students. But this isn't exclusively at the top residencies or programs. And may work against you if you are in a top ranked place but the majority of slots you have the best shot at in the field you are going into actually end up being at a middle ranked school you could have gone to instead.

 

[JLC]

I think the OP's post contains less of a focus on the prestige of the school name and more a focus on the competition with his classmates. My posts above suggest that OP is in for a shocker if he thinks he is deciding between being average at one school and top dog at another. Most of the people who ask this kind of question tend to badly overestimate themselves and will end up treading water at either place. My point is that being average with average steps does not get you the most competitive residency slots. Doesn't matter if you go to a top school or a bottom. And great evals and great steps will put you in line for a competitive residency regardless of where you attend med school. Folks in pre-allo put way too much weight on the school's prestige, which I suppose is understandable because to some extent COLLEGE works that way. So they are extrapolating what they know from undergrad to what they THINK they know about residency selection.

I agree with the above comment that for 99% of the specialties it won't matter. I would suggest that even for that last 1%, the prestige only matters if you happen to already be in the upper X% of applicants in terms of stats an boards. The truth of the matter is that if you have so much in common with other applicants that they have to get to your school name to decide who to take, you already failed in terms of winning them over in away rotations, etc. You should never be in an "everything else being equal" situation with another applicant. Doesn't happen.

The one thing that does happen is some programs like to take their own students. But this isn't exclusively at the top residencies or programs. And may work against you if you are in a top ranked place but the majority of slots you have the best shot at in the field you are going into actually end up being at a middle ranked school you could have gone to instead.

Actually I've heard a lot from professors themselves who have said that going to a top medical school will make matching in a competitive area easier. For example, when I interviewed at X school, the professor asked me why I wanted to come, when I listed some reason and mentioned I was probably a little too choosy, he interrupted me and told me it was good to be selective about the school I wanted to go to. He told me upfront that when med students applied for residency spots, he only glances through the app, the only important part was the references, he simply calls up the residency director at a familiar hospital and asks how the student was and based his decision on that.

 

[Law2Doc]

Actually I've heard a lot from professors themselves who have said that going to a top medical school will make matching in a competitive area easier. For example, when I interviewed at X school, the professor asked me why I wanted to come, when I listed some reason and mentioned I was probably a little too choosy, he interrupted me and told me it was good to be selective about the school I wanted to go to. He told me upfront that when med students applied for residency spots, he only glances through the app, the only important part was the references, he simply calls up the residency director at a familiar hospital and asks how the student was and based his decision on that.

References and LORs are huge, but you don't necessarily get better ones from better ranked places. (And it wouldn't be the residency director he would call about a med student, BTW -- you are confused.)
First, who is a big name depends on the specialty. Each specialty has its own hierarchy of what residencies/programs are best and they don't correlate well with what med school is prestigious. Meaning one prestigious place may be known to have the best IM program, but be considered downright malignant in other fields. Thus the big name person in, eg. Optho may not be at a highly ranked medical school, he will be at a hospital which has a big name optho program, which may be affiliated with a lesser ranked med school. You won't realistically know what specialty you want until 3rd year when you have opportunity to try some rotations.
Second, people do away rotations precisely to get references at places they want to attend. So if you want to go to XYZ ortho program, you spend a month there, and use a faculty member THERE as your primary reference.
Third, as with premed LORs, a person who actually knows you well is going to be a better reference than someone who doesn't. There may be more bigshots at a top ranked school, but that means nothing if they don't know you. At the smaller name places you reportedly often actually find folks willing to work the phones for you.
Finally, if you do research over the first year summer or take a year off to research, you may enroll in a known research program (NIH, etc) and that will be a person who knows you and may be a good reference known in the field.

 

[AdmiralChz]

References and LORs are huge, but you don't necessarily get better ones from better ranked places. (And it wouldn't be the residency director he would call about a med student, BTW -- you are confused.)
First, who is a big name depends on the specialty. Each specialty has its own hierarchy of what residencies/programs are best and they don't correlate well with what med school is prestigious. Meaning one prestigious place may be known to have the best IM program, but be considered downright malignant in other fields. Thus the big name person in, eg. Optho may not be at a highly ranked medical school, he will be at a hospital which has a big name optho program, which may be affiliated with a lesser ranked med school. You won't realistically know what specialty you want until 3rd year when you have opportunity to try some rotations.
Second, people do away rotations precisely to get references at places they want to attend. So if you want to go to XYZ ortho program, you spend a month there, and use a faculty member THERE as your primary reference.
Third, as with premed LORs, a person who actually knows you well is going to be a better reference than someone who doesn't. There may be more bigshots at a top ranked school, but that means nothing if they don't know you. At the smaller name places you reportedly often actually find folks willing to work the phones for you.
Finally, if you do research over the first year summer or take a year off to research, you may enroll in a known research program (NIH, etc) and that will be a person who knows you and may be a good reference known in the field.

Like this, and the other posts. There is a HUGE emphasis on these forums about research, publications, etc... it's more than a little overblown. Just do well, get good LORs, nail the boards, and you'll be fine no matter where you go.

 

[diosa428]

Like this, and the other posts. There is a HUGE emphasis on these forums about research, publications, etc... it's more than a little overblown. Just do well, get good LORs, nail the boards, and you'll be fine no matter where you go.

Hahahaha. Yeah. "Just" do well and nail the boards. Seriously guys, "nailing the boards" isn't easy, and for those of you who didn't "just" nail the MCAT, I wouldn't count on "just" nailing your boards. Also, unless you are totally inept or completely spectacular, you will probably get about the same grades and LORs as everyone else. You need something more to make you stand out.

 

[drizzt3117]

I mentioned this before but I think people have the wrong idea of what school prestige does for a given applicant.

At the most recent AAMC OSR meeting they had a panel of PDs describe what the most important factors in residency selection were, and IIRC the findings were as such:

1) USMLE (and this was far and away the most important category)

2) Dean's Letter + References (this includes PDs calling Deans and people they know at the program, so prestige is somewhat involved here)

3) AOA status (and/or class rank at schools that don't have it)

4) Medical School attended (Prestige and Geography fall in this category)

5) Research + Publications

So while boards are the most important factor by far, the school attended seems to affect categories 2 and 4.

The other thing is that a lot of schools are pass/fail for the basic sciences, so where you're going to fall in the class is a lot more due to factors other than competitiveness of the class.

 

[EveeSTi]

Quick question, someone mentioned that you can do you away rotation where you might want to go for residency.

1) How many away rotations do people do? And how do you get to choose which one you do away?

2) How hard is it to do away rotations at the more prestigious schools? It can't be as simple as calling up Mayo or Harvard and saying "I'm coming up for __ rotation!". So what all is involved?

Thanks in advance!

 

[Law2Doc]

I mentioned this before but I think people have the wrong idea of what school prestige does for a given applicant.

At the most recent AAMC OSR meeting they had a panel of PDs describe what the most important factors in residency selection were, and IIRC the findings were as such:

1) USMLE (and this was far and away the most important category)

2) Dean's Letter + References (this includes PDs calling Deans and people they know at the program, so prestige is somewhat involved here)

3) AOA status (and/or class rank at schools that don't have it)

4) Medical School attended (Prestige and Geography fall in this category)

5) Research + Publications

So while boards are the most important factor by far, the school attended seems to affect categories 2 and 4.

The other thing is that a lot of schools are pass/fail for the basic sciences, so where you're going to fall in the class is a lot more due to factors other than competitiveness of the class.

Most of the lists I've seen indicating what is important actually put the med school considerably lower down than #4. Things like 3rd year grades and evals (to the extent they aren't included in your deans letter), away rotations, etc. come in higher. Often the med school is closer to #10 on lists, which means nobody gets down to that factor. I think you need to separate out geography from the school as well -- that's giving your school too much credit. Residencies do want to see some connection to geography so they can know whether you might actually attend if they ranked you, but this needn't have anything to do with where the med school is located. If you previously lived in State X, or attended college there, or your parents are there that is often as good as where your med school is located. So to the extent your med school is lumped together with geography, I call bogus -- that's not med school dependant and not what these "importance of med school" threads are all about..
I also would disagree that your #2 includes prestige of the school -- you may have references at away rotations, and how well folks know you beats out where they are calling from every time. As mentioned above, some of the places that work the phones the hardest are not the top places. So to the extent phone references matter, the benefit is probably inversely correlated to prestige.

 

[Law2Doc]

Quick question, someone mentioned that you can do you away rotation where you might want to go for residency.

1) How many away rotations do people do? And how do you get to choose which one you do away?

2) How hard is it to do away rotations at the more prestigious schools? It can't be as simple as calling up Mayo or Harvard and saying "I'm coming up for __ rotation!". So what all is involved?

Thanks in advance!

People tend to do 1-3 of them at the beginning of 4th year. That's really all you are going to have time for before you have to start interviewing. You choose them, once you figure out what specialty you are most interested in, by talking to a mentor in the field at your school, and then applying to them. There are fairly comprehensive applications you need to put together, but since you usually have a couple of months to work with, and presumably you are competitive for that specialty if you are looking at it, you usually get some of the places you are interested in. There is a certain amount of competition to get these, but not everybody does them and not everybody wants the same month. And sometimes it isn't cheap.

 

[Law2Doc]

Hahahaha. Yeah. "Just" do well and nail the boards. Seriously guys, "nailing the boards" isn't easy, and for those of you who didn't "just" nail the MCAT, I wouldn't count on "just" nailing your boards. ...

It isn't easy to nail the boards, but it's just as easy to do regardless of what school you are at. So the point is it's the most important factor for residencies, and it's school independent.

 

[flip26]

I mentioned this before but I think people have the wrong idea of what school prestige does for a given applicant.

At the most recent AAMC OSR meeting they had a panel of PDs describe what the most important factors in residency selection were, and IIRC the findings were as such:

1) USMLE (and this was far and away the most important category)

2) Dean's Letter + References (this includes PDs calling Deans and people they know at the program, so prestige is somewhat involved here)

3) AOA status (and/or class rank at schools that don't have it)

4) Medical School attended (Prestige and Geography fall in this category)

5) Research + Publications

So while boards are the most important factor by far, the school attended seems to affect categories 2 and 4.

The other thing is that a lot of schools are pass/fail for the basic sciences, so where you're going to fall in the class is a lot more due to factors other than competitiveness of the class.

I think you have the wrong idea about the role of med school prestige, too. Pretty significant that "geography" was listed alongside, because that does seem to be a significant factor, arguably much more important than prestige by itself.

Pre-meds (and med students, for that matter) perusing match lists should notice the geographic bias in the process.

I would place geography bias ahead of prestige, and whether or not they both come ahead of research and pubs, I don't know, but relative to items 1 - 3, both would come after those as the list you gave us suggests.

 

[phospho]

I think you have the wrong idea about the role of med school prestige, too. Pretty significant that "geography" was listed alongside, because that does seem to be a significant factor, arguably much more important than prestige by itself.

Pre-meds (and med students, for that matter) perusing match lists should notice the geographic bias in the process.

I would place geography bias ahead of prestige, and whether or not they both come ahead of research and pubs, I don't know, but relative to items 1 - 3, both would come after those as the list you gave us suggests.

is it really geography bias as in applicants choosing to stay where they went to medical school (since they are more comfortable in that particular area), or is it because residencies prefer applicants who are from their area, since most likely, applicants from that same area are more serious about that particular residency, and will more likely place it higher on their match list? Or could it be applicant bias in that applicants are too scared to highly rank an out of state residency because they think that that residency won't do the same for them?

For example, I am trying to choose between wright state and ohio state. I love Wright State, but I also would like to go to the west coast for residency. Now if you look at their match lists, OSU's people are matching all over the country, while WSU has people matching mainly in ohio and neighboring states. Here are the factors that play into this:

- OSU accepted about 50% out of state, which means that these OOSers would like to go back home when they're done with medical school
- Wright State accepted only about 8% OOS last year, which means that 92% of its students would like to stay here in ohio or somewhere close

On the other hand, could this have something to do with prestige? Could it be because OSU is much higher ranked, so people are able to match wherever they want to? After talking to quite a few people, I doubt that.

Not sure what the point of my post is, but would you be able to elaborate more on geography?

 

[flip26]

is it really geography bias as in applicants choosing to stay where they went to medical school (since they are more comfortable in that particular area), or is it because residencies prefer applicants who are from their area, since most likely, applicants from that same area are more serious about that particular residency, and will more likely place it higher on their match list? Or could it be applicant bias in that applicants are too scared to highly rank an out of state residency because they think that that residency won't do the same for them?

For example, I am trying to choose between wright state and ohio state. I love Wright State, but I also would like to go to the west coast for residency. Now if you look at their match lists, OSU's people are matching all over the country, while WSU has people matching mainly in ohio and neighboring states. Here are the factors that play into this:

- OSU accepted about 50% out of state, which means that these OOSers would like to go back home when they're done with medical school
- Wright State accepted only about 8% OOS last year, which means that 92% of its students would like to stay here in ohio or somewhere close

On the other hand, could this have something to do with prestige? Could it be because OSU is much higher ranked, so people are able to match wherever they want to? After talking to quite a few people, I doubt that.

Not sure what the point of my post is, but would you be able to elaborate more on geography?

I think there is bias from both applicants and residency programs, but I am starting to believe there is more bias on the part of residency programs than most people believe (or more than is opined about here on SDN).

In your example, I don't think that prestige has much to do with it. I think it is more the self-selection bias of the students to stay in Ohio and the midwest. If you went to Wright State, you could be one of the outliers, the exception to the rule - the grad who strikes out for greener pastures.

I haven't looked at the OSU match list, but are you sure that people are matching "all over the country?" How many? What percentage? Because I have looked at the match list for a similar state school (UVa) that admits 50 percent OOS, and the match list shows a distinct bias for VA residencies and others within the mid-Atlantic.

There are always exceptions to the rule...and there is another factor - the mid-Atlantic is a fairly desirable area to live in, and many of the the people who come to UVa may decide to stay in the region rather than return home...

Some residency programs show a strong bias for the affiliated med school grads which is another way of demonstrating bias...look at a match list for, say, Columbia, and the large number of grads who stay within the Columbia system...or stay in the northeast...it is a "chicken and egg" debate, because people who want to end up in the NYC area or in the northeast tend to apply to those med schools in the first place...

I am reading the tea leaves just like everyone else, but my growing sense is that PDs do have a geographic bias when filling their residency slots - kind of a "go with what you know" philosophy that is human nature. Having said that, I am not sure it is "actionable" opinion for a pre-med trying to decide where to attend med school - I still think that cost and other factors should come before trying to figure out the geog and prestige bias of residency PDs...

 

[AdmiralChz]

There are always exceptions to the rule...and there is another factor - the mid-Atlantic is a fairly desirable area to live in, and many of the the people who come to UVa may decide to stay in the region rather than return home...

This is exactly why I'll be going to UVA next year - I want to stay in this region long term. I havn't even seen UVA's match list, and to be honest it wouldn't really mean much to me anyway. Everyone's advice on this has been about the same - going to a school on the West Coast (regardless of which one) will make returning to a residency back east someone difficult. Geographic bias should NOT be understated.

 

[drizzt3117]

Most of the lists I've seen indicating what is important actually put the med school considerably lower down than #4. Things like 3rd year grades and evals (to the extent they aren't included in your deans letter), away rotations, etc. come in higher. Often the med school is closer to #10 on lists, which means nobody gets down to that factor. I think you need to separate out geography from the school as well -- that's giving your school too much credit. Residencies do want to see some connection to geography so they can know whether you might actually attend if they ranked you, but this needn't have anything to do with where the med school is located. If you previously lived in State X, or attended college there, or your parents are there that is often as good as where your med school is located. So to the extent your med school is lumped together with geography, I call bogus -- that's not med school dependant and not what these "importance of med school" threads are all about..
I also would disagree that your #2 includes prestige of the school -- you may have references at away rotations, and how well folks know you beats out where they are calling from every time. As mentioned above, some of the places that work the phones the hardest are not the top places. So to the extent phone references matter, the benefit is probably inversely correlated to prestige.

Those weren't MY words chosen, they were the summation of the PD comments discussed in the panel <shrug> You can disagree with them if you want, though.

 

[M3dhop3ful]

Ok this thread is very very helpful, and thanks a lot to those who are sharing. My question is why do so many people look at USNews like it is the bible?

With that said, what should we be looking for in a medical school if not "prestige"?

 

[drizzt3117]

Ok this thread is very very helpful, and thanks a lot to those who are sharing. My question is why do so many people look at USNews like it is the bible?

With that said, what should we be looking for in a medical school if not "prestige"?

Rankings /= Prestige... in the context I was putting it with my post anyways.

Things I would look for in approximate order:

1) Location

2) Cost

3) Fit with the school's culture/student body

4) Facilities

5) Grading System

6) Curriculum

7) Research opportunities

 

[flip26]

Rankings /= Prestige... in the context I was putting it with my post anyways.

Things I would look for in approximate order:

1) Location

2) Cost

3) Fit with the school's culture/student body

4) Facilities

5) Grading System

6) Curriculum

7) Research opportunities

Good list, good order. I personally place cost/debt first, but it is not an absolute, and there are limits to how much more I would pay for all the other factors combined.

 

[drizzt3117]

Good list, good order. I personally place cost/debt first, but it is not an absolute, and there are limits to how much more I would pay for all the other factors combined.

I think most people are afraid of taking on debt, personally, I'm not particularly worried about it, but that might be because I have 10+ physicians in my family so I have a pretty good understanding of the economics of the profession. I suppose people worry about it limiting their choices of residency, but at the most recent dinner thrown by our schools Family Medicine program, they had a bunch of physicians talking about their experiences with their debt (probably because they want people to consider fam med) and 6 different physicians in their late 20s and early 30s told us they were either done paying off their loans or close, while owning a house, two cars, and having kids. Granted, the cost of living here is cheaper than NYC or the like, but <shrug> My cousin is 4 years into being an attending in EM in NYC and has his loans paid off.

That said, fiscal responsibility is a good thing. If only people had the same attitude towards car payments or credit card debt as they do towards school debt on SDN

Facilities is a very underappreciated quality. We have exams next week and I'm sure I'll be @ or around campus 100+ hours this week, it would suck if it was a run down POS.

 

[RoadRunner17]

It's pretty tough to read some of these tea leaves. I'm choosing between state schools (as OOS) and private schools, all in the midwest (where I grew up). Because of the thread's discussion of geography, I just looked at the matchlists again and the state schools have a lot of people who stay within the state and the midwest as a whole, while the private schools have people matching all over the country.

It's clear that there is a geographical bias due to the student population. I'm sure that many of the students at these state schools stay in the state because well, they are from the state, likewise for the midwest. Whereas, the private school gets a pretty decent chunk of its class from outside the midwest and that might explain the geographic disparity.

But as L2D is prone to point out, I have no clues as to the reasons which people matched where. So it's a pretty crappy exercise that gets me even more nervous as I currently don't intend to stay in the midwest after medical school. But, if it's true that PDs want to know that you'll rank them (as far as geography goes), then I do have the ability to point out that I have ties to both California (all of my extended family lives out there) on the west coast and the east coast (having been here for the last 6 years) as valid reasons. Then that's something less to worry about.

Of course, this is all assuming that I set my ducks in row. By ducks I mean boards, grades, evals, LORs, etc.

 

[drizzt3117]

It's clear that there is a geographical bias due to the student population. I'm sure that many of the students at these state schools stay in the state because well, they are from the state, likewise for the midwest. Whereas, the private school gets a pretty decent chunk of its class from outside the midwest and that might explain the geographic disparity.

Yeah, I think most state schools have ~85-90% IS, a big chunk of whom want to stay in state. About 30% of our class tends to match in state and ~50% in the midwest, but I suspect that tends to be due to preference. That said, competitive candidates from schools with a national reputation tend to match reasonably well throughout the country. I think they said this year that at our school ~90% of people got their first choice programs.

 

[flip26]

It's pretty tough to read some of these tea leaves. I'm choosing between state schools (as OOS) and private schools, all in the midwest (where I grew up). Because of the thread's discussion of geography, I just looked at the matchlists again and the state schools have a lot of people who stay within the state and the midwest as a whole, while the private schools have people matching all over the country.

It's clear that there is a geographical bias due to the student population. I'm sure that many of the students at these state schools stay in the state because well, they are from the state, likewise for the midwest. Whereas, the private school gets a pretty decent chunk of its class from outside the midwest and that might explain the geographic disparity.

But as L2D is prone to point out, I have no clues as to the reasons which people matched where. So it's a pretty crappy exercise that gets me even more nervous as I currently don't intend to stay in the midwest after medical school. But, if it's true that PDs want to know that you'll rank them (as far as geography goes), then I do have the ability to point out that I have ties to both California (all of my extended family lives out there) on the west coast and the east coast (having been here for the last 6 years) as valid reasons. Then that's something less to worry about.

Of course, this is all assuming that I set my ducks in row. By ducks I mean boards, grades, evals, LORs, etc.

Maybe doing away rotations in CA will do the trick (one more duck).

I am pretty open to living just about anywhere down the road. I actually like where I live (where my fam lives) very much, but I am open to all possibilities. In other words, I am not concerned at all about any geog bias that PDs may have, but I think it is a legit issue and it does seem to be a real thing.

However, I guess that if I really wanted to live in CA post med school, I would probably do everything possible to go to med school there, and if that doesn't work out, then I would go to an OOS school that seems to get lots of CA residents who do return home for residency...any of the Top 30 research schools should make this fairly easy to do, and then there are schools like NYMC and VCU and EVMS that seem to get lots of CA folks...you might post on their class threads and see how actual med students from CA at those schools feel about it.

 

[phospho]

I haven't looked at the OSU match list, but are you sure that people are matching "all over the country?" How many? What percentage? Because I have looked at the match list for a similar state school (UVa) that admits 50 percent OOS, and the match list shows a distinct bias for VA residencies and others within the mid-Atlantic.

no, you're right... there's definitely a lot of bias for ohio, but I guess what I meant is that many more of their students (as opposed to wright state) end up leaving the state.

You make a lot of sense though. I really hope you're right. As I've mentioned before, I am most likely choosing wright state (small class size, lots of friends, small school, small city, etc...) However, I'd be devastated if I found out that the school I chose would limit my geographical options. I would go to OSU in a heart beat if I knew that it was the only way (or the easiest way) I can go to the west coast.

 

[phospho]

It's pretty tough to read some of these tea leaves. I'm choosing between state schools (as OOS) and private schools, all in the midwest (where I grew up). Because of the thread's discussion of geography, I just looked at the matchlists again and the state schools have a lot of people who stay within the state and the midwest as a whole, while the private schools have people matching all over the country.

It's clear that there is a geographical bias due to the student population. I'm sure that many of the students at these state schools stay in the state because well, they are from the state, likewise for the midwest. Whereas, the private school gets a pretty decent chunk of its class from outside the midwest and that might explain the geographic disparity.

But as L2D is prone to point out, I have no clues as to the reasons which people matched where. So it's a pretty crappy exercise that gets me even more nervous as I currently don't intend to stay in the midwest after medical school. But, if it's true that PDs want to know that you'll rank them (as far as geography goes), then I do have the ability to point out that I have ties to both California (all of my extended family lives out there) on the west coast and the east coast (having been here for the last 6 years) as valid reasons. Then that's something less to worry about.

Of course, this is all assuming that I set my ducks in row. By ducks I mean boards, grades, evals, LORs, etc.

It's very interesting how we're in the same exact boat. I have to stay in the midwest for medical school, but I'm trying to choose which school will give me more geographic options, because I really don't want to stay here. And you're right about the private schools being able to match more students outside the state, since they graduate many more OOS students, as opposed to state schools.

This is a bit reassuring I guess, because it looks like it might be more student bias than it is PD bias.

 

[drizzt3117]

It's very interesting how we're in the same exact boat. I have to stay in the midwest for medical school, but I'm trying to choose which school will give me more geographic options, because I really don't want to stay here. And you're right about the private schools being able to match more students outside the state, since they graduate many more OOS students, as opposed to state schools.

This is a bit reassuring I guess, because it looks like it might be more student bias than it is PD bias.

OSU clearly has a bigger national reputation than Wright State... I don't even think most people know where Wright State is, or that it even has a med school (where is it, btw?)

 

[flip26]

OSU clearly has a bigger national reputation than Wright State... I don't even think most people know where Wright State is, or that it even has a med school (where is it, btw?)

Ohio State is a household name mainly for football (no knock on its academics).

But she is choosing between 2 state schools - one lesser known outside the state/region - but the real question is would the better known state school impart significant advantages to her when it comes to residencies, specifically RE CA residency chances?

I doubt it. Just my hunch. If she was comparing Wright State to, say, Case or CCLCM, or say Northwestern or Michigan, I would argue for them.

There may be other reasons for choosing OSU - research opps, better clinical stuff, etc. But I know nothing about any of that...

 

[drizzt3117]

Ohio State is a household name mainly for football (no knock on its academics).

But she is choosing between 2 state schools - one lesser known outside the state/region - but the real question is would the better known state school impart significant advantages to her when it comes to residencies, specifically RE CA residency chances?

I doubt it. Just my hunch. If she was comparing Wright State to, say, Case or CCLCM, or say Northwestern or Michigan, I would argue for them.

OSU is a top research university, and pretty well known. One of my brother's fellow students in his urology program at Brigham is from there, so clearly people match into competitive residencies from there.

Is Wright State even cheaper than OSU?

 

[dragonfly99]

I wasn't sure if this was pre-med question or not, but I figured medical school students would be more informed on this.

Hypothetical, since I do not have any options currently...

If someone were to have an option of 'good school' vs. 'not so good, but US school', and you were interested in a competitive residency such as Orthropedics, ENT, etc, and you were in the middle of your medical school class (average intellegence). At 'good school' you would be competing against a brighter class of students, but 'good school' is known to be a better school with better residency options. On the otherhand, at 'not so good school', would probably be a lot of the opposite.

Which do you think would be the better situation to be in?

If you are in the middle of your med school class, even at a great school/top school, you are unlikely to get ortho anywhere. You might if you had great LOR's, aced your surgical rotations, and had a great USMLE score on the Step 1 exam. ENT is not as competitive, though not super easy to get into. You could likely get a spot having done well on your surgical clerkship, with good letters of recommendation and a decent USMLE score, coming from a middle of the road med school.

If you go to a med school with higher average GPA and MCAT scores for entrants, it will probably be somewhat harder to get a high class rank. It will not be easy to get a high class rank even at a so-called "average" of lower medical school.

I think it's just about impossible to answer your hypothetical question, because residency matching depends on just too many individual factors. Regardless, to get into one of the super competitive residencies requires a good USMLE score AND a high class rank (usually top 1/3 of the class). Having said that, someone on the top of the class at Hopkins is more likely to get the plastic surgery residency at Harvard, Johns Hopkins, etc. The person in the top of the class at U of Nebraska is probably going to get plastics at Iowa, Nebraska, St Louis, etc. ...might get Harvard but not as likely b/c will be competing against top of the classes from Harvard, Duke, Johns Hopkins, etc.

 

[flip26]

OSU is a top research university, and pretty well known. One of my brother's fellow students in his urology program at Brigham is from there, so clearly people match into competitive residencies from there.

Is Wright State even cheaper than OSU?

She hasn't mentioned money.

As I understand it, she prefers Wright State for personal / fit reasons.

Her "goal" is a residency in California. Her question is would she have a better chance at a CA residency if she attended OSU?

My thoughts: I doubt if it will make a difference for that specific goal, so I would pick the school I preferred because if it makes her happier and more productive to be at Wright State, then she will enhance her residency chances greatly everywhere.

 

[RoadRunner17]

My thoughts: I doubt if it will make a difference for that specific goal, so I would pick the school I preferred because if it makes her happier and more productive to be at Wright State, then she will enhance her residency chances greatly everywhere.

I think this sounds more than reasonable.

 

[RoadRunner17]

It's very interesting how we're in the same exact boat. I have to stay in the midwest for medical school, but I'm trying to choose which school will give me more geographic options, because I really don't want to stay here. And you're right about the private schools being able to match more students outside the state, since they graduate many more OOS students, as opposed to state schools.

This is a bit reassuring I guess, because it looks like it might be more student bias than it is PD bias.

Yeah, I think it's more of student bias than anything else. So I'm more or less reassured. I mean, I really don't mind going back to the midwest after 6 years on the east coast for school/work. I'm keeping an open mind about where I would want to go geographically for my PGYs, so I guess I just want to be sure that if I pick a midwest state school, I still have every opportunity for the same geographic areas that I would if I went to a midwest private school. It doesn't have to be California per se (I just bring that up as an example) but I think everyone here gets what I mean.

 

[ChubbyChaser]

I was under the impression that ENT is MORE impressive then ortho.

 

[VincentAdultman]

. ENT is not as competitive, though not super easy to get into.

That is not correct. ENT is more competitive than ortho. It's probably right there with derm and PRS.

BTW, glad a relatively new topic is being discussed. I don't know if "does med school prestige matter?" has ever been discussed at length in this forum.

 

[ChubbyChaser]

That is not correct. ENT is more competitive than ortho. It's probably right there with derm and PRS.

BTW, glad a relatively new topic is being discussed. I don't know if "does med school prestige matter?" has ever been discussed at length in this forum.

Im glad you took the time to respond to the relatively new topic

Of course it had nothing to do with the OP, but thanks nonetheless.

 

[phospho]

OSU is a top research university, and pretty well known. One of my brother's fellow students in his urology program at Brigham is from there, so clearly people match into competitive residencies from there.

Is Wright State even cheaper than OSU?

Not really, they're both about the same for instaters. I would rather go to WSU because of personal reasons (class size and lots of friends in my class and upper classes, among other reasons). You know how you can just see yourself somewhere? That's how I feel about WSU.

She hasn't mentioned money.

As I understand it, she prefers Wright State for personal / fit reasons.

Her "goal" is a residency in California. Her question is would she have a better chance at a CA residency if she attended OSU?

My thoughts: I doubt if it will make a difference for that specific goal, so I would pick the school I preferred because if it makes her happier and more productive to be at Wright State, then she will enhance her residency chances greatly everywhere.

I definitely agree with you about doing better at WSU. So many people have also told me that. I think that even if OSU gives me a small advantage geographically, I'm better off going to WSU because I'll be more comfortable and do much better, which will ultimately give me a bigger advantage in matching in CA (also, I'm not interested in anything competitive).

OP, I've thought about the same thing a while back. For example, in my case, WSU has a lower MCAT and GPA average than OSU. So, I thought that theoretically, that would mean that for an average student like me, it would be easier to be average at WSU. For example, if I were to get a 3.2 at both schools, that would mean (in theory, atleast) that my 3.2 is "worth more" at WSU. At OSU, I would be competing with people who have much higher GPA's and thus my 3.2 would be much less than the average.

After talking to a lot of people, however, this doesn't seem to hold true, because there are so many variables involved. People who were average sometimes end up becoming top students in medical school, and top students in undergrad sometimes end up becoming average students in med school. Also, the fact that most U.S. medical schools have about similar USMLE average says that roughly speaking, everyone is about the same after they start medical school, no matter which school it is. On the other hand, in undergrad, there wasn't really an equalizer for everyone. I'm not sure if I'm right or not, but that's how I understood it

 

[drizzt3117]

Also, the fact that most U.S. medical schools have about similar USMLE average

Huh? There are schools with averages over 240, and obviously a large number of schools have to be below the national average of ~218ish. I guess it sounds like it's a relatively small difference but it is more than one standard deviation...

 

[drizzt3117]

If you are in the middle of your med school class, even at a great school/top school, you are unlikely to get ortho anywhere. You might if you had great LOR's, aced your surgical rotations, and had a great USMLE score on the Step 1 exam. ENT is not as competitive, though not super easy to get into. You could likely get a spot having done well on your surgical clerkship, with good letters of recommendation and a decent USMLE score, coming from a middle of the road med school.

A lot of med schools are starting to deemphasize pre-clinical grades, so I imagine that will start to follow through in residency determination as well. I think evaluations have always been important but they're going to be even more important at schools where your clinicals determine your entire class rank. As I said before, a large panel of PDs from top institutions stated that USMLE was the most important factor, but there were other important factors.

I think head/neck has a average USMLE of ~235ish which is one of the higher average board scores. I don't think it's significantly more competitive than ortho though, which has the same average board scores.

 

[phospho]

Huh? There are schools with averages over 240, and obviously a large number of schools have to be below the national average of ~218ish. I guess it sounds like it's a relatively small difference but it is more than one standard deviation...

true, i guess it's not a small difference... i just meant that the difference in U.S. medical education is much more uniformed than undergrad, where the same person can be a 3.5 student or a 4.0 student, depending on the undergrad s/he is at...

 

[millepora]

Thanks for the feedback so far everyone.

I am guessing the other advantage to going to the best school your admissions cycle will allow you, is competing with a more intellectual class. Most people eventually adapt to their competition, so being in a smarter environment may still keep you on the low end of your class (if you are not a genius), but you would probably do a lot better on your first USMLE. Would this be an agreeable analogy?

As far as the matching goes, I am trying to figure out what exactly there is to matching. When people put their top choices, do they have put just their choices (Ex 1), or the areas they want to practice (Ex 2)?

(1) Ex:
1. Orthopedics
2. ENT
3. Family Practice

(2) Ex:
1. Othropedics- Hopkins
2. ENT - Havard
3. Orthopedics - Nebraska
4. ENT - OSU
5. ENT- Alaska
...59. Family Practice- MSU

 

[drizzt3117]

Thanks for the feedback so far everyone.

I am guessing the other advantage to going to the best school your admissions cycle will allow you, is competing with a more intellectual class. Most people eventually adapt to their competition, so being in a smarter environment may still keep you on the low end of your class (if you are not a genius), but you would probably do a lot better on your first USMLE. Would this be an agreeable analogy?

As far as the matching goes, I am trying to figure out what exactly there is to matching. When people put their top choices, do they have put just their choices (Ex 1), or the areas they want to practice (Ex 2)?

(1) Ex:
1. Orthopedics
2. ENT
3. Family Practice

(2) Ex:
1. Othropedics- Hopkins
2. ENT - Havard
3. Orthopedics - Nebraska
4. ENT - OSU
5. ENT- Alaska
...59. Family Practice- MSU

It would probably be in your best interest to go to the ERAS and NRMP websites and read them. To answer your question, it's more similar to the 2nd example, except that you generally rank programs you interviewed at on your rank order list (because in order to match, you have to rank them and they have to rank you) and additionally, you have to pay $30 for each program you rank in excess of $30.

 

[RoadRunner17]

This begs the question, what explains the differences in the average board scores at different institutions? I know that it is heavily dependent on each individual taking it (naturally) but there are schools that have shown a trend of having high board scores, at least the ones that publish their numbers. How much of it has to do with the curriculum (i.e. teaching to the boards, etc.), do you think? Clearly all I can expect from here is speculation, but it doesn't hurt to hear what you guys think..