Texas residencies: tough to crack?

[Frazier]

For your applicant from the Northeast (average board scores, honors in EM rotations, good med school "pedigree", a bunch of research pubs)... how hard would it be to crack into the Texas residencies?

"California" hard?

I've visited a number of times and like the region. However, my only ties to TX are a number of close family friends that live there. (Should this be mentioned in a regional-tailored PS or just don't mention it at all?)

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[Got Em]

For your applicant from the Northeast (average board scores, honors in EM rotations, good med school "pedigree", a bunch of research pubs)... how hard would it be to crack into the Texas residencies?

"California" hard?

I've visited a number of times and like the region. However, my only ties to TX are a number of close family friends that live there. (Should this be mentioned in a regional-tailored PS or just don't mention it at all?)

Not as competitive as most California schools, but still very competitive.

You forgot to mention the most important aspect of your application. Did you do an away in Texas? If not, it's exponentially harder to match. Even if you did an away in Texas, it's still difficult to match for non-Texas applicants. Texas schools interview about 10-14 applicants per spot. Northeast programs do 14-20 per spot on average. If you take a look on Frieda, Texas schools are as competitive as it gets from the interviews given per spot ratio.

 

[alpinism]

California yes. Texas not so much.

All the CA residences are competitive with the ones in big cities on the coast being the arguably the most competitive in the country.
With regards to TX the big name programs in Houston and Dallas will be more competitive than the lesser known programs in San Antonio and Fort Worth.

 

[Got Em]

California yes. Texas not so much.

All the CA residences are competitive with the ones in big cities on the coast being the arguably the most competitive in the country.
With regards to TX the big name programs in Houston and Dallas will be more competitive than the lesser known programs in San Antonio and Fort Worth.

California residencies, especially in southern cali and SF interview about 10 per spot. As you've stated, they're probably the most competitive in the country. UC Davis and Fresno interview a little more per spot and may not be as competitive. I know you can't base it on just this ratio, but it typically gives you a good idea about how students are likely to rank your program and gives a good idea on competitiveness. Dr. Van Meter gave a good talk on this in the EM Stud podcasts.

As far as Texas residencies, it may be a bit more competitive than what you've stated. You may be completely correct and I'm not trying to disagree with you at all; just that I've heard it's changed so much in the past 3 years from PDs in Texas. FSEDs have increased salary more than other states and all Texas programs have seen their apps go up dramatically in the past few years. UTHSC in San Antonio was a new program, so it wasn't as competitive in the first few years, but now they're almost in line with other programs in the state from what I gathered at TCEP this year.

 

[Cinematographer]

Lol No. UTSW Southwestern (Dallas EM) is probably the more competitive of all Texas programs to get into, but I wouldn't put them at the level of competitiveness of (most) west coast programs. They also seem to fill up their classes with at least 1/3 out-of-state applicants, so they certainly aren't very geographically biased.

 

[Got Em]

Lol No. UTSW Southwestern (Dallas EM) is probably the more competitive of all Texas programs to get into, but I wouldn't put them at the level of competitiveness of (most) west coast programs. They also seem to fill up their classes with at least 1/3 out-of-state applicants.

@Cinematographer is as knowledgeable as it gets when it comes to EM stuff and I'm probably not interpreting correctly here. UTSW filling 1/3 of their class w/ out of state applicants may not be a good indication that it's "not as competitive" as Cali programs.

If you look at UCSF and Highland, 1/2 to 2/3 of their residents were out of state (except Highland's class of 2017 where 7/10 were instate). An argument can also be made that many of these students are from Harvard, UCSF, Stanford, etc., but then again, many are from institutions like Tulane, Florida State, etc.

 

[racerwad]

@Cinematographer is as knowledgeable as it gets when it comes to EM stuff and I'm probably not interpreting correctly here. UTSW filling 1/3 of their class w/ out of state applicants may not be a good indication that it's "not as competitive" as Cali programs.

If you look at UCSF and Highland, 1/2 to 2/3 of their residents were out of state (except Highland's class of 2017 where 7/10 were instate). An argument can also be made that many of these students are from Harvard, UCSF, Stanford, etc., but then again, many are from institutions like Tulane, Florida State, etc.

I think it is fair to question the number of in-state vs out-of-state residents as a proxy for competitiveness, but his original point still stands. Using the number of interviews per spot is also not the best metric to determine competitiveness.

Generally speaking, the only people to put Texas on the same "level" (for lack of a better term) as California and New York are Texans. Everyone else tends to be skeptical of Texans' opinions of Texas.

 

[doggydog]

I think it is fair to question the number of in-state vs out-of-state residents as a proxy for competitiveness, but his original point still stands. Using the number of interviews per spot is also not the best metric to determine competitiveness.

Generally speaking, the only people to put Texas on the same "level" (for lack of a better term) as California and New York are Texans. Everyone else tends to be skeptical of Texans' opinions of Texas.

New York is on the same level as California? News to me.

 

[racerwad]

New York is on the same level as California? News to me.

Sorry, Manhattan, I have heard, is as desirable as CA. I don't see it, but apparently, others do.

 

[doggydog]

Sorry, Manhattan, I have heard, is as desirable as CA. I don't see it, but apparently, others do.

I mean, you can live in Manhattan and ride on the subway to some less desirable programs. Are there any programs in all of California that are even undesirable?

 

[racerwad]

I mean, you can live in Manhattan and ride on the subway to some less desirable programs. Are there any programs in all of California that are even undesirable?

I think it is fair to say that Davis, UCSF-Fresno, Kaiser-San Diego, Kern County, and Kaweah Delta are on the lower end of desirability for different (and subjective) reasons - Kaiser is new but in a great spot; Kaweah Delta is new in a bad spot; UCSF-Fresno is fantastic but in Fresno; Kern County is also not what people imagine life in California to be like; Davis also is, compared to other places in CA, both less desirable geographically and without the cachet of programs like LAC+USC, which is in a rough part of town but makes up for it in virtually every way possible.

 

[mega_colon]

Texas has a several programs outside of the big cities (dallas, houston, SA, Austin). If you apply to all and have a reason to be there I can't see why it would be difficult for an average applicant.

 

[Got Em]

I think it is fair to question the number of in-state vs out-of-state residents as a proxy for competitiveness, but his original point still stands. Using the number of interviews per spot is also not the best metric to determine competitiveness.

Generally speaking, the only people to put Texas on the same "level" (for lack of a better term) as California and New York are Texans. Everyone else tends to be skeptical of Texans' opinions of Texas.

I'm not disputing the fact that most people think Cali > Texas for most programs in terms of competitiveness; I think this is a given. I'm just saying that with all the measures we have available and from various PDs, it's a lot closer than what most people think.

I completely agree with you that the # of interviews per spot may not the best metric, but as far as stats go, it's the best and the only real objective data that we have.

 

[racerwad]

I'm not disputing the fact that most people think Cali > Texas for most programs in terms of competitiveness; I think this is a given. I'm just saying that with all the measures we have available and from various PDs, it's a lot closer than what most people think.

I completely agree with you that the # of interviews per spot may not the best metric, but as far as stats go, it's the best and the only real objective data that we have.

I guess we'll have to disagree as I don't think that it is "a lot closer." In addition, the # of interviews/spot is actually quite subjective; it is driven by the PD's risk tolerance, their performance year-to-year in the Match, internal politics, and myriad other issues none of us are probably aware of. I do think that all of the Texas programs are pretty good and no one is giving up much going there in comparison to anywhere else.

 

[Got Em]

Texas has a several programs outside of the big cities (dallas, houston, SA, Austin). If you apply to all and have a reason to be there I can't see why it would be difficult for an average applicant.

This is a fair assessment and probably the general opinion, but I'll leave some stats. If you leave out DFW, Houston, SA, and Austin, you're left with 3 programs. El Paso, Corpus Christi, and Temple. I have no idea about El Paso, but I'm very familiar with both Corpus Christi and Temple. Let's just say that it would be more difficult than you think.

For Corpus, 8/10 of their PGY-1s did an away in Corpus. Not sure about other years numbers, but it helps tremendously rotating there.

For Temple, 7/14 PGY-3s and 10/14 PGY2s went to medical school in Texas. Many others that matched were either in Texas for undergrad or did rotations there.

The OP asked whether it would be difficult for him to match with almost no connections in Texas (other than family friends) and probably no Texas away. I think most would agree that it would be difficult, but probably not "Cali" difficult for their major city programs.

 

[Got Em]

I guess we'll have to disagree as I don't think that it is "a lot closer." In addition, the # of interviews/spot is actually quite subjective; it is driven by the PD's risk tolerance, their performance year-to-year in the Match, internal politics, and myriad other issues none of us are probably aware of. I do think that all of the Texas programs are pretty good and no one is giving up much going there in comparison to anywhere else.

Sounds good. I agree with you that the number of interviews/spot can be subjective, but generally, more competitive schools interview less students per spot, which is reflected by programs in Southern California and SF vs. other Cali programs. This is also similar for Dallas/Houston/Austin vs. non-big city schools in Texas. I think we may be saying the same thing, but in different ways.

Also, like you have previously stated, the opinions of Texans vs. non-Texans will most likely differ, but I hope our discussion has helped the OP.

 

[weasel23]

Is the competitiveness of Texas programs because of the high attending compensation mainly or are there other factors at play?

 

[fahimaz7]

There are regional biases for a reason. When I was interviewing from the SE out west (OHSU, Davis, Stanford, etc) I was told more than once that they didn't interview many east coast people b/c there is a low likelihood that any of them will actually come out west for residency. Family ties and difficulty coming up with 10k to move across the country sure holds true when it comes time to relocate for residency.

 

[Dr. Texas]

Do an away in Texas or Southeast. As you can see, the residents and docs in Texas are very happy to be there.

I think Texas is like in the Top 10, probably Top 5 places to practice EM in terms of compensation and tort reform. It's obviously much easier to get a job in Texas if you make early contacts with the groups down here during residency.