Tier difficulty

[NP545]

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It's obviously harder to get into the top tier Md schools like top 20, but what benefits do these upper tier schools provide compared to middle or lower tiers other than prestige and resources?

Are these top schools more difficult and present a bigger challenge to the students, or do they just come with more resources to offer?

An MD is an MD, and I'm assuming these top schools have better chances to match... but what else comes with them?

 

[claduva94]

I actually don't think the effect on the Match is always that substantial.

 

[Cyberdyne 101]

I wouldn't focus on tiers. Just look at individual schools that fit your stats, EC's, personal preferences, etc.

 

[darkjedi]

Networking and opportunities are probably the 2 biggest things, neither of which would be useful if you don't take advantage of them.

 

[aegistitan]

This thread may be of value: http://forums.studentdoctor.net/thr...ram-from-a-non-top-25-medical-school.1073026/

What I can glean from this thread is that top tier schools do help you get into that competitive residency

top tier schools:
1. Greater research funding - important for matching to ultra-selective residency
2. More heavy hitters - get a LOR from one, or even a phone call, for better shot to ultra-selective residency
3. more networking

I guess there's a lot of nepotism in medicine but the pre-allo forum tends to overlook it

 

[DermViser]

I actually don't think the effect on the Match is always that substantial.

Says the premed who is going thru medical school admissions this cycle and thus knows nothing about the match.

 

[Cyberdyne 101]

This thread may be of value: http://forums.studentdoctor.net/thr...ram-from-a-non-top-25-medical-school.1073026/

What I can glean from this thread is that top tier schools do help you get into that competitive residency

top tier schools:
1. Greater research funding - important for matching to ultra-selective residency
2. More heavy hitters - get a LOR from one, or even a phone call, for better shot to ultra-selective residency
3. more networking

I guess there's a lot of nepotism in medicine but the pre-allo forum tends to overlook it

I think it's overlooked because most ppl here are simply focused on getting into med school. I guess it comes up individually in school specific threads (ie Hopkins with debt vs state school with free ride).
Anyway, this is another recent thread:
http://forums.studentdoctor.net/threads/how-much-does-pedigree-matter-for-top-residencies.1081216/

 

[DermViser]

It's obviously harder to get into the top tier Md schools like top 20, but what benefits do these upper tier schools provide compared to middle or lower tiers other than prestige and resources?

Are these top schools more difficult and present a bigger challenge to the students, or do they just come with more resources to offer?

An MD is an MD, and I'm assuming these top schools have better chances to match... but what else comes with them?

Several benefits:

• Research opportunities and funding that medical students can take part in to help their CV for the match
• Access to faculty member big wigs whose LORs can open up doors to other places
• Rotations in hospitals as an MS-3 that others would kill to do residency at

While an MD is an MD to the layman, residency program directors know that the quality of the person with the MD varies greatly, so they know which schools put out great graduates, and which ones put out mediocre graduates, as a general rule. There will of course will be exceptions which is when the application will be heavily scrutinized.

It's nice to know that the wall of it "doesn't matter where you get your MD from" is finally being broken down in Pre-Allopathic. There's hope yet.

 

[aspirantmed]

Truth, but when in many cases, there isn't a substantial (~20k+ over 4 years) difference between costs of lower- and higher-tier schools, why not aim as high as you can reach and attain those benefits that you discuss?

Of course, if I had a scholarship to a state medical school that substantially lowered cost, or a compelling geographic factor in school choice .. That'd be another situation..

 

[DermViser]

This thread may be of value: http://forums.studentdoctor.net/thr...ram-from-a-non-top-25-medical-school.1073026/

What I can glean from this thread is that top tier schools do help you get into that competitive residency

top tier schools:
1. Greater research funding - important for matching to ultra-selective residency
2. More heavy hitters - get a LOR from one, or even a phone call, for better shot to ultra-selective residency
3. more networking

I guess there's a lot of nepotism in medicine but the pre-allo forum tends to overlook it

 

[aegistitan]

whoops, am I not using it correctly? I thought it meant favoring certain people because of connections. What is the nuanced meaning?

 

[ace12345]

This thread may be of value: http://forums.studentdoctor.net/thr...ram-from-a-non-top-25-medical-school.1073026/

What I can glean from this thread is that top tier schools do help you get into that competitive residency

top tier schools:
1. Greater research funding - important for matching to ultra-selective residency
2. More heavy hitters - get a LOR from one, or even a phone call, for better shot to ultra-selective residency
3. more networking

I guess there's a lot of nepotism in medicine but the pre-allo forum tends to overlook it

The above posted thread is something I really hope everyone on the pre-allo forum reads. I waited a long time for something like that to pop up, definitely helped me understand things a bit better.

 

[ThisCouldBeYou]

Hummmm… N=1, my cousin went from a school that wasn't ranked (<85+) to #7 for residency / fellowship. Doors are not sealed shut. Just saying.

 

[deuist]

It's obviously harder to get into the top tier Md schools like top 20, but what benefits do these upper tier schools provide compared to middle or lower tiers other than prestige and resources?

Are these top schools more difficult and present a bigger challenge to the students, or do they just come with more resources to offer?

An MD is an MD, and I'm assuming these top schools have better chances to match... but what else comes with them?

You answered your own question. The top tier medical schools provide you with research opportunities, networking, and clinical experiences that you can't get anywhere else. The end result is that you might have a better chance in the match. Yes, if you graduate at the bottom of your class at Harvard you will not be as competitive in the match as compared to someone who graduated number one from the University of Miami, got a 270 on Step I, and published five papers in peer-reviewed medical journals. However you should definitely aim for as good of a university as you can possibly get into.

 

[Cyberdyne 101]

The above posted thread is something I really hope everyone on the pre-allo forum reads. I waited a long time for something like that to pop up, definitely helped me understand things a bit better.

It's relevant for those that have the choice of attending a top tier school. But that doesn't apply to every matriculant. Many are just thrilled to get in somewhere.

 

[DermViser]

whoops, am I not using it correctly? I thought it meant favoring certain people because of connections. What is the nuanced meaning?

Nothing nuanced about it: http://en.wikipedia.org/wiki/Nepotism

 

[DermViser]

Hummmm… N=1, my cousin went from a school that wasn't ranked (<85+) to #7 for residency / fellowship. Doors are not sealed shut. Just saying.

Depends on what the specialty in question is.

 

[DermViser]

You answered your own question. The top tier medical schools provide you with research opportunities, networking, and clinical experiences that you can't get anywhere else. The end result is that you might have a better chance in the match. Yes, if you graduate at the bottom of your class at Harvard you will not be as competitive in the match as compared to someone who graduated number one from the University of Miami, got a 270 on Step I, and published five papers in peer-reviewed medical journals. However you should definitely aim for as good of a university as you can possibly get into.

Forget bottom. Even a middle of the class ranked Harvard medical student would be ranked better to match than the #1 ranked University of Miami student.

 

[Law2Doc]

There are no tiers, per se, in med schools. That's a College thing. However "prestige" is thought to closely track research dollars, so those schools higher up on the US News research ranking are thought of by premeds as more prestigious. As a Med student, it may mean better resources, particularly if you hope to do some research. It may mean your school attracts the faculty whose name is on the text book. I'd say networking aspects are actually a wash because the big name guys are often too busy to pick up the phone and try to help med students the way smaller school faculty might. So resources is the biggie, and mostly only if you plan to do high end research.

But no, these schools won't be "more difficult" or present "more challenging curriculum". It's going to be very similar everywhere. Your level of competition might be a bit harder at a top ranked place than a Mid ranked place but barely -- is there really that big a difference competing with tge guy that got a 3.8 in college compared to a 3.6?

Will it help you match well? SDN pre-allo sure likes to think so, but PDs get surveyed regularly and never put this toward the top of things they consider. I know from my own experience on such committees this wasn't really ever a driving factor compared to other things, but again that's an n=1 argument.

 

[Law2Doc]

Forget bottom. Even a middle of the class ranked Harvard medical student would be ranked better to match than the #1 ranked University of Miami student.

Actually this is false, and any PD will tell you so (in a survey or personally). But thanks for playing.

There are actually many books on the "Harvard Mystique" that talk about how comments like yours manage to keep this propaganda alive, despite the evidence.

But the truth of the matter is the top guy (top student with high Step scores and good evaluations and good research) at almost any US med school is going to match very very well and better, on average than someone outside of the top chunk of the more prestigious school. The middle ranked Harvard guy is probably going to match, but much more modestly. There are of course wrinkles -- it's not just a numbers thing for a lot of fields, so research might matter, but Miami is a big enough place that you could do some decent research.

The real difference is that if you have to be the WORST student at a program, the "D=MD" guy, is there an advantage of being at Harvard. To that I'd say yes -- anything that shines on your resume would help.

 

[WillburCobb]

whoops, am I not using it correctly? I thought it meant favoring certain people because of connections. What is the nuanced meaning?

Cronyism is the term you're looking for. And as BS as it is, it'll be many moons, if ever, before you see it dicipate in medicine. Though, it's significance/effect is somewhat exaggerated on SDN.

 

[Mad Jack]

Cronyism is the term you're looking for. And as BS as it is, it'll be many moons, if ever, before you see it dicipate in medicine. Though, it's significance/effect is somewhat exaggerated on SDN.

There's also some elitism mixed in there. True cronyism only extends to friends. An elitist attitude offers favor to anyone with the appearance of prestige.

 

[Law2Doc]

... Though, it's significance/effect is somewhat exaggerated on SDN.

More than somewhat, and this is key. Something that has trace effect in real life becomes the pervasive methodology programs all use when premeds talk about it.

 

[WillburCobb]

There's also some elitism mixed in there. True cronyism only extends to friends. An elitist attitude offers favor to anyone with the appearance of prestige.

True. I guess if we're looking for umbrella terms meritocracy would be most appropriate. I still strongly feel it's BS but I guess it's the game you have to play to some degree.

Edit - meritocracy is not the most appropriate term.

 

[Law2Doc]

True. I guess if we're looking for umbrella terms meritocracy would be most appropriate. I still strongly feel it's BS but I guess it's the game you have to play to some degree.

Meritocracy is actually the exact opposite of the elitist cronyism term you are trying to describe. Meritocracy implies getting ahead based on merit not connections.

 

[WillburCobb]

More than somewhat, and this is key. Something that has trace effect in real life becomes the pervasive methodology programs all use when premeds talk about it.

Unfortunately, this is something I've noticed that has spread over to the allo and residency forums as well. Even though there is a fair amount of "objective" and anecdotal evidence to suggest otherwise.

 

[Mad Jack]

True. I guess if we're looking for umbrella terms meritocracy would be most appropriate. I still strongly feel it's BS but I guess it's the game you have to play to sme degree.

Meritocracy would actually be the opposite of what is claimed to be happening. In a true meritocracy prestige, who you know, and what pedigree you possess are completely meaningless. All that matters is personal ability. In a meritocracy, the guy from the Carib with a 260, good grades, and several pubs would beat a mediocre US MD with a 245, average grades, and no pubs every time.

 

[WillburCobb]

Meritocracy is actually the exact opposite of the elitist cronyism term you are trying to describe. Meritocracy implies getting ahead based on merit not connections.

Gotcha. Thanks @Mad Jack and @Law2Doc. I see how I misused that.

 

[Law2Doc]

Meritocracy would actually be the opposite of what is claimed to be happening. In a true meritocracy prestige, who you know, and what pedigree you possess are completely meaningless. All that matters is personal ability. In a meritocracy, the guy from the Carib with a 260, good grades, and several pubs would beat a mediocre US MD with a 245, average grades, and no pubs every time.

I agreed with you up to your last sentence. rotations aren't equivalent so the guy in the Caribbean never demonstrates the same merit. The guy in the US isn't getting the residency spot based on an old boy network. He has accomplished things the offshore guy hasn't. Not necessarily couldn't, but hasn't.

 

[Mad Jack]

I agreed with you up to your last sentence. rotations aren't equivalent so the guy in the Caribbean never demonstrates the same merit. The guy in the US isn't getting the residency spot based on an old boy network. He has accomplished things the offshore guy hasn't. Not necessarily couldn't, but hasn't.

Oh I know the Carib doesn't have US-quality rotations, and that many of their students have some deficiencies in the overall quality of their education so it really isn't apples to apples. How about we say that both the US and Carib student did an audition rotation at the residency in question and were found to objectively have the same level of performance? Our replace Carib student with a MSUCOM DO student that had solid rotations at DMC?

 

[mvenus929]

Hummmm… N=1, my cousin went from a school that wasn't ranked (<85+) to #7 for residency / fellowship. Doors are not sealed shut. Just saying.

Just out of curiosity... how are you ranking the residency? Is it based on the school affiliated with the residency? Because that really doesn't mean anything. The same institution may have a fabulous IM program, but a horrible EM program, and visa versa. And residencies aren't really ranked (you can make an argument for Peds because Children's hospitals are ranked, but everything else falls under a big umbrella hospital and its hard to sort it out), there's just word of mouth 'this program is among the top in the country'.

 

[Law2Doc]

Oh I know the Carib doesn't have US-quality rotations, and that many of their students have some deficiencies in the overall quality of their education so it really isn't apples to apples. How about we say that both the US and Carib student did an audition rotation at the residency in question and were found to objectively have the same level of performance? Our replace Carib student with a MSUCOM DO student that had solid rotations at DMC?

Residencies don't go purely by audition rotations so that's just one factor so I don't see how this changes anything.

 

[Mad Jack]

Residencies don't go purely by audition rotations so that's just one factor so I don't see how this changes anything.

I was just sayin', performance is what speaks in a meritocracy. With an audition rotation showing he had equal performance to his US MD peer and all other indicators showing he significantly outperforms said peer, he would get the position IMO. In the real world we both know which is the actual better candidate though.

 

[mimelim]

Forget bottom. Even a middle of the class ranked Harvard medical student would be ranked better to match than the #1 ranked University of Miami student.

After reviewing applications this year for our program, I'd say that this is pretty categorically false. But, then again, n=1.

 

[DermViser]

Actually this is false, and any PD will tell you so (in a survey or personally). But thanks for playing.

There are actually many books on the "Harvard Mystique" that talk about how comments like yours manage to keep this propaganda alive, despite the evidence.

But the truth of the matter is the top guy (top student with high Step scores and good evaluations and good research) at almost any US med school is going to match very very well and better, on average than someone outside of the top chunk of the more prestigious school. The middle ranked Harvard guy is probably going to match, but much more modestly. There are of course wrinkles -- it's not just a numbers thing for a lot of fields, so research might matter, but Miami is a big enough place that you could do some decent research.

The real difference is that if you have to be the WORST student at a program, the "D=MD" guy, is there an advantage of being at Harvard. To that I'd say yes -- anything that shines on your resume would help.

After reviewing applications this year for our program, I'd say that this is pretty categorically false. But, then again, n=1.

We're talking about the 50th% percentile with respect to CLASS RANK. This doesn't include Research or Step scores that are usually not components of medical school class rank. Harvard has a huge Halo effect and their match list posted on SDN from this year shows it.

 

[ThisCouldBeYou]

Depends on what the specialty in question is.

ROAD

 

[claduva94]

I think this breaks down what programs deem important in the match.
http://b83c73bcf0e7ca356c80-e8560f4...ads/2013/08/programresultsbyspecialty2012.pdf
Prestige plays a role but it is far from most important. I will grant that some of the top considerations will be associated with the prestige though.

 

[DermViser]

ROAD

Yes and each letter of the ROAD (as you said your cousin did a ROAD specialty) have a very different level of competitiveness (i.e. Ophtho vs. Anesthesiology).
Also just bc the residency program is with a #7 med school doesn't mean that is how the residency is ranked.

 

[DermViser]

I think this breaks down what programs deem important in the match.
http://b83c73bcf0e7ca356c80-e8560f4...ads/2013/08/programresultsbyspecialty2012.pdf
Prestige plays a role but it is far from most important. I will grant that some of the top considerations will be associated with the prestige though.

Yes, but certain schools consistently get their students into top institutions even in so-called "non-competitive" specialties. Look at WashU -- which doesn't have name dropping power like Harvard or Yale, but is considered to be a top 10 med school: http://residency.wustl.edu/Residencies/WUSMMatch/Pages/Home.aspx

 

[Law2Doc]

We're talking about the 50th% percentile with respect to CLASS RANK. This doesn't include Research or Step scores that are usually not components of medical school class rank. Harvard has a huge Halo effect and their match list posted on SDN from this year shows it.

Meaningless unless you are also telling me where the top person from Miami went, and where these two people actually wanted to go. I suspect the top dog at Miami got exactly what he or she wanted. The mid guy from Harvard probably matched well but it may have been his second or third choice and maybe not even objectively as good. Your off the cuff comment above really isn't ( and can't be, unless you hppen to personlly know these people and what they wanted) supported by useful data, so you are just adding to the mystique, which again isn't supported by fact, just knee jerk comments like yours above. Sorry, while your comments on other topics are usually good, I think you are taking the uninformed pre-allo myth road on this one. Take it from someone who actually served on committees, or take it from the regular PD surveys, but school name is very much a Lesser factor, rarely entering into the discussion.

Except for post like yours on SDN, where apparently if you get into certain med school you never have to crack a book. Please.

 

[ace12345]

Actually this is false, and any PD will tell you so (in a survey or personally). But thanks for playing.

There are actually many books on the "Harvard Mystique" that talk about how comments like yours manage to keep this propaganda alive, despite the evidence.

But the truth of the matter is the top guy (top student with high Step scores and good evaluations and good research) at almost any US med school is going to match very very well and better, on average than someone outside of the top chunk of the more prestigious school. The middle ranked Harvard guy is probably going to match, but much more modestly. There are of course wrinkles -- it's not just a numbers thing for a lot of fields, so research might matter, but Miami is a big enough place that you could do some decent research.

The real difference is that if you have to be the WORST student at a program, the "D=MD" guy, is there an advantage of being at Harvard. To that I'd say yes -- anything that shines on your resume would help.

Thanks for the post. Very helpful. Given this, could you possibly comment upon the thread - posted above - from the IM forum that discusses residency competitiveness? I found that helpful as it appeared a number of well-versed posters had discussed the topic, and done so explaining that medical school pedigree is indeed important. Therefore I am confused where the disagreement lies. Is this perhaps just an IM thing?

 

[DermViser]

Meaningless unless you are also telling me where the top person from Miami went, and where these two people actually wanted to go. I suspect the top dog at Miami got exactly what he or she wanted. The mid guy from Harvard probably matched well but it may have been his second or third choice and maybe not even objectively as good. Your off the cuff comment above really isn't ( and can't be, unless you hppen to personlly know these people and what they wanted) supported by useful data, so you are just adding to the mystique, which again isn't supported by fact, just knee jerk comments like t above. Sorry, while your comments on other topics are usually good, I think you are taking the uninformed pre-allo myth road on this one.

What someone's 2nd or 3rd choice is varies greatly based on what that person values. Are you talking about with respect to getting interviews at prestigious institutions? This also varies greatly by specialty choice as well.

 

[Law2Doc]

Thanks for the post. Very helpful. Given this, could you possibly comment upon the thread - posted above - from the IM forum that discusses residency competitiveness? I found that helpful as it appeared a number of well-versed posters had discussed the topic, and done so explaining that medical school pedigree is indeed important. Therefore I am confused where the disagreement lies. Is this perhaps just an IM thing?

It's less an IM thing and more an SDN thing. People like to think they are set. They don't like to think someone coming from a different path can pass them like they are standing still. So these myths persist. Yet when asked, PDs pretty universally state that school name is a lower or nonexistent factor. So who are you going to believe?

 

[Law2Doc]

What someone's 2nd or 3rd choice is varies greatly based on what that person values. Are you talking about with respect to getting interviews at prestigious institutions? This also varies greatly by specialty choice as well.

Um, I'm saying your above post where you said the middle ranked guy at Harvard beats out the top guy at Miami hands down is just wrong by virtually any metric, and only serves to bolster some of the myths that abound out there. You are better than this.

 

[ace12345]

It's less an IM thing and more an SDN thing. People like to think they are set. They don't like to think someone coming from a different path can pass them like they are standing still. So these myths persist. Yet when asked, PDs pretty universally state that school name is a lower or nonexistent factor. So who are you going to believe?

I agree, but what would be the motivation of SDN residents, academic administrators, moderators, etc. be in perpetuating a myth about residency competitiveness on an IM forum? In fact one of the main points of their argument is that believing medical school competitiveness doesn't matter is a pre-allo myth. I completely agree that medical students/accepted medical students might be doing what you say above, but why would those that have already been through the process? This is where I get hung up.

 

[Law2Doc]

I agree, but what would be the motivation of SDN residents, academic administrators, moderators, etc. be in perpetuating a myth about residency competitiveness on an IM forum? ...

Simple. They went a certain path and want to believe it was the best one. Or they came up short and would rather believe it was an unfair system than their own crummy CV. Lots of possibilities. There are books on the mystique of these places and how the reputation far exceeds the reality. But when it comes down to it, when PDs, who actually make these decisions are surveyed, they pretty consistently say they focus on other factors. And that's in every specialty, region etc. Plus a bunch of us on here already have our own committee experiences and can tell you that the factors the PDs have said were most important in surveys sure seemed to be in real life too.

 

[mvenus929]

Thanks for the post. Very helpful. Given this, could you possibly comment upon the thread - posted above - from the IM forum that discusses residency competitiveness? I found that helpful as it appeared a number of well-versed posters had discussed the topic, and done so explaining that medical school pedigree is indeed important. Therefore I am confused where the disagreement lies. Is this perhaps just an IM thing?

There's a huge selection bias here that no one is really talking about. The top undergrad students tend to get into the top med schools, because they want to go to the top schools. So if we were hypothetically to rank all the medical students who enter the match each year, a large percentage of the top students would likely be going to top schools. But, of course, some of them will be going to state schools or other lower ranked schools because of personal preferences, or what have you. Top med students tend to have an easier time getting in the residency they want to get into.

L2D is saying that it is the applications of these top students, and not the school they came from, that is getting them into these top residencies. They just happen to go to top schools as well. School plays a role, yes, but it's more of a 'do we have a good track record with students from this school?' than a 'this person is from a top 25--they should go at the top of the list'. From my understanding.

 

[mednerd1234]

I'm guessing it may be more networking opportunities. Like the saying goes "It's not what you know, but who you know."

 

[Cyberdyne 101]

This seems to be a pre-Allo double-edged sword. The 2014 match lists were posted on this forum to the dismay (understandably) of med students, residents, etc. Us pre-meds are obviously not in med school (or beyond), so what definitive conclusions can we draw from match lists, especially since we're at least a few years from the process. Also, we (pre-meds) know very little about "prestige" and residency programs (also correctly pointed out by med students and doctors). And doesn't the match criteria vary from specialty to specialty?! What about the individual preferences of each candidate?!
Why are non-premeds now perpetuating the "importance of prestige" dogma in the pre-Allo forum?!

 

[ace12345]

There's a huge selection bias here that no one is really talking about. The top undergrad students tend to get into the top med schools, because they want to go to the top schools. So if we were hypothetically to rank all the medical students who enter the match each year, a large percentage of the top students would likely be going to top schools. But, of course, some of them will be going to state schools or other lower ranked schools because of personal preferences, or what have you. Top med students tend to have an easier time getting in the residency they want to get into.

L2D is saying that it is the applications of these top students, and not the school they came from, that is getting them into these top residencies. They just happen to go to top schools as well. School plays a role, yes, but it's more of a 'do we have a good track record with students from this school?' than a 'this person is from a top 25--they should go at the top of the list'. From my understanding.

Thanks for the post; I think you're exactly right here.

For me when I interviewed, I found it pretty apparent that schools considered closer to the top of the list had more resources/opportunities. There was just a feeling of availability and access to resources that you didn't see elsewhere. Therefore, top students are probably attracted to this, and attend those institutions as a result. The degree to which having that access = greater competitiveness in the match down the road I do not know (Though I am sure if someone takes advantage of said resources it would help). Regardless, had these strong students attended a "lower" ranked institution, for whatever reason, they would probably still be as motivated and still do very well.

The resource discrepancy is definitely there though. Whether it matters or is taken advantage of is another matter.