Tier difficulty

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I think that prestige is important and good to have but not as important in the grand scheme of things. Who you are, what you did and who you know matter a lot. What premeds seem to do is to try to rank things like "gpa vs mcat?" That's not how you look at it, they're totally different things. One is a relative measure of how you did in college while the other is a standardized way to compare you to other applicants and make up for differences in major, school, coursework difficulty, etc. But people like to think of things and try to compare them against one another in a way that usually doesn't make sense.

When you have top schools, you will have top students gravitating to top schools. People at top schools will generally be smarter, have higher step 1s, better and more pubs, better connections for LORs, etc. These top students will do well and go on to populating the top residencies but they're not the only ones who will go to those residencies. From what I've seen (just started M3 so not much), the school you attend won't close doors. A dearth of honors in third year, a lower step 1 score, poor interpersonal skills, etc. are what closes doors. I am at a middle of the road school and we had a bunch of people matching into competitive specialties at top hospitals, including one guy at a top IM program despite an unimpressive usnews rank for our school.
 
Psai said:
I think that prestige is important and good to have but not as important in the grand scheme of things. Who you are, what you did and who you know matter a lot. What premeds seem to do is to try to rank things like "gpa vs mcat?" That's not how you look at it, they're totally different things. One is a relative measure of how you did in college while the other is a standardized way to compare you to other applicants and make up for differences in major, school, coursework difficulty, etc. But people like to think of things and try to compare them against one another in a way that usually doesn't make sense.

When you have top schools, you will have top students gravitating to top schools. People at top schools will generally be smarter, have higher step 1s, better and more pubs, better connections for LORs, etc. These top students will do well and go on to populating the top residencies but they're not the only ones who will go to those residencies. From what I've seen (just started M3 so not much), the school you attend won't close doors. A dearth of honors in third year, a lower step 1 score, poor interpersonal skills, etc. are what closes doors. I am at a middle of the road school and we had a bunch of people matching into competitive specialties at top hospitals, including one guy at a top IM program despite an unimpressive usnews rank for our school.
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Whether people at top schools have top step 1 scores is a can of worms you don't want to open. I don't think you'll find useful data (nothing is officially released, by tacit agreement) and I suspect there are many lesser ranked programs with more of a First aid based curriculum and longer blocks of study time that screw up blanket statements like these.
 
Law2Doc said:
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.
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Look at the Harvard and Penn match lists. Literally, every single person matched at a top academic program. Even the worst of the worst at those schools match incredibly well (even better than the AOAs at state schools). This is also n=1, but I asked the neurosurgery residency director of a top academic program about this to try and get some answers and he said that the 230/240 HMS/Stanford/Hopkins students generally got ranked higher than the 250/260 state school applicants. Notable exceptions included those who took time off to do research there or did Sub Is at the program.
 
Cyberdyne 101 said:
...
Why are non-premeds now perpetuating the "importance of prestige" dogma in the pre-Allo forum?!
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This is nothing new. Just as premeds like to think if you get a certain Lizzy score you are set, they'd like to think if they get into a certain med school they are set. Medicine isn't like that. You earn your dinner every day end ever get to rest on your laurels.
 
WillburCobb said:
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.
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I'm just shocked that SDN premeds think that prestige doesn't matter at all and believe that where you get your MD doesn't matter, as if an MD graduate from Vanderbilt (in Nashville) will be treated the same as an MD graduate from Meharry (also in Nashville).
 
Greenberg702 said:
Look at the Harvard and Penn match lists. Literally, every single person matched at a top academic program. Even the worst of the worst at those schools match incredibly well (even better than the AOAs at state schools). This is also n=1, but I asked the neurosurgery residency director of a top academic program about this to try and get some answers and he said that the 230/240 HMS/Stanford/Hopkins students generally got ranked higher than the 250/260 state school applicants. Notable exceptions included those who took time off to do research there or did Sub Is at the program.
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You likely don't know what are the good residency programs for every specialty so your blanket suggestion that they are matching into a "top academic program" is suspect. A weak program that sounds good to someone outside of the specialty is still a weak program. Both of these schools lists have these.

And how does this really matter in a Vacuum. If for example everyone at Harvard did well on paper (by your estimation) but everyone was unhappy to end up in their third choice or worse, did they really do better than the school which matched everyone into programs that were their first choices at places you maybe aren't as impressed with? The goal is being able to go where you want in the specialty you want, not look top notch on paper to some fool in pre-allo. And this is why match lists are meaningless to premeds.
 
DermViser said:
I'm just shocked that SDN premeds think that prestige doesn't matter and that where you get your MD doesn't matter, as if an MD graduate from Vanderbilt (in Nashville) will be treated the same as an MD graduate from Meharry (also in Nashville).
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Exactly. Although someone from Meharry matched Mayo neurosurgery a couple of years ago. Everyone went ballistic. But this is exactly the point, good matches should not be the exception if your school is well regarded.
 
Greenberg702 said:
Look at the Harvard and Penn match lists. Literally, every single person matched at a top academic program. Even the worst of the worst at those schools match incredibly well (even better than the AOAs at state schools). This is also n=1, but I asked the neurosurgery residency director of a top academic program about this to try and get some answers and he said that the 230/240 HMS/Stanford/Hopkins students generally got ranked higher than the 250/260 state school applicants. Notable exceptions included those who took time off to do research there or did Sub Is at the program.
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Exactly. Thank you. I believe this is now even more the case bc there are now so many resources and companies to help with Step 1 prep. PDs know there's an entire industry for medical board prep.
 
Law2Doc said:
You likely don't know what are the good residency programs for every specialty so your blanket suggestion that they are matching into a "top academic program" is suspect. A weak program that sounds good to someone outside of the specialty is still a weak program. Both of these schools lists have these.

And how does this really matter in a Vacuum. If for example everyone at Harvard did well on paper (by your estimation) but everyone was unhappy to end up in their third choice or worse, did they really do better than the school which matched everyone into programs that were their first choices at places you maybe aren't as impressed with? The goal is being able to go where you want in the specialty you want, not look top notch on paper to some fool in pre-allo. And this is why match lists are meaningless to premeds.
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Forget choice - bc that's arbitrary. We're talking about academic prestige of the institution matched.
 
Greenberg702 said:
Exactly. Although someone from Meharry matched Mayo neurosurgery a couple of years ago. Everyone went ballistic. But this is exactly the point, good matches should not be the exception if your school is well regarded.
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A definite exception and we have no idea if he did an extra research year during med school. Even then his Neurosurgery match was at Mayo (I don't know where they rank in terms of Neurosurgery training, I know USWNR ranks Neurosurg places but too tired to look it up).
 
Law2Doc said:
You likely don't know what are the good residency programs for every specialty so your blanket suggestion that they are matching into a "top academic program" is suspect. A weak program that sounds good to someone outside of the specialty is still a weak program. Both of these schools lists have these.

And how does this really matter in a Vacuum. If for example everyone at Harvard did well on paper (by your estimation) but everyone was unhappy to end up in their third choice or worse, did they really do better than the school which matched everyone into programs that were their first choices at places you maybe aren't as impressed with? The goal is being able to go where you want in the specialty you want, not look top notch on paper to some fool in pre-allo. And this is why match lists are meaningless to premeds.
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I constantly read the specialty forums so I have a pretty good idea. The premise of that argument is wrong, because it assumes that people are happy with their first choice (which is limited by one's rank list which is limited by the interviews that one receives) regardless of where they actually end up. Essentially, you've switched the debate from: Can you match at an elite academic place? to Will you really be happy at an elite academic place? which is a completely different, although interesting discussion. Gunner pre meds who read match lists are asking about the likelihood of matching at an elite place so yes, if NYU HJD was my third choice for ortho behind HSS and Jefferson, I would be happier than if I only got interviews at low tier places and matched my "#1" at Uconn.
 
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Law2Doc said:
Your supporter is a first year med student who just joined SDN. Not exactly the standing you need to know what residencies look at...
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Did u see what I was agreeing with? "Look at the Harvard and Penn match lists. Literally, every single person matched at a top academic program." This is just by looking at the match lists.
 
DermViser said:
A definite exception and we have no idea if he did an extra research year during med school. Even then his Neurosurgery match was at Mayo (I don't know where they rank in terms of Neurosurgery training, I know USWNR ranks Neurosurg places but too tired to look it up).
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Considered elite, along with UCSF, Barrow, MGH, Columbia, BWH, Hopkins, UVa, etc. But yeah, for the first and probably last time.
 
Greenberg702 said:
Look at the Harvard and Penn match lists. Literally, every single person matched at a top academic program.
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I can't speak about all specialties, so I'll just talk about Peds.

For UPenn: CHOP is obviously a top program. UCSF is a great program. Jefferson/DuPont is not a bad program, but it's not a top academic program. St. Chris' is also not a bad program, but it's the urban poor community hospital compared to the academic powerhouse of CHOP. I'm not familiar with where UC San Diego falls because I wasn't interested in SoCal. Boston Children's is also a top program. Columbia is a good program, but I'm not sure if it's considered a 'top' program. It usually doesn't make the list when people rattle off top peds programs in the Northeast.

For Harvard: Baylor, Boston Children's are top programs. Mass Gen has brand name value because the IM program is amazing, but it's not a top peds program. UMass is also not a top program. Northwestern for peds I'm not sure about, but I don't remember it being one of the top programs. Again, CHOP is a top program. But Brown? Not so much. UCSF is a top program.

There are also a couple of people on the lists that don't have a match beyond a prelim year, so it doesn't really matter if they matched at a top academic program or not, because unless they find another position, they aren't going much of anywhere.
 
Greenberg702 said:
I constantly read the specialty forums so I have a pretty good idea...
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Yes, and you probably stayed in a Holiday Inn Express last night too...
I think you sort of epitomize my point here. Premeds (or recent premeds) saying they know what is involved in the residency process better than those PDs who are surveyed or those who have actually been on these committees. Or think they can use match lists usefully, across multiple specialties because they read a few threads on SDN.
 
mvenus929 said:
I can't speak about all specialties, so I'll just talk about Peds.

For UPenn: CHOP is obviously a top program. UCSF is a great program. Jefferson/DuPont is not a bad program, but it's not a top academic program. St. Chris' is also not a bad program, but it's the urban poor community hospital compared to the academic powerhouse of CHOP. I'm not familiar with where UC San Diego falls because I wasn't interested in SoCal. Boston Children's is also a top program. Columbia is a good program, but I'm not sure if it's considered a 'top' program. It usually doesn't make the list when people rattle off top peds programs in the Northeast.

For Harvard: Baylor, Boston Children's are top programs. Mass Gen has brand name value because the IM program is amazing, but it's not a top peds program. UMass is also not a top program. Northwestern for peds I'm not sure about, but I don't remember it being one of the top programs. Again, CHOP is a top program. But Brown? Not so much. UCSF is a top program.

There are also a couple of people on the lists that don't have a match beyond a prelim year, so it doesn't really matter if they matched at a top academic program or not, because unless they find another position, they aren't going much of anywhere.
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Yep, and it's the same kind of range in every other specialty. lots of so-so matches on these lists. Not outstanding from top to bottom like suggested by our first year med student friend. There's a range.
 
Law2Doc said:
Yes, and you probably stayed in a Holiday Inn Express last night too...
I think you sort of epitomize my point here. Premeds (or recent premeds) saying they know what is involved in the residency process better than those PDs who are surveyed or those who have actually been on these committees. Or think they can use match lists usefully, across multiple specialties because they read a few threads on SDN.
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Way to not respond to my rebuttal of your weak example. Those PDs were surveyed across all specialties and all programs. School name will always matter for elite places that are selective enough to be able to consider everything about an applicant.
Good luck dude.
 
DermViser said:
@Law2Doc @Greenberg702

Penn 2014 Match List: http://www.med.upenn.edu/student/MatchResults2014.shtml

Harvard 2014 Match List: http://forums.studentdoctor.net/thr...lication-thread.1003733/page-21#post-15048740
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For Harvard IM, exactly 1 person did not match into a top program (NMC SD). I wouldn't call that variation from top to bottom.


Btw, if people don't care about first year med students' opinions, read this from 4th years applying for the match:
http://forums.studentdoctor.net/thr...ram-from-a-non-top-25-medical-school.1073026/
 
DermViser said:
Forget choice - bc that's arbitrary. We're talking about academic prestige of the institution matched.
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Why does the academic prestige of the programs matched matter all that much? And what about schools that simply don't have a lot of students applying to prestigious residencies to begin with because they just happen to not float their boat?

I just feel like match lists are such an arbitrary thing to go by. The sort of people who go to Harvard are already the type that are likely prestige-oriented, thus they apply to residencies they perceive to be prestigious. Later on in their career they work for these prestigious residencies and bring on students from institutions they perceive to be prestigious due to their preexisting obsession with prestige. It's just a big, meaningless circlejerk imo.
 
Mad Jack said:
Why does the academic prestige of the programs matched matter all that much? And what about schools that simply don't have a lot of students applying to prestigious residencies to begin with because they just happen to not float their boat?

I just feel like match lists are such an arbitrary thing to go by. The sort of people who go to Harvard are already the type that are likely prestige-oriented, thus they apply to residencies they perceive to be prestigious. Later on in their career they work for these prestigious residencies and bring on students from institutions they perceive to be prestigious due to their preexisting obsession with prestige. It's just a big, meaningless circlejerk imo.
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I'm not talking about specialty, I'm talking about the institution itself (i.e. Pediatrics at Boston Children's).
 
Greenberg702 said:
For Harvard IM, exactly 1 person did not match into a top program (NMC SD). I wouldn't call that variation from top to bottom.

Btw, if people don't care about first year med students' opinions, read this from 4th years applying for the match:
http://forums.studentdoctor.net/thr...ram-from-a-non-top-25-medical-school.1073026/
Click to expand...
@Law2Doc,
If you look at Penn's and Harvard's list, you'll see that even in the "non-competitive" specialties, medical students are matching into top hospitals - BWH, Boston Children's, CHOP, etc. It's also a pattern, not just an exception or just the AOAers.
 
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Law2Doc said:
Um, I'm already far down the road and with a lot more prestige points than you (based on your prior posts). And I'm telling you it's not going to make the kind of difference you think. whatever.
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lmao. There's no med school that you could have gone to that would yield you "a lot more prestige points" than those that I got into.
 
Greenberg702 said:
...

Btw, if people don't care about first year med students' opinions, read this from 4th years applying for the match:
http://forums.studentdoctor.net/thr...ram-from-a-non-top-25-medical-school.1073026/
Click to expand...

Fourth year is still in the wrong side of the process to know much. There are people further down the road who actually saw the process from the committee rooms, and there's that annual PD survey you seem intent to ignore which are much better evidence. So basically I'm saying if you want to know how residency decisions work, you can't listen to premeds OR med students. They don't really know. They are focused on the process but not particularly informed about it. That's a Bad combination on discussion boards.
 
DermViser said:
I'm not talking about specialty, I'm talking about the institution itself (i.e. Pediatrics at Boston Children's).
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I'm referring to individual residencies, nit specialties. You can learn decent IM skills at any decently high volume place, for instance, but MGH is a prestige sink of an IM program that has a halo effect around it. Certainly, it is a good place to train, but is it so much better of a place to train than a mid tier university IM program as to merit the ridiculous prestige people attach to it? Or is it prestigious skmply because people believe it to be so, thus people concerned with prestige apply, and eventually become attendings that only bring on residents that they believe will further their institution's (and thus their own) prestige, despite their educational outcomes being only marginally different from many mid-tier programs?

Just a thought.
 
Greenberg702 said:
lmao. There's no med school that you could have gone to that would yield you "a lot more prestige points" than those that I got into.
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Then I misread your prior posts. Whatever man, you are a first year. Relax. You don't know enough about the process to offer a useful two cents here. If you are trying to pat yourself on the back for where you got in, then I get that, but it supports my prior argument about why premeds say what they say about prestige.
 
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Mad Jack said:
Why does the academic prestige of the programs matched matter all that much? And what about schools that simply don't have a lot of students applying to prestigious residencies to begin with because they just happen to not float their boat?
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I couldn't agree more with this. As I mentioned earlier, most pre-meds are simply content with getting into med school. These "residency and academic prestige" discussions only apply to a select few. And earlier in the thread, ppl alluded to the fact that "understanding the correlation between prestigious med schools and residency programs" is a must for all pre-meds. Maybe it's relevant for the person that absolutely wants a spot at Mass General for IM, but that's a very small percentage of ppl.
 
DermViser said:
@Law2Doc,
If you look at Penn's and Harvard's list, you'll see that even in the "non-competitive" specialties, medical students are matching into top hospitals - BWH, Boston Children's, CHOP, etc. It's also a pattern, not just an exception or just the AOAers.
Click to expand...

First, top residency program is what matters, not top hospital or top affiliated med school. The hierarchy is different in every field. There are some fields where hospitals you might never have heard of house one of the top programs, and there are programs at some of the big name hospitals that are really kind of the dregs. There are lousy residency programs in pretty much every hospital in at least one specialty. You likely know this, which is why I'm not sure why you are being obtuse here. Also, there's that same "pattern" at a lot of the schools outside of the top ten too. whatever. The premeds on here clearly know better.
 
Law2Doc said:
First, top residency program is what matters, not top hospital or top affiliated med school. The hierarchy is different in every field. There are some fields where hospitals you might never have heard of house one of the top programs, and big name places are really kind of the dregs. There are lousy residency programs in pretty much every hospital in at least one specialty. You likely know this, which is why I'm not sure why you are being obtuse here. Also, there's that same "pattern" at a lot of the schools outside of the top ten too. whatever. The premeds on here clearly know better.
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By top hospitals, I meant top residency programs in that specialty. As mentioned very accurately previously, while MGH is top for IM, MGH Peds isn't.
 
Cyberdyne 101 said:
I couldn't agree more with this. As I mentioned earlier, most pre-meds are simply content with getting into med school. These "residency and academic prestige" discussions only apply to a select few. And earlier in the thread, ppl alluded to the fact that "understanding the correlation between prestigious med schools and residency programs" is a must for all pre-meds. Maybe it's relevant for the person that absolutely wants a spot at Mass General for IM, but that's a very small percentage of ppl.
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As you progress thru medical school, you acquire this thing called standards. Why do you think people who come into medical school bloviating about how they would be happy doing IM, run for the hills, once they do their MS-3 rotation and suddenly have an affinity for Psych, PM&R, Path, Rads, etc. Same applies for institutions.
 
DermViser said:
... As mentioned very accurately previously, while MGH is top for IM, MGH Peds isn't.
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Yes. Which is why premeds are poorly equipped to read match lists. they see MGH and think "great program". It might not be. You or I could create a match list that looked amazing to premeds that would not be a particularly strong list. And that's my point of why it's foolish for a premed or first year to say "look at X schools match list -- prestige must matter."
 
Law2Doc said:
Yes. Which is why premeds are poorly equipped to read match lists. they see MGH and think "great program". It might not be. You or I could create a match list that looked amazing to premeds that would not be a particularly strong list. And that's my point of why it's foolish for a premed or first year to say "look at X schools match list -- prestige must matter."
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But one could easily see that for Peds in the USWNR Top Hospitals list.
 
Strong schools seem to have strong matching potential. I don't know why we are arguing against that because it just objectively does not appear to make sense.
What I want to know is whether it has more to do with the school itself, or the students attending that school. It would appear to be the latter from what everyone is saying, but I can't imagine having access to more resources good be a bad thing.
 
DermViser said:
But one could easily see that for Peds in the USWNR Top Hospitals list.
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mvenus already did a Nice job of showing that this peds list isn't mind blowing. And peds is but one specialty. Do we really need SDNers from each specialty to chime in as to why theres a few pedestrian matches in each specialty? Because the result will be the same. There's a range here. The top guy at Miami will do better than many of these matches.
 
Law2Doc said:
mvenus already did a Nice job of showing that this peds list isn't mind blowing. And peds is but one specialty. Do we really need SDNers from each specialty to chime in as to why theres a few pedestrian matches in each specialty? Because the result will be the same. There's a range here. The top guy at Miami will do better than many of these matches.
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If you look at the range (i.e. in Peds) at Penn and Harvard, the range is very tight. You don't see them matching into Peds at The University of Colorado, for example.
 
DermViser said:
As you progress thru medical school, you acquire this thing called standards. Why do you think people who come into medical school
bloviating about how they would be happy doing IM, run for the hills, once they do their MS-3 rotation and suddenly have an affinity for Psych, PM&R, Path, Rads, etc. Same applies for institutions.
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I don't follow you. So IM is a lower standard than the specialties you brought up?!
Also, you're implying that prestigious academic residency programs = higher standards. Not every med student is interested in such programs.
 
DermViser said:
If you look at the range (i.e. in Peds) at Penn and Harvard, the range is very tight. You don't see them matching into Peds at The University of Colorado, for example.
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And is the range really the best metric to use for this? If 1 person doesn't match well or doesn't match at all they stretch your range even though 90% of the students may be matching top.
 
rfenzo said:
Strong schools seem to have strong matching potential. I don't know why we are arguing against that because it just objectively does not appear to make sense.
What I want to know is whether it has more to do with the school itself, or the students attending that school. It would appear to be the latter from what everyone is saying, but I can't imagine having access to more resources good be a bad thing.
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Its the latter. You as the student don't always actually have access to more resources at a research heavy program with lots of research grant funding because often it just means the school has some giant cyclotron off campus that you never get to see, let alone work with, and so that isn't going to impact your training one iota. Of course that infrastructure might make the school more attractive to certain faculty who want to get their hands on a cyclotron, so if they are willing to teach med students that might be a Plus. But in terms of number of books in the library or how nice the classroom is or projects you can get your hands on, it probably doesn't mean much as you move from the school ranked 1 to 50. At the bottom of the list there might be less research going on so you might have to go outside your school (NIH or wherever). But that's not really that much of an obstacle.
 
Law2Doc said:
Its the latter. You as the student don't always actually have access to more resources at a research heavy program with lots of research grant funding because often it just means the school has some giant cyclotron off campus that you never get to see, let alone work with, and so that isn't going to impact your training one iota. Of course that infrastructure might make the school more attractive to certain faculty who want to get their hands on a cyclotron, so if they are willing to teach med students that might be a Plus. But in terms of number of books in the library or how nice the classroom is or projects you can get your hands on, it probably doesn't mean much as you move from the school ranked 1 to 50. At the bottom of the list there might be less research going on so you might have to go outside your school (NIH or wherever). But that's not really that much of an obstacle.
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Thanks for the response, I absolutely agree. I do think though that the access to resources might be a bit more significant than alluded to. For example, a lot of top schools have very easy access to grants for international projects, summer research, etc. that - though they existed at some of the non-top schools - seemed to be much more competitive and less accessible. At the top schools, basically anyone that wanted money for these things and had a good reason got it.
 
rfenzo said:
Thanks for the response, I absolutely agree. I do think though that the access to resources might be a bit more significant than alluded to. For example, a lot of top schools have very easy access to grants for international projects, summer research, etc. that - though they existed at some of the non-top schools - seemed to be much more competitive and less accessible. At the top schools, basically anyone that wanted money for these things and had a good reason got it.
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I don't think these resources are tightly aligned with rank, for the reasons in my last post, but I would agree these are legitimate factors to ask about when applying.
 
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