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Top 15 school, How hard is it to match Cali

Dr.Bruh

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Bro I go to a midwest DO and we match 10-15 people in Cali every year. It all depends on what specialty your going for. You go to a top school and your a Ca native? You'll be fine just study hard.
 
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AlteredScale

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Idk, I expect my app to be good but not ground breaking. I'm going to work hard, but idk if I'm going to be spectacular, I doubt it.

No idea bout fields, that's kind of why I ask.
Because if I compeitive specialties are nearly impossible, I might need to resign myself to say IM or Psych early on to have the best chance.

For competitive specialties probably want good scores, good research, and good auditions out in the west coast +/- letters from faculty you work with. Should be doable especially coming from a t15. take advantage of the resources you have being at a such an institution.

For IM, you could do aways on the west coast if you wanted to really show your interest but seems like the general consensus is just have a good paper application and you should be able to match to the west coast easily so as long as you're not super picky (meaning you should NOT just apply to Stanford, UCSD, UCLA, UCSD, look at other mid-tier/community programs like kaiser)
 
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writingdoctor

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Honestly - you shouldn't make the decision about what specialty you match into simply based on location. I understand being in California is a priority for you, but if your calling is elsewhere, do not simply resign yourself to a specialty because you think it will be easier to match into California in that specialty. You're going to be practicing this specialty for your whole life! Residency is just a small portion of your career, with some programs being as short as 3 years (not to undermine this length of time, but I personally find it small in the grand scheme of things).

Instead, pursue your specialty of interest, and apply as broadly as possible in California! Since you come from a Top 15 school and if you put together a decent application, you should match somewhere - there are plenty of programs in California.

If you don't match in California, it's not the end of the world. I promise!
 
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AnatomyGrey12

That's reassuring!! :O

I'm just scared because I created this idea of my future, and suddenly I've started hearing that, oh, it's not actually that easy to match back.

I've lived here my whole life and a part of my identity is connected to it (Im a surfer, my fams here, by best friends are here) so it's just really jarring.

I might change, you might be totally right and I uust cant see it yet.
But right now I just can't imagine every finding a specialty that would call to me so much that it would make me want to abandon everything. 3-6 years is a long time, and I'm not confident of getting work somewhere if I haven't done residency there.

But thank you for your kind words, honestly it might just be I'll end up changing my mind :)

You can easily move back as an attending.... the field you pick is the rest of your career, I would never make that decision based on not being able to live in a specific location for 3-6 years.
 
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efle

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Honestly - you shouldn't make the decision about what specialty you match into simply based on location. I understand being in California is a priority for you, but if your calling is elsewhere, do not simply resign yourself to a specialty because you think it will be easier to match into California in that specialty. You're going to be practicing this specialty for your whole life! Residency is just a small portion of your career, with some programs being as short as 3 years (not to undermine this length of time, but I personally find it small in the grand scheme of things).

Instead, pursue your specialty of interest, and apply as broadly as possible in California! Since you come from a Top 15 school and if you put together a decent application, you should match somewhere - there are plenty of programs in California.

If you don't match in California, it's not the end of the world. I promise!
You can easily move back as an attending.... the field you pick is the rest of your career, I would never make that decision based on not being able to live in a specific location for 3-6 years.
There are exceptions. I'm on year 3 of long distance + opposite coast from family and it's awful. Being able to target a specific area in California for the next 4-6 years matters more to me too. I'd happily switch from rads to gas or IM if it could lock down a spot in the Bay. There are so many fellowship options and variety in practice that I think I could be happy in a lot of gigs, but I know I will be miserable if I spend another half decade away from all my loved ones.
 
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AnatomyGrey12

There are exceptions. I'm on year 3 of long distance + opposite coast from family and it's awful. Being able to target a specific area in California for the next 4-6 years matters more to me too. I'd happily switch from rads to gas or IM if it could lock down a spot in the Bay. There are so many fellowship options and variety in practice that I think I could be happy in a lot of gigs, but I know I will be miserable if I spend another half decade away from all my loved ones.

Different strokes. I’d rather be working every day in the field I wanted for 30 years than live 5 extra years in a specific location, but I don’t really care about living right by family. Gotta do what you gotta do I guess.
 
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efle

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Different strokes. I’d rather be working every day in the field I wanted for 30 years rather than live 5 extra years in a specific location, but I don’t really care about living right by family. Gotta do what you gotta do I guess.
It's mostly the S.O. Everyone I know who is married, engaged, or engaged to be engaged is making proximity to their partner their #1 priority. Plenty of single young guys gunning hard to train at whatever big-name program or elite surgical specialty they want, but also lots of folks like me.
 
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sanfran256

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I just matched back to an academic center in CA from out East for IM. It was not as difficult as anticipated. I'm not from a T15 (more like T30ish). Your connections to the state really help get interviews ( I got way more IVs in CA than my friends who applied without any). For more competitive/smaller specialties I think it will be more tough though from what I have seen- All the typical specialties (Derm/surgical subspecialties) but also Psych and EM seem particularly hard in CA.

PM me if you have any specific questions about iM
 
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Skindoc83

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To truly pick your career in the hopes of getting back to California is foolish. Residency is 3-7 years during which your time is not your own. And the dirtiest part of the whole thing is that there is no guarantee that there will be any jobs available in that area when you’re done. Doing residency in the place you want to practice can help you make connections in that community. But that only helps if someone is hiring. The Bay area is one of the most saturated markets in the country. UCSF pumps out a high number of residents, fellows, and super fellows most of whom have to leave the area to find work. And if You can find a job, reimbursement is abysmal and cost of living is enormous. I love California and have a soft spot for San Francisco but please don’t pick your career based upon geography because there is a good chance when you’re all done training, the job market and financials will necessitate that you move anyways.
 
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AnatomyGrey12

It's mostly the S.O. Everyone I know who is married, engaged, or engaged to be engaged is making proximity to their partner their #1 priority. Plenty of single young guys gunning hard to train at whatever big-name program or elite surgical specialty they want, but also lots of folks like me.

Eh, I’m not a single young guy and still can’t relate. 30 years in the field I love trumps 3-5 additional years in a specific location every time. I would never pick my career based on location, sounds like a great way to have a miserable career.
 
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sanfran256

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To truly pick your career in the hopes of getting back to California is foolish. Residency is 3-7 years during which your time is not your own. And the dirtiest part of the whole thing is that there is no guarantee that there will be any jobs available in that area when you’re done. Doing residency in the place you want to practice can help you make connections in that community. But that only helps if someone is hiring. The Bay area is one of the most saturated markets in the country. UCSF pumps out a high number of residents, fellows, and super fellows most of whom have to leave the area to find work. And if You can find a job, reimbursement is abysmal and cost of living is enormous. I love California and have a soft spot for San Francisco but please don’t pick your career based upon geography because there is a good chance when you’re all done training, the job market and financials will necessitate that you move anyways.
That’s true if you are sub-specialized. Not necessarily so if you are IM/FM wanting to become a PCP
 

EmergDO

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Well it would be 3-7 years near(er) to my friends and family. Ik I will have very little downtime, but when I do I can spend it doing things and with people I love.
That seems very worth it.

Also, I just want somewhere in So-Cal in general at worst, I can live with being pushed out of a specific city. Wouldn't being from a respectable residency at least within a few hundred miles help more than one from the East Coast?

At worst, I just want to be on the Pacific Coast.
This is SDN so Ik there might be a bad reaction to me saying this (along the lines of being in the wrong profession) but I honestly can't see myself practicing away from that general area I just mentioned.

To the point that I would rather be jobless. No kidding. That's how bad I want it.

I'd still apply to other places just in case, but I can't imagine you'd have any trouble matching IM, peds, psych, or FM in SoCal unless you have a truly horrific application with board failures and professionalism violations. My east coast dinky DO school sent several people to Los Angeles for PM&R, IM, and FM. If you have even a remotely solid app then even more things would open up--EM, gen surg, gas, etc.

I get not wanting to leave, I'm from a big city on the other coast and wanted to stay in that kind of environment too. I interviewed at some more rural places that left me pretty bummed out--far from friends and family, no diversity, etc--but I did still rank them, because at the end of the day it was just going to be 3 years and then I could move back to where I wanted.

I'd just focus on doing well in school, getting some research, and seeing how your rotations go. You aren't going to have trouble going back unless you want to do something very competitive.
 
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Dox4lyfe

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Thanks for the encouragement you guys!! I'm glad to think I'm not just crazy. Life is short, and I don't see the point in investing my 20's and 30's away, even if its for a good job in a lucrative field.

Basically, I'm just going to have to work super freaking hard to try and be as good as I can in Med school, and as long as I manage being average or above, I'll have a shot.
I don't mind community programs tbh considering my priorities.

Actually, I have a question: what's the downside of a community program?
Like, aren't you going to be a physician anyway? Don't you get paid basically the same amount, and if you trained in the area you want to work in anyway, what's the downside (besides the ego boost)?

In your case it sounds like a community program is what you'd prefer.

Someone else can add or correct me, but my understanding is the following:

Community programs you see mostly bread and butter cases, almost all clinical work, generally much higher pay, tougher to get a fellowship bc of limited research opportunities/mentors/name

Academic program you see a mix of bread and butter cases + rarer cases, mix of clinical/teaching/research/administrativework, lower pay bc of less clinical work
 
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EmergDO

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Actually, I have a question: what's the downside of a community program?
Like, aren't you going to be a physician anyway? Don't you get paid basically the same amount, and if you trained in the area you want to work in anyway, what's the downside (besides the ego boost)?

Technically, what makes a program "academic" is a primary affiliation with a medical school. So in SoCal that's the main UCLA program, UCSD, USC, Loma Linda, UCI. I guess technically Kaiser LA is now one too. Community programs would be the UCLA affiliates at Harbor and Olive View, Cedars Sinai, and the smaller programs like Scripps and Huntington Hospital. The thought is that academic programs are larger tertiary care centers with a host of subspecialties and see a wide variety of complicated cases while also producing research, while community hospitals have less research and may lack some specialty services, though this means you aren't competing with as many fellows and other residents for patients.


The big advantage (in most, but not all specialties) to going to an academic center is the increased variety and acuity of your patients, the ability to do more research, and most importantly, the name brand recognition/networking if you're going into fellowship. Community programs tend to have more autonomy (not competing with a zillion fellows for patients) and for some specialties more procedural time (like in surgery).

The differences can get pretty fuzzy and programs really exist on more of a spectrum. Harbor UCLA is a big tertiary hospital that is much closer to an academic center than it is to some smaller community hospital like St Mary's in Long Beach, for example. And Kaiser is now technically an academic center because it opened a med school but it isn't going to have the "prestige" or research output of UCLA or UCSD. Depending on what you want to do, many of the differences exist mainly in the mind of SDN commentators trying to rank programs as opposed to differences in real life.


The pay for residents should be the same, as an attending the academic centers will typically pay less.
 
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RangerBob

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None of my friends had any trouble returning to CA for residency. We were not at a top ranked school.

As a CA native, I echo what some of the above posters said and I recommend you pick your specialty based on what you want to do for 30-ish years. If living in CA is critical to you, certainly choose a speciality that’s in demand. For example-my family lives in a more rural part of CA. I was lucky to get a job at the only inpatient rehab hospital in the area. Otherwise the next closest is 2hr away. I realize now that psych (my alternate specialty choice), probably would have been the smarter choice because there’s such a shortage of them and so many jobs are available. However, I like rehab more and fortunately got a job in it, so it worked out.

FM/IM, psych, OB job opportunities are extremely plentiful here, and would give more options.

Side note-when did CA natives start calling it “Cali?” I’ve been seeing that more often. When I was growing up in (I’m not that old-I’m still in my 30’s...) no native called it that, so it was a sure-fire way to know someone was from out of state. I guess times are changing...
 
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AlteredScale

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Wow interesting that pay is lower at the places that are more competitive hmmm.

Suits me fine! I would love to be somewhere in OC or at Scripps! I have my objectives clearly painted haha

If you're not picky, you'll have a very decent time getting back here imo.
Side note-when did CA natives start calling it “Cali?” I’ve been seeing that more often. When I was growing up in (I’m not that old-I’m still in my 30’s...) no native called it that, so it was a sure-fire way to know someone was from out of state. I guess times are changing...

Ha. I think that just started. But I remember in high school that was a big no no or speaking like a surfer in general (cuz 99% of Californians don't do speak like that).

One thing that I could not wrap my brain around was when people would say they are from the "Bay Area" it didn't mean SF but instead was this gigantic umbrella term for essentially what would be central cali.
 
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medstud56

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Noncalifornians will never understand the desperation and need to return back to California. I totally get it!

Lol so true. Taxes are high, COL high, and pay is relatively low. If you want to be rich (like some med students/docs do, let's be real)... NOT for you.
I still don't think you can beat the QOL though, especially for those of us who like ocean sports
 
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