Take a deep breath. Calm down. No where do I suggest, whatsoever, you cannot prioritize programs. You can cop an attitude and call my statements "*****ic" all you want, it doesn't change their content or accuracy. You don't have to evaluate all 200+ programs out there. What should be the number 1 and number 2 decisions in choosing a program? #1)Location. #2)Program size. Based off of completely (I guess) objective analysis, you can effectively cut that list from 200 to a much more manageable list. If the only location you want to live in is the Southeast, what's the point of even thinking about applying to Oregon? If your significant other doesn't want to live in a large metropolitan area, why apply to New York City programs? Likewise, if you are dead set on fellowship, you should apply more to a medium to larger program so you can get good exposure to subspecialities. If you want a small program and want to get to know everyone really well, apply to them. Its that simple. No need to act like its so difficult get an idea of where you want to live. Remember, YOU have a choice. You don't match at a program you don't apply to.
I guess my major issue was that for most people location is most important, and for me it is not important at all. I know I want to do residency, fellowship, and practice in a city bigger than the one I'm in. I have to leave "home". I'll return home for visists regardless of where I am, either by car or plane. It's more important to me how much vacation time I have off that allows me to visit home, honestly.
As far as number 2, I want a bigger program. I like to separate my work and social lives. A lot of the bigger programs, also tend to be the more competitive, large city, academic places. I'd rather not have 7-12 interns in my class. At the same time, in a class of 40 you can often get overlooked, ignored, taken advantage of, and the place could be miserable. There is no way for me to know first hand what a program is like, so i was hoping I could get other peoples opinions on those issues from a thread like this. I was inflammatory toward you, not because of your stance, as it seems like a very common stance... but b/c of the way you presented your argument. I felt you were implying that "if you rank schools like this, you are a gunner" which then scares others from participating. I honestly just was a bit angry b/c I knew after that statement, no one would continue talking about ranks.
I don't think I'm a name *****. I've withdrawn my application to some very big name schools because I think they would be terrible fits. I've withrdrawn from 2 of my "top tier" schools due to such reasons. I have also withdrawn from 1 of my "second tier" schools based wholey on feedback I've received from actual residents/visiting students at the program.
I am interviewing at a couple places that have little national reputation b/c I've heard only glowing reviews.
You see, option A is problematic, especially the way you go around trying to assess it and the advice that has been repeated over and over. Multiple people, including attendings on the forum have told you repeatedly that you can match into fellowship from most programs out there.
I'm a very cautious person. Paranoid even. I applied to 39 programs b/c I was, evidently, extremely overconcerned with how XY or Z would look to program directors. I actually think, in retrospect, this advice you give me is very sound and particularly applicable to my current situation. I'm from a smaller program with average to below average reputation, yet I'm still getting interviews at my top choices. You'd think that'd be enough to tone down the neuroticism. Unfortunately, I just focus on other aspects. Normally a single program doesn't take more than a couple fellows. Since there are considerably less spots a program can fill, It seems every little thing can make a difference. I feel residency at a place like 'nati offers both the reputation and the strong clinical experience (due mostly to catchment area and location). If I go to St. Vincents in Indiana, and have the exact same application as another person from 'nati, and there is only 1 fellowship at Emory (or whatever place i want to go) then I feel I would have to be at a disadvantage. People keep saying I wouldn't be, but they never give me a logical explaination of why, which is frustrating. Just looking at the numbers, it seems, all other things being equal, a strong program name would be a huge plus, especially if Emory does not have any impression at all from a less known place like St. Vincent. No impression tends to be a negative impression.
I guess I just don't like taking chances when it comes to the topic of where I'm most likely going to be living for the rest of my life. That is much much more important to me than where I spend the next 3 years.
Off the top of my head, I can think of one program, that is nowhere on your "ranking" list but meets most/all of your criteria, where there is a highly reputable chairwoman of the entire program (who just about everyone knows her in her subspecialty), who also goes out of HER way to get to know ALL of the residents so she can offer an exceptionally strong LOR. But the problem now is that people are going to read your post and believe your list resembles some-sort of essential truth about programs.
i know. and I wish more people would have spoken up about their favs. I dno't understand the reluctance. You are doing it now. Why not say the name of the program you are speaking glowingly of so that others perusing this thread KNOW about it. this speaks directly to my meta-anaylsis statement. That is not what I intended at all.
Every year, in just about every stage of medical training, people fall into the trap that a great "reputation" can turn an average applicant into a superstar. High schoolers think that getting into the best college is absolutely essential, that they have to go to Harvard over the University of Florida, or else you won't get into medical school despite the face they would have a miserable time at Harvard (obviously on the other hand, though, going to a community college isn't recommended). Med school applicants fall into the same trap, you have to go to Hopkins or you won't match. Even now, fourth year medical students continue to fall into the trap, as this same rule is even more accurate in pediatrics. You have to go to some "highly" named program just to get into fellowship. I remember falling into the same trap as a fourth year medical student.
just from personal experience, I don't agree that this is a fallacy. I'm not saying you cannot match someplace great from a less know program, but I do think it puts you at a disadvantage. I did not give a crap about reputation when applying to undergrad. I figured i could just shine and be able to go to med school anywhere. I went to a top 50 ranked undergrad, but it was a state school and not one with an ivy league reputation. I did very well, had a 3.95 gpa, 95th percentile on MCAT and was denied interviews at most of the "big name" med schools. When talking to others on SDN it seemed most of the people getting interviews were from Ivy league or some fancy private school. It seemed like their stats were equal or worse than mine. So I guess i made the assumption my program was hurting me. It could very easily have been a poor personal statement, or poor LORs... but I just got this gut feeling that it was my institution. I realize the arrogance there (I'm not inadequate, it's the program), and I'm not saying it was my program, it was more likely other parts of my application. But I am who I am. If I get poor LORs b/c I'm introverted, that's not going to change. I could change the reputation of the program I went to though.
Thanks for all the advice. And feel free to PM me that awesome school
