Top Programs

[BobA]

What does it take to be competitive at a top program? Any thoughts about the need to do away rotations to be more competitive at a "top" program?

Basically, I'm an average student with average board scores at a well-ranked medical school. Also, I worked as an untrained residential mental health counselor for several years prior to medical school.

I know there have been several posts about which program's at the "top" and how little the pathology-based step 1 has to do with Psych, but I'm a real-world candidate wondering what tier program I might look at. Also, I'm trying to decide if I need to do an away. So I'd love to hear what people thought about how one matches into the UCSF's and Harvard's of the world.

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[atsai3]

What does it take to be competitive at a top program? Any thoughts about the need to do away rotations to be more competitive at a "top" program?

Basically, I'm an average student with average board scores at a well-ranked medical school. Also, I worked as an untrained residential mental health counselor for several years prior to medical school.

I know there have been several posts about which program's at the "top" and how little the pathology-based step 1 has to do with Psych, but I'm a real-world candidate wondering what tier program I might look at. Also, I'm trying to decide if I need to do an away. So I'd love to hear what people thought about how one matches into the UCSF's and Harvard's of the world.

At a minimum, programs are hoping that you won't fail Step 3, be a danger to patients, or flake on your fellow residents. Typically they will be able to screen for this on the basis of board scores, grades, and letters. Once you exceed a program's general threshold of quality, the letters and interview are very important in helping the program determine whether you would be a good fit for them. So if you fear your 'average board scores', I would say don't sweat it; I know several folks who had average scores or some other handicapping factor (e.g., one is a FMG) but nonetheless managed to Match at 'top' programs (e.g., UW, Stanford, UCSF, Cambridge). In general, programs are looking for residents who will go on to be leaders in their fields. Often research can help but only if there is some suggestion of the potential for sustained interest (i.e., spending two months of MS-4 just so you can say you "did research" probably won't help much).

Doing an 'away' elective can help you get face time at the institution where you would like to match to, and a letter or e-mail of support from your attending may help your application marginally. But it can also backfire -- i.e., if you end up doing poorly in your rotation, or if you don't get along with the residents. Speaking from personal experience, at our program we tend to scrutinize the visiting medical students fairly heavily.

My advice generally is: if you think you look better on paper, then defer the away elective. If you don't look very good on paper and you think you can successfully put your best foot forward, then do the away elective. Getting a letter from the away rotation is a bonus, but you should know that a stellar, detailed letter from an attending at your home institution who knows you well will do a lot more for your application than a generically favorable but otherwise bland letter from an attending at the institution where you are visiting.

-AT.

 

[BobA]

Thanks for your reply! That's exactly the type of info I was hoping for.

Comments from others are welcome as well.

 

[billypilgrim37]

Basically, I'm an average student with average board scores at a well-ranked medical school.

Well, that sounds about like an average resident at an average top program

 

[BobA]

I appreciate the input and the Vonnegut reference.
Any more thoughts?

 

[illusenjester]

Honestly, why does it matter if you make it to the highest, competitive medical school? Does it really matter in the long run? I don't think so, if you make it in any medical school (oviously a prestigious one, is any medical school not prestigious?) Basically what I'm trying to convey is, in the end a physician is a physician is a physician...
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[billypilgrim37]

Honestly, why does it matter if you make it to the highest, competitive medical school? Does it really matter in the long run? I don't think so, if you make it in any medical school (oviously a prestigious one, is any medical school not prestigious?) Basically what I'm trying to convey is, in the end a physician is a physician is a physician...
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If it's competitive, it's because a lot of people want it.

If a lot of people want it, it has value.

If you don't want it, there's nothing wrong with you. If somebody else does want it, there's nothing wrong with them.

That's economics.

 

[illusenjester]

OK...so if a good medical school in comparison to mmm let's say Cambridge or Stanford, you're saying the former has no value because there is not so much competition (in comparison). It doesn't change what you are in the long run, whatever medical school you go to.
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[billypilgrim37]

OK...so if a good medical school in comparison to mmm let's say Cambridge or Stanford, you're saying the former has no value because there is not so much competition (in comparison).

While I'm struggling to parse the grammar (and I don't quite see the point of comparing schools across continents, if that's what you're doing), I'm pretty certain that's not what I said. Things over which people compete have value, because otherwise people would not compete for them. That doesn't follow to any extreme that only things which people compete for are valuable, or that things people compete for are valuable to everyone. Saying Barack Obama is smart is not to say that John McCain is stupid.

It doesn't change what you are in the long run, whatever medical school you go to.

There are many people who would agree with you. I am certainly not one of them. Some medical schools and residency programs simply open up more opportunities for their graduates than others, either through better training in some or all areas, or by virtue of arbitrary name-dropping. And those opportunities are valuable to many people.

If those opportunities aren't valuable to you, that's fine. But to say that your choice of medical school or residency programs doesn't matter is categorically false.

 

[blabbyblab]

I'm in a similar situation as the OP. To use a bit of the terminology I am beginning to loathe, I am from a "mid-tier" medical school and I am currently at a "top-tier" program doing an away elective. I am having an overwhelmingly positive experience, however it is not that much different from my home institution. I am so glad I came though because I think it has opened my eyes to the fact that prestige really is not the whole story. I would suggest doing an away if only for that reason.

 

[illusenjester]

OK...when you put it that way, I guess you're right.
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[DebDynamite]

Basically, I'm an average student with average board scores at a well-ranked medical school. Also, I worked as an untrained residential mental health counselor for several years prior to medical school.

This is all you need, and halfway decent board scores. Or, a lousy step one + a much-improved step two. Good letters that make you stand out also help.