What tier of schools should I apply to?

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premedmike

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Low-tier MD student currently on a research year at a top 20 institution.
  • Stats: Step 1 : 25X
    • Step 2: 26X
  • AOA: Maybe senior, unsure
  • Clinicals: all Honors, 1 HP in Family Med
  • Preclinical: mixed bag, P in anatomy, High pass 2 classes, Honors in the rest
  • Letters: confident about strong letters from my department, known them for years + strong letter from research year
  • Research: 5 pubs (1 first author case report, a bunch of 2nd author). Hopefully 2 basic science papers from the research year
    • Numerous posters (>15)
  • Other things: free clinic volunteering, dedicated volunteering with low-income communities throughout college and med school, Gold Humanism.
Not sure what other info to add.

I feel like the low-tier MD school is holding back my application, along with the fact that my letter writers will mostly be from those who aren't that involved academically.

Where should I aim for aways (if they happen)? What tier of schools should I plan on applying to when ERAS is out?

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The million dollar question here is...
How much does your med school matter?

Your stats indicate that you are a solid applicant who is very likely to match.

Imagine an alternate you with identical stats. The only difference is your alter ego goes to Harvard Med. How much of an advantage do they have over you in applying for ENT residency?

In my experience, your alter ego at Harvard has some advantage, but likely a lot less than you think.

I did residency at an institution where the med school was ranked in the 60-80s on the US news list. Our ENT department was certainly not a “big name” elite place.

During my few years there, every med student who applied for ENT (except one) matched, and at least 1 student matched at Harvard/MEEI, Hopkins, UW-Seattle, Vandy, and several others at a similar level of reputation. I would estimate that 2-5 students per year applied.

The students who matched at those programs were all excellent. There are excellent students at every med school, regardless of its US News ranking.

The one student who did not match had major personality issues and everyone in the department hated him.

To the OP- it sounds like you are doing all the important things right, and you have a solid application to show for it. I don’t think you have to apply to every program, but do apply broadly like any other applicant would.
 
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The million dollar question here is...
How much does your med school matter?

Your stats indicate that you are a solid applicant who is very likely to match.

Imagine an alternate you with identical stats. The only difference is your alter ego goes to Harvard Med. How much of an advantage do they have over you in applying for ENT residency?

In my experience, your alter ego at Harvard has some advantage, but likely a lot less than you think.

I did residency at an institution where the med school was ranked in the 60-80s on the US news list. Our ENT department was certainly not a “big name” elite place.

During my few years there, every med student who applied for ENT (except one) matched, and at least 1 student matched at Harvard/MEEI, Hopkins, UW-Seattle, Vandy, and several others at a similar level of reputation. I would estimate that 2-5 students per year applied.

The students who matched at those programs were all excellent. There are excellent students at every med school, regardless of its US News ranking.

The one student who did not match had major personality issues and everyone in the department hated him.

To the OP- it sounds like you are doing all the important things right, and you have a solid application to show for it. I don’t think you have to apply to every program, but do apply broadly like any other applicant would.

Thanks for your insight. I guess I should be more specific with my question, what percentage of the schools I apply to should be top-tier? I am planning on applying to 80 or so programs, primarily those that are ranked 40 down.

For aways, I am interested in some top-middle tier programs (high 30s or so). Do I have a fair shot at these programs if I do an away there? I would rather not waste a month at a program I won't seriously be considered at because of the tier of medical school I come from.

Thanks.
 
Thanks for your insight. I guess I should be more specific with my question, what percentage of the schools I apply to should be top-tier? I am planning on applying to 80 or so programs, primarily those that are ranked 40 down.

For aways, I am interested in some top-middle tier programs (high 30s or so). Do I have a fair shot at these programs if I do an away there? I would rather not waste a month at a program I won't seriously be considered at because of the tier of medical school I come from.

Thanks.
Any away will not be a waste of time.

Do your away where you want to watch, otherwise your chances at any one program, regardless of medical school, will be low. Taken your application as a whole, you have a pretty good chance of matching. Trying to figure out what tier is essentially useless.

Your chances of matching are as follows:
1. Your home department
2. Your aways
3. Geographic programs around your home department

Medical school tier has very little at all to do with it.
 
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If by top tier, you mean top 25 ranked programs, then even if you apply to all of them, you still have 55+ more spots left in your list. So, I don't think it really matters if you are applying to that many programs. With your stats and research, I don't see how you won't get more interviews than you can possibly attend if you apply to 80+ programs.

I would think about the match like this: there are 2 hurdles you have to clear to get highly ranked at any particular program.

1. You have to get an interview
2. You have to perform well enough at the interview to get ranked highly by the program

#1 is all about your stats, your letters, and more nebulous stuff like where you are from, where you went to college, etc.

By doing an away rotation, you basically circumvent #1 at that program. The away rotation IS your interview. And it is more difficult to go through a whole month without screwing yourself over than just 1 day. But if you perform really well, it can seal the deal for you. That is easier said than done, though.

Once you are at interviews, the primary thing that matters is your personality/what type of person you are. The attendings and residents will have to work closely with you for the next 5 years- the most important thing at the interview stage is convincing them that you are likeable, hard working, and compatible with the culture of the department.

At the interview stage, your stats/letters/med school are used mainly as a tiebreaker. Potentially you could be bumped a little lower than another interviewee from a top school if you are otherwise equivalent to him/her.

Overall, I do think you are overthinking this a bit. You have a very solid application, with excellent USMLEs, clinical grades, and research experience- all above average for matched applicants. Your med school is not going to be the thing that makes or breaks you. Move forward with confidence, and keep doing what you're doing.
 
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If by top tier, you mean top 25 ranked programs, then even if you apply to all of them, you still have 55+ more spots left in your list. So, I don't think it really matters if you are applying to that many programs. With your stats and research, I don't see how you won't get more interviews than you can possibly attend if you apply to 80+ programs.

I would think about the match like this: there are 2 hurdles you have to clear to get highly ranked at any particular program.

1. You have to get an interview
2. You have to perform well enough at the interview to get ranked highly by the program

#1 is all about your stats, your letters, and more nebulous stuff like where you are from, where you went to college, etc.

By doing an away rotation, you basically circumvent #1 at that program. The away rotation IS your interview. And it is more difficult to go through a whole month without screwing yourself over than just 1 day. But if you perform really well, it can seal the deal for you. That is easier said than done, though.

Once you are at interviews, the primary thing that matters is your personality/what type of person you are. The attendings and residents will have to work closely with you for the next 5 years- the most important thing at the interview stage is convincing them that you are likeable, hard working, and compatible with the culture of the department.

At the interview stage, your stats/letters/med school are used mainly as a tiebreaker. Potentially you could be bumped a little lower than another interviewee from a top school if you are otherwise equivalent to him/her.

Overall, I do think you are overthinking this a bit. You have a very solid application, with excellent USMLEs, clinical grades, and research experience- all above average for matched applicants. Your med school is not going to be the thing that makes or breaks you. Move forward with confidence, and keep doing what you're doing.

Thank you for the detailed advice and reassurance! Will be interesting to see how this cycle goes now that away rotations may be cancelled or heavily postponed.
 
Any away will not be a waste of time.

Do your away where you want to watch, otherwise your chances at any one program, regardless of medical school, will be low. Taken your application as a whole, you have a pretty good chance of matching. Trying to figure out what tier is essentially useless.

Your chances of matching are as follows:
1. Your home department
2. Your aways
3. Geographic programs around your home department

Medical school tier has very little at all to do with it.

Thanks for your help.
 
Thank you for the detailed advice and reassurance! Will be interesting to see how this cycle goes now that away rotations may be cancelled or heavily postponed.

No problem. I have a lot more time for writing essays on SDN these days ;-)
 
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FYI, most programs are NOT doing away rotations.
 
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