What's it take for the top 5

[stankem]

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So I'm a third year getting ready for next year's apps. I know getting into the top programs (MGH UCSF BW JH PENN Columbia Duke...top 5 probably has more than 5) isn't the end all be all but I was wondering if it were even possible from a mid tier state school, with little name outside the south, or if I was DOA.

I feel like I've got some of the boxes checked for things applicants there need - 265 step I, 4/4 Hs on Medicine, Surgery, Neuro, Ob/Gyn, one pub basic science in endocrinology - was more of a do as I say little on the intellectual end, potentially 1-2 more on the way from other more self directed work, think I'll get some good letters but not from any national names. Hoping to do some more international work next year because I enjoy that but feel like I may be forced into more research so I can actually produce something more self directed.

Anyway forums here led me to believe boards some research matter less than letters and school don't think I'll have the letters don't have the school is that game over? Have people on the board in similar circumstances gotten those interviews or have met people on the trail like that? Thanks for the help

 

[futureres]

I've interviewed at the "elite" programs and yes, I attend a well-known medical school, but I've also met lots of people on the interview trail from schools I'm less familiar with. Honestly, with your record, it shouldn't matter. You should check out those residency programs and see if they have had any residents from your school in the past. Also, if the dean's letter is coming from someone who has connections at those institutions, you should find out and use that to your advantage. Don't sell yourself short-essentially the top students from most medical schools are similar as applicants and deserve a shot at the elite programs. This may not always happen simply because the process is skewed towards applicants from elite schools. If you attend a smaller school in the south, you may be more on Duke or JH's radar than say NY/Boston/CA programs. This is obviously a generalization that anyone can contradict. But realistically, NY and CA schools tend to be funnier about geography (based on my interview experiences) even if you are a top applicant. There are several other NY or CA applicants who are dying to match in those respective locations (i.e. born/raised there, attend med school there, family connections, significant other, etc). In some of these instances, they may be preferred as candidates to you. Even in the interviews at these programs, I felt that I had to defend why I would go there, state my affinity for the location, etc. It's how the game is played on both sides (applicant vs. program). Apply to a diverse group of programs (i.e. some local programs, the "elite" that you have listed, strong state school residency programs, etc). Letters matter A LOT MORE THAN YOU THINK, especially from your advanced IM rotations. I'm sure there is a thread about that topic but people really need to choose their letter writers wisely. If it's a stellar letter from a lesser known person, that's better than a mediocre one from a Nobel Laureate. Then see what happens...you may get more interviews than you think, or interview at ALL of the listed choices. Top programs want motivated, smart individuals regardless of the med school, so based on your stats you are by no means DOA.

 

[Frugal Traveler]

AOA is also important (but not required) for the top programs.

I agree about the LORs. You need to find people that are passionate about you and will write you a letter stating that you are "exceptional."

Your personal statement needs to be great as well. Someone that knows you should be able to pick it out of a pile of statements. Someone that does not know you should say... wow I have this person's application with all this information in it... but wow this personal statement helps me feel like I know this person and what they want to do with his/her life.

As for your question, programs like MGH try to invite the best student(s) from a variety of schools, and the program is diverse. There is some skewing based on NIH ranking of the medical school, though. Even great talent does not perturb status quo sometimes.

You are by no means DOA. Apply and see what happens.

If you are worried about geographical discrimination, you can write a different personal statement to programs or put a generalized comment that "this is America. I seek opportunity, so I will move anywhere" type of deal.

 

[jdh71]

AOA is also important (but not required) for the top programs.

I seriously almost always love your advice, but I have to quibble on this one . . . If you are not from a top 10 NE medical school, then YES AOA will be a requirement generally.

What I mean is if you're apply from middle of the road state school, say the University of Kansas for instance (not picking on them at all, so no one take offense, but we would all agree they would generally not be considered a top 10 medical school), you will generally need an AOA to get invites regularly at the elite top 5.

 

[Frugal Traveler]

I seriously almost always love your advice, but I have to quibble on this one . . . If you are not from a top 10 NE medical school, then YES AOA will be a requirement generally.

What I mean is if you're apply from middle of the road state school, say the University of Kansas for instance (not picking on them at all, so no one take offense, but we would all agree they would generally not be considered a top 10 medical school), you will generally need an AOA to get invites regularly at the elite top 5.

Diversity, research (Ph.D), and other things can overrule it.

It also depends on how the school does elections... # 1 in the class who is a jerk can get snubbed if the councilor set the chapter up with faculty voting in addition to objective evidence. You have the grades and elements to get elected but not the certificate on your wall.

If you're from a podunk school... I'll agree... it does become important.

 

[Scaredshizzles]

So I'm a third year getting ready for next year's apps. I know getting into the top programs (MGH UCSF BW JH PENN Columbia Duke...top 5 probably has more than 5) isn't the end all be all but I was wondering if it were even possible from a mid tier state school, with little name outside the south, or if I was DOA.

I feel like I've got some of the boxes checked for things applicants there need - 265 step I, 4/4 Hs on Medicine, Surgery, Neuro, Ob/Gyn, one pub basic science in endocrinology - was more of a do as I say little on the intellectual end, potentially 1-2 more on the way from other more self directed work, think I'll get some good letters but not from any national names. Hoping to do some more international work next year because I enjoy that but feel like I may be forced into more research so I can actually produce something more self directed.

Anyway forums here led me to believe boards some research matter less than letters and school don't think I'll have the letters don't have the school is that game over? Have people on the board in similar circumstances gotten those interviews or have met people on the trail like that? Thanks for the help

Elite medicine programs are definitely very heavy on what med school you go to, arguably more than any other field. That being said, over a 265 on step 1 and all honor and some research on your app should honestly get you interviews at most of the elite program. If I had those stats and I got passed over for 230s from Harvard, I would be pretty annoyed. Especially when you consider what med school you go to is based more on just MCAT scores and how well you presented your extracurrics/volunteerism... The other thing is a lot of the top med schools these days inflate clerkship grades, so you'll be competing for interview slots against those 80% of Harvard students who honored medicine.

 

[Fasiculata]

To give you some perspective, here are my stats:
Mid-tier medschool in the south/midwest
Step 1- 264
Step 2- pending
Clinical clerkship honors- medicine, surgery, peds
Basic Science honors- everything
Research for a year in a lab after 3rd yr- publication, national meeting poster presentation. An unrelated publication and abstract
LORs- great letter from IM program director, research mentor, from less renowned attending at one of those elite programs during sub-I away rotation

I only got interviewed at JH and Duke. I was rejected by MGH, BW, UPENN, UCSF, and never even heard back from Columbia. I'm not sure what that means. I guess the medschool I'm from made a bigger difference than I thought. I actually asked our office of student affairs and IM program director if there was something wrong with my application, but they didn't see anything. I'm wondering if IM is a lot more competitive this year.

Suffice it to say I'm pretty annoyed.

 

[Frugal Traveler]

Of course, special abilities never hurt:

http://www.youtube.com/watch?v=pMiE1jLfC-o

 

[futureres]

I'm wondering if IM is a lot more competitive this year.

Suffice it to say I'm pretty annoyed.

Sorry to hear about that, although Duke and JH are not bad options at all. IM actually IS more competitive this year. On the trail, applicants from some of the top schools mentioned that they had almost DOUBLE the average number of classmates entering IM...record #s overall. Most IM program directors, from the top tier to the average, stated that they received 20-30% more applications this year when I was on the trail and that it was harder for them to decide who to interview. In these instances, yes, going to a top med school shifts things in your favor. And no, that isn't fair.

 

[stankem]

Damn that's sobering, don't know what you're missing there, Duke and JH are amazing potential spots though. I've lived in NY, LA, and Chicago in the past but unfortunately settled in the region of our fine country I have no intention of staying long term... I wish I could go tell the college freshman version of myself to stop being a drunkass. I didn't have many complaints about my choice of med school until match prep time. AOA at my school is just grades + boards, but unfortunately for me I got a B on touchy feely medicine BS preclinical class (attitude towards that class is probably why I got a B..) so I'm boned for Junior AOA. Thanks for the advice. I'm guessing away rotations at those institutions don't matter for much.

 

[futureres]

I'm guessing away rotations at those institutions don't matter for much.

I wouldn't say that. I actually think if you are interested in some of the top programs that an away rotation could help give you an inside track. Having a letter from a good attending at a prominent program would help your app overall if you are not from one of the top med schools. I'm sure there are plenty of threads on the risks/benefits of doing an away rotation (more critical for some of the competitive surgical residencies imo). Overall, take everyone's advice with a grain of salt. Having honors on your rotations and a 260+ is not ALL you need, regardless of the school, for MGH, Hopkins, UCSF, Brigham, etc... Having meaningful experiences related to your passions be they research, service, leadership, global health, health policy, etc all contribute to making an applicant more appealing besides the numbers or what med school someone went to. Also, the "big 4" plus Penn, Duke, Columbia, etc are not the end all be all of IM.

 

[scootad.]

Don't be passive during the application season. If you feel you are getting shut out of the northeast programs, give a few of them a call or email the program coordinator sometime in December after you've seen the first wave of people getting interviews. Express that you are sincerely interested in moving to the region.

Programs are flooded with applicants it's easy to get lost in the shuffle.

I got 2 extra interviews that way (albeit a few years ago and in a different specialty).

 

[barmay]

My step 1 score was in the high 230s, was in the top quintile of my class (not AOA), honored most of my third year clerkships, and had great recommendation letters and got rejected from Johns Hopkins and all the Harvard schools! Whoever says that school name doesn't matter is in denial. I am pretty sure AOA status is a make or break if you are not attending a reputable medical school.

But if you don't care about those schools, I think you still have a solid shot in Yale, Columbia, Cornell, .... and other really solid reputable schools.

Good luck next year

 

[Fasiculata]

I highly recommend doing an away rotation. It should atleast secure an interview spot for you. Although, on the other hand, I might be wasting a spot with a program that doesn't plan to rank me highly anyway and is just being courteous.

 

[ResidentMD]

I highly recommend doing an away rotation. It should atleast secure an interview spot for you. Although, on the other hand, I might be wasting a spot with a program that doesn't plan to rank me highly anyway and is just being courteous.

I hear UCSF is like that...from multiple posts on this forum.

 

[VCMM414]

I hear UCSF is like that...from multiple posts on this forum.

Perhaps things have changed, but at least as of 2-3 years ago when I applied for residency, UCSF was notorious for NOT giving out courtesy interviews for those who do away rotations there. There were stories of how some received rejection emails right in the middle of their rotations...

 

[futureres]

I hear UCSF is like that...from multiple posts on this forum.

That's true. UCSF has a pretty high threshold for East Coast applicants because so many West Coast applicants apply/want to go there. The program is thinking realistically-for example, if you were born/raised in Ohio (not picking on it by any means-I 😍 the Midwest and miss it!), lived there all your life, went to undergrad/med school there, then the likelihood of you wanting to up/move to all the way to SF without connections there is lower. Therefore, you are more likely to be ranked lower because they won't expect you to come. I think geography matters a lot in this instance in addition to the caliber of med school you come from. If you are from a mid-tier school in the South/East Coast, I'd shoot for a competitive away rotation at a top S/EC program, which would likely be higher yield. Same thing applies for West Coast applicants.

 

[Frugal Traveler]

Perhaps things have changed, but at least as of 2-3 years ago when I applied for residency, UCSF was notorious for NOT giving out courtesy interviews for those who do away rotations there. There were stories of how some received rejection emails right in the middle of their rotations...

Programs are not going to give you an interview just because you did an away rotation there. Some might... but IM at the top level is competitive. Both UCSF and UCLA are outstanding programs in amazing cities... they can and do get the best.

As far as your geographic discrimination theory (I have a dream that we can go to residency irregardless of where we live or where we were born... how appropriate for MLK day), I think the top programs do a great job with getting a diverse set of applicants from sea to shining sea and from various backgrounds.

 

[futureres]

Programs are not going to give you an interview just because you did an away rotation there. Some might... but IM at the top level is competitive. Both UCSF and UCLA are outstanding programs in amazing cities... they can and do get the best.

As far as your geographic discrimination theory (I have a dream that we can go to residency irregardless of where we live or where we were born... how appropriate for MLK day), I think the top programs do a great job with getting a diverse set of applicants from sea to shining sea and from various backgrounds.

Ah, Frugal Traveler, I'm loving the idealism. lol

 

[ResidentMD]

That's true. UCSF has a pretty high threshold for East Coast applicants because so many West Coast applicants apply/want to go there. The program is thinking realistically-for example, if you were born/raised in Ohio (not picking on it by any means-I 😍 the Midwest and miss it!), lived there all your life, went to undergrad/med school there, then the likelihood of you wanting to up/move to all the way to SF without connections there is lower. Therefore, you are more likely to be ranked lower because they won't expect you to come. I think geography matters a lot in this instance in addition to the caliber of med school you come from. If you are from a mid-tier school in the South/East Coast, I'd shoot for a competitive away rotation at a top S/EC program, which would likely be higher yield. Same thing applies for West Coast applicants.

I think when a person applies to UCSF, it is kind of understood that if UCSF invites them, they will go - and in all probability, it would be their top 3-4 (unless for personal reasons e.g. couples matching). So I dont think the geographic theory holds true for a place like UCSF/Brighams. But I may be wrong.

I agree with your second point - that a competitive and well-done away rotation (read honors or at least high pass) at any program possibly other than the top 4 should help securing at least an interview. I dont know how it works at Brighams/MGH/UPenn but I have heard it doesnt work at UCSF.

Perhaps things have changed, but at least as of 2-3 years ago when I applied for residency, UCSF was notorious for NOT giving out courtesy interviews for those who do away rotations there. There were stories of how some received rejection emails right in the middle of their rotations...

Yes - I meant the applicant would be wasting a month without a reasonable chance of even getting invited.

 

[Phineus]

I think when a person applies to UCSF, it is kind of understood that if UCSF invites them, they will go - and in all probability, it would be their top 3-4 (unless for personal reasons e.g. couples matching). So I dont think the geographic theory holds true for a place like UCSF/Brighams. But I may be wrong.

I agree with your second point - that a competitive and well-done away rotation (read honors or at least high pass) at any program possibly other than the top 4 should help securing at least an interview. I dont know how it works at Brighams/MGH/UPenn but I have heard it doesnt work at UCSF.



Yes - I meant the applicant would be wasting a month without a reasonable chance of even getting invited.

I can speak from personal experience that this is not law. I know people who are moderately competitive and have turned down UCSF and the Brigham (coincidentally!) due to geography- no interest in going to the West coast or to Cold Boston.

 

[ResidentMD]

I can speak from personal experience that this is not law. I know people who are moderately competitive and have turned down UCSF and the Brigham (coincidentally!) due to geography- no interest in going to the West coast or to Cold Boston.

Okay - then my apologies. Just out of curiosity, why did they apply?

 

[Phineus]

Okay - then my apologies. Just out of curiosity, why did they apply?

I know one applied not realizing how competitive he was. When he started getting the interviews he really wanted, he narrowed his choices voluntarily. Personally, I too was greatly debated applying to West coast schools even though I knew that I had absolutely no desire to move to that coast. In the end, I opted not to apply and I fortunately got the East coast schools I was interested in.

 

[Instatewaiter]

To give you some perspective, here are my stats:
Mid-tier medschool in the south/midwest
Step 1- 264
Step 2- pending
Clinical clerkship honors- medicine, surgery, peds
Basic Science honors- everything
Research for a year in a lab after 3rd yr- publication, national meeting poster presentation. An unrelated publication and abstract
LORs- great letter from IM program director, research mentor, from less renowned attending at one of those elite programs during sub-I away rotation

I only got interviewed at JH and Duke. I was rejected by MGH, BW, UPENN, UCSF, and never even heard back from Columbia. I'm not sure what that means. I guess the medschool I'm from made a bigger difference than I thought. I actually asked our office of student affairs and IM program director if there was something wrong with my application, but they didn't see anything. I'm wondering if IM is a lot more competitive this year.

Suffice it to say I'm pretty annoyed.

My step 1 score was in the high 230s, was in the top quintile of my class (not AOA), honored most of my third year clerkships, and had great recommendation letters and got rejected from Johns Hopkins and all the Harvard schools! Whoever says that school name doesn't matter is in denial. I am pretty sure AOA status is a make or break if you are not attending a reputable medical school.

But if you don't care about those schools, I think you still have a solid shot in Yale, Columbia, Cornell, .... and other really solid reputable schools.

Good luck next year

I think it really is a crap shoot as to whether you get an interview. I come from an unranked school in the south.

I got interviews to JH, MGH, Penn and rejected from BW. I didnt apply to UCSF or columbia.

 

[tfom08]

Unranked state school, no research, normal ECs, 260+ Step1&2, AOA. Invited for interviews at JHU, MGH, BWH, Penn, Duke, Columbia, didn't apply to UCSF. Rejected from JHU-Bayview.

I think if your steps are really good and you honor clerkships and have AOA, the "top 5" programs are going to invite you just to take a look because even though the students from top 40 NIH med schools definitely get preference, there aren't that many students even at those schools with those stats (especially going into IM).

 

[intmed3]

Unranked state school, no research, normal ECs, 260+ Step1&2, AOA. Invited for interviews at JHU, MGH, BWH, Penn, Duke, Columbia, didn't apply to UCSF. Rejected from JHU-Bayview.

I think if your steps are really good and you honor clerkships and have AOA, the "top 5" programs are going to invite you just to take a look because even though the students from top 40 NIH med schools definitely get preference, there aren't that many students even at those schools with those stats (especially going into IM).

I agree with tfom08. I go to a mid-tier private school. Some research (no publications), decent ECs, 250+ Step1&2, junior AOA. I received interviews from JHU, MGH, BWH, Penn, UCSF, UW. Rejected from Columbia. You certainly can get interviews if you're not from a top 40 school, but you need to make yourself stand out.

 

[gutonc]

You certainly can get interviews if you're not from a top 40 school, but you need to make yourself stand out.

I went to one of those non-Top X places and the phrase we used was "you need 3 letters after your name, AOA or PhD and you'll be fine."

 

[houstoncfh]

I agree with tfom08. I go to a mid-tier private school. Some research (no publications), decent ECs, 250+ Step1&2, junior AOA. I received interviews from JHU, MGH, BWH, Penn, UCSF, UW. Rejected from Columbia. You certainly can get interviews if you're not from a top 40 school, but you need to make yourself stand out.

I'll echo those comments with a similar set of stats: state school, good EC's with some leadership, 250 Step 1 and 2 (took CK and got score back prior to submitting ERAS), senior AOA (no jr AOA at my school). Got interviews at MGH, Hopkins, UCSF, Columbia, Duke, Penn, etc. Rejected from BWH (as did all the other applicants from my school applying to IM there).

 

[stankem]

interesting...anyone think a good step 2 score early might play a role?

 

[Aciphex]

interesting...anyone think a good step 2 score early might play a role?

you don't need to have it as I did not. Actually studying for it now, step 2 cs I have already passed.

Applied to 16 schools: MGH, BWH, BIDMC, Penn, Cornell, Mt Sinai, Columbia, Duke, UNC, Wash U, Mich, Vandy, Hopkins, Northwestern, and Yale and received invites from all 16 schools.

No I am not an MD/PhD, not from an IVY, not a legacy, didn't cure cancer, not under-represented, go to a middle tier school.....

 

[ID15]

Top 20ish school, Senior AOA, Step 1 239, Step 2 240’s, MPH, 1 first author pub and a good bit of research, lots of ECs, Honors in most clerkships, but none really in pre-clinical years. Rejected from UCSF, Columbia, BWH, and JHU. Got MGH & Penn. Maybe my Steps were too low? Competition seems pretty ridiculous to get interviews at these places. Best of luck.

 

[stankem]

you don't need to have it as I did not. Actually studying for it now, step 2 cs I have already passed.

Applied to 16 schools: MGH, BWH, BIDMC, Penn, Cornell, Mt Sinai, Columbia, Duke, UNC, Wash U, Mich, Vandy, Hopkins, Northwestern, and Yale and received invites from all 16 schools.

No I am not an MD/PhD, not from an IVY, not a legacy, didn't cure cancer, not under-represented, go to a middle tier school.....

whoa ballsy list of schools...begs the question what did you do

 

[Aciphex]

whoa ballsy list of schools...begs the question what did you do

Wrote a really good personal statement

 

[Fasiculata]

What the F? Did I just have bad luck?
I wonder if doing an away rotation at one of those elite programs and getting a LOR from there made it seem like that would be my number 1. Maybe those other programs didn't want to waste their time with me. I just don't know anymore.