What's the one thing to do to get into a competitive IM program?

[IntoTheNight]

TL; DR: I focused heavily on studying, not EC's the first 2 years of med school so my EC's are pretty minimal.

Assuming I have a pretty bare resume now, what are the ways to maximize my chances of getting into a top tier residency program? I feel confident in my ability to get a 260+ Step score.

What are the best ways to figure out what I need in terms of research and EC's? How should I navigate the next 2 years if I have a strong knowledge base but need to focus on productive efforts for my resume?

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[FalconSlice]

TL; DR: I focused heavily on studying, not EC's the first 2 years of med school so my EC's are pretty minimal.

Assuming I have a pretty bare resume now, what are the ways to maximize my chances of getting into a top tier residency program? I feel confident in my ability to get a 260+ Step score.

What are the best ways to figure out what I need in terms of research and EC's? How should I navigate the next 2 years if I have a strong knowledge base but need to focus on productive efforts for my resume?

Almost always the most important things for residency are 1. Scores/grades 2. LOR/"who you know"/phone calls and 3. Everything else (e.g. EC)

Varies depending on specialties but generally it is those three things and generally in that order. Of course, where you go to medical school will generally help especially w/#2

More nuanced answer is what kind of program do you want? If you want a PSTP and want to be an academician, doing some high quality research is your best bet. Do you want a program with high emphasis on rural medicine? Then electives in those settings are best. Etc.

This next part is just my opinion and not directed at you and only tangential to your question (preemptive "caveat" statement):
I also want to touch on the fact that you equated "competitive" with "top tier" and that it is my personal opinion that there is so much "name chasing" and almost all of it is for no other reason that ego. Please note that "top tier" is subjective and has no real basis for an individual. There are some "big names" that have god awful programs in my field of plastic surgery (by my metric anyway) and some "no name" places that are actually world class. I have debated making a larger post about this and still may when I discover some more free time. Just note that just because there is a consensus of "top tier" doesn't necessarily mean it is a good program in reality. And just because a specialty, program, etc. is "competitive" doesn't mean it's actually good. Finally "top tier" =/= "competitive"

 

[Redpancreas]

I have done the nitty gritty (i.e. scoring),sat in IM RoL meetings at more than one place now, and talked to those who have done similar at other places. It's a pretty similar across the board. Applications go through a screening process where after filtering out red flags, PDs generally have some scoring system. This scoring system with subjectivity/connections sprinkled in determines interview invites. The interview is conducted and truthfully with a larger field like IM, most people have similar performance. Post-interview, the same factors are looked at...just more carefully/holistically (i.e. are those 3 publications on PubMed or are they conference abstracts? or... Yeah they 260 is nice, but what's this 3 month delay the student took to take Step 2 CK?). The top factors IM cares about are Medical School Reputation, Step 2 CK, Clerkship grades/AOA. Other factors that can be a boost are publications, particularly if you any first author ones or impactful ones. PhDs help too. In general, AOA can level the playing field for someone from a less reputed school. After that, connections and letters can have a varying impact. After that, few leadership/teaching opportunities like Class President, etc. matter can be impactful. Otherwise, most are diluted by the fact that everyone has something.

If you want to match into a top IM program your application should be well-balanced with an inconspicuous record. Any red flags like failed stuff/professionalism issues will tank you...but there's no hard and fast rule. I have seen people with Ps in medicine and no publications match, albeit this was from upper mid tier schools.

General trend illustrating above point.
Ex. 1) 260, top school - P/F grading but good comments on deans letter, 1 first author publication, 2 others -> Strongest
Ex. 2) 255, H in Med, 1 mid-author publication-> Strong
Ex. 3.) 275, P in Med (most HP/H), 1 first author publication-> Less Strong
Ex. 4.) 260, HP in Med, 1 first author publication, failed Step 1, 3 month delay -> Screened out/DNR at a top program.

 

[Redpancreas]

Almost always the most important things for residency are 1. Scores/grades 2. LOR/"who you know"/phone calls and 3. Everything else (e.g. EC)

Varies depending on specialties but generally it is those three things and generally in that order. Of course, where you go to medical school will generally help especially w/#2

More nuanced answer is what kind of program do you want? If you want a PSTP and want to be an academician, doing some high quality research is your best bet. Do you want a program with high emphasis on rural medicine? Then electives in those settings are best. Etc.

This next part is just my opinion and not directed at you and only tangential to your question (preemptive "caveat" statement):
I also want to touch on the fact that you equated "competitive" with "top tier" and that it is my personal opinion that there is so much "name chasing" and almost all of it is for no other reason that ego. Please note that "top tier" is subjective and has no real basis for an individual. There are some "big names" that have god awful programs in my field of plastic surgery (by my metric anyway) and some "no name" places that are actually world class. I have debated making a larger post about this and still may when I discover some more free time. Just note that just because there is a consensus of "top tier" doesn't necessarily mean it is a good program in reality. And just because a specialty, program, etc. is "competitive" doesn't mean it's actually good. Finally "top tier" =/= "competitive"

I just want to highlight the bolded. Looking back, none of this matters if all you're looking to do is match into a given field.