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

[IntoTheNight]

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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?

 

[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"