Yale vs UTSW IM

[satdixon]

Between Yale and UTSW, which do you think is better for IM?

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[mistafab]

UTSW hands down.

New Haven totally sucks. Dallas is a great, livable city.

Both are good programs. Yale has more 'prestige' but UTSW can get you in all the same fellowships. 3 years in New Haven would be hell.

 

[MercifulCamper]

In academic medicine they're more or less equivalent for IM and as @mistafab said both will get you access to any fellowships if you're interested in that. Where's your family at if that is important to you? Do you want to be in a big city with hot weather or a smaller city with cold weather? Both cities are pretty similar in terms of cost of living but you get much better amenities in Dallas.

 

[satdixon]

In academic medicine they're more or less equivalent for IM and as @mistafab said both will get you access to any fellowships if you're interested in that. Where's your family at if that is important to you? Do you want to be in a big city with hot weather or a smaller city with cold weather? Both cities are pretty similar in terms of cost of living but you get much better amenities in Dallas.

I am from Dallas, so would prefer UTSW. However, my concern is how I can make myself competitive for UTSW if I am graduating from a mid-tier US MD program

 

[Med Ed]

I am from Dallas, so would prefer UTSW. However, my concern is how I can make myself competitive for UTSW if I am graduating from a mid-tier US MD program

Look at the current PGY-2s (all categorical). One from Harvard, one from Wash U, one from Pritzker, but the large majority are from solid mid-tier programs (with a few FMGs sprinkled in). At first gland the most over-represented schools are McGovern and Miami.

If you want to make yourself competitive then just do the normal stuff for IM: pass Step 1 on the first try, get an Honors on your IM clerkship, and do well on Step 2. Do an IM sub-I and some IM electives. Attend IM interest group meetings and try to connect with a faculty member (or two) who can offer some advising/mentorship. Find some meager research project you can attach yourself to (and then actually finish it).

Honestly one of the biggest things you have going for you is that you're from Dallas. Convey that to the PD and they'll have a solid reason to believe you're genuinely interested in the program.

 

[satdixon]

Look at the current PGY-2s (all categorical). One from Harvard, one from Wash U, one from Pritzker, but the large majority are from solid mid-tier programs (with a few FMGs sprinkled in). At first gland the most over-represented schools are McGovern and Miami.

If you want to make yourself competitive then just do the normal stuff for IM: pass Step 1 on the first try, get an Honors on your IM clerkship, and do well on Step 2. Do an IM sub-I and some IM electives. Attend IM interest group meetings and try to connect with a faculty member (or two) who can offer some advising/mentorship. Find some meager research project you can attach yourself to (and then actually finish it).

Honestly one of the biggest things you have going for you is that you're from Dallas. Convey that to the PD and they'll have a solid reason to believe you're genuinely interested in the program.

Do you think AOA is necessary for programs like UTSW? Also for reference I have an MPH if that matters

 

[voxveritatisetlucis]

Do you think AOA is necessary for programs like UTSW? Also for reference I have an MPH if that matters

Probably depends what mid tier means? If it’s a school like bu, uva, uf, usc etc. then probably not. If lower, then probably

 

[satdixon]

Probably depends what mid tier means? If it’s a school like bu, uva, uf, usc etc. then probably not. If lower, then probably

What about for a newer school like UCF?

 

[Med Ed]

Do you think AOA is necessary for programs like UTSW?

I strongly doubt it. Maybe Harvard, JHU, and UCSF can afford to throw all the non-AOA applications in the recycle bin, but they're the exception.

In the 2023 match there were 4,207 US MD seniors applying to IM, and 9,725 categorical positions. So every MD senior could match and 57% of the positions would still be open.

Compare to ortho: 899 positions, 947 US MD seniors applying.

AOA types also tend to go for things like derm and competitive surgical specialties. That's not to say IM doesn't have its share, but it's not going to be particularly enriched with them.

Also for reference I have an MPH if that matters

Perhaps if the department has some special affinity for public health, and/or a public health track in its residency program.

 

[Med Ed]

What about for a newer school like UCF?

IMHO that poster gives a highly disproportionate amount of weight to school tier. Take it with a grain of salt.

In fact, take everything with a grain of salt (including me).

 

[Dwan]

I strongly doubt it. Maybe Harvard, JHU, and UCSF can afford to throw all the non-AOA applications in the recycle bin, but they're the exception.

In the 2023 match there were 4,207 US MD seniors applying to IM, and 9,725 categorical positions. So every MD senior could match and 57% of the positions would still be open.

Compare to ortho: 899 positions, 947 US MD seniors applying.

AOA types also tend to go for things like derm and competitive surgical specialties. That's not to say IM doesn't have its share, but it's not going to be particularly enriched with them.


Perhaps if the department has some special affinity for public health, and/or a public health track in its residency program.

There are actually more AOAs applying for IM than any other field (474 in IM vs 243 in ortho and 178 in derm). While IM obviously has way more spots overall, if we're isolating to the top 20 programs out of 500+, AOA does become pretty important similar to getting into the competitive fields.

 

[Med Ed]

There are actually more AOAs applying for IM than any other field (474 in IM vs 243 in ortho and 178 in derm).

SGU uses this same math on their flyers.

While IM obviously has way more spots overall,

Indeed, and way more applicants. Using your numbers above with 2023 NRMP data, about 11% of the IM pool was AOA, 26% of the ortho pool, and 31% of the derm pool (PGY-2). This supports my previous point, so thank you.

if we're isolating to the top 20 programs out of 500+, AOA does become pretty important similar to getting into the competitive fields.

I'm not trying to diminish that AOA is a very nice feather in one's cap, and at some top programs it could perhaps be a deciding factor in whittling a large applicant pool down to a manageable size. But OP asked if it is essentially required to match at a program like UTSW, and I believe the answer is "no." It will be worth more for the OP to convey that he's from Dallas to the IM PD at UTSW.

 

[Dwan]

SGU uses this same math on their flyers.


Indeed, and way more applicants. Using your numbers above with 2023 NRMP data, about 11% of the IM pool was AOA, 26% of the ortho pool, and 31% of the derm pool (PGY-2). This supports my previous point, so thank you.


I'm not trying to diminish that AOA is a very nice feather in one's cap, and at some top programs it could perhaps be a deciding factor in whittling a large applicant pool down to a manageable size. But OP asked if it is essentially required to match at a program like UTSW, and I believe the answer is "no." It will be worth more for the OP to convey that he's from Dallas to the IM PD at UTSW.

Like I said, the total # of spots is not as relevant if we're talking about top 20 programs. Most of those applicants are not going into top programs - there are 500+ total IM programs, many of which are not competitive at all and taking the average of them all is not reflective of the competition of UTSW or Yale IM (unlike dermatology or orthopedics where they are all competitive). The % of AOAs at the top 20 programs is significantly higher than for the average IM program, particularly if we omit those who come from top 20 medical schools. While AOA is not 100% necessary (as with derm or ortho), it is a huge factor at these programs, similar to the top specialties.

Also, showing the raw # of applicants is not "math" - you had stated AOAs tend to go for ortho and derm, which is not true. Most AOAs go for IM, it is just that IM in general is way easier to get into as there are tons of non-competitive programs and way more spots overall. However, this isn't exactly relevant to OP's concern of getting into a top 20 program (limited spots and competing with the top).

 

[Ho0v-man]

Dude you’re an M1 and don’t live in either of these states. There’s no guarantee you’ll even get an interview at either of these programs. Just do your best in med school and apply to both and see what happens. There’s no reason to be trying to decide between two specific IM programs when you don’t know if either will even give you the time of day in 3 years.

 

[Med Ed]

Like I said, the total # of spots is not as relevant if we're talking about top 20 programs. Most of those applicants are not going into top programs - there are 500+ total IM programs, many of which are not competitive at all and taking the average of them all is not reflective of the competition of UTSW or Yale IM (unlike dermatology or orthopedics where they are all competitive). The % of AOAs at the top 20 programs is significantly higher than for the average IM program, particularly if we omit those who come from top 20 medical schools. While AOA is not 100% necessary (as with derm or ortho), it is a huge factor at these programs, similar to the top specialties.

I'm certainly not arguing that competitive IM programs aren't competitive, or that AOA won't be more common in these programs. But the simple fact remains: a solid (but not stellar) student will have an easier time matching at a name-brand academic program in a less competitive field than a more competitive field. Does that mean OP can match at UTSW without AOA? Hell if I know, but they'd probably be foolish not to at least apply.

Also, showing the raw # of applicants is not "math" - you had stated AOAs tend to go for ortho and derm, which is not true. Most AOAs go for IM, it is just that IM in general is way easier to get into as there are tons of non-competitive programs and way more spots overall. However, this isn't exactly relevant to OP's concern of getting into a top 20 program (limited spots and competing with the top).

I said derm and competitive surgical specialties (not just ortho). And it is true, no matter how you slice it. Derm + ortho alone totaled 421, not far from IM's 478. Throw on plastics, ENT, ophtho, integrated vascular, and neurosurgery and get back to me.

SGU ranks as #1 source of physicians in US workforce

But percentages are more meaningful here. Rough estimate: 18% of MD seniors are AOA. As calculated above, IM applicants are approximately 11% AOA (less enriched), ortho and derm are 24-31% (more enriched). Even if my numbers aren't super accurate I think they're good enough to illustrate the phenomenon.

 

[Moko]

Between Yale and UTSW, which do you think is better for IM?

I would rank UTSW higher in your situation, especially since you're from that area. There's much more to do in Dallas than New Haven on your days off. And the sense I got from others anecdotally is that UTSW is much more resident-run whereas Yale is more fellow-run. You'll get great training at both places, but I do think having that extra independence as a senior resident is beneficial. Of course, talk with the current residents at both institutions before deciding as they'll know the most up to date info. Best of luck and just my thoughts.

 

[Dwan]

I'm certainly not arguing that competitive IM programs aren't competitive, or that AOA won't be more common in these programs. But the simple fact remains: a solid (but not stellar) student will have an easier time matching at a name-brand academic program in a less competitive field than a more competitive field. Does that mean OP can match at UTSW without AOA? Hell if I know, but they'd probably be foolish not to at least apply.


I said derm and competitive surgical specialties (not just ortho). And it is true, no matter how you slice it. Derm + ortho alone totaled 421, not far from IM's 478. Throw on plastics, ENT, ophtho, integrated vascular, and neurosurgery and get back to me.

SGU ranks as #1 source of physicians in US workforce

But percentages are more meaningful here. Rough estimate: 18% of MD seniors are AOA. As calculated above, IM applicants are approximately 11% AOA (less enriched), ortho and derm are 24-31% (more enriched). Even if my numbers aren't super accurate I think they're good enough to illustrate the phenomenon.

I agree UTSW is worth an app anyways, but those percentages aren't really meaningful if the high majority of those applicants are not competitive for a spot at UTSW IM. The heterogeneity in application quality requirements between a low and high tier IM is much larger than in the top specialties, so looking at the field as a whole makes no sense in this context. I'm comparing the top 20 IM programs to any program in ortho, derm, or the surgical specialties (including low-mid tiers). None of the SGU physicians are competitive for UTSW IM so it's not a similar argument, vs the hundreds of competitive US-MD AOAs applying for the top 20 IM programs, in addition to tons from top medical schools (IM is the most popular field among top med schools as well). If there were only 20 IM programs, it would be at least as competitive as the top fields, likely moreso due to popularity, even among AOAs and top schools. Obviously OP doesnt have to make it into UTSW to have a career in IM, and they'd safely match at many hospitals below it (as opposed to ortho/derm), but that has nothing to do with their chances at UTSW.

 

[Med Ed]

None of the SGU physicians are competitive for UTSW IM

The SGU thing was just an example of how a raw number can be misleading when stripped of context.

Since we are now locked in a cycle of talking past each other on a matter of zero consequence, I vote we stick a fork in this.

 

[pierty]

Dude you’re an M1 and don’t live in either of these states. There’s no guarantee you’ll even get an interview at either of these programs. Just do your best in med school and apply to both and see what happens. There’s no reason to be trying to decide between two specific IM programs when you don’t know if either will even give you the time of day in 3 years.

Please listen to this. It is way too early for you to decide between these 2 programs, let alone decide to even apply IM. Spend some time in clerkships with an open mind.

Work hard and enjoy your time in medical school. Try to spend less time on this website.

 

[taeyeonlover]

In the 2023 match there were 4,207 US MD seniors applying to IM, and 9,725 categorical positions. So every MD senior could match and 57% of the positions would still be open.

Omg seriously? It’s that easy for us mds?

 

[Just D.O. it]

Omg seriously? It’s that easy for us mds?

Yes, with the caveat that the goal is to match *any* IM program.

If you are happy being generalist then the requirements are pretty much:

1. Graduate from any US MD school

2. Have a pulse

3. Don't be a convicted criminal

However, If you are wanting to enter one of the competitive subspecialties, then you have to remember that not all IM programs are created equal. The majority of IM programs are low tier/community programs that you will not give you a real shot at things like Cards/pulm/GI/onc.

The prestigious/university based programs are no cake walk to match and you have to work to earn a place there, and those are the programs many "IM applicants" are actually targeting/limiting themselves to because their eventual goal is one of the aforementioned subspecialties as opposed to working in generalist IM.

 

[taeyeonlover]

The prestigious/university based programs are no cake walk to match

When you say university based programs, do you mean top 25 programs only? or do you also mean mid tier state school programs?

Also why do people not like being a generalist?

 

[MercifulCamper]

When you say university based programs, do you mean top 25 programs only? or do you also mean mid tier state school programs?

Also why do people not like being a generalist?

Money talks

 

[Ho0v-man]

When you say university based programs, do you mean top 25 programs only? or do you also mean mid tier state school programs?

Also why do people not like being a generalist?

Only on SDN is an IM resident doomed to a hospitalist life unless they attend a top 25 IM program. Just go to an academic tertiary care center, which as a USMD student is not at all hard to do.

 

[pierty]

When you say university based programs, do you mean top 25 programs only? or do you also mean mid tier state school programs?

Also why do people not like being a generalist?

No. If you want to know about fellowship placements, you can find fellowship match lists online. Roughly the top ~60 programs have strong fellowship placements across all sub-specialties (minus a few community hospitals that are on there, if you are looking at doximity), and plenty more outside that are strong.

It's a complicated and often circular answer. A lot of young, impressionable med students get scared by jaded residents and attendings (especially, ironically, those who began already began their residencies not interested in being a straight internist or hospitalist). Others are interested in sub-specialties because they genuinely love those respective fields, and/or want to perform research. Others are just chronically anxious and/or indecisive, and want to feel like they can cling on to some sense of security by feeling like they have "all paths open" when they don't favor any particular field. It's a mixed bag.