Lower Ranked = Easier?

Thursday, July 29th, 2010 @ 12:40 am

I have heard from many medical students that prestige matters relatively little for medical school and a career in medicine (other than in certain fields). With this is mind, do lower-ranked medical programs offer a more manageable experience for their students? Is the environment more relaxed or is it still a high-stress, competitive atmosphere?

Any input would be great. Thanks.

Answer:Ranking is subjective. I guess when most people look at school rankings they look at NIH funding. Not sure why school’s ranked higher on that list would be more difficult than any others…

Answer:If you’re a C student at Harvard Med you will not be an A student at State Med School.

Answer:Any school that offers something beyond pass/fail will likely be more competitive and stressful.

Answer:I have heard from many medical students that prestige matters relatively little for medical school and a career in medicine (other than in certain fields). With this is mind, do lower-ranked medical programs offer a more manageable experience for their students? Is the environment more relaxed or is it still a high-stress, competitive atmosphere?

Any input would be great. Thanks.

I’d take an environment where teamwork and cohesive action is emphasized over individual achievement any day of the week; you really don’t need the added stress of being amongst cutthroat peers on top of the rather large amount of work you need to do to be successful in medical school. It’s reassuring to know that you can go to people (including your peers) for help when you need it instead of having to worry about individualism and (even) saboteurs among your ranks.

Answer:You learn the same material and take the same boards wherever you go. One of the things I do enjoy about my school is that we are a relative new kid on the block and are far more agile and able to make changes that benefit the students than some places. Our focus is on the education and not churning out research. Many of the profs came here because they wanted to teach and stop worrying about the research aspect. That doesn’t mean the "top tier" don’t do that, but I’m yet to meet someone at my places that cares more about his or her research than the classes here.

Answer:I’d take an environment where teamwork and cohesive action is emphasized over individual achievement any day of the week; you really don’t need the added stress of being amongst cutthroat peers on top of the rather large amount of work you need to do to be successful in medical school. It’s reassuring to know that you can go to people (including your peers) for help when you need it instead of having to worry about individualism and (even) saboteurs among your ranks.

This program you speak of does not exist. Med school is nowhere near the crest of the mountain you have to climb to secure the residency/fellowship/academic placement that your peers are striving to achieve. If this is "distressing" to you, then I recommend seeking out a different career…NOW.

What you’re describing sounds more like a boy scout retreat than 4 years of med school.

To the OP, prestige matters for 3 reasons in ascending order of importance:

1) Patting yourself on the back

2) Giving your grandparents something to brag about at Bingo night

3) Allowing you to remain a competitive candidate for a particular residency despite that "off" semester/step score/evaluation/etc.

Reason 3 is essentially a parachute cord…

The fact is, many students say "oh, I don’t wanna do Derm so I’m not gonna worry about my grades so much and relax." Unfortunately those same people often decide in the end they want to do something equally competitive. 4 years of Med school is a long time and people do change dramatically during this time.

Prestige matters but it’s not critical in the long run.

Answer:This program you speak of does not exist. Med school is nowhere near the crest of the mountain you have to climb to secure the residency/fellowship/academic placement that your peers are striving to achieve. If this is "distressing" to you, then I recommend seeking out a different career…NOW.

What you’re describing sounds more like a boy scout retreat than 4 years of med school.

Judgmental much? My point was that if you have an opportunity to study where not EVERYONE is at each others’ throats, take it.

Answer:I know a lot of people will disagree with me, but certainly I think if a med school is beyond pass/fail, the higher the MCAT/GPA of the school probably the harder it is to do well if the courses are curved for the first two years. Maybe an A- at Harvard is a B at North Dakota, its not huge, but I would imagine it is there.

But be that as it may, in the end it barely matters, Step 1 score is more important, and you learn the same stuff both places, and North Dakota may prepare you better because the prof may not focus so much on areas that he finds interesting and/or does research in.

Answer:I know a lot of people will disagree with me, but…

…in the end it barely matters, Step 1 score is more important, and you learn the same stuff both places, and North Dakota may prepare you better because the prof may not focus so much on areas that he finds interesting and/or does research in.

I disagree with you. Not because you’re wrong, but because you’re extremely naive. The proverbial "end" you speak of is 7-12 years down the road from where you are now. You have no clue. Each and everyone of those years you are ranked. evaluated, and compared against your peers…

Ever hear the saying, "where you come from is a good indication of how far you’ll go?"

If you come from a highly respected program you have a certain credibility regardless of less than stellar performance. A mediocre student from Harvard or Hopkins will match extremely well for residency…the same cannot necessarily be said for a state student. Notice, I have said nothing about the quality of the physician produced…that is a different subject entirely.

Answer:If you come from a highly respected program you have a certain credibility regardless of less than stellar performance. A mediocre student from Harvard or Hopkins will match extremely well for residency…the same cannot necessarily be said for a state student. Notice, I have said nothing about the quality of the physician produced…that is a different subject entirely.
Unless you have stats for this I call BS. The top residency programs I’ve seen tend to have very tight clusters of step 1 scores and a very wide range of schools feeding into them. They don’t care where you come from, they care how you test out. Also, to a lesser extent, they care about your 3rd year grades and your research. Just as going to Hopkins Ugrad doesn’t help much with med school admissions, going to Hopkins Med doesn’t help much for residency.

Of course this still leaves the issue that what "matching well" is depends on the individual. Not everyone is a resume whore, even if they have the test scores and grades to be one.

If your reasoning is that in general people in Harvard or Hopkins tend to be the ones that achieve higher numbers/credentials (step 1, research, etc.) then I can agree with that. But if you’re saying candidate A from Harvard or Hopkins with lower numbers/credentials than candidate B from a State Med School has a better shot at a particular residency, then I have to go with Perrotfish and ask for a source. And if A does have a better shot, what’s the cut off? Does Harvard or Hopkins make up for 5pts on step 1? Or is it 10 pts? Or maybe it’s equivalent to 2 publications? :laugh:

Answer:Only higher-ranked schools are allowed to teach certain things. It is mandated by law.

For example: Since I am at an osteopathic school, for head/neck in anatomy, our practical had only one question. There was a pin in our cadaver’s head, and we were asked to "identify the tagged structure". The answer was "head".

I got it wrong, but was allowed a do-over since most of the class failed.

Answer:Only higher-ranked schools are allowed to teach certain things. It is mandated by law.

I got it wrong, but was allowed a do-over since most of the class failed.

:Clap: Well played, sir.

Also, this is America - if you’re going to a medical school here, people much smarter than you and me (probably) decided that the schooling there is sufficient to prepare you for practicing medicine.

But by all means, keep applying to only top schools - makes it easier for average applicants like me

Answer:Only higher-ranked schools are allowed to teach certain things. It is mandated by law.

I got it wrong, but was allowed a do-over since most of the class failed.

Hahahahaha. You are a very funny guy.

Answer:going to Hopkins Med doesn’t help much for residency.

:laugh::laugh::laugh::laugh::laugh::laugh:

Answer:Of course this still leaves the issue that what "matching well" is depends on the individual. Not everyone is a resume whore, even if they have the test scores and grades to be one.

You are confusing two separte issues, matching well /= resume whore.

Matching well can mean a number of things…percentage matched/unmatched, number of applicants who pursued competitive specialties, matching at one’s number 1 choice, matching in a desirable geographic location, etc.

There are, of course, other important variables depending on individual preferences.

None of the criteria I listed has anything to do with being a "resume whore." This bogus argument is overused and abused.

Answer:You are confusing two separte issues, matching well /= resume whore.

There are, of course, other important variables depending on individual preferences.

None of the criteria I listed has anything to do with being a "resume whore." This bogus argument is overused and abused.

I didn’t say everyone is a resume whore at top schools. However, many people don’t care about prestige associated with their school/program. Those who do care are more likely to be found at those top programs, because they care about that. My point was many people don’t care about program prestige.

The bolded statements are dependent on personal preference and don’t really say anything about the quality of students (there are low tier schools where a bunch of people match into rads ect, it all depends on what the students want). Which is why it’s hard to make statements about match lists, because we don’t know what the individual applicants wanted.

Answer:If your reasoning is that in general people in Harvard or Hopkins tend to be the ones that achieve higher numbers/credentials (step 1, research, etc.)

Numbers and credentials are very important. But, you seem to miss the point of my posts. I’m talking about a student/resident/fellow who has a "flag" on their transcript for whatever reason…not someone who looks flawless on paper.

…if you’re saying candidate A from Harvard or Hopkins with lower numbers/credentials than candidate B from a State Med School has a better shot at a particular residency, then I have to go with Perrotfish and ask for a source.

You are making assumptions about scenarios I never described. Besides, your argument only holds up if we are talking about 2 candidates competing for a single slot…this is never the case, programs have numerous positions they are trying to fill.

Instead, lets compare candidates A and B who each have a "flag" on their transcript for whatever reason (grades, conduct, clinical accumen, etc.). Staff physicians at "prestigious programs" are on staff at these places because of a considerable volume of productivity (most often publications and clinical trials) which brings in NIH funding in the form of grants. A phone call from one of these hot shots to a prospective PD will open a closed door faster than anything. The assumption here is that the candidate nurtured a relationship with said investigator.

You want a source? Look at the fellowship match lists (These are provided every year to interviewees) from MGH, BWH, Hopkins, Columbia, and UCSF. These fellowships are filled with residents from these very same institutions. They do take residents from state schools, but they make up a much lower proportion.

It is harder to cull the same data for residency, but some programs do allow you to search their resident profiles.

And if A does have a better shot, what’s the cut off? Does Harvard or Hopkins make up for 5pts on step 1? Or is it 10 pts? Or maybe it’s equivalent to 2 publications? :laugh:

This is why it is hard to have an honest/open discussion…because people begin to let emotions and inferiority complexes color their arguement. You mention one thing about a prestigious institution and people start calling you a "resume whore." I’m not calling you out personally hal9000, just stating a fact.

Lastly (and no offense), you guys are so far back in the pipeline that its hard for you to know what you’re even talking about. I have to laugh when I see some of you say, "prestige doesn’t matter." You guys/gals, fortunately, have no idea of the variables at play at each step of your training. Unfortunately, the majority are out of your control.

***BTW, I don’t attend any of the mentioned programs in this thread. Just posting my observations.

Answer:I didn’t say everyone is a resume whore at top schools. However, many people don’t care about prestige associated with their school/program. Those who do care are more likely to be found at those top programs, because they care about that. My point was many people don’t care about program prestige.

This again illustrates your naivety. A large portion of the industry funding, clinical research, basic science research, device innovation, patents, etc. takes place at these same institutions. (Someone previously posted that they didn’t understand the role of NIH funding in prestige…now you know). People don’t pursue training at these places to cross of a check box, they go there to be innovators in their field. This is the absurdity of your arguement. Sure, some get through on scores and connections, but this happens less and less frequently as you advance in the training pipeline.

A much more objective indicatior is what percentage matched into a) their chosen field b) their first choice. Of course you (conveniently) didn’t address that statement. I would further argue, matching at a desirable location (i.e. California, NYC, etc.) speaks volumes about the success of a match. Granted, what is desirable to one is not to another…but you have to admit matching in Cali and NYC is difficult regardless of individual preference.

Answer:This again illustrates your naivety. A large portion of the industry funding, clinical research, basic science research, device innovation, patents, etc. takes place at these same institutions. (Someone previously posted that they didn’t understand the role of NIH funding in prestige…now you know). People don’t pursue training at these places to cross of a check box, they go there to be innovators in their field. This is the absurdity of your arguement. Sure, some get through on scores and connections, but this happens less and less frequently as you advance in the training pipeline.

Calm down dude, I didn’t address that statement because I agree with it (and thus it was left out of my doesn’t mean anything post).

Answer:Maybe I haven’t been clear in my arguments…for this I apologize. Maybe I can illustrate my point better with an analogy.

Imagine two applicants climbing a large tree with many branches. Applicant A is sitting on a top branch (i.e. prestigious institution) and applicant B is on a lower branch (i.e. less prestigious instituion). If applicant A "loses his grip" and falls, he will likely land on a lower limb (and remain in the tree), whereas, applicant B is more likely to land on the ground.

The tree of course is one’s career. Falling out of the tree would be akin to "not matching." Losing one’s grip could be as simple as having an off interview or making an inappropriate comment at a critical moment. The point is, it’s always easier to match at a less prestigious institution (lower branch) and applicant A has many more lower branches available than applicant B.

Answer:I think it depends, because some lower rank or less famous school has lower student to faculty ratio, some professors know you personally, they WILL push you harder…I dont know for sure for anybody else, as least it’s true in my school…just my 0.02

Answer:Maybe I haven’t been clear in my arguments…for this I apologize. Maybe I can illustrate my point better with an analogy.

dude… chill. people are arguing with you not because your arguments aren’t sound but because you’re being a dick.

here, let’s give an analogy. let’s say there’s a tree, with many sticks. some people only have one stick in their butt, some none, others many… :thumbup:

Answer:dude… chill. people are arguing with you not because your arguments aren’t sound but because you’re being a dick.

here, let’s give an analogy. let’s say there’s a tree, with many sticks. some people only have one stick in their butt, some none, others many… :thumbup:

Nice analogy. :laugh:

Answer:Imagine two applicants climbing a large tree with many branches. Applicant A is sitting on a top branch (i.e. prestigious institution) and applicant B is on a lower branch (i.e. less prestigious instituion). If applicant A "loses his grip" and falls, he will likely land on a lower limb (and remain in the tree), whereas, applicant B is more likely to land on the ground.No, we get what you’re saying, we just think you’re wrong.

My opinion is that if you did a study that controls for, lets say, undergraduate GPA and MCAT, meaning comparing similar applicants at different ranked schools school, the applicant ant the lower ranked school would be more likely to get a top residency. Reason? Residency programs care way, way more about step one score, class rank, and research than they care about the reputation of your institution. Step 1 score doesn’t improve at better institutions (in fact they tend to teach to the test less), and research opporutnities and class rank are a lot easier to get when you’re a 4.0 student surrounded by 3.5 students than when you’re a 4.0 student surrounded by other 4.0 students.

The trick to succeeding in medicine, other than being smart and working hard, is to surround yourself with the dumbest people possible (dumbest is very relative here, I’m aware everyone’s very smart) so that you can look intelligent by comparison. This is particularly important in ugrad but still sorta true in medical school. That’s why you should go to your state school rather than MIT for undergrad, why you should do the communications major and not the engineering major when you’re there, and (one of the reasons) why you should go to the cheapest/bet fitting medical school you can rather than the most prestigious. The only thing that you want name recognition for is the last thing you’re planning on doing, which is either residency or a fellowship depending on your field. Shooting for name recognition before then is shooting yourself in the foot for the sake of your ego.

It’s like the two applicants are climbing to the top of a tree. One applicant is climbing on the side with a ladder, the other one is climbing on the side with no ladder and a hornets nest. The people on the ground, though, don’t really see the difference between the two sides. To them, the winner is whoever climbs to the top first.

See, I can also do dickish arboreal similies.

Answer:dude… chill. people are arguing with you not because your arguments aren’t sound but because you’re being a dick.

here, let’s give an analogy. let’s say there’s a tree, with many sticks. some people only have one stick in their butt, some none, others many… :thumbup::laugh:

Answer:I always am amused by the pre-med notions of matching well. Just because you have heard of an institution doesn’t make it a great residency. Do you really think all programs at Hopkins are the best or even desireable? Do you imagine everyone from top med schools match where they want to or even match at all? They don’t . There are people who have to scramble even from the top schools. Why? Because there are more desirable candidate who went to "lesser" schools but were better fits for the program.

Answer:No, we get what you’re saying, we just think you’re wrong.

One of the best, most concise descriptions of how to succeed as a pre-med/med student I’ve read (or pre-law for that matter), inspiring work.

I don’t know about you, black and decker, but I place infinitely more precedence on being happy, being surrounded by normal people I can relate to, than being top of the class in everything and matching into the academic research radiation oncology residency with the most NIH grant money. I think I’m not alone.

Answer:…comparing similar applicants at different ranked schools school, the applicant at the lower ranked school would be more likely to get a top residency. Reason? Residency programs care way, way more about step one score, class rank, and research than they care about the reputation of your institution. Step 1 score doesn’t improve at better institutions (in fact they tend to teach to the test less)

I’m calling BS. Show me data.

This is where your argument fails: 20 applicants for 3residency/fellowship spots with virtually identical applications (board scores, class rank, resarch) but one goes to a more well renowned institution? Who gets the interview invite? This is not an uncommon scenario.

The trick to succeeding in medicine, other than being smart and working hard, is to surround yourself with the dumbest people possible…so that you can look intelligent by comparison. This is particularly important in ugrad but still sorta true in medical school.

That’s why you should go to your state school rather than MIT for undergrad, why you should do the communications major and not the engineering major when you’re there

Dumbest. Post. Ever.

This mentality is what’s wrong with this country, "shoot for the middle!" :thumbdown

Following your logic, going to a community college is a smarter investment than a state university because your transcript will be full of straight A’s and you’ll be surrounded by the bottom feeders? :rolleyes:

By your same logic, getting a job out of college has nothing to do with "the name" of said institution? That’s why Yale and Harvard law grads are struggling to find jobs next to all the state school grads? You honestly think an applicant with a MIT engineering degree doesn’t get comparatively more job interviews? Gimme a break. If you honestly believe the answer is "no," then I can’t argue with delusion.

And for the final hole in your logic, I know plenty of Communications majors who, 5 years after graduation, are working the same low-paying jobs (not in their respective field) they worked to support themselves through school. I admit this last argument is anectdote.

…and (one of the reasons) why you should go to the cheapest/bet fitting medical school you can rather than the most prestigious.

Never once have I argued against this logic. Certainly everyone should go to the program that fits them best…show me where I discounted this?

The only thing that you want name recognition for is the last thing you’re planning on doing, which is either residency or a fellowship depending on your field.

Again, this is the difference in our vantage points. I am much further down the pipeline than you…and have the advantage of hindsight. Prestigious institutions are always difficult to crack, however, in the case of the previously mentioned programs…"once you’re in, you’re in" is an accurate description.

Furthermore, if you have a clear idea of what you want to do early on, it helps to surround yourself with individuals involved in high level research to support your eventual career goals. You are somewhat myopic in your argument…you act as if residency or fellowship is sooooo far off in the distance. I am only in PGY2 and can tell you it flies by. Once in residency it is very difficult to generate productive research…this is where a strong track record can be helpful.

See, I can also do dickish arboreal similies.

Such hostility. Unfortunately, as I said previously, emotion is clouding your ability to discuss this rationally and effectively.

You are, in fact, comparing apples to oranges. My illustration (and entire argument up to this point) was comparing an unexpected fall down, not the race up.

The people outside of the profession (those on the ground) will always see you as a "Dr" and they’ll never understand the "ins and outs" of academic medicine.

Answer:I love how if I post a response to an attack, people tell me to "chill" and "calm down." Oddly, these same people don’t hesitate to call me a d!ck.

Answer:Something else you have to remember is now with the internet, future patients can google you. Some patients may be influenced by what they see. Johns Hopkins looks a lot better on paper (or a diploma hanging on the wall of your office) then a state school. This probably isn’t a big deal in most fields but if I was getting a complicated surgery of some kind I might do some research on the doctor.

Yeah. They have a much larger printing budget compared to my state school. The shadowing they do on letter J is da bomb.

Answer:This is where your argument fails: 20 applicants for 3residency/fellowship spots with virtually identical applications (board scores, class rank, resarch) but one goes to a more well renowned institution? Who gets the interview invite? This is not an uncommon scenario.

See, but your choice is not between being a state student and a Hopkins student with an identical resume. Your choice is between being a higher ranked state student vs a lower ranked Hopkins student. The same amount of work and effort gets you better grades, relative to you peers, at the lower ranked school, which is why you come out ahead. I’m arguing that, when the fellowship gets the choice between the higher ranked state student and the lower ranked top tier student, they’re going with the state student. Same goes for premeds applying to medical school.

The trick for life in general is to play by the rules of the game that you’ve chosen. I’ve known Communications majors with 4.0 GPAs that were mistified when they graduated and found out that they were basically unemployable outside of some near minimum wage data entry work. I have also known engineers from top universities with strong research experience and around 3.0 GPAs, easily emlployable for very near to six figures as a starting salary, who were equally shocked to find out that medical schools that were accepting communications majors with 4.0s considered them completely unqualified. Both of the groups of people put in adequate amounts of work, but they weren’t playing by the right set of rules.

And yes, for medical school admissions, a 4.0 from a community college trumps a 3.5 from a good 4 year institution.

Something else you have to remember is now with the internet, future patients can google you. Some patients may be influenced by what they see. Johns Hopkins looks a lot better on paper (or a diploma hanging on the wall of your office) then a state school. This probably isn’t a big deal in most fields but if I was getting a complicated surgery of some kind I might do some research on the doctor

No physician, let alone surgical subspecialists, has trouble getting enough patients. It is one of the few advantages of the profession: there aren’t enough doctors to go around, so physicians can basically work to their hearts’ content. You don’t need to worry about sitting in an empty office because you didn’t go to Harvard.

Yeah, because if you’re getting a complicated surgery of some kind, where they went to medical school is far more important than say, how many of said procedure they’ve performed, or what their outcomes are like.

Answer:I’m calling BS. Show me data.

blah blah blah

I’m calling BS. Show us data.

You’re making a hell of a lot of claims unsubstantiated by real data for somebody that’s challenging his accusers to show him real data. And no, hypothetical situations, including but not limited to every example you’ve brought up in this thread, do not count as data.

So, without further ado, data:

http://www.nrmp.org/data/programresultsbyspecialty.pdf

From page 6: Factors that US residencies cite as factors for selection:
Grades in required clerkships: 71%
Class ranking: 66%
Step 1 score: 82%
Letters of recommendation (various): 75%
Graduate from a US allopathic school: 64%
Graduate from a highly regarded US allopathic school - 54%

46% do not consider where you come from to be important enough for consideration. It is not a factor. It’s not even that its considered an unimportant factor among many; it’s not a factor, at all. Class ranking is cited more often as a factor than your highly regarded institution. Therefore, according to this data, being top of the class at a mid-tier is better for you in the match process than being middle or bottom of the class at a top tier.

Boom. Data. Done. Your arguments do not hold water. Sorry, goodbye. And yes, you’re being a dick. What you write radiates condescension. I, and I’m sure others, do not necessarily take issue with what you have to say, even though I think it’s wrong. I take issue with the extent to which you talk down to people. Who do you think you are? Get off your high horse. It’s possible to dissent without disrespecting the person you’re dissenting with; you should try it out sometime.

I’d be curious to know exactly what your qualifications and expertise on the matter is, that you obviously know so much as to refute a national survey of residency program directors. The survey may not have the highest reporting rate (slightly above 50%), but the reporting rate is high enough for it to be a statistically valid sample.

Also, another important point is, much more so than medical schools, residencies care a lot about intangibles, beyond scores, grades, institutions. This is why they have things called audition rotations. They care about your character, how you interact with people, whether or not you’re a team player, whether or not you’re willing to jump straight to the douche card in an argument; they need to, because they’re picking less than 20, oftentimes less than 10, people, to work with, for several years. Several years is a long time to be trapped in the same program as a douche. If I was a residency director, and I met someone from the middle of the class from Hopkins that was as arrogant as you, and I had the choice to pick that person or a person towards the top of the class at, say, a U of R or a Stony Brook, who was personable and easy to work and get along with, the choice would be clear. You’re becoming a doctor, not an investment banker or a lawyer; I suggest you learn some humility.

Easier? No. You learn the same information everywhere. Although I will say that some schools make the learning process less painful than others. That has nothing to do with rankings, though.

Competitive? That is school/class-specific and has little to do with rankings. My school is pretty collaborative/non-competitive, but I doubt anyone looked at our ranking as was like "Hey, we’re ranked lower than Hopkins so we should be less competitive." :p

Answer:http://www.nrmp.org/data/programresultsbyspecialty.pdf

First off, overall response rate was 55%. Does this mean the other 45% don’t consider this questionairre important enough for consideration, aka not a factor? :rolleyes:

Page 6/144, Figure 1: Percentage of Programs Citing Each Factor In Selecting Applicants to Interview.

All specialties combined:

Graduate of highly regarded medical school: 54%

AOA membership: 53%

Class rank: 66%

Page 8/144, Figure 2: Mean Importance Ratings of Factors in Applicant Ranking.

All specialties combined:

Graduate of highly regarded medical school: 3.3

AOA membership: 3.2

Class rank: 3.9

AOA is a surrogate for class rank, so at the least we could say AOA = prestige of med school. Fortunately, many programs are now moving away from individually ranking students (aka pitting one student against another). So rank is becoming increasingly less relevant…I would not be surprise if it fell off this list soon.

However, one has to consider the disconnect b/w AOA membership and class rank in both figures. Though it’s hard to determine from these two figures, it states that AOA and med school "prestige" are valued for U.S. graduates…therefore, one would assume that class rank becomes more important for non US grads. This is a large inference, but its the only way I can reconcile the discrepancy b/w class rank and AOA (especially since the majority of other countries don’t offer AOA membership..not sure about UK).

Having said this, I can further support my previous comment:

A mediocre student from Harvard or Hopkins will match extremely well for residency…the same cannot necessarily be said for a state student.

Using the data you provided, if a student at a prestigious US med school has an off semester and doesn’t make AOA, he is still at a prestigious institution and per the data that is equivalent to if he had been AOA. So, he has a certain level of credibility by nature of the program. On the otherhand, same student has an off semester at an equally fine state school (that for some reason isn’t as highly regarded) doesn’t make AOA and doesn’t have the credibility of his program to fall back on.

Boom. Data. Done. Your arguments do not hold water. Sorry, goodbye. And yes, you’re being a dick. What you write radiates condescension. I, and I’m sure others, do not take issue with what you have to say. I take issue with the extent to which you’re talking down to people, even through the internet which dulls tone.

Funny, the tone of your posts is becomingly increasingly inflammatory…while your arguments continue to miss the mark. You have yet to provide a convincing counter argument…

Answer:I see you edited your post…

Therefore, according to this data, being top of the class at a mid-tier is better for you in the match process than being middle or bottom of the class at a top tier.

Please show me how you made this short bus leap of logic from the data you provided…

…They care about your character, how you interact with people, whether or not you’re a team player, whether or not you’re willing to jump straight to the douche card in an argument…If I was a residency director, and I met someone from the middle of the class from Hopkins that was as arrogant as you, and I had the choice to pick that person or a person towards the top of the class at, say, a U of R or a Stony Brook, who was personable and easy to work and get along with, the choice would be clear. You’re becoming a doctor, not an investment banker or a lawyer; I suggest you learn some humility.

Your arguments are becoming increasingly emotional and personal…funny how you mention "jumping straight to the douche card."

Answer:See, but your choice is not between being a state student and a Hopkins student with an identical resume. Your choice is between being a higher ranked state student vs a lower ranked Hopkins student. The same amount of work and effort gets you better grades, relative to you peers, at the lower ranked school, which is why you come out ahead. I’m arguing that, when the fellowship gets the choice between the higher ranked state student and the lower ranked top tier student, they’re going with the state student. Same goes for premeds applying to medical school.

See my above post for why this reasoning is not valid. Class rank is becoming less and less frequently reported to residency programs. Your entire argument hinges on whether or not rank is used to compare the two candidates.

Lastly, you continue to argue a scenario that I didn’t initally propose. I will reiterate again, I argued the scenario of two candidates from separate schools who each had a "flag" on their transcript for whatever reason.

Answer:You didn’t answer my question. What are your qualifications? Please tell us. It would give what you have to say greater weight.

Answer:My qualifications are similar to yours…I am posting my observations and providing counter arguments where appropriate. I have slightly more experience having been through the match and interview process. Additionally, I’ve collected the experiences and war stories of fellow students, residents, and faculty. I’ve seen first hand the difference in interview invites from students of different academic standing and of different schools.

I never implied that I was privy to info or somehow directly involved in the selection process.

Answer:Many state schools share hospital privileges with nearby private schools, so 3rd and 4th year rotations are practically the same. Pretty sure that evals by residents/attendings hold much, much more weight than the name of the school

Answer:Some statistics:

population size: 3310
acceptable confidence interval: 12
meaning, "Highly regarded" p value could range from [.48 to .60], and "class rank" could p value could range from [.60 to .72], therefore making it statistically valid to argue that these criteria could possibly have equal weights.

Confidence level: 95% (by convention)

necessary sample size: 65

Take a statistics class. You’ll learn a lot.

AOA is not a surrogate for class rank. AOA means ****. It’s like being a member of the Golden Key honor society as an undergrad; who would put emphasis on Golden Key over MCAT or GPA, or even the prestige of your college? If AOA was truly a valid surrogate for class rank, why would it be its own distinct criteria? why not just make AOA membership the main criteria, as, according to you, it’s equally vigorous?

This minor point aside, you’re missing my main point, which is essentially this: who you are in real life trumps who you are on paper. Prestigious medical schools, that’s a paper credential. Residencies, as I stated above, look for intangible qualities; they look at your character. They have to, because they take so few candidates out of a much larger, possibly more-qualified-on-paper, pool. But character is an easy thing to judge when you meet a person in real life. This is why people from mid and lower tier schools match into residencies, and why there are people (believe it or not) from prestigious schools that don’t match as well.

It’s like med applications. Paper is great. Having a great MCAT and GPA coming from a difficult, well-regarded school is awesome–but at the top schools, the interview is what matters. They can populate their entire classes many, many times over with the 4.0 36 . Having the numbers but also being a personable human being is what gets you in, because medicine is essentially a service industry.

So this is why I’m calling you out on being condescending. You write well, so I’m assuming you’re a pretty smart guy and I’m sure you’re going to get into a decent school; but when you walk into the first day of third year rotations and give your attending the sort of arrogant attitude you’re displaying here–I wish you luck my friend.

Answer:This is getting old, and more importantly, time consuming…I am nearing the limits of my patience.

"Highly regarded US medschool" p value could range from [.48 to .60], and "class rank" could p value could range from [.60 to .72], therefore making it statistically valid to argue that these criteria could possibly have equal weights.

Take a statistics class. You’ll learn a lot.

so at the least we could say AOA = prestige of (i.e. highly regarded) med school.

How are we not stating the same thing here? You post a comment essentially saying the same thing as my post, then throw in an inflammatory statement.

*italicized words were added to show comparative value of the two statements.

You really shouldn’t make inflammatory posts on topics you clearly have no knowledge of.

Selection criteria for AOA:

Junior AOA: Criteria one - must be selected from the top 10% of the class

Senior AOA: Criteria one - must be selected from the top 25% of the class

There are of course other criteria in choosing selectees, however, to even be considered requires numerical class rank of extremely high standing. This is irrefutable. Lastly, many instutions forgo the details and simply select the top 1/6 of the class for the honor.

A cursory google search (which you could have performed yourself and saved some lingering dignity):

"AOA is the only national medical school honor society. Eligibility requires academic rank in the top quartile of the class. Only one sixth of a class may be elected to membership, with a maximum of one half of this number elected in the third year of medical school."

source: http://www.hsc.wvu.edu/som/students/aoa/index.asp

The interwebs are littered with web pages saying essentially the same thing.

Again I reiterate, AOA is a surrogate for class rank. Arguably (mine), now more than ever since fewer programs are reporting individual rank.

Who you are in real life trumps who you are on paper. Prestigious medical schools, that’s a paper credential. Residencies, as I stated above, look for intangible qualities; they look at your character. They have to, because they take so few candidates out of a much larger, possibly more-qualified-on-paper, pool.

Unfortunately, many of these colossal personalities you speak of never even get the invite because of the initial "credential screen" that residencies use to cull the formidable number of applications. Some use Step 1, some use AOA, some use a combination of both. I cannot provide proof of this, but this considered a "not-so-tightly guarded secret." There have been innumerable posts on SDN discussing this subject.

Sorry, nice try. Thanks for coming. Unfortunately, no parting gift.

See above post for answer.

Have you read my posts? I’m not a med student.

I admit, I stooped to your level by getting personal… There’s only so many direct insults one can be expected to take.

Answer:You have failed time and time, post after post to discredit my arguments.

I have made sound arugments that have held against illogical, poorly constructed, and repeatedly inflammatory attacks.

You provided a reference which failed to support your logic: For that you get a cookie.

You have turned disagreement into attack: For that you fail.

You have yet to discredit my agruments: For that you got dominated.

Answer:Golden Key selection criteria: top 15% of college students by GPA and other numerical academic factors.

The analogy is apt. AOA does mean ****. Do an sdn search about it yourself, or post a question in a forum where people know more than you, i.e. the medical forum.

I’m not really sure why you’re so hung up on AOA. So you’re in AOA; ok, that doesn’t really mean anything other than you’re in the top 1/6 of your class. This information would be easily gleaned from class rank, or barring that, grades. Why use AOA when you can use class rank? If the school doesn’t rank, why use AOA when you can use Step 1 scores? Both are cited as more important.

No, your arguments aren’t bulletproof. Don’t pop an aneurysm, guy. You probably should have chilled out a bit back when you first got the chance. If you had been more civil in the beginning, maybe people (i.e. me) wouldn’t be attacking you now.

(edited for a typo)

Answer:You have yet to discredit my agruments: For that you got dominated.

I call BS. Show some data.

Answer:AOA does mean ****. Do an sdn search about it yourself, or post a question in a forum where people know more than you, i.e. the medical forum.
What is ****? Are you implying sh!t?

This information would be easily gleaned from class rank, or barring that, grades. Why use AOA when you can use class rank? If the school doesn’t rank, why use AOA when you can use Step 1 scores? Both are cited as more important.

Again, you are naive. This is not inflammatory, just fact. You haven’t been through the Med school match. Individual grades mean nothing if you can’t compare to the class overall…what is commonly provided is a bar graph showing your comparison to the class overall.

Some residency programs use AOA much more heavily…
In the words of a supreme douche,
"boom, data, done:" http://www.nrmp.org/data/chartingoutcomes2007.pdf

As you will see on review, class rank is not even listed when gauging successfull residency matching.

wait for it……….

deep breath…..

(not even) important enough for consideration. It is not a factor. It’s not even that its considered an unimportant factor among many; it’s not a factor, at all.

…see what I did there?

What you will notice, on page 10, is the striking correlation between presence of AOA and mathcing into the most competitive residencies. The same trend is also present for USMLE scores…which is consistent with my statement about the use of these two data points for initially screening applications and potentially offering interview invites.

No, you just crack me up…previously in a humorous way, now in a pathetic way. How can you continue to cling to faulty logic?

BTW, if I haven’t made clear up to this point….you’re also an idiot.

http://www.threadbombing.com/data/media/2/14631tbv5kf450f.gif

Answer:Sorry to say guys, but it is clear that one of you clearly has no idea what he is talking about. I’ll give you a hint, it’s not the resident.

A few points quick points:
Like it or not what school you go to does matter, at least a little.

AOA is huge. There is 1 medical honor society: AOA. There are probably 1000 undergrad honor societies. AOA is a big deal.

Answer:Sorry to say guys, but it is clear that one of you clearly has no idea what he is talking about. I’ll give you a hint, it’s not the resident.

It’s nice to see some common sense again in this thread…

A few points quick points:

Like it or not what school you go to does matter, at least a little.

Agreed, and despite the furor over my subsequent comments, this is consistent with my very first post.

Prestige matters but it’s not critical in the long run.

Answer:Sorry to say guys, but it is clear that one of you clearly has no idea what he is talking about. I’ll give you a hint, it’s not the resident.

A few points quick points:

Like it or not what school you go to does matter, at least a little.

AOA is huge. There is 1 medical honor society: AOA. There are probably 1000 undergrad honor societies. AOA is a big deal.

:thumbup: I agree the resident is holding his own.

Answer:You may not like the way he says it, but blackndecker is right. I suggest you read some of the posts by students/residents who have experience with the "elite" programs (blondedocteur’s posts about attitudes at Columbia come to mind).

I have heard a neurosurgeon describe his program’s screening process: Step 1: look at USMLE score; Step 2: look at 3rd year core clerkship grades; Step 3: look at what school they attend. After that, they make the decision to interview or not.

I have heard a PD (of a non-competitive specialty) talk openly about the fact that he won’t interview or rank a DO, and that he looks at school name in the initial screening process.

These things do matter. This debate has been had over and over again on SDN. No, prestige isn’t "everything" - but a student from a top school has some advantage in this process.

Answer:Now that I’m more in contact with people that wet to less prestigious med schools than me, I think prestige is more of something nice to land a good residency program, but doesn’t make you necesairly better prepared. I have working mates from less prestigious schools (though a lot of them were top in their class) who know a lot and never slack and are great to work with.

Go with the school that won’t make you miserable, attracts students you can get along with and stll has a good enough educational level to be competitive for the boards.

There is not a single US school that will not prepare you to do well on the boards. Every school in the country has students who score in the 260s.

Prestige of the school follows you around. For instance, whenever we have a visiting professor and they went to JHU or Harvard for med school or residency, people immediately go, oh he must know what he’s talking about, whereas the guy from a less recognized area will not get the same immediate respect.

Answer:I agree with everything BlackNDecker has said in this thread. It’s pretty amusing seeing a couple of pre-meds claiming to have a better understanding of the match than a resident.

Like it or not, the relative prestige of your medical school does matter when you’re applying for residency…especially if your goal is to match into a relatively competitive program. Take a look at Charting Outcomes in the Match 2007 (the link has been posted earlier in this thread)…you’ll find what percentage of successful applicants in each specialty came from top 40 NIH research schools. Students at these schools made up 35.8% of US seniors that year, and are significantly overrepresented in virtually every competitive specialty:

Integrated Plastics - 60.0%
Radiation Oncology - 55.6%
Dermatology - 47.8%
Transitional (internship programs favored by many applicants going into competitive subspecialties) 47.5%
ENT - 43.8%
Orthopaedics - 40.0%

The same is true for prestigious programs in other specialties. Take a look at UCSF’s medicine interns (http://medicine.ucsf.edu/education/residency/current/interns.html)…out of 60, I count a grand total of 9 who aren’t from NIH top 40 schools. Admittely, these are relatively crude ways of looking at the issue, but they are objective data demonstrating a valid point nonetheless. Does this mean you can’t match in ENT if you don’t go to Yale? Hardly…but it will make things somewhat harder from you.

Answer:I don’t know why people bother arguing with the majority of the premed population. Give any indication that if you can get into one of the top schools that you’re better off in some tangible way and you’ll get the same reaction every time: complete denial.

Answer:Ok, good to know about the name factoring into the initial screen.

Please correct me if I’m wrong, but couldn’t a person top of the class at a mid to upper mid tier with good board scores land an interview? And couldn’t a successful interview trump the name of the school that that person came from?

Also, he’s not a resident:
http://forums.studentdoctor.net/showpost.php?p=8533674&postcount=44

Answer:Ok, good to know about the name factoring into the initial screen.

1) Please correct me if I’m wrong, but couldn’t a person top of the class at a mid to upper mid tier with good board scores land an interview? And couldn’t a successful interview trump the name of the school that that person came from?

2)Also, he’s not a resident:
http://forums.studentdoctor.net/showpost.php?p=8533674&postcount=44

1) Of course they could. Name is a factor, but not the most important one.
2) That’s called modesty

Answer:If you’re a C student at Harvard Med you will not be an A student at State Med School.
Agreed. The top students in my school have outstanding board scores ( >260) and would do well anywhere.

Answer:Yeah, because if you’re getting a complicated surgery of some kind, where they went to medical school is far more important than say, how many of said procedure they’ve performed, or what their outcomes are like.
Agreed. Your most important question should be "how many of these have you done?" On my surgery sub-I, people asked the surgeon how often he did this procedure (answer: about 700-800), but I didn’t hear anyone ask him where he went to med school.

Answer:Agreed. The top students in my school have outstanding board scores ( >260) and would do well anywhere.

That may be so but that isn’t really what the poster you were quoting was saying. He was stating that a person that got a C at harvard wouldn’t necessarily get an A at a state school, not necessarily that they’d be the top student.

I think a lot of us are underestimating how strong the matriculants of top scohols like harvard are. Have you seen their applications? To get in they come from the top of all their respective backgrounds and are all then thrown together. I have no doubt that the vast majority of them, regardless of their grades, would be capable of getting A’s at other universities.

I don’t go to an Ivy or anything like that but I’m not so sensitive/insecure that I can’t admit when some schools are comprised of truly unique students.

Answer:Agreed. Your most important question should be "how many of these have you done?" On my surgery sub-I, people asked the surgeon how often he did this procedure (answer: about 700-800), but I didn’t hear anyone ask him where he went to med school.

Again, not contending that they automatically make better doctors. Just that they have the ability to excel at most of the schools around.

Answer:2) That’s called modesty

Nicely put.

Answer:I don’t go to an Ivy or anything like that but I’m not so sensitive/insecure that I can’t admit when some schools are comprised of truly unique students.

Nice succinct summary of the past two pages of argument. Many Pre-Med and Med Students have the biggest chip on their shoulders. They’re used to being top 5% in their respective institutions and some will do anything to maintain that dominance. Including sucking-up, cheating, and even more riduculous examples like majoring in Communications for Pre-Med:confused: and attending a "weak" med school (whatever that means).

I didn’t attend an Ivy institution (though I did apply) at any point in my training, however, I have nothing but respect for the amount of hard work, productivity, and delayed gratification involved to gain acceptance. Sure, some "grandfather in" or get by on natural ability…but that shouldn’t discredit the majority of hard workers.

Answer:Ok, good to know about the name factoring into the initial screen.

I was wondering if you’d come back after licking your wounds….

Of course. But if you had taken the time to actually read the posts, you would have realized this was never in question.

Also, he’s not a resident:

http://forums.studentdoctor.net/showpost.php?p=8533674&postcount=44

Unfortunately, you’re still an idiot.

http://i29.photobucket.com/albums/c261/RoboticStump/idiot.gif

Answer:I call that the fall back method. Having been totally beaten down in an argument with no support from the community, posters typically lash out at the victor and try to discredit them through things like their status in the medical world or their grammar/spelling in an attempt to save face.

Answer:46% do not consider where you come from to be important enough for consideration. It is not a factor.

yes, but what residencies constitute these 46%? just a thought…

Answer:Just a friendly reminder to keep it civil. Disagreement of opinions is welcome, but please keep personal insults out of it.

If only his parents had used the pull out method, this argument might never have occurred…

You get one point for the assist;)

Answer:Just saw the warning…indeed:o

Answer:I am not quite sure why everyone is being so hostile toward BlacknDecker, it seems like a reasonable discussion about something that directly applies to many people who frequent this forum.

Answer:Thank you BlackNDecker for coming here and sharing your insights.

Your avatar is lame, but your logic is awesome!

:thumbup:

Answer:The material is the same everywhere from the lowest ranked school to Wash U. You have to learn all of it. It is ****ing hard.

You’re not competing against anyone except yourself. You’re learning as much as possible so you have as much info as possible to draw on in the clinical years. I can’t comment on the competitiveness there.

Answer:I agree with everything BlackNDecker has said in this thread. It’s pretty amusing seeing a couple of pre-meds claiming to have a better understanding of the match than a resident.

These schools selected good test takers that will have higher step ones than the lower ranked schools. Prestige matters, but not to the extent you suggest.

Answer:Your avatar is lame…

:thumbup:

:laugh:

Really, I always thought it was bad*****…the two things I love most, Jesus and guns. Man, I really am a southern boy.

Answer:These schools selected good test takers that will have higher step ones than the lower ranked schools. Prestige matters, but not to the extent you suggest.
So UCSF’s medicine program couldn’t find more than 9 people from lower tier schools with competitive board scores for their intern class?

You’ll see soon enough. As someone currently applying for a spot in one of the uber competitive specialties named above, I’ve actually met with PDs at some of the more prestigious programs…and some of them have actually told me that while my board score, grades, research, etc are all comprable to those of the people they typically interview/accept, I would most likely not get an interview because they only consider applicants from top tier medical schools.

That’s just life…get over it.

Answer:So UCSF’s medicine program couldn’t find more than 9 people from lower tier schools with competitive board scores for their intern class?

That’s just life…get over it.

At the select few programs you’re talking about, everyone has all their **** in line, so school reputation plays more of a factor. It’s similar to getting into a top ten med school. Ivies and the like are over-represented there, just like top tier schools are over-represented in top residencies. Connections and big name research also play a big factor in these decisions.

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Lower Ranked = Easier?

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