Yes, the prestige of the resIdency program matters most. However, it is not necessarily correlated with the prestige of a med school or university.
How do med school students get into a prestigious residency program then? According to a CCer (Princess’Dad ?), knowing somebody who is “in the network” and is willing to call/bat for you would definitely help.
A student could also spend a few additional years in a MD/PhD program in order to build up the credentials in order to get into a prestigious program. Just like a high school student with stats only is still not good enough (because the ceiling for getting an excellent SAT and GPA is intentionally set low enough for more students to be qualified), a med school student with excellent step-1/2 scores and excellent clinical year grades could also be not good enough. There need to be some other “AND …” factors. Just a wild speculation here on my part though.
Mcat2. Not sure your point.
We know a number of excellent doctors. They graduated from public universities, and went to public medical schools…and had normal,residencies. But my favorite is my eye doctor who followed this,route and then got a fellowship at Wills Eye Clinic, which is most definitely one of the best ophthalmology programs in the country.
@thumper1,
I have the impression that, with few exceptions, many med school students seem to fight tooth and nails among themselves in order to get into a residency program (and that specialty!) that is affiliated with a university. My wild guess is that they will have more chances to continue doing research and getting published while in residency program (just like they have been doing in med school and even in college) in order to secure that extra “AND…” factors (i.e., publications) then helped them to get into a prestigious fellowship program.
Of course, some claims that if a community program has some lucrative/desirable specialty fellowship programs and has the track record of accepting their own residents into their fellowship program, it will also be a “good choice.”
A case that I once heard of is that, because residents at a Stanford Med are assigned to Kaiser (because it is a very large hospital in Santa Clara county) and some students who are eyeing for a top fellowship program are reluctant to go there. (This is because Kaiser is not a university-affiliated program. No academic medicine means less research/publication opportunity while spending too much time doing residency there.)
Why does a doctor need to work on his/her career for such a long time (more than a decade if you count UG years)? In the end, only a small fraction of them will work at a teaching hospital. Is it really worth it? Isn’t having a job at a community hospital good enough for making a living?! I have a mixed feeling about this.
Here is a list of the to rated residency programs for internal medicine, rated by physicians, see:http://health.usnews.com/health-news/top-doctors/articles/2014/02/20/doctors-name-americas-top-residency-programs I know for a fact that the majority of the seats are dominated by students from top ranked medical schools.
Medical education and residency training are standardized. The “research” medical schools have to provide the same curriculum as State U and the small unknown private schools. Residency training may be affiliated with an academic institution or may be community based (often with a loose academic affiliation). Both are regulated by the ACGME and the basic training will be the same. The former will provide more access to Ph.Ds and cutting edge lectures/research while the latter will provide more access to actual clinical care in a community. However, this degree of difference is very small as all residency training is regulated and basic competencies are required.
You will find the most physicians are likely to be dismissive of “rankings” because at the end of the day, we are all just taking care of people. We also all completed the same curriculum, passed the same licensing and certification exams, and have sacrificed a lot to do what we do. I value my colleagues for what they know and how they can help me do my job, not where they went to school/trained. I cannot tell you where anyone trained except those that are close friends.
The best medical school is the one that accepts you and costs the least! Major in whatever you want but do well on 1) your overall GPA, 2) your science GPA, and 3) your MCAT. If you are called to medicine, I would not worry about a cut off GPA. Go for it and try your best. If you are interested in medicine for the money or the prestige, do something else.
Finally, it is true. You can go from a community program to big “name” program. You can go from a small medical school to a top residency. You can go from lesser named community program to big named research fellowship program. You can go from an Ivy medical school to a small community based program. You won’t choose based on prestige but what kind of training you are interested in, the kind of medicine you want to practice, where you want to live, and other variables that don’t make the “ranking”. The doors tend to open to these programs regardless of your previous training because of the standardization in education and training as well as the other variables I mentioned above.
Heard a rumor that for the two in the top four (MGH and B&W), relatively few med school students could get interview invites (II) at both. It is more likely to get II at one of these two and one or two of the other two (JHU and UCSF.) It has little to do with stats, as I heard. It has more to do with all other “AND …” factors (again, just like the college application cycle.) No wonder that it is rumored that the students at HMS actually are not as “focused” on STEP-1 scores as those at other med schools are - they have other more important things to do – to make sure that they have the “AND …” factors. (This is reflected by their students’ not particularly specular STEP-1 scores as compared to their counterpart at some other higher ranked state med schools, or of course, the well-known “stats-driven” wustl, considering the quality of the students they recruit for their med school.)
I read the previous post, #45, with a great interest:
<<See, that’s the thing. The top ~10/15 med schools, don’t see themselves as producing the “everyday doctor.” T
<<<
The thing is…most high school kids who post on CC that they want to become doctors and they want to attend a prestigious med school are NOT saying that because they’re interested in Academic Medicine. Most of the time, they just want to be a regular practicing physician, but they think going to H Med or JHU Med or similar will make them into better doctors and “oh won’t my patients be impressed that I went to Stanford Med.”
Uh, no, most of the time patients won’t know or care. and you won’t get paid more and your practice won’t be larger or more successful.
Amen to post #45!
btw- those rankings would have the same problems as any school ranking methodology- too much name recognition. Besides- rank a residency program higher because it is known for research in x or y or z subspecialty? There needs to be a balance in theory and practice- knowing and doing. Being exposed to cutting edge research and treatment is goo but physicians also need experience in handling things themselves, especially the mundane disorders. btw- the “best” doctor is the one who knows what s/he is doing and AVAILABLE to take care of your needs. Judgment in deciding which tests, procedures, treatments, drugs comes with experience.
A Harvard educated physician is of no use to 99+ percent of the population because s/he is not available. Many of their residency programs are top notch, but some weren’t. An example is the Harvard checklist for anesthesia that came out some twenty years ago because their residents’ rotations at some hospitals were not always done with the best practices so they needed standardization. My training included those and it was a pet peeve of mine that Harvard got to attach its name to something others were doing when they weren’t.
Like PhD programs, there is no one institution with the strongest one in every program. Too strong a surgery program may not be best for a strong anesthesiology program. Residents want strong training in their specialty but also need to decide which programs meet their goals. Although some research may be involved there are many factors involved- including the popularity (not the difficulty) of some specialties.
Anyone in every profession can see where the core/foundation knowledge and skills will be the same regardless of where one got the education. Because ALL medical school graduates need to be competent every medical school needs to teach the material (including skills) to pass licensing exams. Most will find their niche- there is no top/bottom type of physician. A top subspecialist is unlikely to handle areas outside the area of expertise as well as the local physician who diagnoses and treats the problems every day. We see only the tip of the iceberg, not all of the myriads of possibilities that have been sifted through rapidly to give us answers by every physician.
I guess I’m still passionate about medicine despite being retired.
What is the effect of residency and fellowship prestige? Is it easier to find a job after training? Does it limit what specialty you get to choose?
I think that, for many specialties, the specialty is chosen at the time a med school student applies and gets into a residency program. The noticeable exceptions are those specialties which require the completion of the full IM residency program first (not just a one-year preliminary IM program.) Therefore, when a medical school claims that they have a high percentage of their graduates who choose primary care, it is rumored that it is mostly a lie due to the need to be PC (maybe just like University of Texas vs Fisher’s case, the university has no choice but to say/do so in order to secure their funding, or to avoid any potential repercussion? ) For example, I heard that according to one research (JAMA?), only about 20% to 25% of those in IM really go into the primary care in the end; the rest sub-specialize when they apply to fellowship programs. Some private medical school (e.g., HMS) now just does not want to disclose the percentage of their graduates to enter the primary care. The number is not pretty anyway so it is better not to mention it.
Re: easier to find a job after the training, I heard it depends a lot on the luck. The demand and supply could change over time. Although it is not about the US job market, recently there was a news report: In Canada, many new doctors in certain specialties (e.g., ENT for sure, and maybe ortho as well – both are quite competitive specialties to get into in the US market) could not find a job after the residency training. Then, these fully trained doctors may need to join some research group (doing some jobs the career researchers may do in order not to be idle.) It is not because there is no demand; rather, it is the political environment at a certain time that there is just not enough money allocated for the services provided by doctors in a certain specialty. Our medicare and medicaid system seem to share a similar problem. Many busy clinics to serve a certain segment of the population could be closed because more patients they see, the more loss they will have. It is complicated because it is no longer a medicine related issue.
Off topic, but BearHouse’s post (#45) should be a sticky read by every wannabee doctor and the wannabee doctor’s parents. Especially this:
BearHouse is spot-on. All of those yammering about prestige need to read and re read it.
"Most of the time, they just want to be a regular practicing physician, but they think going to H Med or JHU Med or similar will make them into better doctors and “oh won’t my patients be impressed that I went to Stanford Med.”
Uh, no, most of the time patients won’t know or care. and you won’t get paid more and your practice won’t be larger or more successful."
Plus, assuming you are in private practice, how much money you make is completely dependent on your business acumen in running the practice – and not one iota on where you went to med school or residency.
The medical private practice of yesteryear is quickly becoming a thing of the past, for a variety of reasons–https://newsroom.accenture.com/news/many-us-doctors-will-leave-private-practice-for-hospital-employment-accenture-reports.htm
Yes, I’m aware. Hospitals and insurance companies also don’t pay extra if you’ve gone to a fancy med school or residency, either.
The Docs around here with the most successful practices are the ones who proved the best patient care AND have great patient communication skills.
We actually passed on a very well trained doctor who was just awful in terms of how he communicated with us. Didn’t matter a speck that he was from a fancy schmancy school, or was a great specialist. There were others who had the same skill set who also worked well with the patients.
Many doctors get their next patient by word of mouth. It’s not usually “gee I recommend Dr. what’s his name because he got his degree from Yale and did his residency at Hopkins”. It’s “I recommend Dr. Great because he takes the time to help me understand what he is doing, and he listens to me as a patient.”
This thread, like another current one, has morphed into discussing physicians. I could add pages of opinions/insights from the perspective of a patient and physician.
The bottom line about gpa is that in today’s competitive market for admissions closer to an A than B seems to be needed. There are many, many students who would make great physicians but won’t because of the limits of training facilities (medical schools and residency programs).
I heard that in the near future, the limit is due to the fact that the Congress is unwilling to increase the funding for the residency programs. The first “victims” may be those IMGs (US citizens studying at a FMS is even worse.)
Mcat…what funding does congress give to residency programs?
The biggest change will be the merging of MD and DO residency matches which I believe will be fully in place by 2019. This will mean that MD and DO students here in the U.S. will likely match before the off shore students.