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I mean a strong application definitely helps. Doing a couple aways out there helps too. Also having mentors make calls on your behalf helps a lot.

Once you have a solid app, it’s really just a matter of showing PDs that you’re truly interested in their program. When we would whittle the short list down to the 30-40 interviews, people with no connection to our area were more likely to get dinged because frequently those that did get invited wouldnt rank us high enough to match. We’d see they matched somewhere closer to where they had already been. So try and have people reach out on your behalf wherever they may have connections.
 
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I mean a strong application definitely helps. Doing a couple aways out there helps too. Also having mentors make calls on your behalf helps a lot.

Once you have a solid app, it’s really just a matter of showing PDs that you’re truly interested in their program. When we would whittle the short list down to the 30-40 interviews, people with no connection to our area were more likely to get dinged because frequently those that did get invited wouldnt rank us high enough to match. We’d see they matched somewhere closer to where they had already been. So try and have people reach out on your behalf wherever they may have connections.
This^^^^^. Most people who want to practice in a certain area try to attend med school in that area for this very reason. Of course, this is less applicable to people attending "top" schools, but does apply to just about everyone else.

If you are not in an area, from an area, or have a strong connection to an area, you have a lot of "'splainin" to do. This probably also does not apply if you are seeking a position in a top ranked program in your desired specialty and you are a rock star applicant, but this doesn't seem relevant since the OP is focused strictly on geography.

We tend to forget this, but the Match is a big job application. A version of med school applications, but on steroids. Programs are interviewing scores of people, not hundreds or over a thousand, for a handful of spots, not hundreds.

As a result, yield is very important to them, because they don't have interview spots to squander. Again, far more so than in the med school application context. Consequently, just having a desire to maybe spend a few years in a new part of the country, with no obvious connection to it, makes it extremely difficult to break through and score one of those precious few interview spots. A great CV is a given, since everyone getting an interview will have one. Beyond that, everything that @operaman is saying makes sense.

Connections are developed by being from the area and expressing a sincere desire to return, attending school in the area, or by doing aways. Without them, and without a respected mentor, who is known to the programs you are targeting, personally vouching for you, it is not going to be easy. And more research, or volunteering, or a higher than high Step 2 score are not going to meaningfully move the needle. Getting someone to fall in love with you during an away rotation might.

One way or another, you need to develop meaningful connections, and that is very difficult when you have none and are too far away to develop them. Oregon is very different from Colorado, which is very different from California. The fact that you are this flexible, and all over the place, will feed right into a perception that you are not really committed to any of them, without a demonstrable, preexisting connection.
 
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Adding onto this, M3 in a similar boat (from NE, tried and didn’t get into med school on west, aiming for west coast, no ties). Considering 2 aways, is that enough? Interested in surg sub so at the end of the day will be grateful to just match.
 
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Away rotations will certainly be part of my strategy when 4th year rolls around. My school will cover travel expenses and my PIs are more than willing to send me anywhere, so I'll certainly look into going out wherever/whenever I can.

How can I go about networking with AMSA or AMA?
You're currently in medical school? Do you not have student leaders in AMSA? Also, I'm not sure if you already have a faculty dean/advisor, but I also hope you have talked with your student dean. Ultimately you need their help and their MSPE blessing when it comes time for a reference for a residency.
 
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I don’t really get the whole “ties the area” thing. doesn’t the fact that somebody is applying to the residency establish at least some interest in the area?

I mean I guess in certain fields like neurosurgery, ent, plastics etc it makes sense to interview regionally (since numbers of spots are so limited) but for IM and other specialties I just don’t see it
 
I don’t really get the whole “ties the area” thing. doesn’t the fact that somebody is applying to the residency establish at least some interest in the area?

I mean I guess in certain fields like neurosurgery, ent, plastics etc it makes sense to interview regionally (since numbers of spots are so limited) but for IM and other specialties I just don’t see it
Maybe programs have data showing that good candidates with no ties to the area end up not ranking them highly, which ends up being a wasted interview for the program. Kind of like how high stat premeds that show at least some interest in low tier schools by applying to them get yield protected out because the schools know they are not going to come.
 
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I don’t really get the whole “ties the area” thing. doesn’t the fact that somebody is applying to the residency establish at least some interest in the area?
Not when so many people are applying to so many programs. It's incredibly hard for PDs to differentiate interest from panic.
 
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I agree with doing aways. For PM&R that will be particularly important as UW is one of the top programs in the country. And unfortunately, the next closest programs to Idaho are in Utah, Colorado, and Minnesota is the closest program to ID if you go due east. UT and CO programs are also extremely competitive/among the top and doing aways there would also help dramatically.

Same goes for the CA programs, which are generally more competitive than they should be for the quality of the program.

St Lukes in Spokane apparently has a new PM&R residency program, and it's a pretty decent size (6 residents per year). I can't comment on the quality of the program, but my guess it it would be the easiest to match into of the programs closest to ID.

Research would help for all those programs.

Step 1 is to narrow down your specialty choice. I think you've got lots of good choices--those are the exact four specialties I debated early in med school.

Best of luck
 
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