Yes. Both of those explanations for why "higher ranked" schools have more "impressive" rank lists.
I wonder how it factors in though. Is the prestige of the school like a tiebreaker between two applicants with similar resumes and stats? Or is it like a worse applicant from a top 10 school will get the spot over the better applicant from the meh school
Ya by rank i meant prestige. Not US news ranks
Unless one offers full-tuition and the 'better' school puts ya another 250k+ in debt.
Yeah that definitely gets trickier and very individualized. For example, if you want to do a highly competitive field and the cheaper one has no home program, you’d probably want to go with the debt if it means you get the career option you want. If you want something less competitive and less lucrative you’d be better off debt free.
Yeah it just isn't something you can quantify. When you're coming from a name-brand school, and oooh look you got a letter from this luminary in the field, and they know how to plug you into their machine to make sure you get the pubs you need to succeed... it's just much easier to succeed than having to make everything from the ground up at a less prestigious school. You're not going to be given the same benefit of the doubt.
The analogy here is like rock climbing. You start from different places and are trying to get to the same ending place. Not only does someone from a top tier school start higher up, their path up is also easier. There are established footholds for them to take and a well trodden path. And there might even be someone who's already up their guiding them and helping them ascend. The guy or gal on the other side of the rock starts from a lower spot and is looking at a bald rock face with no hand or footholds. Is it doable? Sure. But is it very very very hard? Yes.
will make their crimp stronger though
How can applicants from lower tier school show their caliber? PS? LOR? Preceptor evaluations?
Research output. Step 2 score. To a certain extent letters
Step 2, research, LOR, etc. In some specialities letters are critical, do not overlook that and if possible, secure them from well-known people in the field.
Better training. See a broader range of pathology. Opens up career opportunities. Etc.
This may be, but is not necessarily, true. When you go to one of these ivory towers, there is always some mild tension of there being too many trainees all fighting for the same experience (ie fellows need their procedures so the residents don't always get first shot). Doesn't mean those residencies are bad (obviously), but there absolutely is some merit to going to a different residency where residents get more hands-on training.
I get the difference between academic and community IM but I’m less convinced that an IM resident at say Uchicago or Northwestern gets a dramatically different experience compared to a resident at UIC or Loyola. Probably different in terms of academic opportunities and certain fellowships but not the actual experience.
I think they do. Maybe not the bread and butter stuff. But if you are doing cardiology at a place where there is no cardiac transplantation, surely that is a hit to your training. (for example)
At the top programs, you have top trained faculty(likely a great % also trained at the program), better clinical experience, greater depth of cases, more funding and the list goes on. This does not mean that you will get poor training at the community programs, but I'm giving you objective facts as to why those top ranked programs are just that....top ranked for good reason.
Eh, the idea that top programs give better clinical training gets propagated alot but is dubious at best. Anecdotally my program has had some bad experiences with faculty coming from the ivory towers. Those programs produce good and bad surgeons at the same rate as anyone else. They simply publish more papers than most.
The bolded is such an important point that is not shared enough in the echo chamber of SDN.
Please elaborate to your statement that " better" clinical training at the top programs is "dubious at best."
I think school choice matters more than people are letting on here. Far more for med school than for residency, school choice is absurdly important in terms of tangible advantages. For some of my friends, it's been the difference between NSG or GS, Derm or IM, going back to California or staying in the Midwest. Step scores at a T5 school are ~5 points higher than those from an NIH T40 school, but compare the match lists of Penn vs. Jeff, Wash U vs. SLU, Hopkins vs. UMD, HMS vs. BU, Columbia vs. Einstein, Duke vs. Wake Forest, etc... You can say it's from mentorship, research, or letters, but ultimately school choice matters a ton. The worst students from Penn are matching similarly to the top 10% at a school like Jeff.
Some of what you say may be true, but there still is no arguing against the quality of training at your top programs. I think your explanation regarding ego, while true in some cases, is overstated. I'm sure "ego", "keeping up with the Joneses" are definitely reasons applicants seek out those prestigious residencies, I just don't think that it's the majority of people who want to be in a top program....not even close.
There is arguing though. It's been demonstrated here and almost everywhere else. People say repeatedly that the training at top institutions is compromised by the Ivory Tower mindset, competition with a large training population, fellows stealing good cases, less bread and butter, etc...
Elaborate? To put it simply, it’s not true the training is better most of the time. Sure if you want to compare a tiny community program to MGH, but that isn’t what most people are comparing (that’s not my situation either). There is a stereotype in surgery that the the top program graduates can’t operate, because they spend all their time standing behind fellows and doing research than actually being in the OR. Even their fellows sometimes don’t actually get to operate that much. Now are there obviously exceptions to this? Yes. Is it a bit of an exaggeration? Sure. But the stereotype exists for a reason.
I keep seeing this and i have no idea if this is just an SDN myth. There are many top academic programs that train world class surgeons who pioneer revolutionary procedures and these programs also train surgeons who are just as good (or better) with operating as surgeons from community programs. There is significant variation in surgical education quality within top programs that the stereotype itself is just as inaccurate as the opposite notion that top programs alone offer best training
If you look back in my history, I agree that school choice matters, and that will likely be emphasized with step 1 going pass/fail. But I flatly reject the bolded. Step score is just one data point. People match into competitive specialties and programs from lower ranked programs all the time. If you attend a lower ranked school, it's on you to make sure you meet the criteria to get into one of those coveted spots if you are aiming for it.
It’s far from simply an SDN myth… Of course it’s nuanced, but the stereotype exists for a reason.
I do not think it is true that a supermajority at these programs come from 10 schools. Probably a third come from top 10 schools.
There are 3 from my school on their roster and we are not T20.
Okay, yes we are in agreement. School choice matters a lot, and ultimately it is up to the student to match.
The culture of SDN tends towards people who value prestige, and this leads to two camps on SDN.
Agreed. It’s the drastic oversimplification of complexities that bothers me.
No use in arguing this, people don't care for facts...they'd much rather ignore truth in order to support their beliefs. It is pretty clear based on resident profiles that the two biggest factors/biases were going to the affiliated medical school and going to another local medical school. Otherwise, the resident classes are usually highly diverse.
Which was my entire point. Things are extremely gray instead of black and white
I disagree, but, hey, everyone is entitled to their opinion."There is a stereotype in surgery that the the top program graduates can’t operate, because they spend all their time standing behind fellows and doing research than actually being in the OR"....In what, general surgery that you are currently in, just trying to understand? There are plenty of top residencies in the sub-surgical specialities and I would assume general surgery that operate with a great deal of autonomy(a lot of hands-on), so that blanket statement you made is patently false....Go see what comes out of UPMC, Penn, NYU, Michigan, etc and let me know if they can't operate.
Thanks, best of luck to ya.
See and this is where I think the argument becomes difficult, because you chose HMS as your example for a reason. We all know and I agree that HMS specifically opens doors because their grads get the benefit of the doubt based on the pedigree of the school. To me that's less of a "rankings" thing (which is what the OP asked about, and is generally what is meant when people ask about "prestige") and more of a "brand name school" thing. That's something that probably applies to a very small number of schools (throw in Hopkins, Yale... apologies if your favorite ivory tower isn't listed, I'm intentionally not naming all of the "good schools" because I want to avoid playing "What about X, Y, or Z school." The point is that the list isn't long). When you're making a distinction about those true blue-blood institutions, I think it's sort of pointless to make up a scenario where someone is choosing between a mid-low tier school and literally HMS. Nobody is going to argue they should go to a mid-low tier school over HMS, regardless of cost, and your friend if given the choice wouldn't have had any difficulty making it.
Now we agree completely. I don't think pedigree matters except for general tiers. As in T5, T20, well-established MD, new MD/DO, IMG.
I’ll be surprised if anyone denies this
