Med schools vs. match results?

[carbonylcarbon]

Hi all,

Incoming medical student here who's been thinking about the recent match and had some questions.

I'm sure the match process depends primarily on factors specific to individual applicants, but how much do school-specific factors play a role? From quality of advising to the reputation of the school and previous graduates as well as preference for graduates from home programs, there seems to be a lot of factors that could vary between schools (and by specialty) and contribute to variations between schools in match results.

As a prospective student with little to no certainty in their field of interest, it's hard to get a good picture of these qualities and if and how much they matter, especially when so much can vary by specialty. More transparency in match results--ie, the proportion of students who do not match pre-soap/do not match their preferred specialty would go a long way in giving useful context to the match lists that schools currently share. But this information seems rather difficult to come by.

I don't know how common this is, but I've gotten the impression from the internet and those I've talked to that applicants and mentors alike are routinely surprised by the match results of mentees they have supported and encouraged. And not in a good way. Is the match really process so predictable that those who didn't match had something wrong with them or their app and should have seen it coming (this seems to be a common response when anyone expresses concerns about the match)? Or is there so much uncertainty that anyone from any school applying to any remotely competitive specialty with any expectation of matching is guilty of arrogance?

It definitely feels neurotic to be thinking about all this without having even started medical school, but it seems worth considering given I won't get to go back and choose another school if I come to realize as an M3 or M4 that another school might have helped put me in a much better position to match. For what it's worth, every student and resident I've talked to about this in person has suggested choosing whatever school is cheapest+highest ranked. But this seems to imply that rank correlates sufficiently to advantages in matching across the board, and it's hard to know how much this is the case given limited match result information.

Would be helpful to hear any thoughts, perspectives, insights. Thanks for reading y'all.

p.s. sorry if this comes off as really neurotic--on the whole I'm super excited about starting school and I'm sure things will work out regardless where I go. Just trying to make the most informed decisions and learn more about what I have to expect down the line.

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[Lucca]

The short answer is yes: ur school will impact the match. The better question is: how?

The lazy answer is that it’s all halo effect secondary to prestige, which is real but IMO not the main factor.

I’ll use a few examples based on what PDs in charting the outcomes have said is very important to them and isn’t something more dependent on the individual:

Grading: almost all schools are p/f in preclin now, but most still have clinical grades. There are schools moving away from them, but for most this won’t be a decision point. That said, schools differ in HOW they grade as well. You should ask current clerkship students: how is honors determined in a clerkship? How many people tend to get it? Is there a cap on how many get it? E.g. at my school there is currently no honors, only P/F, but when there was honors about 2 in 3 get it per rotation and there’s no cap on how many can get it within that same clerkship period, eliminating competition. Any school that removes competition and has clear metrics by which you can obtain honors so to target your efforts is acting in the students best interest wrt their eventual match.

Ranking: are students ranked? What is the ranking based on? Is it numerical, or by quartiles or something? How is this reported to residencies if at all? Many schools don’t rank their students officially, but do it in more subtle ways, and a few schools truly do not rank students in any way.

The MSPE: you should know how the MSPE is written at your school. What are the sentences that are always reported and what is the language that is used in the letter. This is really, really hard to find out because basically no one knows this except graduating M4s, and even then almost nobody really knows what it means. That said, the dean’s letter is a part of your app and should be crafted in a way to help the student distinguish themselves, ideally by minimizing coded language and focusing on laudatory evaluations from clerkships.

Research years, funding, and flexibility: particularly in the age of p/f step 1, other line items on your CV will become important ways to distinguish yourself and the most common item accessible to all medical students is research. For uber competitive specialties we will increasingly see people taking extra years to beef up their cv to be more confident in their ability to Match. Does your school support this? Do they provide mechanisms to make it AT LEAST cost neutral for their students to do so? Do they make it time neutral by enfolding research years into the 4-year curriculum by condensing preclin? How flexible are they in adapting to students changing graduation plans as they explore their interests in M3? Relatedly, are there dual degree opportunities that are similarly cost neutral or paid so that research isn’t the only avenue to diversify your CV?

Letters from mentors and the Dept Chair: This is probably one of the biggest areas where the halo effect does come in. Medicine is small, as are it’s specialties, and peoples opinions of you matter. Some peoples opinions can matter a lot. In your desired specialties, do you have mentors you can access and work with who will mentor you and write you a strong LOR? At most major centers the answer is yes, but some schools might not even have departments in the field your interested in depending on how small the field is.

To answer your other question: going unmatched can happen by sheer bad luck if the stars align against you, but you can make a lot of your own luck as well. Sometimes people get bad advice, or are applying very narrowly for reasons we can’t know like family obligations, it’s hard to say. More importantly, if you go unmatched is your school going to be there to have your back and help you SOAP or find a gap year opportunity to try again the next year without taking on more debt?

 

[Goro]

To add to my wise colleague's words, are the graduates a known commodity to the PDs? Have they had good or bad experiences with them? I've seen many times that PDs and residents have noted that they will not take grads from a particular school due to bad experiences with some.

 

[aldol16]

I'm sure the match process depends primarily on factors specific to individual applicants, but how much do school-specific factors play a role? From quality of advising to the reputation of the school and previous graduates as well as preference for graduates from home programs, there seems to be a lot of factors that could vary between schools (and by specialty) and contribute to variations between schools in match results.

Absolutely. Anybody who tells you that matching is only due to individual-specific factors is lying to you and likely to themselves. This should come as no surprise. Just as the top undergraduate programs send more students proportionally to the top medical schools, so too do the top medical schools send students to the top residencies. This doesn't guarantee you anything if you go to a top school but it does increase your chances - the rest is up to you. And yeah, some things will be outside your control - this is going to be true of any job you hold later in life. Who knows who is important and so a program's experience with prior residents from your school. If they didn't like them for whatever reason, they're going to be less likely to take you - which is completely outside of your control.

But since you're about to be starting medical school, I assume you've already made your choice. No use worrying about things that are outside your control now. Do well academically, do super super well on Step 2 and rotations, get involved.

I don't know how common this is, but I've gotten the impression from the internet and those I've talked to that applicants and mentors alike are routinely surprised by the match results of mentees they have supported and encouraged. And not in a good way. Is the match really process so predictable that those who didn't match had something wrong with them or their app and should have seen it coming (this seems to be a common response when anyone expresses concerns about the match)? Or is there so much uncertainty that anyone from any school applying to any remotely competitive specialty with any expectation of matching is guilty of arrogance?

Not sure if routine is the correct word here. There are always surprises - two different types. The first is matched vs unmatched. Usually if unmatched, you can trace it back to specific things that are foreseeable. Especially if those things are specific to the applicant - i.e., any red flags. Other things that are foreseeable by mentors is the relative strength of the applicant relative to the cohort applying. The first level of comparison is to other students applying into the same specialty at that school. Small, competitive programs won't take many applicants from the same school so if you're great but 4 other students are amazing from your school going into that specialty, your odds of matching go down a bit. The second level of comparison is between you and students from other schools. This one is harder to get a finger on the pulse but mentors can help you do that, as they are likely to have seen students from multiple schools in the past and help you contextualize your application.

The second type is where somebody matches. Here there will always be surprises. Not everyone can match at their #1 choice program. That's just a statistical fact (assuming most programs and people conform to the match rules). Some people will match farther down their list than expected. It always happens and it's something to be mentally prepared for.

 

[Mr.Smile12]

Just saying on the prehealth side, there are always some surprises where people get offers or decide to go to school. Admissions and Match are stochastic processes, you control some of the factors but not all of them. You'll never get full transparency because decisions are made at a local level, and only those programs will know their own tendencies... and they won't be telling anyone else.