Yes, connections matter quite a bit... "it's not what you know, it's who you know." For sure. This goes for getting clerkships or residency match, fellow match, jobs, speaker circuit, etc.
Still, no program is really very good at getting graduates jobs, assuming you don't want to work at the training hospital. I would pick training quality over perceived connections any day. Most of the better known programs do happen to be the ones that get sent many form letters:
'Director X, our office/hospital/group is looking to hire a surgical podiatrist. Please forward this opportunity to your graduating residents. Thank you.'
...The historically good programs will get a lot of those letters about the positions before they're widely advertised (if they ever need to be generally posted at all). We got some of those (mostly just for MSG and pod jobs) when I was a resident, and I've done those with good effect when past PP or MSG places I've worked needed another doc to work with me or replace me. I'd imagine some good fellowships might even get a fair amount for ortho group jobs? Recruiters do it too - although they generally just shotgun approach to all residencies in the city. It is a good way to pre-post jobs and avoid the floodgates of the general app screening process.
I agree 100% that you want a director who advocates for the residents to get good job placements, but that influence they can use to help you is often pretty limited outside of maybe that state, though (especially if the job apps are for hospitals or ortho or MSG without DPMs who might have heard of your program). I remember, on my clerkships, a big name PA program's main attending telling a senior resident "just go to the ACFAS meeting to find jobs... you can meet people and find lot of jobs there." The resident was bewildered by the advice since, like many programs, they go there in their last year, so ACFAS is about 4mo before graduation (ok place to look for more options/networking, but not you should already have a job signed or many options by then)... just shows you that they are mostly there to teach, not find you jobs.
...In the end, even with a name program or a fellowship, the vast majority of the time, esp if the graduate is leaving the metro where they did residency (which they should... if you subscribe to the old school mentality of not competing against those who trained you), then grads will be largely on their own. So, their logs and their wit and charisma are what mainly counts. There are typically good certified DPMs on the other end of the job applications doing screening or helping with it for their hospital/group, though. That's why it will never hurt to have beefy case logs, published DPMs among your trainers, household name hospital for your residency, ability to say your hospital is a large teaching hospital or a verified area trauma center, etc. It is not the director's fault if their residents can't approach groups they'd like to work with... sell that training, produce logs for privileging, interview well, follow up with HR of office managers, look and act professional, etc. It is ultimately their career, their life, their responsibility.
Yes, absolutely. I agree here... good advice^
Clerkships at some residencies are screened because they can based on app volume and to let the higher gpa students pick their choice of month, but it never hurts to apply if you are in the ballpark. I'm no longer involved with residency, but I'd say a 3.1 or a middle class rank from az or dmu is probably not considered same as that mark from ny or chi by most places' clerkship directors. In the end, if you are granted the clerkship based on that app, then you have your chance to make an impression... just like whether a pro football player is 2nd round pick or 6th round or UDFA, they all get to try out for the same team and must earn playing time regardless. Good job, you are now invited to training camp lol.
You will find that a lot of the ppl in your class who surprise you by matching a good/great program despite fair/good but definitely not great/excellent rank/gpa/etc are typically the ones with good social skills, confidence, humor, etc. These would be the "jocks," "popular kid" types, etc. Life is a bit more like high school than we like to think it is, but hey, who would you rather work with: a geek know-it-all who might be reclusive or competes with their co-workers, or somebody fun and good at teamwork? Heck, you might surprise yourself where you can match if you are just a genuine good worker. Some of them might have found a program that was under-applied to that year, might have had an outstanding clerk month and really connected with the residents/attendings, might have been direct and just told the director they would fit well at the program and were going to rank them #1 and they'd work very hard if they matched (I did that last one... only after I'd finished all my clerkships). Who cares how it happened? That match happened, the training is theirs, and the name is now on their CV forever
All that said, I'd be trying for and willing to accept less popular clerk months (early/late cycle) and visiting hospitals or residency interviewing and ranking quite a few more backup programs if I had a 3.2 versus a 3.8. You are going to have real problems getting interviews at known programs if you're under about 3.0 (depending on school) or top half class rank, so you need to start looking hard for second tier programs in less desired areas (realize you might scramble if you won't accept crap training) or scout for newer up-and-coming directors nobody's heard of yet offering good volume and training. If you are rejected for a clerkship at a competitive program, you could try a longshot by still asking to visit if you will be in that city anyways for clinic on a day or two the director's seeing patients, but you probably want to just cross that one off your interview possibilities later on too.... that happens, it's a sign their pool is a fair bit stronger than your app this year.
No, it is not simply a numbers game, but there are PLENTY of students with both great smarts and great personality... so, you have to be optimistic, yet also realistic. Remember that while a clerkship month is a chance to succeed, a popular program might have 30-40 or even more clerks per cycle and interview half of those... for only 3 match spots. Also, that doesn't even include the rare but possible elite 4.0 and charming student or a nepotism case who might interview top program(s) without clerking or even without visiting and still have a very high chance at that match. Still, applying for clerkships is basically free, so even if you don't end up liking or end up competitive for a clerkship visit (you never know until you try), at worst, you still got to see and learn good stuff there.
