FYI: Important Factors for the Residency Match

[dblazer]

Hey guys, as someone who went through a BS/MD myself and through the residency application process, I wanted to give an overview of what factors are important for residency since this is something I wish I knew more about before committing to one of these programs. As a disclaimer it is biased towards internal medicine since that is what I am most familiar with.

I will discuss medical school reputation, but below are the most important factors for residency independent of medical school reputation (in relative order of importance):

-Step scores: Yes this is important, but I would say it’s comparable to the way SATs are viewed by colleges. You need to score in a certain range to be competitive for a particular specialty/program, but after meeting certain thresholds, other factors (as I will describe below) are considered at the top most programs. So, much like with SAT, good scores are necessary but not sufficient to get invites from the very best programs. Step 1 was traditionally the more important step but with step 1 going pass/fail, this is honestly a bit of an unknown. My best guess is that Step 2 will essentially replace the role of Step 1. Thus, I feel the Step 2 score will carry a similar weight as Step 1 + Step 2 in the current system.

-Clinical performance/class rank (included in Dean’s letter): This is almost as important as step scores in that doing poorly can neutralize great step scores while doing well can compensate to some degree. Each school has various different ways of calculating these grades; there is a subjective component where people you work with (attendings, residents) evaluate you and there is also an objective component with an exam at the end of each core rotation called the shelf exam. Usually a predetermined distribution of students will be sorted into a top bracket (Honors), second bracket (High Pass), and third bracket (Pass) for each rotation based on their performance (and how much each schools ways evaluations vs exam score is highly variable). In order to be competitive for top programs in a desired specialty, it is important that one is able to get ‘Honors’ in that rotation if it is a core rotation.

At many schools, the pre-clinical years are true Pass/Fail, in that they are not at all used for ranking purposes. At some lower ranked schools however, pre-clinical grades are still used in the ranking formula.

-AOA Status: AOA (Alpha Omega Alpha) is an honors society that spans across US MD schools for which the top 25% of each medical school class is eligible to apply. Each school has a different selection process (at some there is a panel that reads applications, at others there is a voting process, etc.). Being selected for this honors society instantly alerts any residency program director who reads an application that the student is one of the top candidates from their medical school and it is looked upon very favorably by residency programs, especially for students coming from lower tier schools.

-Research/Extracurriculars: These are important to help one’s chances at AOA and more importantly residency, but they will not compensate for poor scores or clinical performance. There are some specialties that pretty much require research (derm, ophtho, ortho, ent, neurosurgery, rad onc) but even otherwise it’s good to have, especially for top programs. While research is necessary for some specialties, for others like internal medicine, having extensive extracurricular involvement can be just as good.

-Letters of Recommendation: These are important but probably only truly help if the letters are absolutely stellar or are written by faculty known to the program directors. For the most part, people won’t write bad letters, so it’s not easy to differentiate students based on the letters alone.

-Away Rotations: These are rotations in a particular sub-specialty at another institution. This is a way to show interest in a particular program/region, work with well-known people in a field of one’s choosing for letters of recommendation, and to get a feel for what other institutions are like. These are pretty much expected/required for many specialties, but internal medicine (and probably several others) is a big exception, where it does not carry any weight at all.

-Interviews: This varies heavily by specialty, with its weight increasing for smaller specialties. For large specialties like internal medicine, the interview has relatively little weight. A poor interview can get one removed from the rank list, but for the most part it’s difficult for programs to differentiate students based on the interviews alone.

-Personal Statement: Might bring up interesting points for the interview but that’s about it - would say very little weight.

So to summarize, the perfect applicant:

• 90th percentile on Step 1/2

• Honors most/all core clinical rotations
• Inducted into AOA (hence also near the top of class)
• Multiple first author publications/abstracts
• Glowing letters of recommendation.

No matter what medical school this individual goes to, they will get invites to interview at all the top programs in whatever field they choose (this is why people say you can theoretically get into any residency from any US MD school if you work hard enough). When an application starts to veer from the ‘perfect application’ is when the medical school reputation enters the picture. Let’s look at example.

Good applicant:

• Step scores in 75th - 90th percentile
• Honors on half of the core rotations
• Top third of class but not inducted in AOA
• An abstract/poster presented at a conference
• Good letters of recommendation

This is an example of an applicant whose interview invites could very much depend on the reputation of the medical school if they are pursuing a moderately competitive specialty. That is to say, med school reputation matters significantly less for individuals pursuing noncompetitive specialties like family medicine, neurology, etc. From the perspective of internal medicine (can extrapolate to other specialties for the most part), the “good applicant” from a top tier medical school would still get invites at many or most of the top programs in the country (though not a clean sweep like the “perfect applicant”). The “good applicant” from a mid-tier or low tier medical school on the other hand would get some invites from top places, but significantly fewer in comparison. Now if the “good applicant” from a mid-tier school managed to be inducted into AOA, then their application would receive a significant boost that would put them on similar footing as the “good applicant” from the top tier school.

To illustrate this, we can take a look at the match lists at top tier places vs mid tier places. Historically, top tier places will send 50+% of their class to top 30 internal medicine programs whereas mid-tier schools will send closer ~30%.

Now whether or not it matters to go to a ‘top’ program is another discussion altogether. The bottom line is that it is mainly of importance for those who plan to pursue a competitive fellowship after residency or desire an academic career.

Hope that helps.

[srk2017]

@dblazer;d-2181669

Hey guys, as someone who went through a BS/MD myself and through the residency application process, I wanted to give an overview of what factors are important for residency since this is something I wish I knew more about before committing to one of these programs. As a disclaimer it is biased towards internal medicine since that is what I am most familiar with.

I will discuss medical school reputation, but below are the most important factors for residency independent of medical school reputation (in relative order of importance):

-Step scores: Yes this is important, but I would say it’s comparable to the way SATs are viewed by colleges. You need to score in a certain range to be competitive for a particular specialty/program, but after meeting certain thresholds, other factors (as I will describe below) are considered at the top most programs. So, much like with SAT, good scores are necessary but not sufficient to get invites from the very best programs. Step 1 was traditionally the more important step but with step 1 going pass/fail, this is honestly a bit of an unknown. My best guess is that Step 2 will essentially replace the role of Step 1. Thus, I feel the Step 2 score will carry a similar weight as Step 1 + Step 2 in the current system.

-Clinical performance/class rank (included in Dean’s letter): This is almost as important as step scores in that doing poorly can neutralize great step scores while doing well can compensate to some degree. Each school has various different ways of calculating these grades; there is a subjective component where people you work with (attendings, residents) evaluate you and there is also an objective component with an exam at the end of each core rotation called the shelf exam. Usually a predetermined distribution of students will be sorted into a top bracket (Honors), second bracket (High Pass), and third bracket (Pass) for each rotation based on their performance (and how much each schools ways evaluations vs exam score is highly variable). In order to be competitive for top programs in a desired specialty, it is important that one is able to get ‘Honors’ in that rotation if it is a core rotation.

At many schools, the pre-clinical years are true Pass/Fail, in that they are not at all used for ranking purposes. At some lower ranked schools however, pre-clinical grades are still used in the ranking formula.

-AOA Status: AOA (Alpha Omega Alpha) is an honors society that spans across US MD schools for which the top 25% of each medical school class is eligible to apply. Each school has a different selection process (at some there is a panel that reads applications, at others there is a voting process, etc.). Being selected for this honors society instantly alerts any residency program director who reads an application that the student is one of the top candidates from their medical school and it is looked upon very favorably by residency programs, especially for students coming from lower tier schools.

-Research/Extracurriculars: These are important to help one’s chances at AOA and more importantly residency, but they will not compensate for poor scores or clinical performance. There are some specialties that pretty much require research (derm, ophtho, ortho, ent, neurosurgery, rad onc) but even otherwise it’s good to have, especially for top programs. While research is necessary for some specialties, for others like internal medicine, having extensive extracurricular involvement can be just as good.

-Letters of Recommendation: These are important but probably only truly help if the letters are absolutely stellar or are written by faculty known to the program directors. For the most part, people won’t write bad letters, so it’s not easy to differentiate students based on the letters alone.

-Away Rotations: These are rotations in a particular sub-specialty at another institution. This is a way to show interest in a particular program/region, work with well-known people in a field of one’s choosing for letters of recommendation, and to get a feel for what other institutions are like. These are pretty much expected/required for many specialties, but internal medicine (and probably several others) is a big exception, where it does not carry any weight at all.

-Interviews: This varies heavily by specialty, with its weight increasing for smaller specialties. For large specialties like internal medicine, the interview has relatively little weight. A poor interview can get one removed from the rank list, but for the most part it’s difficult for programs to differentiate students based on the interviews alone.

-Personal Statement: Might bring up interesting points for the interview but that’s about it - would say very little weight.

So to summarize, the perfect applicant:

• 90th percentile on Step 1/2

• Honors most/all core clinical rotations
• Inducted into AOA (hence also near the top of class)
• Multiple first author publications/abstracts
• Glowing letters of recommendation.

No matter what medical school this individual goes to, they will get invites to interview at all the top programs in whatever field they choose (this is why people say you can theoretically get into any residency from any US MD school if you work hard enough). When an application starts to veer from the ‘perfect application’ is when the medical school reputation enters the picture. Let’s look at example.

Good applicant:

• Step scores in 75th - 90th percentile
• Honors on half of the core rotations
• Top third of class but not inducted in AOA
• An abstract/poster presented at a conference
• Good letters of recommendation

This is an example of an applicant whose interview invites could very much depend on the reputation of the medical school if they are pursuing a moderately competitive specialty. That is to say, med school reputation matters significantly less for individuals pursuing noncompetitive specialties like family medicine, neurology, etc. From the perspective of internal medicine (can extrapolate to other specialties for the most part), the “good applicant” from a top tier medical school would still get invites at many or most of the top programs in the country (though not a clean sweep like the “perfect applicant”). The “good applicant” from a mid-tier or low tier medical school on the other hand would get some invites from top places, but significantly fewer in comparison. Now if the “good applicant” from a mid-tier school managed to be inducted into AOA, then their application would receive a significant boost that would put them on similar footing as the “good applicant” from the top tier school.

To illustrate this, we can take a look at the match lists at top tier places vs mid tier places. Historically, top tier places will send 50+% of their class to top 30 internal medicine programs whereas mid-tier schools will send closer ~30%.

Now whether or not it matters to go to a ‘top’ program is another discussion altogether. The bottom line is that it is mainly of importance for those who plan to pursue a competitive fellowship after residency or desire an academic career.

Hope that helps.

Excellent post!

[brainbuilder02]

@dblazer;d-2181669

Hey guys, as someone who went through a BS/MD myself and through the residency application process, I wanted to give an overview of what factors are important for residency since this is something I wish I knew more about before committing to one of these programs. As a disclaimer it is biased towards internal medicine since that is what I am most familiar with.

I will discuss medical school reputation, but below are the most important factors for residency independent of medical school reputation (in relative order of importance):

-Step scores: Yes this is important, but I would say it’s comparable to the way SATs are viewed by colleges. You need to score in a certain range to be competitive for a particular specialty/program, but after meeting certain thresholds, other factors (as I will describe below) are considered at the top most programs. So, much like with SAT, good scores are necessary but not sufficient to get invites from the very best programs. Step 1 was traditionally the more important step but with step 1 going pass/fail, this is honestly a bit of an unknown. My best guess is that Step 2 will essentially replace the role of Step 1. Thus, I feel the Step 2 score will carry a similar weight as Step 1 + Step 2 in the current system.

-Clinical performance/class rank (included in Dean’s letter): This is almost as important as step scores in that doing poorly can neutralize great step scores while doing well can compensate to some degree. Each school has various different ways of calculating these grades; there is a subjective component where people you work with (attendings, residents) evaluate you and there is also an objective component with an exam at the end of each core rotation called the shelf exam. Usually a predetermined distribution of students will be sorted into a top bracket (Honors), second bracket (High Pass), and third bracket (Pass) for each rotation based on their performance (and how much each schools ways evaluations vs exam score is highly variable). In order to be competitive for top programs in a desired specialty, it is important that one is able to get ‘Honors’ in that rotation if it is a core rotation.

At many schools, the pre-clinical years are true Pass/Fail, in that they are not at all used for ranking purposes. At some lower ranked schools however, pre-clinical grades are still used in the ranking formula.

-AOA Status: AOA (Alpha Omega Alpha) is an honors society that spans across US MD schools for which the top 25% of each medical school class is eligible to apply. Each school has a different selection process (at some there is a panel that reads applications, at others there is a voting process, etc.). Being selected for this honors society instantly alerts any residency program director who reads an application that the student is one of the top candidates from their medical school and it is looked upon very favorably by residency programs, especially for students coming from lower tier schools.

-Research/Extracurriculars: These are important to help one’s chances at AOA and more importantly residency, but they will not compensate for poor scores or clinical performance. There are some specialties that pretty much require research (derm, ophtho, ortho, ent, neurosurgery, rad onc) but even otherwise it’s good to have, especially for top programs. While research is necessary for some specialties, for others like internal medicine, having extensive extracurricular involvement can be just as good.

-Letters of Recommendation: These are important but probably only truly help if the letters are absolutely stellar or are written by faculty known to the program directors. For the most part, people won’t write bad letters, so it’s not easy to differentiate students based on the letters alone.

-Away Rotations: These are rotations in a particular sub-specialty at another institution. This is a way to show interest in a particular program/region, work with well-known people in a field of one’s choosing for letters of recommendation, and to get a feel for what other institutions are like. These are pretty much expected/required for many specialties, but internal medicine (and probably several others) is a big exception, where it does not carry any weight at all.

-Interviews: This varies heavily by specialty, with its weight increasing for smaller specialties. For large specialties like internal medicine, the interview has relatively little weight. A poor interview can get one removed from the rank list, but for the most part it’s difficult for programs to differentiate students based on the interviews alone.

-Personal Statement: Might bring up interesting points for the interview but that’s about it - would say very little weight.

So to summarize, the perfect applicant:

• 90th percentile on Step 1/2

• Honors most/all core clinical rotations
• Inducted into AOA (hence also near the top of class)
• Multiple first author publications/abstracts
• Glowing letters of recommendation.

No matter what medical school this individual goes to, they will get invites to interview at all the top programs in whatever field they choose (this is why people say you can theoretically get into any residency from any US MD school if you work hard enough). When an application starts to veer from the ‘perfect application’ is when the medical school reputation enters the picture. Let’s look at example.

Good applicant:

• Step scores in 75th - 90th percentile
• Honors on half of the core rotations
• Top third of class but not inducted in AOA
• An abstract/poster presented at a conference
• Good letters of recommendation

This is an example of an applicant whose interview invites could very much depend on the reputation of the medical school if they are pursuing a moderately competitive specialty. That is to say, med school reputation matters significantly less for individuals pursuing noncompetitive specialties like family medicine, neurology, etc. From the perspective of internal medicine (can extrapolate to other specialties for the most part), the “good applicant” from a top tier medical school would still get invites at many or most of the top programs in the country (though not a clean sweep like the “perfect applicant”). The “good applicant” from a mid-tier or low tier medical school on the other hand would get some invites from top places, but significantly fewer in comparison. Now if the “good applicant” from a mid-tier school managed to be inducted into AOA, then their application would receive a significant boost that would put them on similar footing as the “good applicant” from the top tier school.

To illustrate this, we can take a look at the match lists at top tier places vs mid tier places. Historically, top tier places will send 50+% of their class to top 30 internal medicine programs whereas mid-tier schools will send closer ~30%.

Now whether or not it matters to go to a ‘top’ program is another discussion altogether. The bottom line is that it is mainly of importance for those who plan to pursue a competitive fellowship after residency or desire an academic career.

Hope that helps.

Thank you doc! Truly enlightening.

[ParentCA]

@dblazer

Thanks, Doc for this super helpful post!! Do you have any thoughts on DO vs MD and whether a DO with strong academic credentials and ECs will have a steeper uphill than an MD with similar stats and ECs? Thanks!

[dblazer]

@ParentCA

@dblazer

Thanks, Doc for this super helpful post!! Do you have any thoughts on DO vs MD and whether a DO with strong academic credentials and ECs will have a steeper uphill than an MD with similar stats and ECs? Thanks!

Realistically, you’re better off coming from a low-tier US MD school than the best DO school in country. With a few exceptions, most top academic programs in competitive specialties do not consider DO candidates for their program.

[dbsmd2027]

Hi @dblazer,

thanks for the awesome advice and info as us high schoolers do not know much about residency. I have taken the advice of many on which BS/MD to go for and would appreciate your advice.

I have made a list of all the programs I am considering and made a pro-con list.

Adelphi University + SUNY Upstate- 7 year program

Pros:

• No MCAT
• 7 year program
• 1.5 hours from home
• Adelphi is a private school with seminar style classes
• Close to NYC
• Will have a pretty light premed experience since they accepted my dual enrollment credit for Gen Chem I & II, Gen Bio I & II, Gen Physics I & II

Cons:

• Fairly new program
• Not as highly ranked as VCU (I don’t know if this matters).
• Cohort of BS/MD kids will be 2-3 students
• Syracuse is cold
• Will not be able to make connections at Upstate early on since it is in Syracuse, but Long Island Jewish Hospital and NYU Winthrop are close to Adelphi University.
• Not as great research at Adelphi.

Virginia Commonwealth University + VCU SOM- 8 year program

Pros:

• Established and reputed program
• 5 min from med school so ample opportunities to do research and get published while also making connections with faculty early on which might prove beneficial once in med school
• Loved the honors college and the comradery among BS/MD students.
• Great Med School
• Cohort of 15 driven students
• Great Dorms- single rooms for all honors college students with private bathrooms
• Honors college is well set up
• Better weather

Cons:

• 8 year program- but I can graduate in three years and then do something else for the 4th year
• 508 MCAT
• More required science courses
• 5 hours away from home

Thanks again!

[dblazer]

@dbsmd2027

Hi @dblazer,

thanks for the awesome advice and info as us high schoolers do not know much about residency. I have taken the advice of many on which BS/MD to go for and would appreciate your advice.

I have made a list of all the programs I am considering and made a pro-con list.

Adelphi University + SUNY Upstate- 7 year program

Pros:

• No MCAT
• 7 year program
• 1.5 hours from home
• Adelphi is a private school with seminar style classes
• Close to NYC
• Will have a pretty light premed experience since they accepted my dual enrollment credit for Gen Chem I & II, Gen Bio I & II, Gen Physics I & II

Cons:

• Fairly new program
• Not as highly ranked as VCU (I don’t know if this matters).
• Cohort of BS/MD kids will be 2-3 students
• Syracuse is cold
• Will not be able to make connections at Upstate early on since it is in Syracuse, but Long Island Jewish Hospital and NYU Winthrop are close to Adelphi University.
• Not as great research at Adelphi.

Virginia Commonwealth University + VCU SOM- 8 year program

Pros:

• Established and reputed program
• 5 min from med school so ample opportunities to do research and get published while also making connections with faculty early on which might prove beneficial once in med school
• Loved the honors college and the comradery among BS/MD students.
• Great Med School
• Cohort of 15 driven students
• Great Dorms- single rooms for all honors college students with private bathrooms
• Honors college is well set up
• Better weather

Cons:

• 8 year program- but I can graduate in three years and then do something else for the 4th year
• 508 MCAT
• More required science courses
• 5 hours away from home

Thanks again!

If you are committed to either of these two options, I would personally go with VCU. Probably more enriching undergraduate experience, better medical school, option to apply out.

[applestudent23]

Hi @dblazer,
This was really helpful, thank you so much!

I am considering accepting Drexel’s BS+MD early assurance program (8 years).

My question is how much does the reputation/‘rank’ of the affiliated hospitals and clinical training sites matter when applying for residencies?
Because Drexel is considered a mid-low tier med school, and it has recently had some issues with its affiliated training sites…so how much would those aspects impact in the long run and when applying for competitive residencies?

[dblazer]

@applestudent23

The short answer is that the quality of affiliate rotation sites should not significantly impact the residency application process. It’s very common for medical schools to have community hospital affiliates to accommodate the large number of students in their class (in fact, Drexel shares sites with SKMC and Temple). The overall rotation grade, which is what residency programs mostly care about, should theoretically be independent of rotation site and I don’t believe the site is even listed on the Dean’s letter.

The main situation I could see it being an issue is for getting letters of recommendation. Ideally, these are from individuals with an academic title and I can imagine that being more difficult with the loss of Hahnemann where many faculty worked. It is to be determined how this will influence residency prospects, but don’t think it would be a major factor compared to other components of the application.

[applestudent23]

@dblazer

@applestudent23

The short answer is that the quality of affiliate rotation sites should not significantly impact the residency application process. It’s very common for medical schools to have community hospital affiliates to accommodate the large number of students in their class (in fact, Drexel shares sites with SKMC and Temple). The overall rotation grade, which is what residency programs mostly care about, should theoretically be independent of rotation site and I don’t believe the site is even listed on the Dean’s letter.

The main situation I could see it being an issue is for getting letters of recommendation. Ideally, these are from individuals with an academic title and I can imagine that being more difficult with the loss of Hahnemann where many faculty worked. It is to be determined how this will influence residency prospects, but don’t think it would be a major factor compared to other components of the application.

Ohh okay I see. Also with Hahnemann closing, they are planning to partner with a new hospital system (Tower Health), but its almost 1 1/2 hours away from the med school campus I think… Also I’m not sure how well things will be established and running with the new partnership within the next 3-4 years and if it will be good, so that’s a concern…

What is your overall recommendation for proceeding, and is there any other things I should look into/consider about Drexel? Do you think Drexel and this program is a good option?

[dblazer]

@applestudent23

I don’t necessarily have a particular recommendation, but just be aware of what you would be signing up for. The bottom line is that Drexel is a lower-tier medical school and, as I describe in my post, this may limit your options for residency down the line. You will match somewhere but there’s a lower likelihood that it’s a top program due to the reputation of the medical school - not to say it’s impossible. They send people to good programs every year, but they tend to be the top of the class. Maybe this matters to you, maybe it doesn’t. If you’re OK with this and willing to sacrifice the opportunity to get into a better med schools to have that peace of mind, it’s a fair option.

[applestudent23]

@dblazer

@applestudent23

I don’t necessarily have a particular recommendation, but just be aware of what you would be signing up for. The bottom line is that Drexel is a lower-tier medical school and, as I describe in my post, this may limit your options for residency down the line. You will match somewhere but there’s a lower likelihood that it’s a top program due to the reputation of the medical school - not to say it’s impossible. They send people to good programs every year, but they tend to be the top of the class. Maybe this matters to you, maybe it doesn’t. If you’re OK with this and willing to sacrifice the opportunity to get into a better med schools to have that peace of mind, it’s a fair option.

This trade-off is what’s making the decision so difficult.
But thank you for all your help!

(may I also ask which BS/MD program you went through?)

[dblazer]

@applestudent23 I agree, sometimes having multiple options can be more stressful than having one, but I almost guarantee you’ll be happy with whatever decision you make. Went through PSU/SKMC.

[applestudent23]

@dblazer

@applestudent23 I agree, sometimes having multiple options can be more stressful than having one, but I almost guarantee you’ll be happy with whatever decision you make. Went through PSU/SKMC.

Yes for sure, but thank you for your time!
Oh ya, that’s a great program for sure, I applied but didn’t make it haha.

Also, just curious, there’s obviously alot of info online for what it’s like to be an intern/resident, but I wanted to ask you since you have direct knowledge, what are the hours and intensity truly like?

And side question, if one decides to apply for a fellowship, are the key factors more or less the same as applying for residency?

[dblazer]

@applestudent23 It will depend quite a bit on the specialty and specific program you train at. I can just speak to internal medicine - the busiest rotations tend to be inpatient wards where you are the primary provider for up to 10 patients. Typical hours are 6-7 am to 6 pm +/- a few hours depending on how busy you are. Typically busier if you are admitting a lot of new patients to your service. You work 6 days/week on average those months (ends up 60-80 hrs/week). The other rotations are inpatient subspecialty consulting services (i.e. cardiology, GI) and outpatient medicine which generally have better hours and more weekend days off. There’s also ICU which is busier than inpatient wards. Programs will vary on the exact number and set up of each type of rotation and business of clinical services, but hope that gives you an idea. Surgery and surgical subspecialties tend to have significantly longer hours because of the time spent in the OR on top of managing surgical patients in the hospital. Overall I wouldn’t worry about it too much though. You end up adapting and it because the new norm.

For medicine subspecialties, the reputation of your program tends to be the most important factor for better or worse since there are less objective criteria like step scores (which still matter a little) and clinical rotation grades to evaluate applicants. After that, research is probably the other major factor and letters of recommendation including from your program director.

[applestudent23]

@dblazer

@applestudent23 It will depend quite a bit on the specialty and specific program you train at. I can just speak to internal medicine - the busiest rotations tend to be inpatient wards where you are the primary provider for up to 10 patients. Typical hours are 6-7 am to 6 pm +/- a few hours depending on how busy you are. Typically busier if you are admitting a lot of new patients to your service. You work 6 days/week on average those months (ends up 60-80 hrs/week). The other rotations are inpatient subspecialty consulting services (i.e. cardiology, GI) and outpatient medicine which generally have better hours and more weekend days off. There’s also ICU which is busier than inpatient wards. Programs will vary on the exact number and set up of each type of rotation and business of clinical services, but hope that gives you an idea. Surgery and surgical subspecialties tend to have significantly longer hours because of the time spent in the OR on top of managing surgical patients in the hospital. Overall I wouldn’t worry about it too much though. You end up adapting and it because the new norm.

For medicine subspecialties, the reputation of your program tends to be the most important factor for better or worse since there are less objective criteria like step scores (which still matter a little) and clinical rotation grades to evaluate applicants. After that, research is probably the other major factor and letters of recommendation including from your program director.

I see, thanks so much for this insight Doc!!

One last thing I’d like to ask, how much do you think age matters to residency program directors? (Like would they prefer older candidates because it may imply more maturity…?) Because I am already young for my grade, and if I do go the bs/md route I will be one of the youngest applicants for most res programs…

Thanks again for your time and help!

[dblazer]

@applestudent23 for internal medicine I don’t think it really came up, can’t speak as much to other specialties. I don’t know if surgical specialties would care more. Overall though, I don’t think you should worry about it.

[grtd2010]

@dblazer
May I ask you how would you compare Temple LKSOM vs SKMC as far residency match goes since you went to SKMC. They do share some rotation locations and you must have met some LKSOM students.

[dblazer]

@grtd2010 Match lists are more or less on par with each other. Only advantage I would give to SKMC are with orthopedics (Rothman) and ophtho (Will’s eye) which are particularly strong and provide plentiful opportunities for research.

[applestudent23]

@dblazer

@applestudent23 for internal medicine I don’t think it really came up, can’t speak as much to other specialties. I don’t know if surgical specialties would care more. Overall though, I don’t think you should worry about it.

Okay. Thanks again for all the advice!

Also, in one of your previous replies, you mentioned Drexel shares sites with SKMC and Temple. Would you happen to know which ones Drexel shares?