<p>*Residency matters if:</p>
<p>2) If you’re planning to apply for fellowships. It’s a lot easier to get a prestigious cardiology fellowship if you did internal medicine at UCSF or to get an IR fellowship if you did diagnostic radiology at UCSF*</p>
<p>I know what a fellowship is for graduate schools. What is it for the medical world?</p>
<p>You do a residency in a PRIMARY specialty(Internal Medicine, Pediatrics, OB-GYN, Surgery, Radiology, Neurology, Anesthesiology etc…); You may then pursue fellowship training in a sub-specialty of the primary: Internal Medicine sub-specialities include Cardiology, Rheumatology, Endocrinology, Pulmonary/Critical care, Allergy/Immunology; Surgery Sub-Specialities(Plastic Surgery, Cardiothoracic Surgery as examples); Radiology(Internetional radiology, nuclear Medicine, Neuro-radiology) and so on for each primary specialty. You usually complete your primary training(3-5 years) and then may pursue the fellowship sub-specialty training(another 1-3 years depending on the specialty). It is not unusual for people to spend 6+ years in training after graduation from medical school to finally become the fully-trained attending physician that most people think of as a 'Doctor"</p>
<p>*It is not unusual for people to spend 6+ years in training after graduation from medical school to finally become the fully-trained attending physician that most people think of as a 'Doctor" *</p>
<p>So, is the doctor earning some kind of low pay during this time? And are loans deferred during this time or not?</p>
<p>Post-graduate training (residency and fellowship) lasts anywhere from three to nine years or sometimes even more. During this time, the physician is usually making somewhere between $45,000 to $70,000 a year.</p>
<p>I believe that loan payments are deferred but that interest might not be.</p>
<p>
</p>
<p>Just my opinion, but if finances aren’t the issue, I think it’s worth it for the student to attend the more prestigious medical school, even if he’s on the low end as far as MCAT scores go. As you noted, his USMLE score is probably likely to be the same no matter where he attends. Many medical schools (especially top medical schools) have P/F grading the first two years. So, it really comes down to the third and fourth year grades. I don’t necessarily think the assumption that someone with a 30 MCAT score would get lower grades than someone with a 35 MCAT score is valid because:</p>
<ol>
<li><p>The correlation b/w MCAT score and medical school grades isn’t perfect. Some people get their act together in medical school and do great. Others struggle to pass the USMLE despite the fact they came in with 3.7/35 stats.</p></li>
<li><p>I don’t know how every school works but at my school our clinical grades are based on objective criteria, not a curve. Theoretically everyone can get “honors” in a clinical rotation (but of course most people don’t). So, you aren’t necessarily competing against their classmates.</p></li>
<li><p>Third year grades at my school tend to intentionally de-emphasize test taking. The shelf exam (which is the exam you take at the end of every rotation) is typically only worth 15-25% of your rotation grade. The rest of the grade is based on subjective evaluations. Out of the 8 or so criteria on which you are evaluated, only 2 or so are “fund of knowledge” and “clinical reasoning.” Everything else is things like “quality of oral presentation,” or “initiative,” or “communication skills,” or “quality of written notes.” In other words, how intelligent you are and know well you know your stuff is only a fraction of your clinical grades. This is why I suspect non-science majors and people with lower MCAT scores are not at a disadvantage at all in the third and fourth years and might actually excel. If you have a good personality, great communication skills, are hard-working, and are enthusiastic, you will do very well.</p></li>
</ol>
<p>
</p>
<p>THIS. </p>
<p>But as I’ve said in the past, what’s the “right” residency for you, may be quite different than any “rankings” out there. And there are plenty of exceptional programs that may not be on the list that everyone thinks about. Perhaps it’s location, facilities, or lower research output, but they still deliver excellent clinical education, producing great physicians. </p>
<p>
</p>
<p>There generally aren’t any formalized lists, but through discussions with faculty, residents, and other applicants, you just kind of get a feel for where the good places are. For example in Pediatrics, I’d say the top places are Children’s Hospital of Philadelphia, Boston Children’s and Texas Children’s Hospital in Houston. After that places like University of Cincinnati and Children’s Hospital Denver and Seattle Children’s are in the next ‘tier’. Places like University of Utah, Children’s Mercy in Kansas City, and Riley Children’s Hospital in Indianapolis would easily fall into that sleeper category. I’ll admit though I have a bit of regional blindness and can’t tell you much about what separates the programs in California or New York City. One thing that perhaps separates out pediatrics is that there are magazines like PARENTS that do their own ranking which may provide a framework for overall care (though it may miss much of the education portion which is important for residents). And then like anything, there are places that are great in particular specialties - Emory/Atlanta Children’s is an amazing Pediatric Oncology center, Pittsburgh is great for Critical Care, lots of infectious disease research comes out of Hopkins, and a place like Arkansas can be a leader in ECMO and transport medicine (which speaks highly of their Neonatology and Critical Care divisions).</p>
<p>
</p>
<p>BDM is correct, most residencies will fall in to that range. Salary is determined by your post graduate year (ie PGY 1 is first year as a resident). So if you’re a first year pediatric critical care fellow (PGY 4), you’ll be paid the same as 4th year general surgery resident. </p>
<p>Lenders are required to grant a forbearance for individuals in an accredited residency program if it is requested. There are no more deferments available that I’m aware of. Some residents will forbear, others will request an income based repayment plan or some other variation. It’s a pain regardless.</p>
<p>This appears to be OSU’s schedule:</p>
<p>
</p>
<p>[Resident</a> Salaries and Benefits](<a href=“Surgery Department | Ohio State College of Medicine”>Surgery Department | Ohio State College of Medicine)</p>
<p>
Anybody got any input?</p>
<p>Middle. Most other surgical specialties tend to be more competitive. No one wants to have to do a grueling gen surg residency if they can help it.</p>
<p>Sounds like a big party lol.</p>
<p>The criteria that residencies use to rank their applicants vary by specialty and specific programs. It is complicated by the fact that different medical schools have different grading policies. In general the most important criteria are grades or evaluations and LOR’s in the specialty you are applying for, grades in required clerkships, Part 1 Boards scores, AOA and medical school attended. The interview, if you get one is the most important factor. In competitive residencies, everything on your application is important. When you are only going to interview 1 out of 10 applicants, all factors come into play. Research with publications is often necessary for the most highly regarded academic residencies. Applicants also tend to self select themselves for the competitive spots which makes decisions on who to interview difficult.
Selectivity by specialty does change with time. Anesthesia for example was easy to get into at one point perhaps 10-20 years ago. Rad Onc used to be easy specialty to get into. This may again be the case as Medicare tried to change some payment rules recently which would have drastically reduced compensation. I suspect that Medicare will try to do this again soon. Radiology is also under compensation pressures with out sourcing of some diagnostic work and hospital hiring changes. Plastic surgery is somewhat deceptive in it’s selectivity as the integrated programs which combine internship, general surgery and plastic training under one application process is very competitive but they make up less than 50% of the plastic surgery training slots. The majority of plastic residency positions are applied for after a couple of years of general surgery residency.
Finding out what are the best residencies in your specialty is probably best determined by asking the appropriate clinical professors of your medical school and recent graduates in your field. Which one is best for you is an individual decision. Location plays a large role for many in determining where one goes to a undergraduate school, medical school and residency. The competitiveness of your choices at each level of education will help determine where you are educated. The most important part of a physician’s training is his/her last stop which for most is their residency.</p>
<p>NCG, I understand your point and thank your for the advices.</p>
<p>I heard from my colleague that 25% of the NYU medical school students were not matched last year per the following post. His D graduated from that class. I only got one reply from mmmcdowe. But, I can’t confirm what I heard.</p>
<p><a href=“http://talk.collegeconfidential.com/pre-med-topics/888900-matching-statistics.html[/url]”>http://talk.collegeconfidential.com/pre-med-topics/888900-matching-statistics.html</a></p>
<p>This is scary if it is true. I couldn’t help but wondering that some of non-matched students might have a better chance at a lower tier school. They might have better LOR and USMLE scores compared to their classmates competing for the same residency program. Since a residency program probably would not accept too many students from one medical school, the lower tier students in a top tier school may have a disadvantage.</p>
<p>ace550, From mmmcdowe’s reply on that thread, I think what he was saying is likely too many of NYU medical school students applied to competitive residency programs.</p>
<p>An analogy is that, when too many students from a top college (or any college – but I have MIT in mind when I wrote this) were applying to top medical schools, a higher percentage of them would not get into any one.</p>
<p>I had the impression that typically about half of a class graduated from a state medical school go into primary care. That may be the key reason why their match rates are not low.</p>
<p>
</p>
<p>Until I see actual statistics on this, I don’t believe this is true. </p>
<p>Schools are in general pretty good about guiding their students into appropriate residencies. We’re required to have an advisor in the residency we want to apply into (multiple advisors even) and we must meet with the dean before we apply to discuss our plans. If you don’t match, it’s because your advisors and school administration didn’t do their job, not because your classmates were too smart. Even if you have a 190 USMLE score and no honors grades, you should still match somewhere. Outside of derm and plastics, match rates, even for specialties like radiology are really high nationwide. If you don’t match, you likely made a huge mistake somewhere in the application process.</p>
<p>*I heard from my colleague that 25% of the NYU medical school students were not matched last year per the following post. *</p>
<p>If true…Would the problem be that these kids were only interested in top residencies?</p>
<p>All,</p>
<p>I also had doubt about NYU’s match rate I posted. Nonetheless, I did learn that approximately 40% of my nephew’s classmates at Northwestern U went into primary care. That is not that much different from mcat2’s state school statistics. </p>
<p>I understand that the tuition differences between most in-state and private medical schools are not huge. Trying to get into a top medical school makes sense for a lot of reasons. However, I would definitely worry more about my son’s going into a top medical school due to the competition even if he could. </p>
<p>I am just wondering where I can find the match rate data. That is really the top concern for many students.</p>
<p>
</p>
<p>This is also not true. </p>
<p>The majority of internal medicine residents at top institutions including Northwestern will be pursuing fellowships and working as specialists. In fact, from talking to internal medicine residents at my institution, 80% of them go on to pursue fellowships and work as cardiologists, gastroenterologists, whatever.</p>
<p>You can’t automatically count “internal medicine” or “pediatrics” as primary care as many of them go on to become specialists. And I see no problem with a school that does produce a lot of primary care doctors. It shouldn’t inhibit you getting a specialist position if you so wish.</p>
<p>A Family Practice residency is what is usually considered as the “true” primary care. In addition, the numbers for Internal Medicine are always skewed because they usually include the categorical “one year” programs which some students choose for internship to be followed by specialties like Neurology, Dermatology, Radiology and Psychiatry. Those who choose Internal Medicine as a specialty continue another two years, and they may follow with the subspecialties (fellowships) that norcal mentioned (pulmonary, GI, Endocrine, etc)</p>
<p>There are also the so called “transitional” programs, which serve the same purpose as the “categorical” programs (internships) required for the specialties I mentioned above. I have found two main differences between the two: first, the “transitional” is sort of like a first year of Family Practice (rotating thru pediatrics, OB, etc) while the “categorical” is strictly the first year of Internal Medicine; and second, the quality of the “categorical” programs is usually better.</p>
<p>Some Residency Programs will specifically request that you do a “categorical” year and not a “transitional” if you are pursuing a determined specialty.</p>
<p>
</p>
<p>Co-sign. As a pediatrics resident who is going on to fellowship in critical care, I will not be spending any time doing well child checks, giving primary series vaccines, or handing out lollipops or stickers. I do those things now as a resident, but in the future most of my patients will be intubated - a very different life than “primary care”. </p>
<p>Further, I did go to a public state medical school that listed production of “primary care” physicians as a top priority…and while 60% of us went into Primary Care residencies (Family, Internal Med, Peds, OB/GYN), I know that out of the 31 Medicine and Peds residents, at least 12 are going on to fellowships, and there are about another 10 that I just don’t keep in touch with.</p>