Good call
@illinois1234, I agree with @Johnny H and @skermax1. Besides the immense cost savings to you and the availability of scholarship support in the undergraduate years (Chancellor’s GPPA Excellence Award), you also have available many of the competitive specialty residencies that aren’t available at UMKC. The 2 years “saved” is not worth the cost differential. I would take into consideration @Johnny H’s post, esp. regarding undergraduate quality. He is correct, that UMKC is a Tier 3 undergraduate institution.
Hahaha. I thought I would read some of the smack talk people are saying about UMKC now. The people who go to UMKC and go above and beyond and don’t just conform to what they are told to do, get into good residencies. Yes, if you only focus on your grades at UMKC and don’t study for boards on your own or anything else, yeah you probably won’t end up at the best residency. But if you are confident in yourself that you can do well on the USMLE and you don’t have an ego and are okay with graduating from a “third tier” med school, then UMKC is a good choice. Especially if you know you want to be a doctor for sure. Going through four years of undergrad, applying to med school and taking the MCAT, and then sitting through another 4 years of med school is asking for burnout.
Smack = “I don’t like what people are saying, bc my feelings are getting hurt”
For @Illinois1234, UIC is a better decision financially and for his goals of doing research and possibly going for a competitive specialty (which UIC actually has residencies in), as well as being close to home. Saving 2 years doesn’t make sense for him esp. since he doesn’t benefit financially. Those like @illinois1234, who didn’t apply to JUST one BA/MD program have real and better options. @Johnny H and esp. @Skermax1 (a former resident at UMKC) are 100% accurate in their assessments which are very honest and not Pollyannaish.
@Johnny H is right - UMKC is a tier 3 undergraduate institution per USWNR. You can Google that. He’s not making it up.
Actually, those who do 4+4 don’t “burnout” as they have their summers off in undergrad which they don’t have to take courses. They also have the opportunity to obtain merit university scholarships and build up an outstanding and cohesive CV. With UMKC, the rate of burnout is naturally higher bc it runs year round without any summers off for 6 years - hence the huge extension and attrition esp. early on. This is important to know beforehand due to the huge financial risk you’re taking and bc you can’t finish the premed requirements and apply out. You don’t get a chance to recharge your batteries. It’s why even the more well-regarded BA/MD programs: Northwestern, Brown, Rice/Baylor, get their summers off during the undergrad years. Those universities aren’t stupid.
Getting good grades, doing well on the USMLE (240+), and matching into a residency (esp. one which might be competitive) is more than just hard work, confidence, and not “conforming”. @Skermax1 is right, you will be compared to the normal 4+4 med student and not necessarily considered “special”. All medical students are by nature hard working, who focus on doing well academically and on the boards. Like it has been established, if you want to do primary care or a more non-competitive residency, you’ll be fine going to UMKC. If you’re thinking of aiming for a more competitive specialty, coming from UMKC, it will be a more uphill battle based on the resources you have available to you. I don’t see how that’s so difficult to understand.
@Roentgen, I am aiming for a competitive specialty and yes I am going to UMKC. But I will get into the specialty of my choice because I know what I have to do early on. For instance, instead of waiting until year 3 to start doing research and buying USMLE resources, I’m doing that now… Also, burnout is only for people who don’t want it bad enough in the first place or are not strong enough to make it in a year round program. People complain about how much time UMKC gives you off but its actually almost as much as everywhere else. In a traditional 4 year med school a student typically only gets a month-6 weeks off a year anyways. Also, in the first year of the program there is extensive vacation time. For instance, the winter break is four weeks long. Also, There are two weeks off before and after summer. If anyone intends on getting into a medical school from the 4 year route anyways better plan to use their summers wisely. Most students in undergrad are doing research, taking classes, and studying for the MCAT. Anyone with a decent mind can get a 240+ on the USMLE if they want to. I’ve already looked at the format and info thats required to know on that test and its all about how much time you put into it. The score on that test is a direct correlation with 1) how many questions and clinical vignettes you do, and 2) How thoroughly you study the review books. Also, in order to be successful on it, you must buy the books prior to like a couple months before the exam. Of course, a med school class isn’t intended to specifically prepare you for boards. But its a good idea to buy a review book and use it alongside the course you are taking. Btw, it doesn’t matter what “tier” undergrad UMKC is. I highly doubt residencies care about that. They care about 1) your USMLE score and GPA, 2) being AOA, 3) letters of recommendation (from people who speak highly of you, 4) at least a few research publications, 5) student involvement in med EC’s, and of course the interview if applicable. If someone gets a 250 or so on the USMLE, then they are already in the 90% percentile of medical students. Also, if you are AOA, it greatly improves chances of matching into most competitive residencies. As @Johnny stated before, there are students at UMKC who win the uphill battle and match into great places. I will strive to do the same and so should everyone else. However, a lot of people go into med school with the sole intention of doing the bare minimum possible to “pass” the boards and get through. Well thats not going to cut it.
@PursuitToExcel, It’s nice that somehow you’ve got all the answers as an 18 year old and think that you’re the first one to think your solutions are novel and have never been thought of before. Guess what? They’re not. Everyone in your class will be highly motivated and very hard working as those are the type of people who apply to BA/MD programs in the first place, esp. the out-of-staters and regionals. This will be esp. the case, starting at Year 3. You forget a huge percentage of your class will be of Asian descent just like yourself, who will be just as hardworking and motivated if not more so to do research early on, get good grades, strive for AOA, etc. and will also be wanting to do competitive specialties. At baseline, BA/MD students and 4+4 med students are not going to be doing the “bare minimum” to get by to “pass” the boards. Many of them will also be doing research early on, getting USMLE review books to use along with classes, doing question sets/clinical vignettes, etc. It’s quite obvious you have no idea what it takes to get a 240/250 on Step 1. What you listed for USMLE prep is what medical students do at a MINIMUM.
If you actually believe that “burnout is only for people who don’t want it bad enough in the first place or are not strong enough to make it in a year round program,” then I truly feel sorry and pity you for your lack of knowledge in this area. I won’t argue regarding vacation as I’ve been through the program and know quite well how much time you get off in the first 2 years, and how much time undergrads get off, not going to classes. Even if they are doing research, studying for the MCAT, volunteering, etc. all on their own watch, the pace is much much slower.
Newsflash: If you’re going for a <em>competitive</em> residency, everyone who is applying and interviewing for competitive residencies will have very high USMLE scores, good preclinical grades, good clinical grades based on evals by residents & attendings, a large percentage being AOA, good LORs, research pubs, and ECs. They will all have the same things you theoretically would have, if not better. The only difference left to compare is your “tier” of your med school.
The tier of your institution helps in 2 ways: 1) Residencies know that it’s much harder to be at the top of your class in a higher tier medical school, than at an unranked state medical school, and 2) Higher tier schools tend to have home residencies in the more competitive specialties allowing much better networking within that specialty, allowing more opportunities to expand your CV and get meaningful LORs from those who are not only “speak highly of you” but are actually known by others in that field. Your highest chance of matching in a competitive specialty is when you have your home program, even if you briefly rotate elsewhere, bc your home program knows you for a longer period of time. The specialty you’re interested in: Neurosurgery, doesn’t even exist at UMKC as a department or a residency program. It doesn’t even have Neurology as a department! You WILL (not if) have a harder time matching into Neurosurgery as a student with no home Neurosurgery residency program.
It’s not a big coincidence that match lists of higher tier med schools have much higher percentages of students successful in getting competitive residencies compared to lower tier schools. Medical schools are not treated equal in the residency game. It matters, esp. for competitive residencies. And it will matter even more now than ever, bc you have all these new medical schools popping up across the US. By the time you apply for residency, unfortunately for you, there will be more US medical students graduating than there are available residency spots available. Thus the competition will be greater and this will be for ALL specialties. So the already competitive specialties will become even MORE ridiculously competitive than they are now and the ones that weren’t competitive will become more so. This being the case, just by the arithmetic, there will be students who don’t get a residency spot.
Good luck with your confidence in your ability to buck the trend and be the exception. You’ll need a whole lot of it, once you’re humbled as to the realities of the real limits your school affords you with the ridiculous level of out-of-state tuition you will be paying (or I guess your parents will foot the bill, so maybe you won’t appreciate the amount so much).
@Roentgen, if you are right about UMKC, then why did their match list yield more impressive positions that a bunch of the other med schools you listed. Multiple people matched in neurosurgery, radiation oncology, orthopedics, and dermatology. Year after year there are stellar students at UMKC who get into top places. And no, see you obviously don’t understand. There are a lot of people who care about having fun in college and don’t want to just focus on their career all the time. Well it’s all a time race. Everyone has about the same amount of time in med school so it’s all about who does more with that limited amount of time. You act like becoming a physician is the hardest thing ever yet there are thousands and thousands of physicians out there who all got where they are by working hard, NO LUCK. Yes, I will let you know how things go for me at UMKC and I will continue posting on this forum on behalf of the success of my fellow classmates and myself.
To everyone else, please don’t use this forum as a means of deciding what school to choose. That is a foolish decision and college admissions across the US despise college confidential bc it gives people misleading information. Do your own research and don’t trust forums because it’s not something to base your life decisions off of.
I think we should all accept that this is a real world and so nothing is black or white. We should not be too pragmatic with our view. It is true that UMKC is never going to be in the same rank as the likes of Harvard, Northwestern, WUStL, etc but it does serve its missions to educate students to be physicians. It is also true that one may not be regarded as highly if one is a graduate of UMKC than if one graduates from one of the top tier schools. However, not everyone is suitable for the top tier school and not everyone is suitable for UMKC. Just because you go to UMKC, it does not mean that you will end up doing only primary care or having difficulties getting into good residency program. In every medical school, there are always some who do not do as well because of many factors such as change in the priority, inability to cope with the work load, etc etc, whether you are at UMKC or at Harvard. Equally just because you work hard, it does not necessarily mean that you will definitely succeed at UMKC and “buck the trend”. Having said that, having the right attitude and positive outlook when you get into UMKC or any other schools will increase your chance of success. I like to see that the choice of medical school is one that is not only dependent of the options available to you but also whether the medical school is a good fit for you. UMKC was obviously not the right fit for some people (judging by the posts in this thread) but it was definitely the right fit for others. So, it might be rather simplistic to say that UMKC is bad for all students and is not worthy of attending or to say that the “trend can be bucked” as long as you work hard, but the willingness to work hard will take to you half way there.
@PursuitToExcel, I don’t know which match lists you’re looking at, but if we’re being honest here and looking at the match lists of the institutions I just mentioned: Northwestern, Brown, Baylor (which happen to have Bachelor/MD programs), they are MUCH better and are also cheaper in med school tuition than you will be paying at UMKC as an out-of-stater from Florida. If you look at the match lists below, it isn’t only the people at the very top of the class/AOA who are getting into competitive specialties (i.e. Radiology, Dermatology, etc.) and high caliber institutions from these schools. It’s spread throughout the class (see Brown’s and Baylor’s list from this year). Compare this to UMKC’s list.
Even in the “non-competitive” specialties, like Internal Medicine and Pediatrics, you can see the high caliber of clinical residency matches at places like Mass General, Beth Israel, Hopkins, Yale, etc. These places don’t train just researchers, they train clinicians. Compare this to the caliber of the matches in IM and Peds at UMKC (which in theory, if it gives you such a great early, hands-on clinical experience, where UMKC students are ahead, high caliber residencies should be falling all over themselves to recruit a majority of these students). Now you could make the excuse, that oh, it’s a midwestern school so people like to stay in the Midwest. But that doesn’t really make sense when you have a large number of regional, out-of-staters, and advanced standing students (those who complete a 4 year undergrad degree 1st) attending. On an unrelated note, every year that has a Rad Onc match at UMKC, the person has ALWAYS had to take a year off to do research somewhere else, bc UMKC doesn’t have a Radiation Oncology dept. or a residency. If you look at the UMKC website of the guy who matched into Rad Onc this year, he was also at the top of his class and AOA (which is hard enough on its own) and even then he STILL had to take a year off to do research. If he was at any of the other schools, he would not have had to take a year off, bc the Rad Onc dept would have been right there to do research.
You’re essentially paying a sticker price higher than any private, Ivy-League medical school (out of state: $60,124/yr for the last 4 years) without any of the great benefits. You’re shelling out $328,612+ (and that’s only tuition alone) for an unranked state medical school, whose undergrad is Tier 3.
As a Floridian, you would have been better off going to a better caliber BA/MD program in Florida, all of which have Neurosurgery residency programs:
- University of Florida (ranked #42, $32,744/yr for medical school) — <a href=“http://jhmp.med.ufl.edu/”>http://jhmp.med.ufl.edu/</a> (apply after sophomore year)
- USF (ranked #78, $33,725.79/yr for medical school) — <a href=“http://honors.usf.edu/ap_med.html”>http://honors.usf.edu/ap_med.html</a>
- UMiami (ranked #46, $35,892/yr for med school) —<a href=“Undergraduate Admission | University of Miami”>Undergraduate Admission | University of Miami;
But it’s easy to understand where you’re coming from:
- Your family is UMKC doctor alumni, so it’s natural you feel some level of wanting to go to UMKC esp. since they’ll probably be footing the entire bill.
- You’re enamored with saving 2 years, even though financially you’re not really saving anything
- This was the only BA/MD program you got an acceptance to, even though you had very good, if not better in-state BA/MD options. I’m not sure if you didn’t apply to your Florida options, as chances are with your stats and CV you would have made it in.
Most other people applying, however, are nowhere close to the same circumstances financially that you are and many others here have other great options to choose from or great reservations based on cost and future career specialization goals (illinois1234). I don’t want anyone to take what I say as gospel and I don’t think @johnny h and @skermax1 want people to take what they say as gospel either. I really believe transparency is important to align the medical school you attend with your eventual career and specialty goals. While many people believe they can be the exception to the rule, the reality is a lot more complicated.
In that respect, I think College Confidential is a good tool for those who aren’t family “connected” or have direct human access to alumni to get more experienced viewpoints, before they fork over $169,505 (in-state), $249,063 (regional), or $328,612 (out-of-state) in tuition money. It’s only my point of view, which I give on here as well as to those who have PMed me recently with the choices they are faced with making when they’re choosing among programs. Although you may not like “this forum as a means of deciding what school to choose”, I’m sure there are many that politely disagree with you. Colleges may hate CollegeConfidential for a reason, and it’s not bc they have your best interests at heart.
Becoming a physician IS difficult, with the years of education required to be at the top. It requires years of hard work and sacrifice on many levels, no matter what field you’re going for. No one said it’s impossible. Whether you realize it now or not, burnout happens when you’re so focused on work (career) and CV building at the expense of having any fun, which will inhibit your ability to effectively learn when the material starts getting harder. Contrary to your belief now, your career path is not a “time race”, you’re not competing against a stopwatch. Bc once you start the “medical school part” there’s no turning back or stopping the clock, there are no do overs. No matter how much you wish you had taken it a little easier, or a had a little bit more fun, in the undergrad years, that time is gone. I honestly and sincerely do wish you the very best of luck and hope you can truly accomplish being the exception to the rule.
MATCH LISTS
Brown:
<a href=“http://www.brown.edu/academics/medical/about/facts-and-figures/md-14-match-list”>http://www.brown.edu/academics/medical/about/facts-and-figures/md-14-match-list</a>
Baylor College of Medicine:
<a href=“Match Day 2014 | Page 7 | Student Doctor Network”>Match Day 2014 | Page 7 | Student Doctor Network; (apparently they don’t post the match list on the website, but a student took a picture)
Northwestern:
<a href=“MD Education: MD Education: Feinberg School of Medicine”>http://www.feinberg.northwestern.edu/education/current-students/career-development-residency/residency-application-process/match-results/</a>
They haven’t posted the results from 2014 yet, but you can at least see the matches from the last 10 years.
By the way, I did get into all of the Florida schools and the USF 7 year med program. But none of them are as good as UMKC. Rankings don’t mean ■■■■ in the real world. Neither do numbers. I had lower numbers than a ton of people applying out of state to UMKC. It was my interview and the way I presented myself that got me into this program. The real world is based heavily on interpersonal relationships and connections. The reason why a lot of people from UMKC end up in the Midwest is because the Midwest likes KC. People every year match in Chicago and the Mayo clinic bc those are both considered Midwest. Yes, the northeast usually does not want to have anything to do with Midwestern schools. Also, so what if those students had to take a leave of absence in order to accomplish their goals? I actually already plan to do the same. After I take step 1 I plan to take a leave of absence to pursue research at hopefully the NIH or HHMI. I know that doing all of these things above and beyond will even the playing field with people from other elite institutions. And yes, I’d still be saving a year from undergrad and all of the stress of applying to med school. Guarantees come very rarely in life, it’s very hard to turn one down when only 35% of people who APPLY to med school get in. Actually that number is skewed bc a lot of pre meds get weeded out before applying. And thank you, yes I will try my best to be the exception. I prefer climbing uphill to going with the flow.
@PursuitToExcel congratulations and good luck with your studies. I just wanted to let you know that HHMI is focusing its dollars in an educational science big box office movie. Also, here is what their website says:
“Students cannot be enrolled in a combined medical, dental, or veterinary/PhD program (e.g., MD/PhD) or PhD, or ScD program, or have a PhD or ScD in a laboratory-based biological science.”
Does this include combined BS/MD too? maybe not - not sure.
Maybe Mayo or NIH might be better.
You know a summer and a year may or may not be long enough to produce significant results. It all depends on the timing of the research in the lab at the time. Maybe you should consider doing an MD/PhD.
Yes but I am not sure that UMKC allows for an MD/PhD in the six year program. I know that they have a student right now who finished his fourth year and is now doing a year of internship at NIH. And I am sure that in a year I would have accomplished something doing research. They dont expect you to have cured cancer as a med student. Residencies just want to see some small publications and experience in a research setting. I just thought of another huge advantage of the UMKC 6 year program over a regular med school. In the UMKC 6 year program you have two extra years to start building your resume for residency. Like you can start doing research, forming connections, studying for step 1, getting involved in organizations, doing medical volunteering, etc.
@PursuitToExcel, UMKC has never been a big numbers type of school or big on requiring research. That’s pretty well known in BA/MD admissions. They can’t be, unlike Brown, Northwestern, Baylor, UPitt, etc. that can afford to be much more selective with not just numbers but also quality of ECs. Medical literature hasn’t really correlated SAT/ACT scores or high school GPA to USMLE Step 1 scores (which isn’t surprising, as most people entering med school aren’t coming straight from high school). If you looked at their match lists from those schools, you’d see that they had high caliber institution matches all over the U.S., not just geographically restricted to the East Coast.
Specific ordinal rankings of med schools don’t matter in the real world (I never said they did). However, where your school falls in the spectrum of top tier/mid tier/low tier does play a role in the <em>residency match process</em> when it comes to competitive residencies. If you go here to page 127: <a href=“http://www.nrmp.org/wp-content/uploads/2013/08/chartingoutcomes2009v3.pdf”>A non Match-participating program at my institution offered a position to an applicant who has a concurrent year match to another program. Is my institution liable? | NRMP, You’ll see that out of the 171 people that successfully matched into Neurosurgery, a little more than 50% came from med schools that were in the top 40 US medical schools with the highest NIH research funding (The top 40 research rankings in USWNR).
Much more importantly, though, in general, having a home residency program in the specialty of your choice gives you the ability to culture those “interpersonal relationships and connections” over a much longer period of time: <a href=“http://health.usf.edu/medicine/neurosurgery/residency/index.htm”>http://health.usf.edu/medicine/neurosurgery/residency/index.htm</a>. You would have gotten the ability to do this in USF’s 7 yr. BA/MD program (which was guaranteed). The HHMI with the NIH is quite competitive across the US, so that’s definitely nowhere near guaranteed, esp. not with federal budget cuts.
But, like I said, good luck. You’ll definitely need it.
@Roentgen yeah those HHMI and NIH programs seem like a sort of dream opportunity. I’m sure that someone having that on their CV would definitely hop a few steps up in the residency application process. Its impressive that someone from UMKC is currently attending the NIH program. I will ask them what he did to get into that program. If not that or HHMI, I am sure there are other year-long fellowships across the country for med students. The NIH program pays an annual stipend of $33,500, which is a lot for just a research internship while still in med school. So if someone did that they would not have to pay tuition at UMKC during that leave of absence. And no, I looked into the USF program thoroughly and the students there are not all getting into the med school. It is not guaranteed like UMKC. And no, I will not need luck. Life isn’t about luck. Everything is about hard work and uniqueness and how to be different from others. If someone is able to distinguish themselves in some special way then they will stand out to residencies.
Avoid UMKC at all costs
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Sorry for the above post, Freudian slip.
UMKC is fine for the few who do very well and those who get by…and wouldn’t have gotten by anywhere else. The extension rate is ridiculous. Everyone is a stud in high school, but then 60% fall below expectations.
The feedback that I’ve gotten from my successful classmates has been that, despite their great Step 1 and Step 2 scores/AOA/research/etc… the fact that UMKC is not a ‘known’ institution nationally, is a major hindrance. Many times, their interviewers were asking them if their school is a part of KU and the Jayhawks…they had to correct them with “Kangaroos”…and a lot of doors were closed because of the lack of regard.
Residency interviews are just like interviews for most jobs - you are being judged on your resume, personality, and fit. Zooming in on just your scores/accomplishments isn’t realistic.
If you’re at UMKC right now as a student, keep a positive attitude and do as well as you can.
Your forget, @Johnny H, they all believe that they will be the one to be at the top of their medical school class and be the one to get AOA, based on their track record from high school. After all, if one can get into NHS from high school, then AOA, can’t be that hard to get right? (lol).
I agree, I think UMKC helps those who end up being near the bottom of their class. These people normally might/might not have made it through a normal 4 year medical school in which everyone has completed a Bachelor’s.
I think UMKC ends up hurting more the people who end up in the middle to very top of the class, who are going for very competitive specialties. Someone in the middle to top of his/her class at Baylor, Northwestern, Brown, UPitt, Boston U, Jefferson (all of which have BA/MD programs), etc. with the same CV of Step scores, AOA, and research will be more easily offered an interview and chosen over someone coming from UMKC, when going for the same position in a competitive specialty.
That’s bc UMKC’s med school is not known as an academic powerhouse, nor is it known nationally by residency programs for its clinical prowess. It’s also easier to match in a competitive specialty, when you have a home residency program at your med school to network with during your education and serve as a springboard. If you don’t have a home program to network with over years, it can be difficult to garner many interviews in those competitive specialties, bc word of mouth from a faculty member they know means a lot. This was very frustrating to those students in my class who worked ridiculously hard to always be at the top of their class in everything - basic science grades/step scores/clinical grades and build up their CV for 6 years and not getting enough interviews to match in that specific specialty. If they were at KU, they would have likely matched.
Residency interviews look at the entire picture: the quality of your resume (based on the quality of the universities you attended), personality, and fit, just like when you interview for a job in the real world. I think you’re very right, that expecting someone to just zoom “in on just your scores/accomplishments” isn’t realistic bc education at different medical schools is known to be inherently different.
Hence why I laugh at “hard work”+“uniqueness”+ being “different from others” as being the silver bulletsolution, bc the real world isn’t adherent to such black-&-white thinking.
You can see ALL the medical specialties available here: <a href=“Specialty Profiles | Careers in Medicine”>https://www.aamc.org/cim/specialty/list/</a>
You can see what medical specialties are and aren’t available at UMKC here:
<a href=“http://med.umkc.edu/gme/residencies-and-fellowships/”>http://med.umkc.edu/gme/residencies-and-fellowships/</a>
One issue that everyone seems to have forgotten to include in the equation relating to the above matter (or refusing to acknowledge the importance of the issue) is the power of having a family member/s in the particular specialty and who know/s the inner circle to be able to tilt the balance. Unfair it might be to those who do not come from a medical family, but “this real world isn’t adherent to such black-&-white thinking”. @PursuitToExcel comes from a medical family and if he chooses to go into a specialty identical to those of his “family pull”, I am confident he would have advantage over those who do not. I acknowledge the shortfalls at UMKC but if my son is accepted into the program (he is on wait list) and chooses to go there, being in the medical world and having extensive contacts, I am confident that as long as he has the numbers, the appropriate opportunities will be created for him.
The medical world is definitely prone to politics and favoritism just like any other industry. That being said, unless you know people of major influence at particular programs or hospitals, there is a lot of red tape and perhaps other competitors doing the same thing you are. Having extensive relationships can definitely help, but I would never bank on opportunities to be automatically created. That generally requires a lot of work and relationship maintenance. If you’re talking about having a close family friend who runs his/her own clinic, that’s obviously a different story (easy hookup). If we’re talking about a connection at UCSF or Stanford…there will be other staff there who have their own kids to push as well.
Whether it be extra phone calls, helping out the old MDs out with PowerPoints for their conference presentation, etc…hustling to get “in” with people is just like other industries. I don’t think anything is guaranteed.
Well said, Johnny H. I do not believe in pulling strings unless the object to be pulled (the candidate) is worthy of the pull. That is why any pull can only work if the candidate has competitive stats, research, etc etc but maybe the only down side if that the kid has gone to a lesser medical school. Creating opportunity does not mean just a phone call or meeting. It takes more than that. And yes, nothing is automatic but it is definitely better than if the kid were to do it all by him/herself.