Do Top 20 schools really have an edge on what specialty you match into?

[DocToBe2018]

Well, I am at a top 20 school and I see our home programs as the biggest merit. Most specialties at my home programs rank top 10-20 and along my clerkships this year, I was lucky to have personal conversations with the program directors. I think the fact that the program director can associate the face to the name on the application is a huge advantage.

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[efle]

Interesting how their match list doesn't seem overly impressive to me though: Match Day 2017 | UMKC School of Medicine

Makes you wonder if the OP is onto something

Yeah, when you compare UMKC to Johns Hopkins, you would not expect to find out they had the same avg scores.

 

[LePepe]

Yeah, when you compare UMKC to Johns Hopkins, you would not expect to find out they had the same avg scores.

I'm actually pretty fascinated by this...

It completely flies in the face of all the accumulated wisdom on SDN that says that where you go to school doesn't matter as much as your Step scores

 

[efle]

I'm actually pretty fascinated by this...

It completely flies in the face of all the accumulated wisdom on SDN that says that where you go to school doesn't matter as much as your Step scores

Sort of like how SDN mantra used to be that undergrad didn't matter until I started spamming the AAMC survey every time it came up, lol

 

[sullen-burger]

Let's just keep a cool head though and remember what statistics say about and how they apply to the individual.

 

[LizzyM]

Yeah, when you compare UMKC to Johns Hopkins, you would not expect to find out they had the same avg scores.

But who chooses UMKC and why? What's the school's mission? do they choose applicants in keeping with that mission and do students embrace it? Could it be that the grads there don't value the same things that Harvard grads are seeking?

 

[AnatomyGrey12]

Eh one issue though with the whole Missouri thing is that you have to remember that it is a state school with a specific mission. It actively recruits people for that mission so you can't just look at the match list and compare it to Hopkins and draw conclusions from that. You have a different student population at Missouri than at Hopkins, and the overall goals of the class are going to be different. No doubt prestige helps (particularly with IM it seems) with getting residency spots but only to a certain point. Especially when you are talking about USMD schools.

Edit: also want to add that for the competitive fields you still need to be a competitive applicant for that field regardless of school name. Doesn't matter if you went to Hopkins if you pull a 225 and have no research, you won't be matching ENT or Neurosurgery.

 

[efle]

But who chooses UMKC and why? What's the school's mission? do they choose applicants in keeping with that mission and do students embrace it? Could it be that the grads there don't value the same things that Harvard grads are seeking?

Eh one issue though with the whole Missouri thing is that you have to remember that it is a state school with a specific mission. It actively recruits people for that mission so you can't just look at the match list and compare it to Hopkins and draw conclusions from that. You have a different student population at Missouri than at Hopkins, and the overall goals of the class are going to be different. No doubt prestige helps (particularly with IM it seems) with getting residency spots but only to a certain point. Especially when you are talking about USMD schools.

Well, looking just at the ones leaving the state for competitive specialties, it still seems a very different kind of match list.

Certainly casts some doubt on the theory about different kinds of raw materials if the two schools can bring 29 vs 36 MCAT medians up to the same level of step performance, too

 

[AnatomyGrey12]

Well, looking just at the ones leaving the state for competitive specialties, it still seems a very different kind of match list.

Remember this thread is just about getting a spot, any spot, in a competitive field. If you start looking at the prestige associated with matches then yeah the top school gives a (big) leg up, but just on a raw analysis of someone's chances of matching a competitive field from a school like Missouri compared to a Hopkins, they probably aren't that much different. You still need the app for the specialty regardless of school. I do agree however that someone with a 250 and some decent research will probably match to a "better"/prestigious/whathaveyou program coming from the top school, if that's what they want.

 

[Lawpy]

Let's face it. Your board scores will determine in large part whether you are competitive for certain specialties just as your MCAT scores determined if you were competitive for certain medical schools. Students who go into college or who go into medical school with prior performance that was exemplary are, on average, more likely to do well in the next phase of their career than those who had prior performance that was marginal. Schools that take only students who were exemplary in undergrad are, in all likelihood, going to produce MDs who did well on the step exams and distinguished themselves in clinical clerkships. Schools that take highly motivated students who were not stellar test takers in undergrad and on the MCAT are likely to produce graduates who can pass the boards and be licensed but who do not rise to the top 5% of all MD grads.

Now, do you think it is the schools that produce great match lists or the raw material that enters the school is better at some schools than at others?

Maybe it's both that complement each other? Smart students do well on exams, excel on rotations, get solid research and have strong letters. But I bet the countless resources offered at top schools and associated name brand/connections also play a major factor. And so this complementary rather than antagonistic or binary relationship between the two could explain the significantly different match outcomes between Top 20 schools and the rest.

 

[LePepe]

After seeing UMKC's step scores, IMO any school that is serious about giving their students the best opportunities possible should be emulating UMKC's curriculum to the T.

Then again, after reading this thread, not sure if Step scores even really matter.

 

[WedgeDawg]

Eh one issue though with the whole Missouri thing is that you have to remember that it is a state school with a specific mission. It actively recruits people for that mission so you can't just look at the match list and compare it to Hopkins and draw conclusions from that. You have a different student population at Missouri than at Hopkins, and the overall goals of the class are going to be different. No doubt prestige helps (particularly with IM it seems) with getting residency spots but only to a certain point. Especially when you are talking about USMD schools.

Edit: also want to add that for the competitive fields you still need to be a competitive applicant for that field regardless of school name. Doesn't matter if you went to Hopkins if you pull a 225 and have no research, you won't be matching ENT or Neurosurgery.

If you look at charting outcomes, something like 50% of people with a 220-230 step score still match ent and nsgy. Do you think that med school reputation has no effect on those applicants?

 

[libertyyne]

If you look at charting outcomes, something like 50% of people with a 220-230 step score still match ent and nsgy. Do you think that med school reputation has no effect on those applicants?

Could be related to PDs. Or have an excellent home program/connections. We know that people match with those numbers we don't know where those people come from. or could be programs in unappealing areas.

 

[cactusman]

After seeing UMKC's step scores, IMO any school that is serious about giving their students the best opportunities possible should be emulating UMKC's curriculum to the T.

Then again, after reading this thread, not sure if Step scores even really matter.

Yes UKMC is doing something right. OTOH, Emory has an average score of 252, so I don't think they (or some of the others) need to worry about emulating another school because they didn't have quite as much improvement off of already-high incoming stats.

 

[AnatomyGrey12]

If you look at charting outcomes, something like 50% of people with a 220-230 step score still match ent and nsgy. Do you think that med school reputation has no effect on those applicants?

Oh no it does, but all I'm saying is it probably isn't a huge factor. Not to the point where you can throw out board scores like the above poster is suggesting. Also people who match those specialties will lower scores tend to have killer apps in other regards. I.e. Research, a big name LOR writer going to bat for them, etc (this is probably where the top school gives the biggest boost). On top of that it is an extrapolation that you are making because we don't know where those 50% are coming from. Could be mostly top schools, but could also be people who matched at their home program at some state school after making good connections there.

 

[efle]

Avoid the whole mission confound then by looking at some middle-ranked non-mission private schools with relatively high step scores. A few points difference on the step 1 does not explain the differences between like George Washington and Hopkins, for example.

And yeah it might not be just a reputation thing, might be the people you have recommending you or the research resources at your disposal...but those things come with the Top X school like rep does. Seems fair still to consider them in the "Top X advantage"

 

[libertyyne]

Avoid the whole mission confound then by looking at some middle-ranked non-mission private schools with relatively high step scores. A few points difference on the step 1 does not explain the differences between like George Washington and Hopkins, for example.

And yeah it might not be just a reputation thing, might be the people you have recommending you or the research resources at your disposal...but those things come with the Top X school like rep does. Seems fair still to consider them in the "Top X advantage"

I think it is program specific. I know a school in detroit has a well respected EM program, going to that school and applying to EM at any level of prestige usually leads to success. That being said I am sure there are other schools that have well respected/ strong programs in certain specialties which would lead to success of their UG medical education graduates in that program. U of Miami is always on point leading to optho placements. RFU has a disproportionate amount of Derm than one would expect based on rank and mcat, etc, etc. The only way these trends can be made sense of is through the lens of the home program's strength and the network/second order effects of these programs.

 

[efle]

I think it is program specific. I know a school in detroit has a well respected EM program, going to that school and applying to EM at any level of prestige usually leads to success. That being said I am sure there are other schools that have well respected/ strong programs in certain specialties which would lead to success of their UG medical education graduates in that program. U of Miami is always on point leading to optho placements. RFU has a disproportionate amount of Derm than one would expect based on rank and mcat, etc, etc. The only way these trends can be made sense of is through the lens of the home program's strength and the network/second order effects of these programs.

And so being at an inbreeding med school with strength in a huge variety of residencies (cough harvard cough) sounds like it would be suuuper advantageous

 

[Lucca]

That and Baylor, either they are very good at consistently lying or there is something about the curricula or selection process for their medical students.

It would be interesting if performing better than McAT predicts is associated with curricula that incorporate patient interactions / PBL as early as possible. I know for Baylor and Columbia at least core clerkships are done prior to Step 1

 

[efle]

It would be interesting if performing better than McAT predicts is associated with curricula that incorporate patient interactions / PBL as early as possible. I know for Baylor and Columbia at least core clerkships are done prior to Step 1

My money is on time given to study for step, and how much preclinicals teach to the test

 

[libertyyne]

My money is on time given to study for step, and how much preclinicals teach to the test

I have heard some rumblings of clinical exposure improves performance on the step because the STEP questions are now mostly clinical vignettes. But it is difficult to isolate curricula differences contributing to improved step performance because the implementations are not standardized and the reported step data is not really high quality. Some schools that taught the TBL /PBL success have published improvements in step compared to previous classes at the same schools. However they dont adjust for time given for step prep or incoming mcat class, and the effect is usually very small

 

[Lucca]

I have heard some rumblings of clinical exposure improves performance on the step because the STEP questions are now mostly clinical vignettes. But it is difficult to isolate curricula differences contributing to improved step performance because the implementations are not standardized and the reported step data is not really high quality. Some schools that taught the TBL /PBL success have published improvements in step compared to previous classes at the same schools. However they dont adjust for time given for step prep or incoming mcat class, and the effect is usually very small

I theorize: It is necessary to show a 0.000001% in Step 1 performance when you change your pedagogical method so that you can justify overwhelmingly welcome and positive changes by faculty and students to the administrative overlords.

 

[libertyyne]

I theorize: It is necessary to show a 0.000001% in Step 1 performance when you change your pedagogical method so that you can justify overwhelmingly welcome and positive changes by faculty and students to the administrative overlords.

There is usually no statistical analysis performed either to see if the change is score is just within normal variations to be expected, rather they change the curriculum, and proclaim "We increased STEP scores by 1 point by making students wear wet t-shirts to bed on tuesdays. So now we have implemented the changes to our curriculum."

 

[aspiringmd94]

A doctor at Johns Hopkins told me that the applicants are given scores when they are considered for residency positions and this score was multiplied by 1.2 if you went to a top 20 school, at least for some specialties.