Finding job post residency - Most important factors?

[smr]

I apologize if this has been asked before (couldn't find a thread) but I am very curious to know what the major factors are that determine post training job prospects.

For example, does the ranking of your medical school factor in to any appreciable degree, does the status of your residency make a big difference, does research matter, etc.

I feel like I have a good idea what residencies look for and now I'm interested in knowing what's most important in the next stage in the process (presumably the last).

Appreciate any insight.

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[colbgw02]

I apologize if this has been asked before (couldn't find a thread) but I am very curious to know what the major factors are that determine post training job prospects.

For example, does the ranking of your medical school factor in to any appreciable degree, does the status of your residency make a big difference, does research matter, etc.

I feel like I have a good idea what residencies look for and now I'm interested in knowing what's most important in the next stage in the process (presumably the last).

Appreciate any insight.

Outside of academics, one's pedigree really doesn't matter too much. Assuming that you're board-certified (or on schedule to be BC) and able to get an unrestricted medical license, then employers and practices care exponentially more about your work ethic and personality. It's pretty simple - carry your weight and be easy to get along with. Accordingly, networking is crucial. As in other industries, it's not what you know - it's who you know.

 

[smr]

Outside of academics, one's pedigree really doesn't matter too much. Assuming that you're board-certified (or on schedule to be BC) and able to get an unrestricted medical license, then employers and practices care exponentially more about your work ethic and personality. It's pretty simple - carry your weight and be easy to get along with. Accordingly, networking is crucial. As in other industries, it's not what you know - it's who you know.

This is what I have heard elsewhere and it just seems strange because I'm beginning to think what's the point of worrying about matching into "top" programs when it apparently doesn't make any difference at any point.

This seems to be a recurring theme in medicine. Undergrad doesn't matter for med school, med school doesn't matter for residency and now apparently residency program status doesn't matter for jobs (at least to any significant degree). Very confusing, hope I'm not missing something.

 

[colbgw02]

This is what I have heard elsewhere and it just seems strange because I'm beginning to think what's the point of worrying about matching into "top" programs when it apparently doesn't make any difference at any point.

This seems to be a recurring theme in medicine. Undergrad doesn't matter for med school, med school doesn't matter for residency and now apparently residency program status doesn't matter for jobs (at least to any significant degree). Very confusing, hope I'm not missing something.

First of all, who has told you that undergrad doesn't matter for med school or that med school doesn't matter for residency? That's straight up false.

Secondly, people want to match into top programs because, at least hypothetically, the training is superior. In general, we want to be good at what we do, so we'll go where the training is best, even if that training is neutral with respect to job prospects.

Thirdly, training doesn't stop with residency. Many people complete fellowships, and the quality and reputation of your residency will influence that.

Lastly, again, it's about networking. A letter or a phone call from a big name at a top institution will open more doors for you. Also, top hospitals will attract people from all over, so the network available to you may be larger than otherwise.

 

[smr]

First of all, who has told you that undergrad doesn't matter for med school or that med school doesn't matter for residency? That's straight up false.

Secondly, people want to match into top programs because, at least hypothetically, the training is superior. In general, we want to be good at what we do, so we'll go where the training is best, even if that training is neutral with respect to job prospects.

Thirdly, training doesn't stop with residency. Many people complete fellowships, and the quality and reputation of your residency will influence that.

Lastly, again, it's about networking. A letter or a phone call from a big name at a top institution will open more doors for you. Also, top hospitals will attract people from all over, so the network available to you may be larger than otherwise.

Generally speaking, undergrad isn't considered a significant factor, excluding rare exceptions where med schools take their own (that's what I've consistently heard). On the list of things residencies PDs consider, school reputation isn't even in the top 10 according to the studies I've seen posted here.

I'm sure the other things you mentioned are definitely important, but aside from LOEs, how would a potential employer know those things about you? I've heard about people re negotiating their schedule/salary, which makes me wonder what puts someone in a good position to do that? I know with law school rank is extremely important and would definitely affect your future job prospects, but I'm not seeing that in medicine.

However, the networking thing certainly makes sense.

 

[DrfluffyMD]

Generally speaking, undergrad isn't considered a significant factor, excluding rare exceptions where med schools take their own (that's what I've consistently heard). On the list of things residencies PDs consider, school reputation isn't even in the top 10 according to the studies I've seen posted here.

I'm sure the other things you mentioned are definitely important, but aside from LOEs, how would a potential employer know those things about you? I've heard about people re negotiating their schedule/salary, which makes me wonder what puts someone in a good position to do that? I know with law school rank is extremely important and would definitely affect your future job prospects, but I'm not seeing that in medicine.

However, the networking thing certainly makes sense.

Go ahead and do a quick review of applicants from Harvard vs state school with the same gpa and mcat as well internal medicine match of applicant with 230 step 1 score from HMS or Hopkins versus state med school.

Read between the lines of PD reports.

 

[smr]

Go ahead and do a quick review of applicants from Harvard vs state school with the same gpa and mcat as well internal medicine match of applicant with 230 step 1 score from HMS or Hopkins versus state med school.

Read between the lines of PD reports.

IMO you'd have to control for a few other factors like research for example. For med school, undergrad reputation itself certainly isn't a major factor. It's easy to think it is because a lot of people at top med schools are from ivy league colleges but obviously they are just selected for because of their performance on standardized exams among other things. It's of course anecdotal evidence, but I went to a ****ty city school and still interviewed at top 10s/20s because my MCAT was high. From what I have seen and heard, the same is true for residency. Step 1 is the major determinant and then research, most other things are only marginally important accordingly to everything I've seen.

But regardless, what I'm thinking now is that it doesn't even matter, since the end goal is to get an actual job in medicine and assuming you don't want to work at a major academic hospital, what difference does any of it make? Trying to figure that out.

 

[DrfluffyMD]

IMO you'd have to control for a few other factors like research for example. For med school, undergrad reputation itself certainly isn't a major factor. It's easy to think it is because a lot of people at top med schools are from ivy league colleges but obviously they are just selected for because of their performance on standardized exams among other things. It's of course anecdotal evidence, but I went to a ****ty city school and still interviewed at top 10s/20s because my MCAT was high. From what I have seen and heard, the same is true for residency. Step 1 is the major determinant and then research, most other things are only marginally important accordingly to everything I've seen.

But regardless, what I'm thinking now is that it doesn't even matter, since the end goal is to get an actual job in medicine and assuming you don't want to work at a major academic hospital, what difference does any of it make? Trying to figure that out.

If you are a specialist with a job market that isn't wide open (by wide open I mean EM, psych, primary care type of job market), having done your rad onc at UCSF versus alleghany general hospital will influence whether you will work at the SF bay area or not.

I have a n = 1 example. I went to a top 20 school. This school's IM program is considered to be a reach to state MD grads and they do not interview candidates from certain state MD school even. They also do not interview DOs.

Meanwhile, this program is considered to be a safety for folks at HMS or hopkins....

Example number 2, a west coast ROAD program. Senior resident complain to me "my PD wants to recruit from top 5 school no matter what. We had a guy from HMS and he was extremely weak (on paper and clinically)." This same program also do not routinely match DOs...

It's incredibly messed up, and wrong, to judge people so differently base on where they went to school. but it would be a disservice to dismiss that this happens. The Pd survey on weighing of school does not seem represenative in my personal experience and I feel it's on par with step score as far as importance goes. I chased training myself and ended up in a place with incredible training but weak name. Now I am going backward and every single fellowship program I am ranking are household names.

Watch what people ahead of you do. Competitive programs are competitive for a reason.

 

[mvenus929]

It's incredibly messed up, and wrong, to judge people so differently base on where they went to school. but it would be a disservice to dismiss that this happens. The Pd survey on weighing of school does not seem represenative in my personal experience and I feel it's on par with step score as far as importance goes. I chased training myself and ended up in a place with incredible training but weak name. Now I am going backward and every single fellowship program I am ranking are household names.

Watch what people ahead of you do. Competitive programs are competitive for a reason.

I feel like the higher you are up in pedigree (for a program), the more 'desirable' you are seen by applicants, and thus the more selective you can be. But people apply to residencies for all sorts of different reasons, which is why looking at a Match List doesn't necessarily mean anything, except that if someone ahead of you matched at a specific program, you are slightly more likely to get an interview (assuming they liked said person).

I went to a school that varied in rank from like 22-26. I had people at my school match everywhere from a brand new program to Yale and the upper echelons of several specialties. I went to a program that's not known outside the region in terms of applicants, but produces a lot of solid clinicians who end up going places in their careers (but many also come back to the program because they love it).

 

[Raryn]

I apologize if this has been asked before (couldn't find a thread) but I am very curious to know what the major factors are that determine post training job prospects.

For example, does the ranking of your medical school factor in to any appreciable degree, does the status of your residency make a big difference, does research matter, etc.

I feel like I have a good idea what residencies look for and now I'm interested in knowing what's most important in the next stage in the process (presumably the last).

Appreciate any insight.

The above discussion is ridiculous.

Of course undergrad matters some for med school, med school for residency, etc. To say otherwise would be to ignore all empiric data to the contrary. Does going to HMS guarantee you a "top tier" residency? No. But it helps. What doesn't matter is two levels back. That is, undergrad doesn't matter for residency. Med school doesn't matter (much) for fellowship (though US MD vs DO vs foreign MD still does) and certainly doesn't matter for jobs (though again, US MD vs other may in certain cases due to peoples biases).

For purposes of jobs, the strength of reputation of your final place of training, whether residency or fellowship makes some difference, but it varies widely depending on the job: If you want to stay in academics, your pedigree and research credentials make a huge difference. If you want to work out in the community? Connections makes a difference because the best jobs are typically not advertised widely. That said, in most fields within medicine (outside of pathology, radiology, a handful of others), the job market isn't super tight, and as long as you're reasonable to talk to and board eligible/certified in your field, you won't have too much trouble.

Finally, do remember that the "best" programs don't necessarily make the "best" clinicians. Academic reputation is highly dependent on research credentials, and in some cases that is inversely proportional to the clinical exposure you get during your training. So doing your Endocrine fellowship at the NIH might be highly prestigious, but you'd probably have gotten better training managing DM at a random inner-city program somewhere.

 

[DarkLordofSith]

I got absolutely screwed over by Vanderbilt when looking for a job due to where I went to med school. So it matters to douchey places like that. I got an offer from them, they told me the contract was in process, and I declined my other job offers. 7 weeks later, I get an email telling me they decided against sending me a contract due to my training which they knew about before they even offered me a phone interview. Completely screwed me over. Speaking to a heme/onc fellow, apparently the same thing happened to him. They just never sent him the contract and stopped communicating with him.

So apparently it's a big deal at these unprofessional academic places with sticks up their butt.

 

[anonperson]

I apologize if this has been asked before (couldn't find a thread) but I am very curious to know what the major factors are that determine post training job prospects.

For example, does the ranking of your medical school factor in to any appreciable degree, does the status of your residency make a big difference, does research matter, etc.

I feel like I have a good idea what residencies look for and now I'm interested in knowing what's most important in the next stage in the process (presumably the last).

Appreciate any insight.

To be honest though, it doesn't come into play that much in private practice. In my several interviews for private practice, where I trained did not come up. Mainly a very conversational/casual interview to see if I was a normal human being. But the caveat is that is can. You can peruse the anesthesia section and posters are frank about this. Some groups know that physicians who trained at a certain place have a certain level of competence. There is always risk in hiring anyone, it's just one way to try to minimize it.

For academic places, they generally want some type of pedigree not only because of the name (Surgeon XX trained at Hopkins!!!! etc) but you also have big name people advocating for you and the medical field is small. I ran into this on my one academic job interview. Had a good interview, gave a good grand rounds, have a fair number of publications (more than the person who got the job), but the job went to someone who has a bigger name PD from their fellowship throwing their weight around.

 

[hamstergang]

7 weeks later, I get an email telling me they decided against sending me a contract due to my training which they knew about before they even offered me a phone interview.

I'd be very interested to know how they phrased such an email. Because "even though we liked you in our interview, and your residency said you were competent, your med school sucks so we think you must not be as good a clinician as latest evidence suggests" just sounds ridiculous.

 

[colbgw02]

There's something funky going on at Vanderbilt, because I've heard too many stories similar to what Sith describes about strangely arrogant behavior. And it's not like the stories come from a single department so as to be explained by one person's attitude. For example, I had a good college friend who received a rejection letter from Vandy's medical school, which not only declined to send her a secondary application, but it suggested that she should pursue an alternative profession. That year, she had multiple acceptances to and eventually graduated from a solid allopathic medical school. Weird.