MD Incoming M1 concerns about STEP1 pass/fail & med school prestige when it comes to residency match

[(;FutureEyeDoc;)]

Hola everyone,

I am starting M1 in less than a week (OMG finally), and with STEP1 becoming pass/fail, there's a lot of uncertainty as to how to plan my life for the next 4 years. Some say pre-clinical grades will matter more than ever, some others say research is going to be an even more crucial component for residency match into competitive fields, and yet others say that nothing will matter more than STEP2 score. All of those are clearly important, and I will really try to excel at every level, but all in all, nobody seems to know exactly what we're supposed to mainly focus on.

I am dead set on going into ophthalmology and I have been since the summer before freshman year of college. I already have a published textbook chapter on glaucoma (co-author), an ARVO glaucoma poster that I haven't presented myself, and my name is also on a cornea/LASIK presentation given during a national conference of a developing country in Africa. I am currently working on two retina projects destined for publication (co-author) that were delayed because of COVID. I would say that research-wise, I am ahead of the curve

Question 1:
- Will my research experience done before med school still matter when I apply to residencies?

Unfortunately, my med school is not particularly prestigious, it is a mid-tier MD school according to the US News primary care ranking, and low-tier according to their research ranking. My school does not consistently match their students into ophthalmology (but that might be because it is primary care heavy and students might not be interested in the field every year). From what I have seen in their published match lists, those who match into ophthalmology do not necessarily match into top well-known programs either.

Question 2:
- Can students from any medical school, irrespective of rank, match into top research-heavy academic centers around the US, or will the prestige of my institution hold me back in terms of my options for the residency match?

While doing research in ophtho these past 4-5 years, I have networked quite extensively and know a couple of attending physicians/faculty at prestigious institutions that I would dream to attend for residency. If prestige of medical institution and letters of recommendation are going to matter more than in previous years to match competitively, then..

Question 3:
- Should I actively aim to do research with those top academic faculty during the summer between M1 and M2 and maybe do an away rotation at their institution at the end of 3rd/beginning of 4th year do secure good letters of recommendations?

"Dear FutureEyeDoc, you're thinking way ahead, try to focus on acing your first blocks in med school and you'll have time to think about that later" - YOU. Thank you for your concern, I will certainly put all of my energy into learning as much as I can from the very start of medical school, but can you answer my questions anyway?

Thanks again everyone, sorry i'm already gunning.
Best,

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[deleted854547]

Prestige plays a huge factor.

 

[Goro]

Hola everyone,

I am starting M1 in less than a week (OMG finally), and with STEP1 becoming pass/fail, there's a lot of uncertainty as to how to plan my life for the next 4 years. Some say pre-clinical grades will matter more than ever, some others say research is going to be an even more crucial component for residency match into competitive fields, and yet others say that nothing will matter more than STEP2 score. All of those are clearly important, and I will really try to excel at every level, but all in all, nobody seems to know exactly what we're supposed to mainly focus on.

I am dead set on going into ophthalmology and I have been since the summer before freshman year of college. I already have a published textbook chapter on glaucoma (co-author), an ARVO glaucoma poster that I haven't presented myself, and my name is also on a cornea/LASIK presentation given during a national conference of a developing country in Africa. I am currently working on two retina projects destined for publication (co-author) that were delayed because of COVID. I would say that research-wise, I am ahead of the curve

Question 1:
- Will my research experience done before med school still matter when I apply to residencies?

Unfortunately, my med school is not particularly prestigious, it is a mid-tier MD school according to the US News primary care ranking, and low-tier according to their research ranking. My school does not consistently match their students into ophthalmology (but that might be because it is primary care heavy and students might not be interested in the field every year). From what I have seen in their published match lists, those who match into ophthalmology do not necessarily match into top well-known programs either.

Question 2:
- Can students from any medical school, irrespective of rank, match into top research-heavy academic centers around the US, or will the prestige of my institution hold me back in terms of my options for the residency match?

While doing research in ophtho these past 4-5 years, I have networked quite extensively and know a couple of attending physicians/faculty at prestigious institutions that I would dream to attend for residency. If prestige of medical institution and letters of recommendation are going to matter more than in previous years to match competitively, then..

Question 3:
- Should I actively aim to do research with those top academic faculty during the summer between M1 and M2 and maybe do an away rotation at their institution at the end of 3rd/beginning of 4th year do secure good letters of recommendations?

"Dear FutureEyeDoc, you're thinking way ahead, try to focus on acing your first blocks in med school and you'll have time to think about that later" - YOU. Thank you for your concern, I will certainly put all of my energy into learning as much as I can from the very start of medical school, but can you answer my questions anyway?

Thanks again everyone, sorry i'm already gunning.
Best,

1) Some research is better than none, if that's what you got.
2) Yes
3) Yes. But stop thinking in terms of just bench research. You can and should do clinical research in your M3 and M4.

 

[altblue]

Prestige plays a huge factor.

It does, but clinical grades, Step 2 and research are also huge factors.

Although you'll have to work harder for ophtho coming from, say, Drexel compared to Harvard, it should definitely be doable.

 

[collegestud2013]

-Pre-clinical grades only matter if your school is not P/F and uses them to rank students.
-Continue doing research throughout med school especially during M1 and M2 when you'll likely have more time. It's common for those matching into ophtho to take a research year to get the amount of research needed to match unless they're at a top research school that blocks off nearly a year of time for research during the usual 4-year curriculum. It seems like you're ahead in terms of research which can help you avoid taking a research year.
-Medical school reputation/prestige will matter more for matching once Step 1 becomes P/F and this has already been confirmed by PDs in anonymous surveys (even if they're hesitant to admit this in person). So coming from a lower tier research school (the Primary Care rankings aren't really that useful and no one really pays attention to them) will make it harder to match into a top program of a competitive specialty even if you do research at at reputable institution and have connections there (though still possible).
-Step 2 is going to be key in deciding whether you have a strong shot at matching ophtho now . Unfortunately, it's not taken until the end of M3 at most schools so you won't have a score until it's almost time to apply
-Keep an open mind and find an additional specialty you may also like besides ophtho over the next 3 years. Entering M1s as a whole have a heavily concentrated interest in competitive specialties like derm, plastics, ortho, ENT, neurosurgery since these specialties get the most attention and are thus more well-known among previous. However, throughout med school, statistically more than half of med students will end up matching at a different specialty than the specialty they envisioned doing as an entering M1. Some of it is due to a shift in interest, but in many cases it's a shift a from a more competitive specialty to a less competitive specialty after finding out that their scores and grades aren't competitive (and specialties like IM, FM, Peds, Neuro get more interest). After Step 1 is a common switching point (It's not uncommon to see med students do a tremendous amount of research and publish for a competitive specialty during M1 and M2 and then get a sub-par Step 1 score that makes matching into that specialty very uncertain, and as a result have to either withdraw applying to that specialty altogether, or double apply to a less competitive back-up). However, with a P/F Step 1 coming, less students will self select out of competitive specialties after M2 and probably still apply even if they end up with a subpar Step 2 score.

 

[deleted688779]

Question 2:
- Can students from any medical school, irrespective of rank, match into top research-heavy academic centers around the US, or will the prestige of my institution hold me back in terms of my options for the residency match?

I'm not an expert but generally, in life, the answer to these types of questions is always yes. Can you drop out of high school and still become a billionaire? Yes! You can! You can be a DO student and still can match MGH derm; that would be a truthful statement. But is it likely, or will it be much harder, or require you to have a different approach to the process?

It is better to ask in terms of likelihood compared to average or compared to a school with higher prestige. Or better, ask for the data, if available, and decide for yourself. Or perhaps ask what kind of T5 student gets in and what kind of student from a lower prestige school gets in. Can the T5 person be middle-of-the-pack with a decent Step? While the T70 student needs to be absolute top of the class, with dozens of research items, with a 260+ (and perhaps STILL not be enough)?