Narrowing my application list?

[Lara]

So I'm starting to seriously put together my application list for the next cycle...and it's turned into a ridiculous huge amount (at least for peds). I'm paranoid because a lot of these programs are well known and I don't have a great transcript (no fails, but third year was pretty uninspiring with straight passes...and my step 1 was about the mean). My personal LORs should be fine, but I don't expect a great Dean's Letter. I do speak Spanish which I hope will help. I really don't know how to guage my chances, peds is supposed to be noncompetitive but it filled well this year. Bottom line is I don't know whether I'll only get 25% interviews (only possibly requiring a few cancellations), or be completely overwhelmed with invites.

Anyway, here's the list to give an idea. I'm an East Coaster at Temple, and as you can tell I have no geographic limitations. I tried to give myself a shot at warmer weather. Basically I'm for big cities but am curious to see some college towns too...

West Coast:
UCI
CHOC
CHLA
UCLA
UCLA-Harbor
UCSD
UCSF
Stanford
CHOakland
UWash
OHSU
Children’s Denver
Phoenix Children’s

Midwest:
Mayo
UMichigan
Children’s Memorial
U Chicago
Advocate Christ - Hope
Rush
Loyola
Cleveland Clinic
Rainbow Babies

East Coast:
UVM
UConn
UMass
Brown
Maine Medical Center
Dartmouth-Hitchcock
MGH
BCRP
Tufts
Mount Sinai
NYP-Columbia
NYP-Cornell
NYU
Einstein-Montefiore
UPMC (Pitt)
CHOP
St. Christopher
Children’s National DC
UMaryland
EVMS
UVA
UNC
MUSC
Orlando Regional
Miami Children’s
Jackson Memorial
UFlorida Gainsville + Jacksonville

Is this really crazy??? Of course I'll be meeting with the Dean etc. to discuss my options, but I'm hoping to get some input here...

---

Members don't see this ad.

 

[14022]

but I'm hoping to get some input here...

I can speak on the Chicago programs. Northwestern (Children's Memorial) is the only one in Chicago that would be difficult for the average person. This year, they matched a lot of people from great schools (eg, Harvard, WashU, Duke, etc.). On their website, they say that half of all pediatric applicants apply to the program, so they go through a ton of applications which I am guessing (I do not know this for sure) that there may be some objective cut off (eg, USMLE) that they use to make the job of choosing who to interview a bit easier. If you are serious about going there, I recommend doing an away elective there. A friend of mine interviewed at the top peds programs in the country (eg, CHOP, Denver, Emory, Baylor, WashU, Rainbow, etc.) and Northwestern was the only program that asked why he did not do any away electives. They look favorably upon those that rotate through there.

U of Chicago is smaller than NW but they have a new stand alone children's hospital. They draw a lot of applicants from average schools, but I have been told that these people do pretty well at these schools. On their website, they boast of the extensive role they play in career planning and advising.

Rush is a hospital within a hospital and smaller than the previous two. They are known for the hemophilia division and their NICU. They see a diverse patient base. There are not a lot of fellows at the program, unlike NW and UofC. I have heard that the residents are very happy at the program. Rush is relatively easier to match into compared to UofC and NW.

Loyola is in the suburbs (Maywood is pretty run down) and is also a hospital within a hospital. They do not see a large volume of patients. I have heard that they are known for the oncology dept and NICU (record for smallest baby to ever survive...depending on your views on saving the super premies, this may be good or bad). They also do not have a lot of fellows and is easier to match.

Advocate Christ- Hope Childen's Hospital is a stand alone children's hospital in the south suburbs. I have heard of several people raving about the quality of teaching by the faculty, the wonderful PD, and the camaraderie (sp?) of the residents. It is a community hospital but has an academic affiliation with University of Illinois at Chicago. The Heart Institute for Children has its home at Hope and sees the largest volume of cardiology patients in Chicago. I have heard it is relativey easy to match here.

I have also heard good things about Advocate Lutheran General in Park Ridge (Northwest suburbs by Ohare airport). It is similar to the Advocate Chirst program with the exception of the cardiology division.

I did not see UIC on your list and would leave it out because I have heard bad things about the program.

I think you need to decide whether or not you want to subspecialize. Some prestigious programs provide poor general peds education. For example, St. Louis Children's (WashU) do not have any general pediatric attendings on staff. But you will get any fellowship you want afterwards.

What I do is email people that graduated from my medical school who are now residents in programs I am interested in. SDN and scutwork.com are both great resources to find out about other programs that you are interested in. Best of Luck!

 

[jamie]

Wow. That's a lot of programs. I initially applied to 22 (which seemed like a lot, compared to my classmates going into peds), then narrowed down my interviews to 10 once I got offered interviews and got a better sense of what my chances were based on that. I can't tell you how to narrow down your list, although you may want to consider some top programs as well as some "safer" programs. Some things I used to narrow down my list:

1. Region of the country (I stayed east of the Mississippi, which, if nothing else, kept my list shorter).
2. Size of city you want to live in (NYC vs. Cleveland vs. middle-of-nowhere)
3. Size of program (6 vs. 40 residents per year)
4. Free-standing chidren's hospital vs. a few floors within a hospital (I preferred the former).
5. Lots of fellows ("fellow-run") vs. few or no fellows -- Fellows are great teachers, and you may have a better chance at a fellowship (especially at that hospital) if you've worked with a lot of fellows (or not); but residents get more hands-on and decision-making when there are fewer fellows.
6. Tertiary care center vs. community program
7. "Prestige" or competitiveness of the program -- a very relative characteristic
8. How resident-friendly the program is. This is hard to really tell before you visit, but I got a sense of this from some programs' websites (ie., Vanderbilt and Columbus)
9. Focus on primary care vs. subspecialty care
10. Research opportunities/requirements

Good luck!

 

[GeneGoddess]

You have some great schools on your list. I interviewed at several of them (16 places total), and will be more than happy to tell you about MY impressions. But you really need to narrow your list down. I'd do it by geography first (as another poster said: where do you want to live?). I don't mean certain states, I mean towns. I interviewed on all three coasts, but avoided the midwest (too cold and landlocked). I wanted hospital based or hospital associated (mostly former). I wanted large cities for my spouse and his job. That narrowed it down to about 25 and I eventually applied to twenty. Yes, it was high, but I didn't know my "status" and I honestly wanted to keep my options open. I'm glad I applied to some that I normally wouldn't have (Brown!!!). Also, what are your goals? Do you want general? Academic? Private practice? I want to specialize, but I wanted a good, well rounded Pedi residency to help me learn GENERAL pedi before I went off to specialize...

 

[Lara]

I do think I'll want to specialize, but like GeneGoddess would like a program that'll help me learn good general peds. I'm kinda contemplating taking 4-5 years off before fellowship to qualify for loan repayment by working in an underserved area, if that's feasible.

What's the easiest way to tell if a program is "fellow-run"? That's a good point - I'd likely learn more at a program without them. But I don't know if I'd have to go community for that, in general I probably would rather a university association (and freestanding hospital if possible). I don't need it to be very heavy on research though. As far as size, I don't want a tiny (say 5 resident) program but it doesn't have to be very large (>25) either, midsized is probably best.

Now I wish I had a significant other to tie me down! At least it would help in narrowing down locales. I'm also torn between "cool" and "lower cost of living"...NYC/Boston/Seattle/Cali etc. (should I actually have a shot) would be super but probably not the most responsible choice considering my debt.

Thanks for the tips, keep them coming. And Chicago is a major consideration, so I appreciate the reviews!

 

[14022]

I'm kinda contemplating taking 4-5 years off before fellowship to qualify for loan repayment by working in an underserved area, if that's feasible.

I think it would depend on what you want to specialize in. Specialties like nephrology and rheum are dying for applicants, so it would be incredibly easy to do so. Cardiology and heme-onc are fairly competitive so I would think programs would look for people with more of an academic background.

What's the easiest way to tell if a program is "fellow-run"?

You can check the programs website or FRIEDA to find out the number of fellowship programs and fellows. That will give you an idea of how many fellows are in the program. In terms of the fellows' role, it depends on the program. I have heard at Northwestern the cards fellows are responsible for most aspects of patient care and are not allowed to delegate to the residents and students. Other programs have the fellows serve a more supervisory role to the residents. That would be a good question to ask residents and PD's on interviews.

But I don't know if I'd have to go community for that, in general I probably would rather a university association (and freestanding hospital if possible).

I would rather go to a free-standing hospital as well, but keep in mind that there are very good programs that do not have a free-standing hospital, eg, Mattel Children's Hospital at UCLA and Duke. If you do go to a "hospital within a hospital" make sure that they have services specific for children, such as child-life specialists, pediatric-trained ER physicians, pediatric-trained radiologists, etc.

 

[Morgul]

Honestly, that's a pretty hefty list. I'm a west coast guy, and limited my applications to the west coast and the south (with a couple in the midwest thrown in). I applied to 17 programs, interviewed at 11 and by the end was REALLY sick of the process. As other's have said, you need to narrow down your initial list a bit...I can try to give you some advice on the WC.

First, the presence of a Children's hospital is begining to be a big thing. Many top programs around the country are just finishing new ones or expansions (UNC, Cinci, Vanderbilt, UCLA) or are starting new ones (U Mich, Denver Children's). It doesn't need to be stand alone, but it is a nice feeling to know that you are in a building built ground up with kids in mind. (My top 4 picks were all stand alones). This can also play a big role with retention and recruitment of faculty. New facilities are also nice for comfort, you are going to be spending a lot of time indoors and being in a modern facility helps.

Second, really consider where you want to live. Been to LA? Its pretty massive, and nothing like an East Coast city. SF may be more inline with that, but the prices are going to be horrific. (Ie, 1500 a month in rent for a postage stamp sized place). Big gritty urban centers? (Cleveland. BMore) College towns? (Ann Arbor, CVille). Like outdoor activities? (SLC, Denver, Tucson). You said you would like warm weather, I'll keep that in mind for a bit later.

Third, although fellowships are not as difficult to come by as IM ones, they are becoming harder to get into. More people are trying to get into fellowships every year (esp higher paying ones). This is something you need to consider. Academic programs really own the fellowships, so community based would probably not be the best idea. I had a 3 subspecs I was interested in, and using FRIEDA helped pare down my programs. I basically looked at programs and gravitated to those which had high number of fellowships available. Although you can get to a fellowship from pretty much any decent University program, being at the program which offers the fellowship will give you a nice head start.

Fourth, "prestige" Although some may try to pretend it doesn't exist or matter, being from a big name program can help open doors later on. However, just because a program has a big time rep due to IM or Surg doesn't mean their Peds program will be of a similar caliber!

Some quick thoughts on my situation compared to yours. I think I had a moderately better record (middling first 2 years, high pass/honors everything 3rd year) from a small southwestern state school. I got shot down by the top programs on the WC, but got interviews every where I applied in the south and midwest. The WC schools may be more receptive to someone coming from the east, not sure about that. Its a hard call on how you are going to do interview wise. I just don't know how being from the east coast will play for some of these western programs.

Don't forget you can add programs after your initial application! I sent in probably three rounds of applications. Some programs will give you ultra fast responses, some will take their time. If you apply early and feel you aren't getting the love you can try adding more (a bit risky though as program's interviews spots may have filled)

Finally, a couple comments on your list. For the WC, a lot of people say the most well known are Denver, UCSF, Seattle, and Stanford. Most people who have visited Denver really loved it, but it is not easy to get into. I would toss out some of the UC schools unless you had a good reason to go there. If you are sure you wouldn't mind living in LA you can keep LA children's and UCLA. If you are a big fan of outdoorsy stuff involving mountains consider U Utah in SLC. Phoenix children's is an up and comer in the west. If you are looking for heat you found it!

For the midwest, I only interviewed at Cinci and U Mich. (Canceled Mayo...) Cinci surprised me quite a bit, I had applied on the advice from my advisor and didn't know much about it. I thought it was easily the best overall program I visited, although also the largest. (Just to point out, US News agrees and put it 4th in the country in a ranking of peds programs)

In the south, for sure keep UNC. Great program with nice facilities, not too bad weather, and a great college city/well educated atmosphere. Also, consider Vanderbilt, that was an impressive program and I didn't find anyone on the trail who had applied there and wasn't excited by it. UVA was good too, its smaller but if you are looking for that its very nice.

Err, probably typed too much! Anywas I'll stop here. I can get into a lot more specifics regarding the programs I interviewed at if you want, but anyways good luck!

 

[ekydrd]

Morgul has given great advice. With about 50 programs on your list I hope you are independently wealthy or have a relative with deep pockets. Such a list will cost an arm and a leg to apply to. Don't sell your self short. You sound like a decent applicant so you should do better than 25%, but you could increase your chances (and decrease the pain of rejections) by narrowing your list a little. Shoot for about half as many as you have listed right now, but keep a good mixture of your "reach" programs (those you feel you may not be as good a candidate for but would love to attend), and safety programs (those you feel more comfortable about your chances).

You will probably get more invites than you can handle, and don't schedule more than 2 or 3 in a week. It is very exhausting, not to mention expensive as not all programs pay for housing or provide a meal, and you will be responsible for getting yourself there and back.

Good luck.

 

[GeneGoddess]

You will probably get more invites than you can handle, and don't schedule more than 2 or 3 in a week. It is very exhausting, not to mention expensive as not all programs pay for housing or provide a meal, and you will be responsible for getting yourself there and back.

Good luck.

I disagree with the number of invites per week. I literally scheduled 13 in a row (every day except weekends for 2.5 weeks) and found it fine. I also interviewed at 16 schools (several two-day interviews, making 19 total days) for under $1500. That includes travel, lodging, suits, pantyhose, and even food. And only two places were within driving distance. If I had scheduled time in between, I would have been paying extra for hotels, etc. It IS expensive, but planning well helps (group geographically, ask if residents offer a place to stay, go to the pre-interview dinners, rent a car instead of flying).

 

[makesomerheum]

Morgul,

Would you mind giving a few insights on the West Coast schools (esp CA)?
Thanks.

 

[fourthyearmed]

I applied to 12, was invited to all, and then cancelled 2 interviews. You will be so sick and tired of travelling when it is over that you won't want to go on vacation ever again. It all comes down to where you want to live. Don't waste the money applying and travelling to schools that deep down you know you won't go to. Pick your top 15 choices and apply. Narrow it down to 10 to interview at (assuming they aren't all top 10 schools) and go for it. You'll be surprised where you get invited!

 

[edmadison]

Just be forwarned that scheduling can be a big puzzle. Many programs only interview 2x a week and may only have a few openings by the time you are invited to interview. Plus, you have to factor in travel time. I think it would be really hard to schedule more that about 15 interviews total.

Ed

 

[Blessedone]

I agree with 4th year med. You will get tired of interviewing and have to cancel some. For me, I applied to about 18 schools, got 17 interviews and ultimately went to 10. Apply early so you can have first dibs on interview dates.

As far as deciding which programs to apply to, it's all about location, location, location. Eliminate programs that are in cities you do not want to live in. When it's all said and done, my final choice was based on 1. city, 2. personality of the residents, 3. name (academic vs community).

Hope this helps.

 

[ekydrd]

... I literally scheduled 13 in a row (every day except weekends for 2.5 weeks) and found it fine...

Doing this can be a logistical nightmare, but as GeneGoddess stated it can be done... if you are a glutton for punishment (just kidding GG )