Regional Bias

[Harvey Harvardson]

Hi guys, I've been trying to find some extra details about regional bias and how it would affect my situation. I currently attend a DO school in the South and am hoping to attend an EM (maybe IM) residency out in the West where I'm originally from. I've seen that away rotations may help as well as some sort of connection to the area. However, would connection to just one state in the West (WA) be strong enough for applications to the other Western states (CA, OR, etc)? I guess I'm unsure about just how big a role regional bias plays. I'm planning to apply to both ACGME and AOA programs.

USMLE Step 1: 243; Comlex 1: 651. Haven't taken Step 2s. No research (yet?).

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[The White Coat Investor]

I think regional bias is the least of your concerns. You just need to be convincing at your interview as to why you want to come out West.

I'd worry more about DO bias than regional bias as it will affect you far more applying out West.

 

[doggydog]

I think regional bias is the least of your concerns. You just need to be convincing at your interview as to why you want to come out West.

I'd worry more about DO bias than regional bias as it will affect you far more applying out West.

The regional bias affects getting the interview more than anything.

 

[SpacemanSpifff]

Hi guys, I've been trying to find some extra details about regional bias and how it would affect my situation. I currently attend a DO school in the South and am hoping to attend an EM (maybe IM) residency out in the West where I'm originally from. I've seen that away rotations may help as well as some sort of connection to the area. However, would connection to just one state in the West (WA) be strong enough for applications to the other Western states (CA, OR, etc)? I guess I'm unsure about just how big a role regional bias plays. I'm planning to apply to both ACGME and AOA programs.

USMLE Step 1: 243; Comlex 1: 651. Haven't taken Step 2s. No research (yet?).

In short: probably not. If you want to come out west for EM then rotating out west will maximize your interview chances. California is its own beast. Rotating in CA or nearby states will by no means guarantee you invites in CA, although it will probably increase your chances.

 

[Harvey Harvardson]

I think regional bias is the least of your concerns. You just need to be convincing at your interview as to why you want to come out West.

I'd worry more about DO bias than regional bias as it will affect you far more applying out West.

Do you believe the DO bias applies to even the mid-/low- tier programs?

The regional bias affects getting the interview more than anything.

In short: probably not. If you want to come out west for EM then rotating out west will maximize your interview chances. California is its own beast. Rotating in CA or nearby states will by no means guarantee you invites in CA, although it will probably increase your chances.

Anything I can do to increase my chances of landing interviews in CA besides the away rotations?

 

[The White Coat Investor]

Do you believe the DO bias applies to even the mid-/low- tier programs?



Anything I can do to increase my chances of landing interviews in CA besides the away rotations?

Are there any mid/low tier programs out West?

 

[SpacemanSpifff]

Do you believe the DO bias applies to even the mid-/low- tier programs?



Anything I can do to increase my chances of landing interviews in CA besides the away rotations?

Crush Step 2 and your aways. Talk to mentors who may be able to plead your case with any connections out in CA. Take up surfing.

 

[Perfect Hair Day]

Forgive my ignorance, but can someone explain to me how widespread a given bias is?

Lets say, for discussions sake, I grew up in New Jersey and then went to medical school in the Southeastern US. I do an away rotation in Boston. Will New York and PA programs pass me up, or does being from NJ and doing an away in Boston help me to 'secure' an interview berth from the Northeast programs? (Assume I am a middle-of-the road to above average applicant for EM in this scenario)

 

[Frazier]

I'm a resident at a Cali program... out of my cohort, every single one of us has ties to the state. Basically either born, raised, undergrad, or med school here.

I personally did not do an away west of the mississippi.

It's not a lock-out, but there is indeed bias.

 

[Frazier]

Do you believe the DO bias applies to even the mid-/low- tier programs?

There are no low tier programs in CA. They basically all have good volume, high acuity, and mad diversity.

When it comes to DO bias, one trick to do with grain of salt is to check out recent class rosters for pedigrees. If there are zero DO's in the program, draw your own conclusions.

Be sure to apply to the DO-oriented programs. Arrowhead and Palm Springs come to mind.

 

[monkeyfeet]

I think I've read on here that some component of the regional bias is that PDs are more familiar with local programs and therefore SLOEs from within the same region are easier to interpret. (Or I just made that up, but I think I read it at some point.) I'm curious then if a solid SLOE from a "top" program would do anything to expand the geographic viability of an application, as presumably PDs would have some awareness of the program even though it was out of region?

Basically, if I can't do aways in every part of the country where I have an interest, would doing well on aways at places that perennially grace SDN rank lists help my app gain traction in other regions as well?

 

[RainbowOtterz]

So let's say I'm born in Arizona, but moved to Washington state and am technically a resident there. I would like to go back to AZ for EM residency, with eventual goals of practicing somewhere in the south/midwest/southwest because of weather and culture (not a fan of big cities/rain). I'm currently a 3rd year at an eastern US MD school, step 1 of 237. What do I need to do to secure a residency in AZ/texas/Midwest? I've heard of EM electives that are basically required- are these done in 3rd or 4th year? And is it necessary to get high marks in electives like Psych, or is "pass" okay?

Good grades are good grades. You want them, they bolster your application. EM requires away rotations (electives) four year for special letters (SLOEs). If you are interested in a region/program it is a good idea to rotate at that program or region.

So, do an away in Arizona. At my fairly large program in Arizona approximately 50% of the residents in each class for the last few years were four year rotators.

 

[Status Sciaticus]

Good grades are good grades. You want them, they bolster your application. EM requires away rotations (electives) four year for special letters (SLOEs). If you are interested in a region/program it is a good idea to rotate at that program or region.

So, do an away in Arizona. At my fairly large program in Arizona approximately 50% of the residents in each class for the last few years were four year rotators.

Do we get looked at more favorably compared to regular applicants if we do the US rotation there (clerkships are full)?

 

[HooliganSnail]

Do you believe the DO bias applies to even the mid-/low- tier programs?



Anything I can do to increase my chances of landing interviews in CA besides the away rotations?

Supply/ Demand = ability to be picky.

EM is more competative. The south and West of the country are not as friendly to DOs, this is a fact.

Keep in mind. No one at a low tiered program (whatever that is) goes to work and thinks, "Gosh our residency is decidedly mediocre". Everyone thinks they are great.

 

[jw3600]

When are you taking step 2?

 

[Jabbed]

Kind of curious what the rationale is for the regional bias, especially in states like CA. Does it go anything beyond "we don't think you're serious about us if you don't already have any ties here"?

 

[Lexdiamondz]

Kind of curious what the rationale is for the regional bias, especially in states like CA. Does it go anything beyond "we don't think you're serious about us if you don't already have any ties here"?

In general yeah. It takes time, money and resources to interview people and you have to interview a lot of people to fill your program most of the time, so why waste time on people who would rather not be in your region? If I was a PD in Erie, PA I wouldn't waste my time interviewing a med student from Harvard who grew up in Manhattan, there's no reason they'd want to come to my program geographically speaking.

In the case of CA programs, it's more a function of there not being that many CA programs relative to the state's population, so preference goes to people who have personal ties to the area or people who trained/rotated there and are known to the PDs

 

[alpinism]

In general yeah. It takes time, money and resources to interview people and you have to interview a lot of people to fill your program most of the time, so why waste time on people who would rather not be in your region? If I was a PD in Erie, PA I wouldn't waste my time interviewing a med student from Harvard who grew up in Manhattan, there's no reason they'd want to come to my program geographically speaking.

In the case of CA programs, it's more a function of there not being that many CA programs relative to the state's population, so preference goes to people who have personal ties to the area or people who trained/rotated there and are known to the PDs

This.

Academic EM like many things in life is very buddy buddy and all about who you know.