by DrDave » Sat Jun 28, 2008 10:20 am
I have never personally participated in the admissions process so my comments are just from what I've heard and my impression talking with residency program directors.
When looking at prospective residents, if I had to guess the importance of various factors in getting accepted, I'd say the list is as follows:
1. A personal phone call from someone respected in the field (ie, department chairman) to the residency director with positive praise
2. Positive letters of recommendation from people in the field you are pursuing who are respected nationally
3. Positive letters of recommendation from people the residency director knows or respects
I would say those top 3 factors are probably necessary to get into the most competitive fields, especially at the most competitive programs. The above factors are unnecessary for the majority of residency programs.
4. Graduating from a top medical school. I would define a top medical school as one that is nationally recognized as a top medical school. People in the medical field know which schools are excellent, which ones are good, and which ones are not so good. The general opinion is that osteopathic schools are a moderate step below the lowest M.D. school, and that foreign medical schools (including Caribbean schools) are a significant step below US medical schools when it comes to accepting students into a residency program. While this may not be entirely fair, it seems to be the quality of applicants from DO schools and foreign medical schools is much more variable. Occasionally residency programs get outstanding graudates from foreign medical schools, but often they get very poor residents from foreign medical schools as well. There is much more variability when the student has not come from a US medical school.
5. Getting good grades (although my medical school fortunately was entirely pass/fail)
6. Positive letters of recommendation from faculty at a top medical school
7. Positive letters of recommendation from anyone else
Research experience with a top named person in the field or at a top institution can play a factor, especially in a competitive field.
Again, this is just my experience and remember that I have never been part of the decision making process in accepting residents (other than having the residency directors ask my opinion at times of applicants I met while they were interviewing). I just know that when I was looking at residency programs, one of the ways to measure the caliber of a program is based on what percentage of US graduates they attract vs what percentage of their program is filled with foreign medical graduates. It may not be fair, but it is the reality of the system. I am certainly open to opinions to the contrary if they can be backed with some solid evidence.
Also, these factors are significantly less important if you are going into a less competitive field like family medicine. If you are choosing to go into a field like orthopedic surgery, plastic surgery, radiation oncology, or actually any other surgical field, then you would have virtually no chance of getting a residency unless you graduated from a US medical school. I actually will see if I can track down what the percentage of foreign graduates is based on field of specialty, as I would expect in some fields there are almost no slots going to foriegn medical graduates. In many fields it is difficult for US graduates to get a spot too.