Hovering over the shoulders of program directors throughout the country right after the NRMP match, sponsoring hospital and medical school administration eagerly monitor the match results and statistics from each radiology residency. And, what excites these bureaucrats?
First and foremost, they love it when you’ve matched all your spots, a legitimate achievement. Second, these administrators want to see how far down the rank list you went. Now, I believe this to be a bogus statistic because many of our best residents have been ranked farther down the rank list. But, OK, I will give them that statistic willingly (although I think it’s silly!)
And, finally, they ask to see how many residents came from “Ivy League” institutions. Now, this arena is where I have a real problem. It shows a lack of insight into the residency selection process and medical school training, as well as demonstrates a hubris undeserved of the sponsoring institution. And, let me tell you why.
Medical School Selection Bias
With all this talk about Lori Loughlin and the unfair practices of the university selection process and knowing what I know about the university selection process, I believe that university selection biases also apply to many medical schools. In particular, these issues tend to affect “Ivy League” medical schools more than most because of the aggressive pursuit of applicants (and snowplow Moms!) to get in. Between legacy favoritism and the eternal quest for diversity (not necessarily having to do with the making of a quality physician), these institutions do not necessarily select for the best candidates at our radiology program. Now, don’t get me wrong. There are some great students at these institutions. But, great students sit on the rosters of almost any medical school.
Poor Fit For The Institution?
Many of the candidates that come from “Ivy League” medical school (not all) want to work in radiology residency programs that have a preference for getting grants and bench research. And, not all programs offer this sort of work. Instead, some residencies provide a solid clinical experience without in-depth bench research. Why would these candidates fit in well with the philosophy of these programs? They do not!
No Difference In Resident Performance
In this realm, I am a bit biased. But, in a look back of all the residents that we have had over the years, our best residents ironically have often come from Caribbean medical schools or have been D.O. candidates. Not to say that the “Ivy League” graduates have been terrible. But, I have not seen standouts of increased performance compared to the other residents in our program.
And this same idea you can also see in the top 20 CEOs in this country. Take a look at the Crain’s Chicago Business article called No One Asks Where The Top 20 CEOs Went To College. (Hint: Only one went to an Ivy League institution) So, why make an increased effort to recruit these applicants when these residents have not performed any better?
Possible Attitude Issues
And finally, as an associate residency director, what is one of the worst things I can do? Well, naturally, recruit residents that do not want to be here. If we are a profoundly clinical residency without that hardcore research component, why would I want to hire an applicant who intends to apply for research grants? These sorts of residents can develop the wrong attitude for a residency program without these resources and will regret being there. Discontented residents make for a miserable residency experience.
The “Ivy League” Applicant
Now, I am not saying that programs should avoid taking applicants from these prestigious medical schools. Indeed, many will make excellent residents. My point is that great residents can come from any medical school. To make accepting these residents into your program as a badge of honor neglects the right reason for the application process in the first place. And what is that reason? It is to find a candidate who thrives and performs successfully over the four years of training!