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prestige vs fit when ranking

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Hello everybody; longtime lurker. First time poster. Carms applicant here, post-interviews, about to submit rankings and having some difficulty.

I interviewed widely for a competitive specialty and was wondering if anybody has any thoughts on how important program prestige vs personal fit is when ranking. I loved some of the smaller/community-focused programs and can really see myself at a few of them, but my interviews at some of the "powerhouse" programs (that is to say, greater global impact, attendings who lead major studies, etc) went really well.  I suppose I could be happy at these big programs, but perhaps not as happy as I might be at certain smaller programs for 5 yrs.

Does happiness and fit really matter all that much in the end when ranking, if all programs are essentially good? Should I be considering "fit" at the expense of potentially not being able to match to  strong fellowships down the line? (problem is, I dont really know whether I would even want to do a fellowship down the line... I just wouldn't want any doors to be closed, you know?)

Thanks

 

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Prestige doesn’t exist in Canada/Canadian medical schools - regardless of what some places would have you believe. They are all good, just different so you need to find the one that is best for you, eg. FIT. A residency from any Canadian school keeps options open to any Canadian fellowship. I doubt it would impact US fellowships much either. 

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Choose based on how content you precieve yourself to be, as well as where your support systems are, if that's important to you. I can only speak for peds, but residents at smaller programs match to the big centres for fellowships all the time. If you really want to do academics/research then that may change the equation a bit.

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Not really much prestige in Canada tbh. I doubt anyone would be impressed if I did my training at UBC for example over Western. Harvard maybe, but even then it's just pointless vanity for the most part.

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FIT - hundred percent. You need to be happy at your program to do well, if you don't fit into the culture, don't fit into the city or are away from family and friends, you aren't going to perform your best and you ultimately won't get into a good fellowship if you so chose to seek one. 

The prestige that you are talking about may get you an interesting conversation or two at international conferences, potentially some more curiosity from US doctors when networking at conferences, but it means nothing if you can't back it up and one huge factor is FIT. 

You'll also find a lot of prestige is more mirage than truth. Don't believe that everything is better at a more brand name program. Pros come with cons often. More research? maybe less time for teaching then. Better location? More competition and less free time to enjoy said location. Etc. 

Keeping options open is also important, but its unlikely that any program would care where you went to residency as long as you can back up your application with a strong resume. Its much more important that you find yourself in a culture that will let you thrive and grow and be your best. That will ultimately lead to better career success. 

 

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Matching to a desired specialty and considering fit vs prestige?  Go for that rare alignment of the stars with both!  

Or if you're really lucky you can look at that great opportunity of going unmatched.  That's when the choices get real good. 

 

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On 2/17/2020 at 9:48 PM, ZBL said:

Prestige doesn’t exist in Canada/Canadian medical schools - regardless of what some places would have you believe. They are all good, just different so you need to find the one that is best for you, eg. FIT. A residency from any Canadian school keeps options open to any Canadian fellowship. I doubt it would impact US fellowships much

Faculty level personal contacts matter more for US fellowships.  Look at research collaborations if that matters to you.

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