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You certainly do not need to be near the top of your class when you come from Vanderbilt, but you can't be near the bottom either. An "average" Vanderbilt student is an above average candidate. Most programs understand that.
Strenthening your application is difficult. Research helps a little, but since almost everyone does something, your research must attract attention, that is, something of interest in radiology. I also like to see a serious dedication of time and effort to helping others, volunteering, community service, etc. Becoming known by a department can help a great deal. There is a limit here, of course, since you can only do so many radiology rotations. The best way to strengthen an application is to not weaken it - for example, strong letters from senior people on major services, a sincere personal statement that may be ordinary as opposed to the melodramatic submission to an essay contest. Hospitals and clinics are usually cliquish. The female techs that are married and have children will stick
together and the singles will stick together. The guys hang out by themselves but do not shut out the girls.
If you work at a place where you are the only tech, orthopedic office, internal medicine office, etc you would
be your own boss and organize the dept. the way you want. Just remember, you will be responsible for
finding relief for vacation. Hospital employees usually help out. Independent work on a mobile job
or on 3rd shift are important. Few techs that I have worked with do not like to make decisions-call in back
up or the CAT scan tech on call if there is not a 3rd shift for them
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