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- Thread starter dsonic
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Agree.
The difference would be much greater when talking about a class size of 50 (Mayo) vs 180- 200+ (often, at State/Public schools)
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Agreed, a difference of 30 is negligible. But to your point, the manifestation of class size is the bottleneck in clinical volume. Only so many surgical cases to go around. Only so many patients on the medicine census to divide up.
One proxy to ensure adequate clinical volume is a bunch of different hospitals:
- county hospital = late presentation of common diseases; bread and butter
- university hospital = zebras
- children's = weird congenital
- women's = self explanatory
- VA = bread and butter
A lot of lower tier schools have to send their students hours away for certain rotations.
Other things to look for are:
- NCI designation = complicated surgeries, medical management, and imaging
- Busy transplant service = as above
- Large catchment area and referral base. I'll pick on Boston or New York where there is a high density of healthcare systems relative to the population size. This often creates niche specialization within a particular healthcare system which is fine for faculty or subspecialty trainees but not great for medical students or junior residents.
Also when you're shopping around for research projects or mentors it's nice to have fewer people to compete with.
One proxy to ensure adequate clinical volume is a bunch of different hospitals:
- county hospital = late presentation of common diseases; bread and butter
- university hospital = zebras
- children's = weird congenital
- women's = self explanatory
- VA = bread and butter
A lot of lower tier schools have to send their students hours away for certain rotations.
Other things to look for are:
- NCI designation = complicated surgeries, medical management, and imaging
- Busy transplant service = as above
- Large catchment area and referral base. I'll pick on Boston or New York where there is a high density of healthcare systems relative to the population size. This often creates niche specialization within a particular healthcare system which is fine for faculty or subspecialty trainees but not great for medical students or junior residents.
Also when you're shopping around for research projects or mentors it's nice to have fewer people to compete with.
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For most students the most significant academic impact you will see between class sizes will probably be wrt clerkships and AOA.
You should ask clerkship students how many med students / team or clerkship site on a given rotation. During normal times at our smaller school with a fairly large number of clerkship sites this number is typically ~1 MS3 and if there was another student it was usually an MS3 + MS4 on Sub-I. At least here many perceived that to be advantageous to them because they rarely felt like they were "competing" with another student for attention, cases, patients, or on evaluation. That said, it's perfectly possible to have a similar experience at a school with a much larger class size if it also has many clerkship sites / a very large medical center.
Depending on how the school does AOA, class size will likely have an impact with it potentially being harder to land at the "top" of the class by whatever metrics they are looking at in a larger class.
Socially, it will depend on what kind of environment you prefer and the school culture.
You should ask clerkship students how many med students / team or clerkship site on a given rotation. During normal times at our smaller school with a fairly large number of clerkship sites this number is typically ~1 MS3 and if there was another student it was usually an MS3 + MS4 on Sub-I. At least here many perceived that to be advantageous to them because they rarely felt like they were "competing" with another student for attention, cases, patients, or on evaluation. That said, it's perfectly possible to have a similar experience at a school with a much larger class size if it also has many clerkship sites / a very large medical center.
Depending on how the school does AOA, class size will likely have an impact with it potentially being harder to land at the "top" of the class by whatever metrics they are looking at in a larger class.
Socially, it will depend on what kind of environment you prefer and the school culture.
This is so important and so often overlooked by residency applicants. Especially in surgical fields, the wide catchment area is a hugely important factor in both clinical volume and variety of cases. This is the reason that UW has such a strong reputation across so many surgical subspecialties. Other places like Colorado, Utah, Emory, Vanderbilt, UAB benefit from the same idea and tend to have great surgical training.
On the other hand, you the nail on the head re: NYC and Boston.