Accept offer at low tier school, or defer a year?

[iceman55]

Well, if he's going to call me an "idiot," he should make more of an effort to use proper grammar!

well am on my phone, I don't pay attention minor errors.

And i stand by my quote, you are an idiot

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[QuinnTheEskimo]

well am on my phone, I don't pay attention minor errors.

And i stand by my quote, you are an idiot

There is something wrong with you, did you even read the thread?

 

[huskydock]

I say if he's really that apprehensive about taking the acceptance at a MD school, then let him reapply. That way, a spot will be open for someone who really wants to be there and would be overjoyed at being given a chance to be a physician.

 

[iceman55]

There is something wrong with you, did you even read the thread?

Dude, someone asked the same question less than a week ago. To your benefit, his was even worse. I think he asked if he should give up an acceptance to mid-tier. How ridiculous does that sound?

 

[BlueLabel]

There is something wrong with you, did you even read the thread?

See this is exactly what goes through my head every time I read one of your posts.

 

[TreadLightly]

Tell him to absolutely reapply next year. He seems smart, something should work out...

On the other hand, I could really use a low tier acceptance this year so I can take that off his hands

 

[ManOfDiligence]

HARVARD MD/PHD/JD/MBA/MS/MPH OR BUST

Lmao

 

[ChemNerd07]

Little off topic. Where on earth is this magical list of 'ranking' schools? Is it the USNews list? If so what determines a school as a T10, T20, etc? Is it the primary care rank? Research rank? ...

You can obviously tell how much I cared about prestige lol.

 

[Euxox]

Little off topic. Where on earth is this magical list of 'ranking' schools? Is it the USNews list? If so what determines a school as a T10, T20, etc? Is it the primary care rank? Research rank? ...

You can obviously tell how much I cared about prestige lol.

When people talk about rank, it's usually US News research rank.

 

[wades]

I have a related but more specific question; (not to hijack the thread but..) hypothetically could someone defer an acceptance for a year and apply to other schools during the following cycle without the school finding out? And if so, could that applicant just take the acceptance at the end of the deferment period if the other options didn't pan out? Just wondering, someone asked me this the other day and I didn't quite know how to respond.

 

[Lya]

I have a related but more specific question; (not to hijack the thread but..) hypothetically could someone defer an acceptance for a year and apply to other schools during the following cycle without the school finding out? And if so, could that applicant just take the acceptance at the end of the deferment period if the other options didn't pan out? Just wondering, someone asked me this the other day and I didn't quite know how to respond.

Highly doubtful.

There are only a few ways to get that deferral--usually things like Rhodes, or perhaps completing PeaceCorps. Besides, AMCAS will ask you if you are accepted somewhere or if you already matriculated into medical school. If you don't tell the truth there and get caught later on, well, come back to this thread and keep us posted!

 

[Law2Doc]

When people talk about rank, it's usually US News research rank.

The research rank gives a sense of prestige, as the amount of research money a program brings in sometimes means the program has more money to use to attract big name faculty or build better infrastructure. But It doesn't usually translate to how good the education is or whether you can get a great residency from there. Truthfully if you get in at any US allo school, you probably can get to where you want to go, but the very top of the list sometimes gives you access to resources you won't have at the very bottom. Now if we are talking about the sixty or so programs in the middle, I'd say you are splitting hairs. We have had people on SDN over the years who somehow got into their heads that they belonged at top 20 schools, and after a year or two of being reapplicants finally realized that schools simply didn't share that view and took what they could get. One had much higher numbers than your "friend". This isn't just a Numbers driven process, and there are a Lot of things besides applying late that could make your friend be deemed not a "good fit" for schools. Certainly if the arrogance of thinking oneself too good for a mid-range school seeped through, your friend was lucky to get ANY offers. Your friend should jump at what's on the table, and milk it for whatever educational value and research opportunity is there. If they don't screw it up, the "top tier" residency could absolutely be attainable from there.

 

[sourdoughllama]

The research rank gives a sense of prestige, as the amount of research money a program brings in sometimes means the program has more money to use to attract big name faculty or build better infrastructure. But It doesn't usually translate to how good the education is or whether you can get a great residency from there. Truthfully if you get in at any US allo school, you probably can get to where you want to go, but the very top of the list sometimes gives you access to resources you won't have at the very bottom. Now if we are talking about the sixty or so programs in the middle, I'd say you are splitting hairs. We have had people on SDN over the years who somehow got into their heads that they belonged at top 20 schools, and after a year or two of being reapplicants finally realized that schools simply didn't share that view and took what they could get. One had much higher numbers than your "friend". This isn't just a Numbers driven process, and there are a Lot of things besides applying late that could make your friend be deemed not a "good fit" for schools. Certainly if the arrogance of thinking oneself too good for a mid-range school seeped through, your friend was lucky to get ANY offers. Your friend should jump at what's on the table, and milk it for whatever educational value and research opportunity is there. If they don't screw it up, the "top tier" residency could absolutely be attainable from there.

Agreed. Top 20 advantages get thrown around SDN a lot with extremely vague reasons like "more opportunities and better resources." In my opinion, the real advantage of attend a top tier school is the prestige that comes with it (and the nice letters you get). It will always give you a little advantage over someone from a less prestigious school, but I'd argue that besides that the education should be pretty comparable at most schools from what I've seen. Research funding is always cited as a metric because US News uses it and it's the only official ranking (again, my opinion).

 

[3838]

The research rank gives a sense of prestige, as the amount of research money a program brings in sometimes means the program has more money to use to attract big name faculty or build better infrastructure. But It doesn't usually translate to how good the education is or whether you can get a great residency from there. Truthfully if you get in at any US allo school, you probably can get to where you want to go, but the very top of the list sometimes gives you access to resources you won't have at the very bottom. Now if we are talking about the sixty or so programs in the middle, I'd say you are splitting hairs. We have had people on SDN over the years who somehow got into their heads that they belonged at top 20 schools, and after a year or two of being reapplicants finally realized that schools simply didn't share that view and took what they could get. One had much higher numbers than your "friend". This isn't just a Numbers driven process, and there are a Lot of things besides applying late that could make your friend be deemed not a "good fit" for schools. Certainly if the arrogance of thinking oneself too good for a mid-range school seeped through, your friend was lucky to get ANY offers. Your friend should jump at what's on the table, and milk it for whatever educational value and research opportunity is there. If they don't screw it up, the "top tier" residency could absolutely be attainable from there.

This. Exactly this. Think like the med school. For med schools, students are an investment because of the limited number of spots. They know that numbers, while important, are not going to create great physicians. Their real reputation is built on the caliber of student that they produce. At best, they want students who will be leaders in the field of medicine, who will innovate and push the field forward. At least, they want good physicians who will serve well. Getting into any med school is getting a vote of confidence that you have that potential; once you're in, you have the opportunity to become a great physician, wherever you go.

And the idea that a state school has "too few" resources is ridiculous. Most schools have more resources than you could ever use. Sure, some have more than others. Tell me, how many resources did you actually use from your undergrad institution? So, follow Law2Doc's last sentence to the letter. No one gives a crap where you come from or where you go. It's what you freaking do that matters. In the world of medicine, at least, prestige obsession is ridiculous and people need to get over it; by being obsessed with prestige, you're losing sight of more important goals. IMO, your friend should make the choice between the two schools he's gotten into based on how he meshes with the people, the curriculum he will do best in, where he wants to practice medicine. And he really should learn to humble himself.

 

[NickNaylor]

And the idea that a state school has "too few" resources is ridiculous. Most schools have more resources than you could ever use. Sure, some have more than others. Tell me, how many resources did you actually use from your undergrad institution? So, follow Law2Doc's last sentence to the letter. No one gives a crap where you come from or where you go. It's what you freaking do that matters. In the world of medicine, at least, prestige obsession is ridiculous and people need to get over it; by being obsessed with prestige, you're losing sight of more important goals. IMO, your friend should make the choice between the two schools he's gotten into based on how he meshes with the people, the curriculum he will do best in, where he wants to practice medicine. And he really should learn to humble himself.

Despite how appealing this egalitarian ideal is - and I really do wish it were true - it flies in the face of what I've been told by multiple advisers/attendings. A good school reputation will not make up for glaring deficits or otherwise give you a huge advantage, but, per the people I've spoken with, it can definitely open doors that may not otherwise be open to you. Take that for what you will. Is it worth it to go to a prestigious school solely for that purpose? Definitely not. But there does seem to be an intangible and poorly defined advantage that can definitely be helpful to you depending upon what you want to do.

 

[3838]

Despite how appealing this egalitarian ideal is - and I really do wish it were true - it flies in the face of what I've been told by multiple advisers/attendings. A good school reputation will not make up for glaring deficits or otherwise give you a huge advantage, but, per the people I've spoken with, it can definitely open doors that may not otherwise be open to you. Take that for what you will. Is it worth it to go to a prestigious school solely for that purpose? Definitely not. But there does seem to be an intangible and poorly defined advantage that can definitely be helpful to you depending upon what you want to do.

I've definitely heard this too. Of course there is an advantage. There is always an advantage. But, that doesn't mean that you can't become the the kind of physician that you want from a lower tier MD school. The question here is what are the OP's career goals as a physician. What does he want to do as a physician? By this, I don't mean what residency does he want or what award does he want to win. But, as a physician, what does he want to accomplish for his patients and for the field of medicine? If he answers that question, I think he will honestly find that he can achieve these things by going to pretty much any MD program in the country. The point is that most people don't need a top residency to accomplish their goals. I want to be a physician that is able to respond to the community's needs with public health research. In fact, my goals are even more specific with how that research should be done; I have a vision for re-defining how public health research is done in this country. It might be easier with a top program, but I really don't need a top program to do that. That said, I will choose the program that best fits me if given the choice, and that is a top program. But I still could achieve these goals at my state school.

I have a sneaking suspicion, though, that the OP doesn't really know what that goal is, that his goals do revolve around getting the most prestigious residency possible or getting fame and glory or whatever.

 

[Perrotfish]

Despite how appealing this egalitarian ideal is - and I really do wish it were true - it flies in the face of what I've been told by multiple advisers/attendings. A good school reputation will not make up for glaring deficits or otherwise give you a huge advantage, but, per the people I've spoken with, it can definitely open doors that may not otherwise be open to you. Take that for what you will. Is it worth it to go to a prestigious school solely for that purpose? Definitely not. But there does seem to be an intangible and poorly defined advantage that can definitely be helpful to you depending upon what you want to do.

I disagree. This has been pretty extensively studied at the high school level (elite/prestigious/magnet high schools) and there is a very significant DISadvantage to going to a higher ranked school when it comes times for college admissions. I have never seen a paper to support it but I would guess that the same holds true for medical school when it comes time for the match.

Think about it: the biggest part of your application is your grades, and you are graded on a curve compared to your peers in that school. Similarly you compete with classmates for letters of rec and opportunities to do research. When you go to a top school you are subjecting yourself to a level of competition that will probably push your class rank back by at least a quartile, and its hard to look distinguished to your advisors when a lot of your peers are running circles around you. Residencies probably aren't any better at colleges at giving credit for normalizing for difficulty of an applicant's curriculum, so the big fish in the small pond is probably more likely to get the job.

The only person that I would trust to get an advantage out of a top school is someone who graduated at the top of their class in the top school. And if you're that guy, chances are you didn't have any trouble getting in in the first place.

 

[NickNaylor]

I disagree. This has been pretty extensively studied at the high school level (elite/prestigious/magnet high schools) and there is a very significant DISadvantage to going to a higher ranked school when it comes times for college admissions. I have never seen a paper to support it but I would guess that the same holds true for medical school when it comes time for the match.

Think about it: the biggest part of your application is your grades, and you are graded on a curve compared to your peers in that school. Similarly you compete with classmates for letters of rec and opportunities to do research. When you go to a top school you are subjecting yourself to a level of competition that will probably push your class rank back by at least a quartile, and its hard to look distinguished to your advisors when a lot of your peers are running circles around you. Residencies probably aren't any better at colleges at giving credit for normalizing for difficulty of an applicant's curriculum, so the big fish in the small pond is probably more likely to get the job.

The only person that I would trust to get an advantage out of a top school is someone who graduated at the top of their class in the top school. And if you're that guy, chances are you didn't have any trouble getting in in the first place.

Sorry, I'm either confused or we're misunderstanding each other. I was talking about this within the context of medical school, not high school or college. I agree with all of the points you said. I don't have an opinion on the matter, I'm simply repeating what I've been told by several people from several different specialties. Whether this is blowing smoke up my ass or not I don't know, but considering these people advise students for applying to residency I accept at face value that they generally have an idea of what's going on.

 

[darkjedi]

I disagree. This has been pretty extensively studied at the high school level (elite/prestigious/magnet high schools) and there is a very significant DISadvantage to going to a higher ranked school when it comes times for college admissions. I have never seen a paper to support it but I would guess that the same holds true for medical school when it comes time for the match.

Think about it: the biggest part of your application is your grades, and you are graded on a curve compared to your peers in that school. Similarly you compete with classmates for letters of rec and opportunities to do research. When you go to a top school you are subjecting yourself to a level of competition that will probably push your class rank back by at least a quartile, and its hard to look distinguished to your advisors when a lot of your peers are running circles around you. Residencies probably aren't any better at colleges at giving credit for normalizing for difficulty of an applicant's curriculum, so the big fish in the small pond is probably more likely to get the job.

The only person that I would trust to get an advantage out of a top school is someone who graduated at the top of their class in the top school. And if you're that guy, chances are you didn't have any trouble getting in in the first place.

I went to an 'elite' high school and would definitely agree with your assessment about top end high school > college.

That said I don't think the analogy carries over from medical school to residency as they seem drastically different processes. Even the students in the bottom of our class get matched into specialties like derm, anesthesiology and radiology.

 

[Law2Doc]

Despite how appealing this egalitarian ideal is - and I really do wish it were true - it flies in the face of what I've been told by multiple advisers/attendings. A good school reputation will not make up for glaring deficits or otherwise give you a huge advantage, but, per the people I've spoken with, it can definitely open doors that may not otherwise be open to you. Take that for what you will. Is it worth it to go to a prestigious school solely for that purpose? Definitely not. But there does seem to be an intangible and poorly defined advantage that can definitely be helpful to you depending upon what you want to do.

Even if what you say were true (for the sake of argument), do you really advocate that this guy should throw away an acceptance at a "UMass equivalent", not a bottom ranked school, for another shot at a "top" school? Because that's what his take home message from reading your post might be. I actually see really bad things happening if he does this. He thinks he could do better, but there's every reason to think he won't look as good as a reapplicant next time around, and the UMass equivalent will be off the table. We have had people on SDN in the past who played themselves down to lesser schools and are now lucky to be doctors after seriously overrating themselves.

 

[darkjedi]

Even if what you say were true (for the sake of argument), do you really advocate that this guy should throw away an acceptance at UMass, not a bottom ranked school, for another shot at a "top" school? Because that's what his take home message from reading your post might be. I actually see really bad things happening if he does this. He thinks he could do better, but there's every reason to think he won't look as good as a reapplicant next time around, and UMass will be off the table. We have had people on SDN in the past who played themselves down to lesser schools and are now lucky to be doctors after seriously overrating themselves.

I think what Nick is trying to say is that there is a middle ground between "no one cares where you went to school" to "it's difficult to succeed without going to an elite school." The true answer definitely lies somewhere in between these two extremes, but I think most of us can agree that the majority of your potential success will depend on how hard you work and not necessarily where you are from.

 

[ZeaL6]

Why is this thread even still going? Seems like an easy decision...

 

[NickNaylor]

Even if what you say were true (for the sake of argument), do you really advocate that this guy should throw away an acceptance at a "UMass equivalent", not a bottom ranked school, for another shot at a "top" school? Because that's what his take home message from reading your post might be. I actually see really bad things happening if he does this. He thinks he could do better, but there's every reason to think he won't look as good as a reapplicant next time around, and the UMass equivalent will be off the table. We have had people on SDN in the past who played themselves down to lesser schools and are now lucky to be doctors after seriously overrating themselves.

No, of course not. I thought that I had implied that in my other post but I guess not. Trying to go to an elite school and putting aside everything to do so is an absolutely poor decision, regardless of any sort of advantage that kind of opportunity may or may not provide. But to deny that there's no advantage at all is, I think, not reflective of reality.

 

[Perrotfish]

Sorry, I'm either confused or we're misunderstanding each other. I was talking about this within the context of medical school, not high school or college. I agree with all of the points you said. I don't have an opinion on the matter, I'm simply repeating what I've been told by several people from several different specialties. Whether this is blowing smoke up my ass or not I don't know, but considering these people advise students for applying to residency I accept at face value that they generally have an idea of what's going on.

I'm saying I think they don't have any idea what is going on. Their opinion is based on perception: a disproportionate amount of people in top residencies come from top schools, so they think 'Oh, a top school must help'. People think that about top high schools and colleges too, for the same reason. However I think they're wrong, for the reasons stated above, and at lower levels of education there is some evidence that they are wrong: when you normalize for the quality of matriculant the advantage of 'top' schools goes away, at least in high school, and I think that it makes sense that that would carry over to college and medical school as well.

I think this is a great example of the difference between correlation and causation. Going to a top school strongly correlates it a top residency, but there's no evidence it causes it. If anything the evidence is that it's a detriment. I also think its a great example of how a strong, obvious correlation can SEEM like causation to even very scientifically trained people who should know better.

 

[notbobtrustme]

This. I've always just assumed that success rates in anything are higher in Ivy League schools because the quality of students there is higher, so they will succeed regardless of where they go.

eh, every school, even the low ranked ones, will have people who were waitlisted at "top schools." I don't think it's that. I think it's more the school name and prestige give you intangibles that can't be duplicated no matter what. For example, doing a rotation under a "big ****ing deal" researcher/clinician opens so many more doors than what's available elsewhere. Board score averages don't differ that much from school to school that it would account for the drastically different quality of match lists.

 

[frosted_flake]

I say your friend should reapply next year and give his spot to someone who wants to be a doctor for all that right reasons and who would be overjoyed with an acceptance, period.

Exactly! Pass that acceptance my way, I would be more than happy to have one.

 

[Law2Doc]

This. I've always just assumed that success rates in anything are higher in Ivy League schools because the quality of students there is higher, so they will succeed regardless of where they go.

There were a series of books and papers that came out a decade or so ago, in the wake of a big grade inflation scandal, about the "Harvard mystique" that posited that much of the reputation of these institutions isn't earned and that it's mostly just propagation of a reputation that was perhaps more true long ago. You probably won't get a better education at a top place, but they might have more money to fund your mentors research project, if that matters to you. (generally it won't). At any rate, at all med schools there will be people who land at top residencies. There is no allo school that isn't a decent launch pad for most specialties. You perhaps won't have the "home school advantage" of being able to try and stay at an affiliated residency, but you might (and this is big maybe) have faculty who are more accessible to residents, more interested in teaching over research, and more willing to make phone calls.

Regardless, while I think it might not be unreasonable to favor a top twenty school over a bottom twenty, if only for the resources and faculty names, I think it's actually very hard to distinguish the program ranked 30 from the program ranked 60 on any reasonable metric. So if we are talking about trying to trade up, we had better be talking about some Nobel winning Olympic medalist who is a shoe in for the top ten or it's not worth bothering. The OPs friend is far from this, based on the info we have been provided.

 

[histidine]

eh, every school, even the low ranked ones, will have people who were waitlisted at "top schools." I don't think it's that. I think it's more the school name and prestige give you intangibles that can't be duplicated no matter what. For example, doing a rotation under a "big ******* deal" researcher/clinician opens so many more doors than what's available elsewhere. Board score averages don't differ that much from school to school that it would account for the drastically different quality of match lists.

I agree, but I wanted to add that many big name clinicians/departments aren't at the "top" schools. For example, I believe Jefferson's orthopaedic residency is one of the top in the nation, but you never hear premeds raving about Jefferson medical college.

 

[BlueLabel]

@Amygdarya might be interested in skimming through the previous 10-20 posts

 

[questions-----]

I agree, but I wanted to add that many big name clinicians/departments aren't at the "top" schools. For example, I believe Jefferson's orthopaedic residency is one of the top in the nation, but you never hear premeds raving about Jefferson medical college.

Same for Rush

 

[Law2Doc]

I agree, but I wanted to add that many big name clinicians/departments aren't at the "top" schools. For example, I believe Jefferson's orthopaedic residency is one of the top in the nation, but you never hear premeds raving about Jefferson medical college.

Also in fields like ortho where clinical skills are a bigger deal than your publications when coming out of residency, some community hospital residencies that med students won't ever have heard of can have national prominence. But I think we muddy the waters mixing residency selection with med school selection. People should just realize that the path to get to where they want to go doesn't always dovetail with NIH funding.

 

[JJMrK]

Also in fields like ortho where clinical skills are a bigger deal than your publications when coming out of residency, some community hospital residencies that med students won't ever have heard of can have national prominence. But I think we muddy the waters mixing residency selection with med school selection. People should just realize that the path to get to where they want to go doesn't always dovetail with NIH funding.

That's potentially a bad example, as most top ortho fellowships are largely obtained through phone calls from prominent academicians and publications, and nearly everyone does one. I agree with the sentiment of your post, however.

 

[Mad Jack]

Despite how appealing this egalitarian ideal is - and I really do wish it were true - it flies in the face of what I've been told by multiple advisers/attendings. A good school reputation will not make up for glaring deficits or otherwise give you a huge advantage, but, per the people I've spoken with, it can definitely open doors that may not otherwise be open to you. Take that for what you will. Is it worth it to go to a prestigious school solely for that purpose? Definitely not. But there does seem to be an intangible and poorly defined advantage that can definitely be helpful to you depending upon what you want to do.

For the most part though, I doubt many people would argue that rescinding a low tier acceptance and throwing away a year of your life is not worth whatever advantage one might gain from a higher tier school. Unless you're gunning for like, academic plastics or something, where every split hair could be the bump that gets you over the next guy.

 

[NickNaylor]

For the most part though, I doubt many people would argue that rescinding a low tier acceptance and throwing away a year of your life is not worth whatever advantage one might gain from a higher tier school. Unless you're gunning for like, academic plastics or something, where every split hair could be the bump that gets you over the next guy.

Absolutely, I completely agree with that. As I mentioned above, pursuit of a prestigious school at the expense of everything else is unwise.