CCLCM v. HMS v. JHU v. UMich

[pyromania]

Hey guys, first of, this is not intended to be a troll post nor to offend anyone. I am just facing this decision (for which I am infinitely grateful and was extremely lucky) and I am pretty torn. Here is my reasoning thus far:

CCLCM---------------------------------------------------------------------------------------------------------------
I liked the school when I interviewed, but I did not really like the location. Furthermore, while I was a fan of PBL at first, I am no longer so sure... and the required attendance is a bummer. I am a pretty independent learner, and while I like collaborating for tough solutions, I do most of my foundational learning by myself. Cleveland clinic is also a great institution, but as I understand it the core rotations are done at the university hospital. Overall, if I where to choose CCLCM it would be mainly due to the money, which makes me afraid I'll live with regret.

Pros:
Full ride (no debt, no investment)
Can do electives at Cleveland Clinic (but no core rotations)
Free masters

Cons:
I am not a fan of Cleveland
Required fifth year (opportunity cost)
Heavy PBL, required attendance and dress code
Lacks the world class programs outside of medicine available at UMich/HMS
Lacks the strong alumni network of other programs

UMich----------------------------------------------------------------------------------------------------------------
I liked UMichigan and the strong alumni network and programs are solid. Nonetheless, it only seems a bit cheaper than JHU/HMS, and the network/programs/prestige at HMS are probably stronger. Location wise, while Ann Arbor is a nice college town, it is super cold and not the most exciting city. Similar to CCLCM, while I like the program, money is the motivating factor and I'm afraid of regret.

Pros:
Full tuition (no debt, ~85k cost)
Large university with world class programs (in case I want to pursue dual degrees)
Strong Alumni network
Very good residency director ranking

Cons:
Ann Arbor is nice, but it is still a college town
Investment required
Weekly quizzes
Not that much diversity/OOS

HMS------------------------------------------------------------------------------------------------------------------
I loved HMS and love Boston. The hospitals network and opportunities seem unmatched, and I have tons of friends in the area. Furthermore, while in medicine JHU/HMS carry the same weight, I feel if I ever want to branch out, the Harvard name would open more doors (I dislike that this is a reason, but reality is what it is). Overall, my heart is set here, with the cost being the only deterrent.

Pros:
Hospital and alumni network
Amazing programs in university covering all areas
Boston is the best city IMO
Diversity in patient population, faculty and students
Prestige

Cons:
Cost (~75-85k debt at graduation, +85k cost)
Boston is an expensive city
Not too much flexibility in choosing a place to rotate

JHU-------------------------------------------------------------------------------------------------------------------
I also loved JHU (albeit not as much as HMS), and their facilities are completely revamped and new. What pulls me away from JHU is Baltimore, and the fact that I would prefer HMS over it. Nonetheless, JHU is slightly cheaper, and my SO is nearby.

Pros:
Amazing Hospital
Proximity to SO
Prestige

Cons:
Cost (~65-75k debt at graduation, +85k cost)
Baltimore

------------------------------------------------------------------------------------------------------------------------

Overall, I feel my decision comes down to what weight I want to give debt in this situation. As I mentioned, my heart is set on HMS, but I'm conflicted about debt. That being said, I don't want to make a decision I regret, and I'm not sure how much impact <100k debt has.

I would appreciate any and all advice! Thanks so much!


EDIT: As a point of reference, my goal is to go into academic medicine at a large university institution, blending research, clinical care and teaching.

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[seeinghowitgoes]

Admittedly I'll be at CCLCM, so I'll be a bit biased and several of my comments will reapond to your current thoughts on that program, but I actually had to go through a similar, albeit not identical, decision making process. As such, a couple things come to mind:

1) all programs are beyond fantastic. Considering future opprtunities, you're working at the margins here, which can be hard to remember when everybody says this is such an important decision.

2) I think you may be undervaluing several aspects of being at the Cleveland Clinic. For example, the program is literally built around independent study/unstructured time - it requires very few hours per week in class. I don't think PBL means doing studying together - it means instead of sitting in solely lectures you do some learning in teams (and I say some because they still have "seminars" every week). If you want independence, I actually believe that the Cleveland Clinic is actually a great fit in many ways.

Also, what do you want to do professionally - yea, the Cleveland Clinic doesn't have Harvard business school, but if you want to work in the healthcare space, either in the public or private sector and as a clinician, researcher, or medical director at some device company, etc, the Cleveland Clinic name won't limit you at all, so again I just question how much that should play into your thought process. That being said, if you want to work in investment banking afterwards, perhaps venture capital (maybe even with a healthcare focus), yea, I suppose Harvard probably helps a bit.

Also, faculty and students at all these places are going to be top notch. I personally know people that have turned down top offers to go to each of the programs you mentioned as well as those that have turned down one school on your list in favor of another on your list. Honestly, each school is flooded with more NIH funding than you could possibly use, and each has internationally renowned physicians. If anything, at the Cleveland Clinic you'll get more attention from those amazimg faculty because of the smaller class size (which I understand could be a negative, too, having only 32 classmates).

As for patient diversity, Cleveland is medically underserved, so combined with the elites that rent out entire floors at the Cleveland Clinic, I think diversity is definitely present at the program. Not saying HMS and JHU don't have diversity, just saying if you list it as a strength for them, it's probably a strength for the Clevelans Clinic as well.

2) So, with that in mind, if it's me Hopkins is the first one out. If you're going to spend money, go to the place you want to go to (HMS). Second goes Michigan - it is probably the least diverse of all the institutions, and if you want a well-rounded university that's strong in everything, go Harvard, and if you want a strong name in healthcare, go Cleveland Clinic.

Thus, it would come down to Harvard v. The Cleveland Clinic (for me). 85k isn't crazy crazy, so I think you have a debate. If upon reevaluation you really feel that you want to leave healthcare, or that your understanding of what PBL and the clinic's collaborative environment is is as you conveyed above and that this is definitely not for you, then sacrifice the money and go Harvard. If upon reevaluation you realize the aforementioned issues actually are only at the margins and/or are much less significant than you may have originally thought, go the Cleveland Clinic route and don't think twice about it.

Good luck! Honestly, seems like you can't really go wrong as long as after you make the decision you don't think back on it too much and drive yourself crazy.

 

[Oso]

I agree with the above. It seems like you have your heart set on Harvard, although none of these programs will hold you back career-wise.

In all honesty, I'm really just here to say this:

 

[SN12357]

From your write-up it seems you want to be at HMS or JHU. I'd probably choose JHU in your situation because long distance relationships are very, very hard.

 

[vagabondrunning]

Like @seeinghowitgoes, I'll be at CCLCM, too. I will add that CCLCM isn't completely free- you still have to pay for the cost of living unless you get another merit scholarship in May (which is possible). So, unless you're coming into medical with money or your parents are paying for your cost of living (neither of which is my case), you'll still leave with probably $40-$70k in debt (which will probably be my case, though I will look for scholarships to cover cost of living second year and beyond).

Additionally, Cleveland Clinic and Case Western do have world class programs. Which master's are you interested in? I'm interested in bioethics, medical anthropology, and history of medicine and science. They have a superb bioethics program, and their medical anthropology program is tied in prestige with Harvard and the joint UCSF-UC-Berkeley program. Their history of medicine and science program is phenomenal, too. So, it really depends what you want to study. For what I want to study (for the master's), CCF and Case are world-renowned. As seeinghowitgoes mentioned, CCLCM is structured around autonomy, and there isn't that much class time. As for the dress code, I mean, you're going to have to dress professionally after year 2 anyway...

I also interviewed at JHU and HMS, and again, it depends what you want to study besides medicine at those institutions. Personally, I withdrew my app after the interview at HMS because I didn't like the environment, and I am wait listed at JHU (though will withdraw). I guess if I had to choose, I would probably choose HMS because of the resources in the Department of Social Medicine, Harvard Divinity School (I'm currently in seminary), and the departments of anthropology and history of science. I also liked that Harvard's "gap year"/"research year"/etc. is literally amazing- you can do whatever you want. You could work in a coffee shop if you wanted to. I thought that was pretty cool.

Best of luck making a decision. You are in an incredible position!

 

[Amygdarya]

I just stopped by to congratulate OP on his/her choices 🙂

 

[Farmerboy]

OP - which program at HMS are choosing between? I think that if you want to do academic medicine, research, and the other activities you alluded to, I think the HST program will prepare you for that capacity very thoroughly.

 

[Great White Buffalo]

Not sure if comparing the weather in Baltimore and Boston to Ann Arbor/Cleveland is really relevant. Sure, more lake effect snow in Cleveland, but the winter is about the same in Boston/Baltimore as in Ann Arbor (not super cold, just a weird year this year all over the country). Summers are great in Ann Arbor, and spring/fall are pretty nice, just not as good as California is year round!! But it is a smaller town, not like Boston. Baltimore is more like Cleveland, not as bad as Detroit though.

Fully disclosure: I grew up in Ann Arbor, attended U of M undergrad and will be attending U of M Med School. My Dad attended U of M undergrad and Med School, did his residency at Stanford, and came back as faculty at U of M. 100% of folks matched this year for residency. Now, U of M really likes its own folks, so lots of people come for medical school and never leave. Or if you leave for residency, lots of folks wanting to raise a family come back. A very liberal town in a very blue state, diversity in Ann Arbor is pretty good, but very white in towns outside of Ann Arbor (I'm biracial myself, so it was a noticeable difference from the Bay Area in California).

I personally don't go to Detroit often, usually go to Chicago 3-4 times a year (4 hour drive from Ann Arbor). Public schools in and around Ann Arbor are top notch, real estate is cheap by coastal standards, the 2 major reasons my parents left California for Ann Arbor. Folks from the coast think of the midwest as fly over states, but Detroit has an international airport is only 1/2 hour away from Ann Arbor, and you can afford to travel, as the cost of living in the midwest is cheap!! Now, if you combine that with free tuition, cheap cost of living, it is a good deal. However, U of M is not in the same league reputation wise as Harvard/Hopkins (who seem to vie for tops spots). U of M has a large endowment for a public school (around $7B or so), and really pushes for a lot of financial aid, so you will probably get more socioeconomic diversity at of U of M. But it is a public school, and requires about 50% or so instate students for its graduate programs (which are highly ranked, but not as high as Harvards). Not sure of Hopkins reputation outside of medicine.

I think the decision is really dependent on your goals and lifestyle. If you are thinking of a place to raise a family and have a great career, can't beat Ann Arbor. If you want to be Dean someday and like the large city atmosphere, go for the Hopkins/Harvard route!! FY I, U of M just is getting a new EVPMA in June who was a Wayne State med school grad, a U of M residency alumni, faculty at Hopkins before going to Emory as Chancellor. And the new President at U of M is a Physician from Brown (I think EVPMA there) who was previously Dean at Berkeley.

Best wishes to you, as you'll get a great education at any of these fine institutions.

 

[Patros]

I say CCLCM or U.Mich all the way, if a research-based is what you are looking for. UMich gets the most overall research funding of any public university and is only beat by JHU among private universities, and a large chunk of that comes from the NIH funding to the medical school. I don't know much about CCLCM, but it is a research-oriented program, so I assume their training will open doors for that.

I don't like the Harvard-worship in these forums. Yeah, it's a household name, so it's a good bet if building up your ego is a priority. I'm not buying for a second that their research facilities or opportunities are any better than those at JHU or UMich, and I don't think their HST program is worth it compared to the CCLCM. Boston is definitely the most enjoyable city of the four, however. I suppose it is true that HMS has no weaknesses, but their strengths don't surpass the others you listed. If you really have to pay 85k/year, then I think this option is a terrible one. If you get a financial aid that cuts the cost by 50%, then it would be much better.

Same goes for JHU. JHU has huge research facilities, but not really worth ~$300k. Certainly, JHU's clinical facilities are unmatched by any other institution, but worry about that for residency.

Basically, if you want a research-oriented career, then you can't afford to go heavily into debt. If going into derm/ortho/rads is your hope, then maybe taking $200-300k in debt is worth it. If you want to go into academic medicine, you will have to work as a research fellow after residency for 2-3 years, making $50k/year. If you want to blend research into your long-term career, plan on making $100-200k/year for the rest of your life. You really want to pay $500k-1million over the course of your life?

Edit: That's 85k at graduation, I have no reading skills. HMS or JHU are both really good options then.

 

[pyrrion89]

If you really have to pay 85k/year, then I think this option is a terrible one.

Forgive me if I'm wrong, but I think the OP is saying 85k debt total, not 85k debt per year.

 

[Patros]

Forgive me if I'm wrong, but I think the OP is saying 85k debt total, not 85k debt per year.

Oh, oops. Ignore me, I'm dumb.

 

[pyromania]

Thank you all for the helpful advice! It is very insightful.

Just to clarify some more, I meant 75-85k total debt at graduation (including compiled interest and whatnot) plus an out of pocket total investment of 85k. So not really anywhere near 300k total, which would basically make the decision for me @Underu .

@vagabondrunning , I think the CCLCM stipends are on a rolling basis, so some come before May.

As for long term career goals, I am aiming for interventional radiology (could change of course, but most likely some sort of specialty or subspecialty) and some research, but not at the PI level, so I'm not really sure how that translates financially. That being said, Im not aiming to earn lots of money, or I would have gone into another field... Kinda just wanna have a livelihood and a challenging career. Does anyone know if 85k over 10 years repayment would be crippling debt? I'm confused by medloans, but it seems to suggest 750-1k a month, which seems steep as a resident but should be manageable later on no?

Also, does anyone know of good resources to read up on loans/repayment plans/interest?

Thanks all!

Edit: for HMS I'm only into NP

 

[seeinghowitgoes]

Thank you all for the helpful advice! It is very insightful.

Just to clarify some more, I meant 75-85k total debt at graduation (including compiled interest and whatnot) plus an out of pocket total investment of 85k. So not really anywhere near 300k total, which would basically make the decision for me @Underu .

@vagabondrunning , I think the CCLCM stipends are on a rolling basis, so some come before May.

As for long term career goals, I am aiming for interventional radiology (could change of course, but most likely some sort of specialty or subspecialty) and some research, but not at the PI level, so I'm not really sure how that translates financially. That being said, Im not aiming to earn lots of money, or I would have gone into another field... Kinda just wanna have a livelihood and a challenging career. Does anyone know if 85k over 10 years repayment would be crippling debt? I'm confused by medloans, but it seems to suggest 750-1k a month, which seems steep as a resident but should be manageable later on no?

Also, does anyone know of good resources to read up on loans/repayment plans/interest?

Thanks all!

Just a personal opinion here, but I don't think 75-85k paid over 10 years will be crippling at all (don't have any resources to confirm though, lo siento). Yea, it may be a bit steep during residency, so you may sacrifice a bit on standard of living then, but then again you won't have much time out of the hospital to have a life anyway, right 🙂 ?

Difference between the schools (even seemingly the financial ones) are all at the margins, so listen to your heart, when (HMS) is calling for you, listen to your heart, there's nothing else you can do.

 

[SN12357]

Thank you all for the helpful advice! It is very insightful.

Just to clarify some more, I meant 75-85k total debt at graduation (including compiled interest and whatnot) plus an out of pocket total investment of 85k. So not really anywhere near 300k total, which would basically make the decision for me @Underu .

@vagabondrunning , I think the CCLCM stipends are on a rolling basis, so some come before May.

As for long term career goals, I am aiming for interventional radiology (could change of course, but most likely some sort of specialty or subspecialty) and some research, but not at the PI level, so I'm not really sure how that translates financially. That being said, Im not aiming to earn lots of money, or I would have gone into another field... Kinda just wanna have a livelihood and a challenging career. Does anyone know if 85k over 10 years repayment would be crippling debt? I'm confused by medloans, but it seems to suggest 750-1k a month, which seems steep as a resident but should be manageable later on no?

Also, does anyone know of good resources to read up on loans/repayment plans/interest?

Thanks all!

Edit: for HMS I'm only into NP

Assuming you take out federal loans you can do IBR (income-based repayment) during residency so that the loans will not eat up most of your income, and then repay them quickly as an attending. 85-100k should be very manageable.

 

[vagabondrunning]

Thank you all for the helpful advice! It is very insightful.

Just to clarify some more, I meant 75-85k total debt at graduation (including compiled interest and whatnot) plus an out of pocket total investment of 85k. So not really anywhere near 300k total, which would basically make the decision for me @Underu .

@vagabondrunning , I think the CCLCM stipends are on a rolling basis, so some come before May.

As for long term career goals, I am aiming for interventional radiology (could change of course, but most likely some sort of specialty or subspecialty) and some research, but not at the PI level, so I'm not really sure how that translates financially. That being said, Im not aiming to earn lots of money, or I would have gone into another field... Kinda just wanna have a livelihood and a challenging career. Does anyone know if 85k over 10 years repayment would be crippling debt? I'm confused by medloans, but it seems to suggest 750-1k a month, which seems steep as a resident but should be manageable later on no?

Also, does anyone know of good resources to read up on loans/repayment plans/interest?

Thanks all!

Edit: for HMS I'm only into NP

Has CCLCM started rolling out stipends?

 

[Ace-Co-A]

Hell of a cycle, congrats. That seems like a decision between HMS and JHU, to me. Go for HMS if you have your heart set on it, as others have mentioned. Baltimore is terrible and Boston is awesome.

 

[CrunchyTeddy]

Congrats! These are amazing options to pick from. I read through the thread, and it sounds like everyone had valid points. At the end of the day though, I think you should go with the school that you are the most excited about/that you most want to attend, and I think it's just a gut feeling. I know I'm waaaayy over-simplifying here, but I'm also in a situation of money vs. other considerations (quality of school, location, etc.), and I think that gut feeling is going to be the final tie-breaker for me. In reading through your post, it sounds like that school is Harvard =)

 

[Psai]

It sounds like you want to be at Harvard. Go for it.

 

[FluffyRabbit]

Hey guys, first of, this is not intended to be a troll post nor to offend anyone. I am just facing this decision (for which I am infinitely grateful and was extremely lucky) and I am pretty torn. Here is my reasoning thus far:

CCLCM---------------------------------------------------------------------------------------------------------------
I liked the school when I interviewed, but I did not really like the location. Furthermore, while I was a fan of PBL at first, I am no longer so sure... and the required attendance is a bummer. I am a pretty independent learner, and while I like collaborating for tough solutions, I do most of my foundational learning by myself. Cleveland clinic is also a great institution, but as I understand it the core rotations are done at the university hospital. Overall, if I where to choose CCLCM it would be mainly due to the money, which makes me afraid I'll live with regret.

Pros:
Full ride (no debt, no investment)
Can do electives at Cleveland Clinic (but no core rotations)
Free masters

Cons:
I am not a fan of Cleveland
Required fifth year (opportunity cost)
Heavy PBL, required attendance and dress code
Lacks the world class programs outside of medicine available at UMich/HMS
Lacks the strong alumni network of other programs

Congratulations on your amazing acceptances! Current CCLCM student here, and I just want to correct one of the inaccuracies here - you CAN do core rotations at the Cleveland Clinic. There are four core rotations (IM/FM/Geriatrics, OB/Gyn/Peds, Neuro/Psych, and Surgery/EM), and most classmates I know are doing three, if not all, at the Cleveland Clinic. There are specific reasons why one may choose to do one of them elsewhere (e.g. to do EM at MetroHealth, the Level 1 trauma center).

Overall, based on what you've written so far, I would advise going to Harvard. Looking at your analysis, it appears it wins in every category except the money. While that's nothing to scoff at, four years is a long time, you'll probably be happier there, and you should have no trouble paying it back if you're shrewd with your money.

 

[byaaaaaaah23]

Agree with above that 85k total is not a major debt load for medical school and shouldn't dissuade you from the school you really want to go to.

 

[pyromania]

Thank you all for the advice! Just as an update, I've preliminarily chosen HMS 🙂 I feel it is the right choice because a kind of calm has replaced the endless anxiety I was feeling >.< . I figured money is nice and all, but it is not my reason to go into medicine, so it shouldn't be a key deciding factor in choosing a school. Debts can be paid off... regret is forever (lol sorry for the cliché).

Nonetheless, I'll give UMich one last look since they are the closest in my mind to Harvard's multidisciplinary atmosphere. I'll be withdrawing from others soon 🙂

Thanks all again!

 

[Meredith92]

Thank you all for the advice! Just as an update, I've preliminarily chosen HMS 🙂 I feel it is the right choice because a kind of calm has replaced the endless anxiety I was feeling >.< . I figured money is nice and all, but it is not my reason to go into medicine, so it shouldn't be a key deciding factor in choosing a school. Debts can be paid off... regret is forever (lol sorry for the cliché).

Nonetheless, I'll give UMich one last look since they are the closest in my mind to Harvard's multidisciplinary atmosphere. I'll be withdrawing from others soon 🙂

Thanks all again!

Congrats on making your decision! Just wondering, have you decided to stay long distance with your SO? I am making a similar decision, and my heart is telling me to go to a school closer to my SO... so I'd love to hear your thoughts on that.