Choosing prestige vs. fit

[ricardo.wannabedoc]

I was wondering if anyone here would be willing to share their reflections after choosing to attend a medical school that wasn't the best fit, but was higher-ranked (or vice versa; lower-ranked, but better fit). Any regrets?

I don't mean to over-simplify the decision, and I definitely understand it's more than a black/white choice. I also understand in most cases your mileage may vary--it depends on your career goals and what is most important to you. However, I hope by keeping the "prompt" vague I get as many perspectives as possible. I'm still really early in my decision-making process and just hoping to hear from others about their experiences.

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[KnightDoc]

I was wondering if anyone here would be willing to share their reflections after choosing to attend a medical school that wasn't the best fit, but was higher-ranked (or vice versa; lower-ranked, but better fit). Any regrets?

I don't mean to over-simplify the decision, and I definitely understand it's more than a black/white choice. I also understand in most cases your mileage may vary--it depends on your career goals and what is most important to you. However, I hope by keeping the "prompt" vague I get as many perspectives as possible. I'm still really early in my decision-making process and just hoping to hear from others about their experiences.

You seem to understand that YMMV, so why do you think that the various perspectives of the multiple participants here would or should influence your values and what's important to you? You clearly understand the issues and the tradeoffs. Why would you allow what's important to a bunch of anonymous strangers to help determine the path you take? I honestly don't understand!

Also, I will paraphrase the wise advice given by several of the adcoms who participate here, and tell you that you are wasting time and energy by even thinking about this now. There is a 60% chance you will have nothing to worry about because you won't receive any As, and there is an additional 60% chance that if you are among the fortunate 40% with an A that you will only have one, so, again, you won't have to worry about fit vs. prestige. Why not wait to see if you are among the very fortunate 16% with more than one A, and then to see if your choices even involve fit and prestige before worrying about this??

Think about it like this -- the schools have a ton of applicants to choose from, and are pretty good at selecting people who are good fits, whether they are T10 or bottom 50. I'd bet it's a very tiny fraction of people with As at top schools who don't like the fit and have what they feel is a better fit at a significantly less prestigious school, and consequently ever have to deal with your question. Also, maybe it's not obvious to you, but rank only matters (if at all), at the top (i.e., T10, 20 or 30, depending on who you talk to). Picking #60 over #90 due to rank is really not a thing. USNWR lumps 93-120 into one rank, and doesn't even publish rank below that (i.e., nobody really cares about relative rank in that neighborhood, so all you need to know is that it's in the bottom 65).

 

[thespitfire]

You seem to understand that YMMV, so why do you think that the various perspectives of the multiple participants here would or should influence your values and what's important to you? You clearly understand the issues and the tradeoffs. Why would you allow what's important to a bunch of anonymous strangers to help determine the path you take? I honestly don't understand!

Also, I will paraphrase the wise advice given by several of the adcoms who participate here, and tell you that you are wasting time and energy by even thinking about this now. There is a 60% chance you will have nothing to worry about because you won't receive any As, and there is an additional 60% chance that if you are among the fortunate 40% with an A that you will only have one, so, again, you won't have to worry about fit vs. prestige. Why not wait to see if you are among the very fortunate 16% with more than one A, and then to see if your choices even involve fit and prestige before worrying about this??

Think about it like this -- the schools have a ton of applicants to choose from, and are pretty good at selecting people who are good fits, whether they are T10 or bottom 50. I'd bet it's a very tiny fraction of people with As at top schools who don't like the fit and have what they feel is a better fit at a significantly less prestigious school, and consequently ever have to deal with your question. Also, maybe it's not obvious to you, but rank only matters (if at all), at the top (i.e., T10, 20 or 30, depending on who you talk to). Picking #60 over #90 due to rank is really not a thing. USNWR lumps 93-120 into one rank, and doesn't even publish rank below that (i.e., nobody really cares about relative rank in that neighborhood, so all you need to know is that it's in the bottom 65).

No offense, but what’s wrong with just answering the question? OP may have multiple acceptances already. I don’t really understand why some people act like certain questions aren’t worth asking or exploring. I think hearing others’ experiences can help aid informed decision-making. This is an incredibly important decision (given OP has more than one option to choose from, which is possible).

 

[thespitfire]

My personal answer: I’m matriculating in 2020, but I have multiple acceptances. I think fit is incredibly important. I would argue that it’s more important than rank. However, it depends on your personal goals. the social networks (and potential platform) you can cultivate at a more prestigious institution should be factored in, IMO. However, it’s hard to capitalize on the resources available to you when you feel unhappy and out of place... so fit should come first.

 

[asdfOu]

No offense, but what’s wrong with just answering the question? OP may have multiple acceptances already. I don’t really understand why some people act like certain questions aren’t worth asking or exploring. I think hearing others’ experiences can help aid informed decision-making. This is an incredibly important decision (given OP has more than one option to choose from, which is possible).

Absolutely. Asking people who have made this decision already could also help people in this situation take in to account certain aspects of "prestigious" or "better fit" schools that are harder to realize without having matriculated.

 

[Moko]

Keep in mind that for some people, prestige and fit are one and the same 😉.

It is difficult to give a meaningful analysis of the pros and cons without knowing an individual's goals (for medical school, residency and beyond), preferences (for location, family, minimizing debt, etc), and the schools in question (deciding between schools ranked #2 vs #10, #2 vs #100). Similarly, what may initially seem like a match may not be after starting medical school as life circumstances and priorities may change, the actual school environment/city/relationships/social life may not live up to (or may exceed) expectations, etc. If there is a discordance between prestige and fit, speaking in very broad strokes, there are four possible outcomes:
- Prioritizing prestige, remain happy with decision at the time of graduation
- Prioritizing prestige, regret decision at the time of graduation
- Prioritizing fit, regret decision at the time of graduation
- Prioritizing fit, remain happy with decision at the time of graduation
Among the two unfavorable outcomes, how likely are they to occur, and how much worse would one outcome be over the other? That should help guide which choice is right for you.

 

[Tenk]

I picked a cheaper, less known school in a less desired area (that also happened to be cheaper) over a better known, more expensive school at a more desirable area (but also more expensive). I am very, very, very, very, very glad with my decision. I have actually paid off all my med school loans too which came to about $350,000 if we include interest.

 

[deleted1001426]

Spent a few days debating over this exact same issue and I’ve come to the conclusion that it’s fit, hands down at least imo. Prestige will only take you so far and Afaik, if you’re not gunning for something Uber competitive at a world renowned program then it really doesn’t matter and even if you are, if you’re at a usmd no doors are closed if you’re willing to put the effort in. But it really just comes down to the fact that I’d rather be somewhere I feel at home/comfortable, surrounded by likeminded peers than somewhere marginally higher ranked where I was miserable, just so I could “wow” people when I name drop my school.

 

[KnightDoc]

No offense, but what’s wrong with just answering the question? OP may have multiple acceptances already. I don’t really understand why some people act like certain questions aren’t worth asking or exploring. I think hearing others’ experiences can help aid informed decision-making. This is an incredibly important decision (given OP has more than one option to choose from, which is possible).

Because he hasn't indicated that he has such a choice, and because there is no answer. He understands the issues, but the answer is personal to each of us, and since he has no idea who or what I am, what's important to me should be of no consequence to him.

 

[KnightDoc]

My personal answer: I’m matriculating in 2020, but I have multiple acceptances. I think fit is incredibly important. I would argue that it’s more important than rank. However, it depends on your personal goals. the social networks (and potential platform) you can cultivate at a more prestigious institution should be factored in, IMO. However, it’s hard to capitalize on the resources available to you when you feel unhappy and out of place... so fit should come first.

So, will you prioritize fit over prestige, or, like most, are they not in conflict for you? And I don't mean choosing #7 over #3, I mean choosing #70 over #3!! 🙂

Saying fit is really important, that's why I'm choosing NYU over Mt. Sinai doesn't really answer the question, does it?

Give up NYU for Cooper and then come back and talk to us about fit. 🙂

 

[ricardo.wannabedoc]

You seem to understand that YMMV, so why do you think that the various perspectives of the multiple participants here would or should influence your values and what's important to you? You clearly understand the issues and the tradeoffs. Why would you allow what's important to a bunch of anonymous strangers to help determine the path you take? I honestly don't understand!

Also, I will paraphrase the wise advice given by several of the adcoms who participate here, and tell you that you are wasting time and energy by even thinking about this now. There is a 60% chance you will have nothing to worry about because you won't receive any As, and there is an additional 60% chance that if you are among the fortunate 40% with an A that you will only have one, so, again, you won't have to worry about fit vs. prestige. Why not wait to see if you are among the very fortunate 16% with more than one A, and then to see if your choices even involve fit and prestige before worrying about this??

Think about it like this -- the schools have a ton of applicants to choose from, and are pretty good at selecting people who are good fits, whether they are T10 or bottom 50. I'd bet it's a very tiny fraction of people with As at top schools who don't like the fit and have what they feel is a better fit at a significantly less prestigious school, and consequently ever have to deal with your question. Also, maybe it's not obvious to you, but rank only matters (if at all), at the top (i.e., T10, 20 or 30, depending on who you talk to). Picking #60 over #90 due to rank is really not a thing. USNWR lumps 93-120 into one rank, and doesn't even publish rank below that (i.e., nobody really cares about relative rank in that neighborhood, so all you need to know is that it's in the bottom 65).

Thanks for your insight, and I think you make some good points.

I suppose you could say it is curiosity more than anything. I don't necessarily anticipate what people say here will determine my path. However, perhaps there's a possibility that someone may bring a perspective I haven't thought about, and that it may expand my own perspective in some way. On a more personal level, I have found from my past experiences that making decisions in-the-moment can be very state-dependent, and in hindsight, there were things that I was blind to, or things that I irrationally weighed heavily over other things... But that was not something I realized until long after the decision was made. So, I figured it could not hurt to hear from others who have already made the decision and thus have had time to reflect. Even if it is a very tiny fraction of people.

For what it is worth, I am among the 16%. I am asking this question because my choices already do involve this "predicament."

 

[KnightDoc]

Thanks for your insight, and I think you make some good points.

I suppose you could say it is curiosity more than anything. I don't necessarily anticipate what people say here will determine my path. However, perhaps there's a possibility that someone may bring a perspective I haven't thought about, and that it may expand my own perspective in some way. On a more personal level, I have found from my past experiences that making decisions in-the-moment can be very state-dependent, and in hindsight, there were things that I was blind to, or things that I irrationally weighed heavily over other things... But that was not something I realized until long after the decision was made. So, I figured it could not hurt to hear from others who have already made the decision and thus have had time to reflect. Even if it is a very tiny fraction of people.

For what it is worth, I am among the 16%. I am asking this question because my choices already do involve this "predicament."

Fair enough!!! Still, I honestly don't think what's important to me, a total stranger, should have any value to you. I think the value is in having people highlight the issues, and you seem to already have a good handle on them.

My advice would be not to overvalue prestige, but not entirely dismiss it. Don't go someplace you'll be miserable because it will impress people, but also don't make a decision based entirely on convenience or money, unless that is REALLY important to you!!

Congratulations, and good luck!!! 🙂

 

[ricardo.wannabedoc]

Keep in mind that for some people, prestige and fit are one and the same 😉.

It is difficult to give a meaningful analysis of the pros and cons without knowing an individual's goals (for medical school, residency and beyond), preferences (for location, family, minimizing debt, etc), and the schools in question (deciding between schools ranked #2 vs #10, #2 vs #100). Similarly, what may initially seem like a match may not be after starting medical school as life circumstances and priorities may change, the actual school environment/city/relationships/social life may not live up to (or may exceed) expectations, etc. If there is a discordance between prestige and fit, speaking in very broad strokes, there are four possible outcomes:
- Prioritizing prestige, remain happy with decision at the time of graduation
- Prioritizing prestige, regret decision at the time of graduation
- Prioritizing fit, regret decision at the time of graduation
- Prioritizing fit, remain happy with decision at the time of graduation
Among the two unfavorable outcomes, how likely are they to occur, and how much worse would one outcome be over the other? That should help guide which choice is right for you.

Thank you! This is super helpful, I've never thought about it in this stratified way.

 

[thespitfire]

So, will you prioritize fit over prestige, or, like most, are they not in conflict for you? And I don't mean choosing #7 over #3, I mean choosing #70 over #3!! 🙂

Saying fit is really important, that's why I'm choosing NYU over Mt. Sinai doesn't really answer the question, does it?

Give up NYU for Cooper and then come back and talk to us about fit. 🙂

Maybe I'm overanalyzing your response, but you sound pretty antagonistic. I'm choosing a school that aligns well with my goals (educational + financial) and will make the most sense for my family (location + residency). Prestige is not a priority to me - I didn't go to a prestigious undergraduate institution.

 

[KnightDoc]

Maybe I'm overanalyzing your response, but you sound pretty antagonistic. I'm choosing a school that aligns well with my goals (educational + financial) and will make the most sense for my family (location + residency). Prestige is not a priority to me - I didn't go to a prestigious undergraduate institution.

Sorry for the antagonism, and we aren't talking about UG, so I'm calling out the hypocrisy of anyone going to a T10 on a merit scholarship advising anyone to prioritize fit over prestige. You are going to do what makes sense for you, as most of us would, which is typically to find a good "fit" at the best (oftentimes most prestigious) school at which the finances work.

Coincidentally, NYU is going to have a very high yield for this very reason. The person having credibility while advising fit over prestige would be the person who "loved" his visit to Cooper and thereafter chose it over NYU, notwithstanding NYU's prestige and financial package, not the person who reasonably found the best fit at the best school with the best merit scholarship.

 

[thespitfire]

Sorry for the antagonism, and we aren't talking about UG, so I'm calling out the hypocrisy of anyone going to a T10 on a merit scholarship advising anyone to prioritize fit over prestige. You are going to do what makes sense for you, as most of us would, which is typically to find a good "fit" at the best (oftentimes most prestigious) school at which the finances work.

Coincidentally, NYU is going to have a very high yield for this very reason. The person having credibility while advising fit over prestige would be the person who "loved" his visit to Cooper and thereafter chose it over NYU, notwithstanding NYU's prestige and financial package, not the person who reasonably found the best fit at the best school with the best merit scholarship.

.

 

[KnightDoc]

Weren't you the one saying above that other posters should prioritize their own value and insights over others' experiences? Yet now you are acting as gatekeeper, making assumptions about the choices I have available to me, and saying I shouldn't share my own experience because it's not "credible" BASED on your assumptions. I'm astounded that you have the audacity to call me hypocritical. You seem frustrated that I was accepted to NYU. Also, I'm a woman, and I was waitlisted at Cooper.

I won't be baited into sharing more info. I'm sorry that others' acceptances and suggestions are upsetting to you. Ultimately, to elaborate on what I said above, I think the RESOURCES that prestigious institutions have available SHOULD be part of one's consideration. I DON'T think prestige in itself (branding/name recognition) is more important than fit. I'm making my personal selection based on fit, not because I want to be able to brag about having graduated from a particular school.

OP, I apologize for derailing your thread, and I hope you gained some helpful perspective! This will be my last posting here.

I'm sorry -- I had no intention to "bait" you into anything, and I did not mean any personal offense. I only meant to say that advising to prioritize fit over prestige has little meaning when coming someone going to a prestigious institution. Your point about prestigious institutions having superior resources, contributing to fit, is universally true. That's how they become prestigious!

And nobody suggested anyone prioritized prestige in order to brag. The OP was all about whether to prioritize the resources, and all the other benefits associated with prestige, over fit, whatever that is. I'm not trying to be a gatekeeper. I'm suggesting that OP knows the issues and needs to figure out what's important to him himself, and not to take advice from any of us.

I didn't mean to make it personal, but someone whose ideal fit happens to be at NYU (or any other top school) is really in no position to advocate fit over prestige. YMMV, but, to me, such advice would only be credible coming from someone who turned down a top school to go to a much lower school, and for reasons of fit, not money. It's exceedingly easy to find fit at prestigious institutions (for the reasons you noted), and I don't think that's what OP was asking about.

Finally, congratulations on NYU. I did not apply this cycle, and do not begrudge anyone any success whatsoever, particularly a stranger on SDN!! 🙂

 

[deleted962973]

I was wondering if anyone here would be willing to share their reflections after choosing to attend a medical school that wasn't the best fit, but was higher-ranked (or vice versa; lower-ranked, but better fit). Any regrets?

I don't mean to over-simplify the decision, and I definitely understand it's more than a black/white choice. I also understand in most cases your mileage may vary--it depends on your career goals and what is most important to you. However, I hope by keeping the "prompt" vague I get as many perspectives as possible. I'm still really early in my decision-making process and just hoping to hear from others about their experiences.

Can you describe what fit means to you? It means something different to everyone. Do you prioritize finances, location, friends/family nearby, curriculum, etc etc- just so we can get a better idea of how to answer. I don’t think fit and prestige are mutually exclusive.

 

[Goro]

My personal answer: I’m matriculating in 2020, but I have multiple acceptances. I think fit is incredibly important. I would argue that it’s more important than rank. However, it depends on your personal goals. the social networks (and potential platform) you can cultivate at a more prestigious institution should be factored in, IMO. However, it’s hard to capitalize on the resources available to you when you feel unhappy and out of place... so fit should come first.

Multiple wise SDN attendings have told us that once you hit practice, it doesn't matter. You get paid the same if you went to Harvard or Western.

The only thing it will affect is if academic medicine is your career path.

And yes, it affects residency, but again, even that flattens out once you get inyo practice.

So pick fit and tuition.

 

[ricardo.wannabedoc]

Can you describe what fit means to you? It means something different to everyone. Do you prioritize finances, location, friends/family nearby, curriculum, etc etc- just so we can get a better idea of how to answer. I don’t think fit and prestige are mutually exclusive.

Right, I agree they aren't mutually exclusive, but I'm sure some individuals face cases where one school does not satisfy both, or the most prestigious school was not the school that left the best impression. Again, I recognize that this is not exactly a common scenario, but I just thought I'd throw the question out there and get some thoughts. I will probably make a more specific "X vs Y" post with more details once I've narrowed down my options and it's closer to April.

I kinda kept "fit" deliberately vague...I'm not sure I can adequately describe what it is for me, because in part it is a feeling. At the moment, location, finances, and family/friends are very important for me, but I am also considering the general vibe I got from the students I interacted with, as well as the overall impressions I had on interview day. Also, as a URM student, those resources/available mentors are important as well.

 

[Morc]

I want to spend long time with girlfriend. Med school close to girlfriend. Med school accept. I go.

 

[KnightDoc]

Right, I agree they aren't mutually exclusive, but I'm sure some individuals face cases where one school does not satisfy both, or the most prestigious school was not the school that left the best impression. Again, I recognize that this is not exactly a common scenario, but I just thought I'd throw the question out there and get some thoughts. I will probably make a more specific "X vs Y" post with more details once I've narrowed down my options and it's closer to April.

I kinda kept "fit" deliberately vague...I'm not sure I can adequately describe what it is for me, because in part it is a feeling. At the moment, location, finances, and family/friends are very important for me, but I am also considering the general vibe I got from the students I interacted with, as well as the overall impressions I had on interview day. Also, as a URM student, those resources/available mentors are important as well.

You're making my point!!! What's important to you is unique to you. There is value in sourcing a list of things to consider, but my values (or anyone's elses) should be irrelevant to you.

I really think you know what you are doing. As a URM, you have some unique factors to consider, and really should do whatever feels right to you. You don't need our permission to pass on a more prestigious school that doesn't make you comfortable, but, hopefully, you will end up where many people do and find comfort at one of your more prestigious options, particularly if money is not a factor.

 

[ricardo.wannabedoc]

You're making my point!!! What's important to you is unique to you. There is value in sourcing a list of things to consider, but my values (or anyone's elses) should be irrelevant to you.

I really think you know what you are doing. As a URM, you have some unique factors to consider, and really should do whatever feels right to you. You don't need our permission to pass on a more prestigious school that doesn't make you comfortable, but, hopefully, you will end up where many people do and find comfort at one of your more prestigious options, particularly if money is not a factor.

Look, I understand where you are coming from! And I assure you that the decision I ultimately make will not be fully determined by anything anyone says in this post.

Part of the reason I left the question relatively ambiguous is because I am not necessarily looking for advice (though it is appreciated). I just wanted to hear from others about their experience. The question I am asking is not "should I choose prestige vs fit"--it's "did you have to choose one or the other? After making your decision, what can you say about your experience?" Call it curiosity, call it a desire to connect with others going through the same thing, call it pointless--whatever floats your boat.

Some might say we should just get rid of "X vs Y" posts entirely, because there is no way any random internet strangers know what you are thinking/feeling, what your personal circumstances are, what is most important to you, etc (and I think there is merit to that way of thinking). But that sub-forum still exists and I doubt it's going away anytime soon 😉

 

[KnightDoc]

Look, I understand where you are coming from! And I assure you that the decision I ultimately make will not be fully determined by anything anyone says in this post.

Part of the reason I left the question relatively ambiguous is because I am not necessarily looking for advice (though it is appreciated). I just wanted to hear from others about their experience. The question I am asking is not "should I choose prestige vs fit"--it's "did you have to choose one or the other? After making your decision, what can you say about your experience?" Call it curiosity, call it a desire to connect with others going through the same thing, call it pointless--whatever floats your boat.

Some might say we should just get rid of "X vs Y" posts entirely, because there is no way any random internet strangers know what you are thinking/feeling, what your personal circumstances are, what is most important to you, etc (and I think there is merit to that way of thinking). But that sub-forum still exists and I doubt it's going away anytime soon 😉

Fair enough, but you should realize responses are going to be all over the place. Most people would not intentionally make themselves miserable for 4 years chasing prestige, but some certainly would. And some who are miserable will be in denial.

Even though I apparently offended @thespitfire, she is absolutely correct insofar as the better schools have the better resources and opportunities, and these make for the better fit for most, so many people do not have to choose one over the other. The choice more often comes down to money -- if you don't receive need based aid, prestige is often more expensive than the alternative (IS state schools), and this drives decisions for many.

Your issues as a URM are going to be different than for others, and most here will not be able to speak to whether the superior resources at the more prestigious schools will be able to adequately address these issues for you. I know the UGs have historically fallen way short in this regard, and are working hard now to fix it. Even among the URM community, though, one person's comfort level will not equal another's. Again, you know the issues. Good luck!!! 🙂

 

[tessellations]

When it comes down to it, we all prioritize different things. Some people want to stay close to their family. Some have children and/or partners to consider. Some people hate where they are from and want to leave or are worried about the political climate in certain areas. Some people really want to match into a competitive specialty. Some people want a small, close-knit class, while others just want to gun, gun, gun and thrive in competitive environments. Some people could care less about prestige, and some people really care. Some people want to take on as little debt as possible. etc, etc.

So far I only have one A, but if I am lucky enough to receive some more, I know I personally will be most concerned with location (I would love to be within driving distance of home) and cost. Admittedly, none of my IIs are at T20s, but my one acceptance is the highest ranked of my 5 IIs. And while it is an amazing school, it is in a very snowy climate, requires either a flight or a 9 hour drive, and I know no one in the area. Two of my IIs are much closer to home, and the other two are in better locations/climates, which personally matters to me. I have to prioritize my own well being and access to support systems.

 

[NickNaylor]

I would second the above, which is that everyone is going to have different priorities, thus this decision is something that you, and only you, are really in a position to make.

I went to a great school but it was lower ranked than other schools that I was accepted to. I was also rejected from a school that was lower-ranked than all of the other schools I was accepted to that I would've attended had I been accepted. Things like cost, location, and gestalt impression of the school, with a particular focus on how students felt about the school, were extremely important to me. I don't regret my decision in the slightest, and given my circumstances I would've made the same decision again.

"Prestige" is extremely overvalued by those early in the training process. In contrast to your fantasies, going to a top-ranked school is not going to open to golden gates of opportunity and make the world your oyster. A **** student is a **** student and an outstanding student is an outstanding student, irrespective of the name of the institution on the diploma. Take a look at the resident lists of any training program at a "prestigious" institution: yes, you will see plenty of people who graduated from "prestigious" schools, but you will also see folks from seemingly random, off-the-wall schools that are of a much lower caliber. I can also guarantee you that for competitive specialties, the people going into those specialties were still at the top of their classes, even at prestigious institutions.

If you are planning on a career in academia - especially research - then the prestige of an institution is probably relevant, and it may make sense to make compromises in the name of attending a more prestigious institution at the expense of other considerations (cost, location, etc.). Beyond that, it is unlikely to have a meaningful impact on your career. If you are an outstanding student, are motivated, and are willing to work hard, you will succeed irrespective of - and possibly even in spite of - your institution, whether that's #100 or #1 on whatever rank list you decide to deem importantly. Similarly, if you are a horrible student, have an attitude problem, or otherwise difficult to work with, your Harvard diploma will not save you.

 

[deleted804295]

If you can live without family, and live with a couple extra tens of thousands of dollars in debt, and don't have anything else preventing you then I don't see why you wouldn't go for the school that accepts you with the highest prestige.

 

[NickNaylor]

If you can live without family, and live with a couple extra tens of thousands of dollars in debt, and don't have anything else preventing you then I don't see why you wouldn't go for the school that accepts you with the highest prestige.

Because it offers a questionable benefit with significant costs? "A couple extra tends of thousands of dollars" is not insignificant - it just seems like it in comparison because it's all abstract Monopoly money until you start paying it back. That is another several months of paying thousands of dollars each month when it does come time to pay that money back - assuming that the debt hasn't grown even further. And for what?

 

[KnightDoc]

Because it offers a questionable benefit with significant costs? "A couple extra tends of thousands of dollars" is not insignificant - it just seems like it in comparison because it's all abstract Monopoly money until you start paying it back. That is another several months of paying thousands of dollars each month when it does come time to pay that money back - assuming that the debt hasn't grown even further. And for what?

I'd like to meet you half way. Everything you said about questionable benefit sounds reasonable and resonates with me, but significant cost really is relative. I agree that it's all abstract Monopoly money until you start paying it back, but, even then, it's really insignificant over the course of MD career earnings, especially if you think the prestige has any value.

Even $100,000, plus interest, is nothing over the course of a 30+ year career in which you can expect to make multiple hundreds of thousands of dollars per year over most of it. YMMV, but if this were not the case, 50,000 people would not be vying every year for the opportunity to spend what sometimes approaches $500,000 in pursuit of the degree!

 

[deleted1001426]

Even $100,000, plus interest, is nothing over the course of a 30+ year career in which you can expect to make multiple hundreds of thousands of dollars per year over most of it.

That $100,000 if you didn’t owe it in loans could be invested and if so, compounded at a mere 6%/year would yield a return greater than 500k Over the course of a 30 year career and if 10% you’d be nearing 2mill so idk If id call that nothing. This is why almost everyone advises that we attend the cheapest school possible.

I’d take a guess and if you approached any attending physician nearing the end of their career and asked if they’d rather have attended x prestigious school or had >1.7m more in their retirement fund the vast majority would pick the latter. But I guess it depends on personal preferences

 

[deleted1001426]

Didn’t you go to Pritzker for free...? Sure it might have been “lower ranked” than your other schools, but it’s still a prestigious T20 and I hardly think it negatively impacted you in the slightest. So when you say you don’t regret your decision- yeah I don’t think anyone would.

Also I highly doubt you would have turned down your full tuition scholarship at Prtizker for a much lower ranked school unless you had some location-restricted circumstances. But then again, if you did have restrictions, why would you apply to Pritzker in the first place?

I appreciate you trying to keep things positive for us, but I feel your argument on the importance of prestige doesn’t carry much weight given your background. Multiple doctors I’ve spoken to have told me life is significantly easier after you graduate if you go to more well-renowned schools. More attention given to your residency apps, better connections, etc. Not saying it’s not impossible to do it from other schools, but I can see why it would be easier.

You missed the entire point of his post.. the tldr version of it was essentially to get a clear view of your career as well as financial goals and then to choose a school based on that. If you want a career At a prestigious academic institution then go to x oos school for 80k/year as it will make your path a bit easier and if you don’t then go to the lower tuition, lesser known school and gain financial freedom earlier

 

[NickNaylor]

Didn’t you go to Pritzker for free...? Sure it might have been “lower ranked” than your other schools, but it’s still a prestigious T20 and I hardly think it negatively impacted you in the slightest. So when you say you don’t regret your decision- yeah I don’t think anyone would.

Also I highly doubt you would have turned down your full tuition scholarship at Prtizker for a much lower ranked school unless you had some location-restricted circumstances. But then again, if you did have restrictions, why would you apply to Pritzker in the first place?

I appreciate you trying to keep things positive for us, but I feel your argument on the importance of prestige doesn’t carry much weight given your background. Multiple doctors I’ve spoken to have told me life is significantly easier after you graduate if you go to more well-renowned schools. More attention given to your residency apps, better connections, etc. Not saying it’s not impossible to do it from other schools, but I can see why it would be easier.

Yes, I went to Pritzker tuition-free, however I was also accepted to a much lower ranked state school that I absolutely would've gone to if I didn't receive that financial support from Pritzker. I told Pritzker as much when it was getting down to crunch time, and I received an increased scholarship offer as a result. There is 0% chance that I would've gone there if I had been more expensive than other options.

I'm not making the argument that my approach is the one that everyone should take. However, I do think that pre-meds generally SUBSTANTIALLY undervalue the importance of cost in choosing a school because it's all imaginary money. As someone on the other side of it who is now having to pay all that money back (and yes, I did still end up with loans from Pritzker), seeing posts along the lines of "it's only $Xk more total, you should just go there" makes me cringe. Not because cost is the most important factor going into choosing a school, but because there will come a day when all of that imaginary money becomes very real money, and you will be responsible for paying it all back. I think it's difficult to understand the real costs that many pre-meds are willingly bearing because "I'll pay it back someday."

I also think that prestige is substantially overvalued. This creates a bizarro world where unsuspecting pre-meds are willingly taking on ridiculous amounts of debt when cheaper options are available for highly questionable benefit.

 

[deleted804295]

Because it offers a questionable benefit with significant costs? "A couple extra tends of thousands of dollars" is not insignificant - it just seems like it in comparison because it's all abstract Monopoly money until you start paying it back. That is another several months of paying thousands of dollars each month when it does come time to pay that money back - assuming that the debt hasn't grown even further. And for what?

I don't disagree with you. I'm most likely going to my state school due to lowered tuition, and close to family.

I indicated if somebody *could afford to* pay for the higher tuition (ie. rich parents) and didn't care as much as being near family then they should pick higher prestige.

 

[KnightDoc]

That $100,000 if you didn’t owe it in loans could be invested and if so, compounded at a mere 6%/year would yield a return greater than 500k Over the course of a 30 year career and if 10% you’d be nearing 2mill so idk If id call that nothing. This is why almost everyone advises that we attend the cheapest school possible.

I’d take a guess and if you approached any attending physician nearing the end of their career and asked if they’d rather have attended x prestigious school or had >1.7m more in their retirement fund the vast majority would pick the latter. But I guess it depends on personal preferences

Absolutely -- I'm definitely not advocating blindly for the most prestigious option. I only saying that what seems like a lot of money at the start of a career really is not, particularly after taking inflation into account, in relation to cumulative lifetime earnings.

Also, I'm not sure how you did your calculation, but there is no such thing as a 6% guaranteed return compounded annually for 30 years, and the $100,000 you owe wouldn't be immediately available at the beginning of the period for investment, so I really don't know how you could turn 10 years' worth of payments on a $100,000 debt into $500,000 in 30 years unless you are able to make pre-IPO investments in Google each month during your 10 year repayment period!!! 🙂

 

[Goro]

I'd like to meet you half way. Everything you said about questionable benefit sounds reasonable and resonates with me, but significant cost really is relative. I agree that it's all abstract Monopoly money until you start paying it back, but, even then, it's really insignificant over the course of MD career earnings, especially if you think the prestige has any value.

Even $100,000, plus interest, is nothing over the course of a 30+ year career in which you can expect to make multiple hundreds of thousands of dollars per year over most of it. YMMV, but if this were not the case, 50,000 people would not be vying every year for the opportunity to spend what sometimes approaches $500,000 in pursuit of the degree!

But the prestige isn't going to affect the earnings, whether the degree says U WA or U Miami, or JAB or Harvard. An attending is attending, and that will be your salary. And, it's worth noting that those in academic medicine have lower salaries.

 

[KnightDoc]

But the prestige isn't going to affect the earnings, whether the degree says U WA or U Miami, or JAB or Harvard. An attending is attending, and that will be your salary. And, it's worth noting that those in academic medicine have lower salaries.

Very true - my point was only that, if for whatever reason prestige is important to you, the extra expense is manageable over a lifetime of earnings, although it seems overwhelming when you are a student with no earnings. I wasn't making a value judgment on whether or not it was a good investment. To your point, if someone is interested in academic medicine, they might HAVE to make the investment even though it will result in a lower earning potential than other, possibly less expensive options.

 

[deleted1001426]

there is no such thing as a 6% guaranteed return compounded annually for 30 years, and the $100,000 you owe wouldn't be immediately available at the beginning of the period for investment,

Are you insinuating that over a 30 year period a person can’t average 6-10 percent/year over the life of their investment..Right now the average corporate bond rate is 6.14% compounded monthly. As for the second point, once you’ve paid off your loans there’s no reason why someone making 250k couldn’t live moderately frugally and put away 100k over the course of a year or 2 for investments

 

[Engrailed]

Can ppl stop splitting hairs about $$. It’s not even School X vs. School Y season yet -financial aid packages mostly arrive in March/April

obviously ppl are going to prioritize different things based on their life goals, values, and finances. There’s no one size fits all rule! I mean, is this really supposed to be groundbreaking?

and FWIW, even for those that do take out loans, I have yet to meet doctors (in academic settings) that were miserable because they were steeped in crushing debt. I assume that for most, at the attending level, the debt can be managed within a few years-granted that one isn’t burning his/her wallet into the ground with each paycheck.

 

[KnightDoc]

Are you insinuating that over a 30 year period a person can’t average 6-10 percent/year over the life of their investment..Right now the average corporate bond rate is 6.14% compounded monthly. As for the second point, once you’ve paid off your loans there’s no reason why someone making 250k couldn’t live moderately frugally and put away 100k over the course of a year or 2 for investments

No; I not am insinuating anything -- I am flat out stating that the only guaranteed return is a U.S. Treasury return, and that is currently 2.24% for 30 years, not compounded. Bonds don't compound, they pay interest, and you have to be able to reinvest the interest you receive at the same rate to achieve compounding. And nothing compounds monthly except a bank account! Corporate bonds don't pay monthly, and, as I said, they don't compound at all unless they are zero coupon bonds, in which case they compound twice a year, not twelve times! Makes a big difference over time, and, as I said, it's not guaranteed.

Anything else is speculative (corporate bond rates go up and down, are subject to capital gain or loss, and are also subject to default -- what would you be saying about Sears corporate bonds you might have purchased 20 years ago? Remember, before Walmart and Amazon, Sears was where America shopped, and it was as solid as, as, as U.S. Steel, all the U.S. auto companies that were bailed out during the financial crisis, and before that, the Great American Buggy Whip Company 🙂), and, as they say, past performance is not a guarantee of future results.

Is Google going to be Google in 20 years, or Netscape (look it up!! 🙂)? It's pretty easy to look back in 30 years and say, of course, Microsoft or Amazon, definitely not pets.com, but nobody has a crystal ball and knows what is going to return 6-10% compounded over the next 30 years. NOBODY!!!!!!

Nevertheless, you are making my point. If anyone making $250K/yr could easily invest $100K over a year or two, that same person could easily pay off a $100K loan over a year or two, so they should attend whatever school makes them happy. 🙂

 

[Blueprint Med School]

I was wondering if anyone here would be willing to share their reflections after choosing to attend a medical school that wasn't the best fit, but was higher-ranked (or vice versa; lower-ranked, but better fit). Any regrets?

I don't mean to over-simplify the decision, and I definitely understand it's more than a black/white choice. I also understand in most cases your mileage may vary--it depends on your career goals and what is most important to you. However, I hope by keeping the "prompt" vague I get as many perspectives as possible. I'm still really early in my decision-making process and just hoping to hear from others about their experiences.

Fit > Prestige all day every day. Especially in the world of MD where pretty much every school is solid.

Exceptions include:

* Major scholarship offers. I would go to Podunk State if they gave me a free MD, 100%.
* Strong desire to be in a certain geographic area.
* Family ties.

David D, MD - USMLE and MCAT Tutor
Med School Tutors

 

[NickNaylor]

Can ppl stop splitting hairs about $$. It’s not even School X vs. School Y season yet -financial aid packages mostly arrive in March/April

obviously ppl are going to prioritize different things based on their life goals, values, and finances. There’s no one size fits all rule! I mean, is this really supposed to be groundbreaking?

and FWIW, even for those that do take out loans, I have yet to meet doctors (in academic settings) that were miserable because they were steeped in crushing debt. I assume that for most, at the attending level, the debt can be managed within a few years-granted that one isn’t burning his/her wallet into the ground with each paycheck.

Depends heavily on your circumstances. Once of my colleagues is divorced (and paying child support) with a kid and substantial amounts of loans. He is not living an extravagant lifestyle, but those costs alone substantially eat into the ability to pay off loans.

I don't think it's a situation of being "miserable" vs. not. I never make the argument that any working physician will be unable to pay off loans. Of course you will be able to. Nor will you be on the edge of homelessness because of educational debt. But every dollar - actually, more than that due to interest - going to to debt is money that isn't going to something else. That may be something as trite as your dream car or dream house to money that could be going toward retirement. If you're married or have kids, that could be money going toward things that they may want. The point is that the cost of medical school is a zero sum game, and I would argue that the deciding factor is not "miserable or not" but, instead, whether that money might do something more useful/enjoyable/whatever for you than saying that you went to a "prestigious" school.

 

[Frazier]

Out of all the schools where you have great fit, choose the most prestigious. Not the other way around.

My medical school helped me get into my residency program. Which helped me get into my fellowship. Which will help me, I'm sure, get the attending job I do.

It trickles down, and does get diluted the more you progress.

Stated in another way: The attending job doesnt care about my med school -- but they will about my fellowship program. The fellowship doesnt care about my med school, but they cared about my residency program. The residency did indeed care about my med school.

Ymmv. Do what's best for you to shoot for your dreams, just as long as it's not through your foot.

 

[Cornfed101]

Going into medical school you may think that you want to go into academic medicine, but you might change your mind. You are going to want money 100% of the time. Also, that degree from Harvard doesn't do you much good if you become disabled in residency or shortly after becoming an attending (PSA for getting disability insurance).

 

[Moose A Moose]

Fit>prestige

Unless you’re coming from a family that won’t be able to get over the fact.

 

[CosmeticLeFort3]

Whenever my scribe coworkers got into multiple schools and asked the doctors opinion they always said choose the more prestigious school regardless of tuition. Granted I used to scribe in a prestigious IM subspecialty.