Class Ranking in Medical School

[Yasargil]

This a perhaps a naive question, and being under the assumption that some schools rank the students academic standing, I wonder how 'being the top in your class' at a state school would compare to a middle of the road student at a well known school when matching for residency all else being the same?

So where it may be more difficult to be 'top of the class' at a well known school, might one be better served where hypothetically, you could rank at the top more easily (ie, caliber of student competition) at a lesser 'named' school?

This above, is simply a hypothetical thought and not me having some neurosis about competing with potential fellow medical students.
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[PeepshowJohnny]

Generally, you're "mostly" judged regardless of your school. Step 1 scores are huge because they're standardized, and third year grades are very important even though they're "subjective".

But it does vary from field to field.

For example, if you read the Internal Medicine residency board, they'll be threads about how OUTSTANDING applicants from a "no name" school with crazy Step 1's, AOA, get rejected from "big name" programs like a Harvard in favor of somebody who's a bit weaker but with a better name school.

 

[MrBurns10]

So where it may be more difficult to be 'top of the class' at a well known school, might one be better served where hypothetically, you could rank at the top more easily (ie, caliber of student competition) at a lesser 'named' school?

I can't really answer your question because I haven't applied to residencies yet, but I actually took the opposite approach when choosing my school a couple years ago. Realize that it's not going to be easy being at the top of your class at a "lesser named" school because everyone is thinking the same way you are...i.e. I need to be at the top so I can get into insert competitive specialty here. So I looked at it in the opposite light, that I wouldn't feel the need to be on the top at a school with a "better name."

 

[Doublecortin]

This a perhaps a naive question, and being under the assumption that some schools rank the students academic standing, I wonder how 'being the top in your class' at a state school would compare to a middle of the road student at a well known school when matching for residency all else being the same?

So where it may be more difficult to be 'top of the class' at a well known school, might one be better served where hypothetically, you could rank at the top more easily (ie, caliber of student competition) at a lesser 'named' school?

This above, is simply a hypothetical thought and not me having some neurosis about competing with potential fellow medical students.
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'Anyways' is not a real word.

I believe pretty much ALL schools rank their students. They have to for the dean's letter and AOA selection

 

[SStorm]

I believe pretty much ALL schools rank their students. They have to for the dean's letter and AOA selection

I know that the Cleveland Clinic does not. I specifically asked their dean when they spoke to us (the interviewees) and he said that they have no AOA and no GPA. They only "portfolio grading" and the USMLE's to judge students. I'm not sure if other schools are like CCLCM though...

 

[Instatewaiter]

Most schools rank in one way or another. Most pass/fail schools have internal rankings. There are a few notable exceptions.

The person who is top of the class at a state school will fare better than someone who is middle of the pack at a well known school. All things are rarely equal so this point is moot.

 

[Instatewaiter]

For example, if you read the Internal Medicine residency board, they'll be threads about how OUTSTANDING applicants from a "no name" school with crazy Step 1's, AOA, get rejected from "big name" programs like a Harvard in favor of somebody who's a bit weaker but with a better name school.

Because clearly these people know the stats of the other applicants and how they match up.

 

[Bananas Foster]

the issue of how pass/fail schools ranking applicants have been somewhat of a confusing issue for me. Most schools I applied to have moved at least somewhat to pass/fail, but Talking to students at Minnesota ( I think, all running together now) I heard that there is no class ranking in the residency application (leading to some grief in the match process i would assume) but at another school I heard that the Match required some ranking of students from their respective medical schools, even if they are p/f (I assume this is where the honors and high pass fit in)

I wish I had a better Idea of how these nuances in grading policy differ in the long term, and better idea of how these difference actually do affect residency applications.

 

[Jolie South]

the issue of how pass/fail schools ranking applicants have been somewhat of a confusing issue for me. Most schools I applied to have moved at least somewhat to pass/fail, but Talking to students at Minnesota ( I think, all running together now) I heard that there is no class ranking in the residency application (leading to some grief in the match process i would assume) but at another school I heard that the Match required some ranking of students from their respective medical schools, even if they are p/f (I assume this is where the honors and high pass fit in)

I wish I had a better Idea of how these nuances in grading policy differ in the long term, and better idea of how these difference actually do affect residency applications.

I know of one particular school that does absolutely no ranking, even if programs ask.

 

[MrBurns10]

I wish I had a better Idea of how these nuances in grading policy differ in the long term, and better idea of how these difference actually do affect residency applications.

The way I've understood how my school does it is if your class rank helps you, they include it in a way, like "this person was in the top quarter of his/her class" but that if it doesn't help you they don't include it. Other schools basically give class rank info in a very subtle way: "X would make an exceptional resident" means he/she was near the top, all the way down to "In the right program, Y could make a solid resident."

 

[167649]

I know of one particular school that does absolutely no ranking, even if programs ask. They send out a letter explaining how the school works and that there is no ranking.

I know, for one, CCLCM doesn't have any student ranking. Their method of evaluation is about as non-trad as it can possibly get.

 

[notdeadyet]

Most schools rank in one way or another. Most pass/fail schools have internal rankings. There are a few notable exceptions.

No, lots of schools do not rank. The trend started years ago for schools to move to a Pass/Fail model. Lots have switched over but I don't know of many (any?) moving back to grading.

Simliarly, lots of schools have moved towards a no ranking model. You are judged based on your Step 1 score and your clinical performances. But your dean's letter does not indicate a rank.

Just as grades are becoming less relevant to residency directors, I think you'll find class rank becomes less relevant too as more schools move this direction.

(btw, as for AOA, non-ranked schools select you for your clerkship performances/reviews and Step 1)

 

[notdeadyet]

Most schools I applied to have moved at least somewhat to pass/fail, but Talking to students at Minnesota ( I think, all running together now) I heard that there is no class ranking in the residency application (leading to some grief in the match process i would assume) but at another school I heard that the Match required some ranking of students from their respective medical schools, even if they are p/f (I assume this is where the honors and high pass fit in)

Not true. Class rank is not a requirement of the match. Many pass/fail schools do not rank. This doesn't stop folks from killing in the match.

 

[Dane07MD]

Bottom line is this: being at the top of your class anywhere is better than being middle of road somewhere else, regardless of competition.

In medical school, every program will have an elite few students in every class, and to be above them is equally different, regardless of the school. Rather than focusing on rankings, and focusing on being as good as you can be, you'll be much better off.

 

[Bananas Foster]

Not true. Class rank is not a requirement of the match. Many pass/fail schools do not rank. This doesn't stop folks from killing in the match.

This is why you should always fact check your tour guide.

 

[ryandote]

.

 

[Instatewaiter]

No, lots of schools do not rank. The trend started years ago for schools to move to a Pass/Fail model. Lots have switched over but I don't know of many (any?) moving back to grading.

Simliarly, lots of schools have moved towards a no ranking model. You are judged based on your Step 1 score and your clinical performances. But your dean's letter does not indicate a rank.

Just as grades are becoming less relevant to residency directors, I think you'll find class rank becomes less relevant too as more schools move this direction.

(btw, as for AOA, non-ranked schools select you for your clerkship performances/reviews and Step 1)

Just so everyone is clear, pass/fail in no way means that a school doesnt rank. Most school with very few exceptions keep internal rankings whether you like it or not. So you and johhny may have a pass but Johnny's 98 is going to be kept track of while your 75 will too. The ranking may not be divulged to the students but there are intricacies that will come out in your deans letter. Tour guides, unless a faculty member, are not an accurate source.

Class rank, as it stands now, is relatively low on the totem pole. Step 1 scores, clerkship grades, LORs, AOA all arguably rank higher. So all in all it doesnt really matter.

 

[Phoenix.]

I know, for one, CCLCM doesn't have any student ranking. Their method of evaluation is about as non-trad as it can possibly get.

Ditto for Mayo. There is absolutely no ranking, even for residency evaluations.

Hmmm - aren't CCLCM and Mayo two of the smallest med school classes? Perhaps that plays a part in the determination to do away with rankings.

 

[ChubbyChaser]

I know of one school thats Honors, pass, low pass, and Fail

I dont really understand why they do this, IMO it just makes it harder for their students to do well. Alot of ppl that just got Pass at this school might have gotten a High pass elsewhere, and the ppl that got low pass might have gotten a Pass at another school.

 

[lord_jeebus]

My school has no ranking, but like most schools still assigns an "adjective" in the MSPE (Dean's Letter) that roughly indicates where you fall in the class, based on what seems to be a gestalt look at evaluations and number of Honors.

The MSPE also has a section where the breakdown of H/P/F for each class is shown on a bar graph. I believe this is standard practice at most if not all schools (they don't tell us about it, but I saw it on my residency interviews).

 

[lord_jeebus]

Oh, and to answer the original question...

I'd rather be middle of the class at Harvard or UCSF than #1 at a state school of limited prestige. But I'd rather be top of the state school than middle of the road at most "top" schools.

I'd definitely rather be in the bottom 1/3 at a "top 10" school than in the middle 1/3 at a state school.

 

[Law2Doc]

So where it may be more difficult to be 'top of the class' at a well known school, might one be better served where hypothetically, you could rank at the top more easily (ie, caliber of student competition) at a lesser 'named' school?

It doesn't really work this way. You have to remember that while in undergrad there were a ton of "average" people that kept you looking like a superstar, in med school pretty much everyone got "mostly A's" in undergrad. There is huge self selection of people who apply to med school and then only 50% of all applicants thereafter get in. So the average of matriculants at most med schools is in the 3.5/30 ballpark, and there will be a ton of people capable of getting the high score on a given test at pretty much any school. Even the B+ students get their share of A's now and then and a lot of folks push themselves harder in med school than they did in undergrad. Thus it's not really like you'd be average at Harvard but the top of the class at Tufts down the block. It just doesn't pan out. There is simply a much smaller range of stats between the top and bottom med school as compared to the top to bottom of an undergrad class. Also bear in mind that a decent number of the top applicants to med school go places for geographic/family reasons, so it's conceivable that a handful of folks at any med school could have gone to a top school if they found it geographically desirable.

Bottom line is that you are going to be working harder than you ever have just to do well even in the "worst" of US allo med schools. I wouldn't bank on coasting in med school whereever you go. If anything, some of the lower ranked schools are probably more apt to make folks repeat courses/years than the top schools, so they may instill more of an incentive for their students to work harder to stay above the mean and as a result keep the competition more (not less) heated.

Just go where you think you'd flourish, and don't try to play gamesmanship. Underestimating folks at other schools is a fatal flaw, as you will learn in a few years when you will likely be working under such folks on rotations.

 

[Phoenix.]

How important is class rank in the scheme of things? Given that at many schools I've heard you don't even know your class rank (but it is indicated in the letter for residencies), it seems odd to me that it would then be so important. Or is it?

 

[Law2Doc]

How important is class rank in the scheme of things? Given that at many schools I've heard you don't even know your class rank (but it is indicated in the letter for residencies), it seems odd to me that it would then be so important. Or is it?

It isn't hugely important, but doesn't hurt. If you have high Step 1 and good clinical rotation evaluations, you are in good shape. Things like high class rank, AOA look nice in the Deans letter and are thus icing on the cake.

 

[Tired Pigeon]

It isn't hugely important, but doesn't hurt. If you have high Step 1 and good clinical rotation evaluations, you are in good shape. Things like high class rank, AOA look nice in the Deans letter and are thus icing on the cake.

As usual, L2D is right on. If you have excellent step 1 scores & clinical evaluations, you're set. Also agree with the advice about not underestimating the competition at an 'average' school. Not everyone is there because they couldn't get in anywhere better - some choose a middle of the road school over more prestigious options due to major cost differences, family/living situation considerations, or for the same reason the OP was discussing, namely looking for a 'big fish in a small pond' type of situation. The overall competition may be less intense at Average State U Med School vs. a top 10, but I think it's a serious miscalculation to just walk in there expecting a cakewalk.