Columbia (4YMD) vs. Stony Brook 3YMD with Directed Residency Pathway

[Fermat]

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Choosing between two programs and would love some outside perspective.

Columbia

Pros

• Strong prestige and name recognition
• Would definitely rather be back in NYC than on Long Island

Cons

• One year later to attending salary
• One additional year of tuition and expenses
• No guaranteed residency pathway, have to stress about matching into a competitive specialty.

Stony Brook

Pros

• 3-year program saves a full year of expenses
• Directed pathway conditionally guarantees my target residency match
• Eliminates the most stressful part of med school

Cons

• Less brand prestige than Columbia
• Residency match is conditional. Failing a shelf, Step, or remediation sends you back to the 4-year track

Columbia obviously carries more prestige and name recognition, but the directed pathway makes me an attending a year sooner and essentially eliminates the most stressful part of med school.

 

[YellowSalamander]

What are your career interests? If you want to become a community surgeon without fellowship training and you are 100% sure you are guaranteed a residency spot in your specialty of interest, I think Stony Brook sounds like a great idea. However, if you are interested in becoming an academic physician or want to match into a specialty that requires a fellowship (cardiology, PCCM, GI, heme onc etc.) I would be a bit more cautious.

 

[Fermat]

What are your career interests? If you want to become a community surgeon without fellowship training and you are 100% sure you are guaranteed a residency spot in your specialty of interest, I think Stony Brook sounds like a great idea. However, if you are interested in becoming an academic physician or want to match into a specialty that requires a fellowship (cardiology, PCCM, GI, heme onc etc.) I would be a bit more cautious.

I feel like it's way too early to say if I wanna do academics, private practice, community hospital, or whatever.

I want to do a competitive specialty that doesn't require a fellowship. I feel pretty confident in it, though obviously I understand that many people end up change their mind on what specialty they want to go into..

 

[YellowSalamander]

I feel like it's way too early to say if I wanna do academics, private practice, community hospital, or whatever.

I want to do a competitive specialty that doesn't require a fellowship. I feel pretty confident in it, though obviously I understand that many people end up change their mind on what specialty they want to go into..

What is the difference in cost of attendance? I would honestly just go for Columbia. It will be another year, but you will keep your doors open and will almost certainly be able to match into a competitive specialty at an elite academic medical center if you put in the effort. Loss of attending salary for a year sucks, but the school you attended and later trained at will stay with you for the rest of your career. With that said, I think you will do well wherever you end up. Go with your gut instinct here.

 

[riv_jordan]

I'm not familiar with Stony Brook's directed residency program? Have you already been admitted into a specific guaranteed specialty or do you choose down the line? How committed to this specialty are you and are there options to switch to a different specialty and still have guaranteed match? What hospital would you be training at? Also, what is the COA difference? I assume Stony Brook will be cheaper purely because it's a year shorter.

In response to some of your cons for Stony Brook, I'd say 1) prestige is only relevant as a proxy for other factors that will help you match competitively. But if you are guaranteed to match your desired specialty at Stony Brook and are happy with where you'd be training, then med school prestige becomes irrelevant (who would you be trying to impress)? 2) Failing step or remediating are things you'd want to avoid at any school, so I wouldn't list it as a con for Stony Brook. That said, I would try to get a sense of attrition rate. Do most students admitted through the 3-year program actually make it to the end, or do they get kicked out.

I'd try to assess the flexibility of this Stony Brook option just to make sure there aren't any hidden clauses that are unacceptable to you. But otherwise, I think if you are truly committed to whatever specialty you're currently interested in and know yourself well enough to know that you can succeed at Stony Brook and won't agonize over what-ifs, then a guaranteed residency spot in your preferred specialty is a rare opportunity that i can't imagine passing up.

 

[Fermat]

What is the difference in cost of attendance? I would honestly just go for Columbia. It will be another year, but you will keep your doors open and will almost certainly be able to match into a competitive specialty at an elite academic medical center if you put in the effort. Loss of attending salary for a year sucks, but the school you attended and later trained at will stay with you for the rest of your career. With that said, I think you will do well wherever you end up. Go with your gut instinct here.

Stony Brook will be $70k cheaper, but even if Columbia was free Stony Brook would be the better decision financially. Becoming an attending making $500k+ a year sooner is very valuable.

 

[Fermat]

I'm not familiar with Stony Brook's directed residency program? Have you already been admitted into a specific guaranteed specialty or do you choose down the line? How committed to this specialty are you and are there options to switch to a different specialty and still have guaranteed match? What hospital would you be training at? Also, what is the COA difference? I assume Stony Brook will be cheaper purely because it's a year shorter.

In response to some of your cons for Stony Brook, I'd say 1) prestige is only relevant as a proxy for other factors that will help you match competitively. But if you are guaranteed to match your desired specialty at Stony Brook and are happy with where you'd be training, then med school prestige becomes irrelevant (who would you be trying to impress)? 2) Failing step or remediating are things you'd want to avoid at any school, so I wouldn't list it as a con for Stony Brook. That said, I would try to get a sense of attrition rate. Do most students admitted through the 3-year program actually make it to the end, or do they get kicked out.

I'd try to assess the flexibility of this Stony Brook option just to make sure there aren't any hidden clauses that are unacceptable to you. But otherwise, I think if you are truly committed to whatever specialty you're currently interested in and know yourself well enough to know that you can succeed at Stony Brook and won't agonize over what-ifs, then a guaranteed residency spot in your preferred specialty is a rare opportunity that i can't imagine passing up.

I've already been accepted into the specialty I want to go into. I'm pretty sure about the specialty, but I understand many people end up changing. If I do change my mind, I'd have to either apply again to a different 3 year program or go to the 4 year track.

According to the program director, the only people that have left the 3 year program have done so willingly, either because they wanted to change their specialty or because they couldn't take the summer classes for family obligations.

 

[BenzeneToluene]

Hey, congrats on a great cycle! I made a very similar decision a couple years back between 3-yr option for a surgical subspecialty at a mid-tier school vs more prestigious 4-yr tracks. I ended up going with the 3-yr option, and haven’t regretted it so far. But you certainly have 2 great options, and you can’t really go wrong here.

If you have any questions, feel free to send me a message!