Cost > Location

[WestCoastNative]

What would you rather pick? Say you get into a few medical schools that are located in less expensive locations, and a few in more expensive locations such as L.A., NYC, Boston, SF, etc.. The variation between costs can be quite large. I would imagine that living in NYC could add 100k-150k more onto your student debt. For this reason, I feel that more people might care about the cost more than the location... right?

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[Boolean]

Cost over location for every area except Boston. I have a ridiculous love of Boston, and it would likely be the only place I would consider location > cost

 

[WestCoastNative]

If you go to medical school in a certain location than it's easier to get a residency there compared to someone coming from some other medical school outside of the area right? Getting a residency in this location means that it'd be easier to find work there after residency as well right? Does this imply that in certain situations, if you want to work in a certain location after graduation and residency, than you should try and get into medical school there no matter what the cost is?

 

[MedWonk]

Depends on location. The west coast generally > cost for me, except for Boston and NYC, which I hold even. It's a combo of the two. Generally, I hold location to be on top, but it sort of depends on what you're willing to stomach for debt. Problem solved if you get a combo of the two (love Seattle, WA resident, in at UWash, for example).

 

[WestCoastNative]

Depends on location. The west coast generally > cost for me, except for Boston and NYC, which I hold even. It's a combo of the two. Generally, I hold location to be on top, but it sort of depends on what you're willing to stomach for debt. Problem solved if you get a combo of the two (love Seattle, WA resident, in at UWash, for example).

I'm pretty sure that if UCSF, Cornell, Columbia, Harvard, etc.. accepted someone on SDN, than cost wouldn't be an issue.

 

[Boolean]

I'm pretty sure that if UCSF, Cornell, Columbia, Harvard, etc.. accepted someone on SDN, than cost wouldn't be an issue.

Not necessarily. Sometimes cost is a very real and unavoidable issue, even in spite of the amount of loans one may receive from these schools.

 

[ortnakas]

Depends on situation, too. I'm married, so location is a bigger factor than it would be if I was 22 and single.

 

[Perrotfish]

If you go to medical school in a certain location than it's easier to get a residency there compared to someone coming from some other medical school outside of the area right? Getting a residency in this location means that it'd be easier to find work there after residency as well right? Does this imply that in certain situations, if you want to work in a certain location after graduation and residency, than you should try and get into medical school there no matter what the cost is?

1) No, being in a location does not make it much easier to get a residency in the area. Arguably there may be a slight bias towards you from your home institution, but otherwise residency doesn't really do regional bias. The match is a very formal process that is based almost exclusively on grades, research, LORs, and standardized test scores. If you really want a given residency in a given location perform well in school. If you really feel the need to spend some personal time with your dream residency you can always do an audition rotation to impress them.

2) Doing residency in an area may arguably make it slightly easier to join an academic practice in the area that you already rotated through. It won't help you with the dozens to hundreds of practices you didn't rotate through. In any event this isn't like engeineering or business where breaking in to a company is an important part of your career: compensation and career trajectories are relatively flat for physicians compared to other kinds of professionals. Physicians possess skillsets that are consistently profitable and relatively scarce, if you're board certified chances are you'll be able to move where you want and find a job.

3) Cost is going to limit your options, both for what career to choose and where to live. While most kind of physicians can afford to live in most cities without living in poverty, remember that physician salaries are unique in that, unlike every other career, salaries are actually inversely related to the cost of living. If you want to live in New York, for example, you will be making a fraction of what someone in North Dakota makes in the same job despite the fact that your cost of living is much higher. A high debt load wouldn't absolutely prevent you from moving to one of those locations, but it wouldn't help either. Keeping your costs low keeps your options open for both low paying but fulfilling careers (you might like Pediatrics) and for fun but uneconomical living situations after residency (you might like New York or San Francisco).

If you are lucky enough to have multiple options for medical school, and one is significantly cheaper than the others, I would go to the cheaper one.

 

[WestCoastNative]

Hmm I see. Thanks for the information. How hard is it really to find a job as a physician/surgeon? Is the competition so bad that you'd have trouble finding work in big cities?

 

[IlDestriero]

Hmm I see. Thanks for the information. How hard is it really to find a job as a physician/surgeon? Is the competition so bad that you'd have trouble finding work in big cities?

That's entirely dependent on your specialty and the market saturation.
I don't know any physician out of work unwilling, but they may not be working in their dream job/city/arrangement.

 

[WestCoastNative]

That's entirely dependent on your specialty and the market saturation.
I don't know any physician out of work unwilling, but they may not be working in their dream job/city/arrangement.

Speaking of, I always here that it depends on specialty. How though? More competitive specialties have it harder, or the other way around? Hard for family medicine specialties to find work, while orthopedic surgeons have it easy? Or how does it work?

 

[Ismet]

It depends on the cost and it depends on the location as well as the school itself. I could have saved about $30-40,000 over 4 years by going to another school in my state, but I chose my school because of location, as well as a lot more opportunities and a better reputation, among other things.

If the price difference was in the ballpark of $100,000 over 4 years, I would probably be singing a different tune.

 

[MedWonk]

I'm pretty sure that if UCSF, Cornell, Columbia, Harvard, etc.. accepted someone on SDN, than cost wouldn't be an issue.

And also not least because they're all in, IMO, excellent locations. I wouldn't have any qualms, either, and it's not because of perceived prestige in my case. I would go where I want to live for four years (possibly longer if I had residency in the same location). As an example, I would choose OHSU over Wash U barring some ridiculously generous financial aid package from Wash U. To me, PDX>>>STL. Others will have different priorities, but this thread isn't about prestige/ranking, so I stayed away from it.

 

[MedWonk]

That's entirely dependent on your specialty and the market saturation.
I don't know any physician out of work unwilling, but they may not be working in their dream job/city/arrangement.

Attendings I work with (EM) tell me it tends to come down to a trade-off between money and location, where more desirable locations/prestigious hospitals will bring in less money. So, basically to work where I really would like to live (PDX or LA), I'd have to sacrifice money, whereas I could work in some less desirable area for more money. Does this hold across all specialties, or is it going to vary a lot?

 

[IlDestriero]

Money, location, workload.
Pick 2.

 

[Pacna]

I only applied to locations I would be happy going to. That makes cost my only deciding factor now.

 

[Perrotfish]

Speaking of, I always here that it depends on specialty. How though? More competitive specialties have it harder, or the other way around? Hard for family medicine specialties to find work, while orthopedic surgeons have it easy? Or how does it work?

The only specialty that has a truly hard time finding work in general is Pathology, and even most of them are employed.

Other than that, the impression I've got is that you can likely find work in pretty much any given area if that's what you want. You might not get an ideal practice, since more desirable locations will likely expect more for less, but you can get something if location is a top priority for you.