Cost of Attendance for Medical Schools: Should it even be a consideration?

[LuluLovesMe]

Out of boredom at work, I started looking at the costs of attendance for the medical schools I applied to. To my surprise, the differences were not that big.

Tufts which is considered one of the most expensive medical schools to attend has an estimated cost of attendance of $85k. UMass which is a public school with one of the lowest tuitions has a cost of attendance of $65k. Even Virginia Tech which is private has a cost of attendance of only $66k.

So at the most I would be looking at a difference of $80k over 4 years.

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[Affiche]

Out of boredom at work, I started looking at the costs of attendance for the medical schools I applied to. To my surprise, the differences were not that big.

Tufts which is considered one of the most expensive medical schools to attend has an estimated cost of attendance of $85k. UMass which is a public school with one of the lowest tuitions has a cost of attendance of $65k. Even Virginia Tech which is private has a cost of attendance of only $66k.

So at the most I would be looking at a difference of $80k over 4 years.

Once you're factoring in interest that's going to be a difference of over $100,000k. To me, that's not a small difference.

 

[Doudline]

The importance of money is relative.

It depends on your specialty and work environment (PP, academics, humanitarian...), your envisioned lifestyle, whether you plan on having children and when, whether you choose a working partner or a trophy wife/husband, etc.

100k is not that big a deal in the grand scheme of things, but it can force some projects on the back-burner.

 

[lmn]

Make sure to look at match lists, that cheaper school may save you money, but if they have a poor track record of matching people into a certain specialty, competitive programs, or geographical regions and those are programs or places you want to be for residency, then it might not suit you well to go there.

But if they match equally to programs and places you think you might want, and you like both schools fairly equally, then the cheaper option might very well be the better option.

 

[Affiche]

100k is not that big a deal in the grand scheme of things

Depends on what field you'd like to go into. If you're into primary care, $250k vs $150k in debt is a big deal. If you want to specialize, it's not as big of a deal.
That said, do you really want to feel pressured to specialize because of debt? This is a very real thing to consider. Lots of medical students who attend high CoA schools end up specializing because the amount of debt they've accumulated makes primary care unappealing.

 

[MSTPtastic]

It should be one of many considerations. $100k is a lot of money - for example, it's the down payment on a very nice house where I live. Is it worth one hundred thousand dollars for you to go to school in Boston vs. Worcester? What if it were a $20,000 difference? If we're talking about schools with very different rankings, is it worth, say, $60k (or, in other terms, a luxury car) to increase your chances of ending up in a competitive specialty?

The answers to these questions are personal, and depend on your priorities and goals. Cost may matter much more to an aspiring primary care doc than an aspiring rad oncologist.

 

[LuluLovesMe]

It should be one of many considerations. $100k is a lot of money - for example, it's the down payment on a very nice house where I live. Is it worth one hundred thousand dollars for you to go to school in Boston vs. Worcester? What if it were a $20,000 difference? If we're talking about schools with very different rankings, is it worth, say, $60k (or, in other terms, a luxury car) to increase your chances of ending up in a competitive specialty?

The answers to these questions are personal, and depend on your priorities and goals. Cost may matter much more to an aspiring primary care doc than an aspiring rad oncologist.

How much does the school you attended affect your chances at a residency? If your school is primary care focused but you have great scores and evals would it still be harder to place into a more selective residency?

 

[lmn]

Depends on what field you'd like to go into. If you're into primary care, $250k vs $150k in debt is a big deal. If you want to specialize, it's not as big of a deal.
That said, do you really want to feel pressured to specialize because of debt? This is a very real thing to consider. Lots of medical students who attend high CoA schools end up specializing because the amount of debt they've accumulated makes primary care unappealing.

I don't think most students at high cost schools end up specializing simply b/c primary care doesn't pay well. Plenty of med students come in thinking primary care is what they want to do, but once they rotate through family med, many people find the field boring (most patients aren't that sick/interesting) and the pressure to see so many pts in so little time (along with all the charting) very unappealing. Then they see specialties where patients tend to have more interesting problems and more interesting treatments/interventions. And to top it off you get better compensation doing what many people find more interesting, it's a pretty easy decision for many med students.

Personally I feel like the selection criteria/process for med school tends to predispose students towards specialties over primary care more than just the $$.

 

[Affiche]

I don't think most students at high cost schools end up specializing simply b/c primary care doesn't pay well. Plenty of med students come in thinking primary care is what they want to do, but once they rotate through family med, many people find the field boring (most patients aren't that sick/interesting) and the pressure to see so many pts in so little time (along with all the charting) very unappealing. Then they see specialties where patients tend to have more interesting problems and more interesting treatments/interventions. And to top it off you get better compensation doing what many people find more interesting, it's a pretty easy decision for many med students.

Personally I feel like the selection criteria/process for med school tends to predispose students towards specialties over primary care more than just the $$.

I agree that interests change, but I know a fair number of students who were still genuinely interested in primary care but chose to specialize because of their debt. I think a lot of students specialize because that's what they're interested in, but I think a lot also specialize because the amount of money they owe makes it a more appealing option.

 

[NotYou20]

It should be one of many considerations. $100k is a lot of money - for example, it's the down payment on a very nice house where I live. Is it worth one hundred thousand dollars for you to go to school in Boston vs. Worcester? What if it were a $20,000 difference? If we're talking about schools with very different rankings, is it worth, say, $60k (or, in other terms, a luxury car) to increase your chances of ending up in a competitive specialty?

The answers to these questions are personal, and depend on your priorities and goals. Cost may matter much more to an aspiring primary care doc than an aspiring rad oncologist.

Ehhh, I'm planning things based on doing primary care and I think that's the safest way to go. There's no guarantee that any of us will be able to specialize, nor that we won't end up really liking primary care.

 

[MSTPtastic]

How much does the school you attended affect your chances at a residency? If your school is primary care focused but you have great scores and evals would it still be harder to place into a more selective residency?

Others will be able to answer this question better than I can, but my impression is that it matters on the margin. I.e., all other things (STEP score, grades, evals, etc.) being equal, you'll stand a better chance of getting your first residency pick if you go to Harvard over Rush (not to pick on Rush). But those other factors matter more - someone with a perfect STEP-I score from Rush will stand a better chance of getting their first pick residency than someone from Harvard who had to take the test three times to pass.

 

[Law2Doc]

Make sure to look at match lists, that cheaper school may save you money, but if they have a poor track record of matching people into a certain specialty, competitive programs, or geographical regions and those are programs or places you want to be for residency, then it might not suit you well to go there.

But if they match equally to programs and places you think you might want, and you like both schools fairly equally, then the cheaper option might very well be the better option.

Um no. This is bogus and reflects why I keep explaining why premeds shouldn't be looking at match lists. You can never have a clue whether a match list reflects people not getting certain things they wanted versus getting exactly what they wanted. A match list can look objectively great to a premed but in fact every match can reflect someone getting their fifth choice, while another match list can look quite pedestrian but in fact every person got their dream residency. How can you know? And how can you tell what a good match list is anyhow -- i doubt you actually know the pecking order of residencies in every specialty, and there are quite a few gems and rising stars that may not be common knowledge to premeds and even a number of brand names that are known in each specialty to be malignant. You find all this out from mentors later in med school but will be clueless as a premed. And do you seriously think the same person with eg the same interview skills, test scores research, and evaluations is going to have a hugely different experience on te residency trail coming from Tufts or UMass? I doubt there's much difference. Most US allomed schools do a pretty good job, and your board scores will be your own effort, so 20 spots on the rank list probably doesn't mean as much as some premeds seem to think. I'd say most US allo med schools are pretty good launching pads for any specialty, and the rest is up to you. But don't get fooled if the top student at X school ended up at IM at program Y, instead of derm or ortho, because there are so many reasons that student may have wanted IM at Y rather than derm or ortho. residency selection us about starting into the career you want, not the residency some premed perhaps sees as more prestigious. So in short DO NOT look at match lists for this reason. Guaranteed you will misinterpret what you see, and you shouldn't guide big decisions of your life with misunderstandings of how to interpret this data. I liken using match lists as a premed to coming into the last minute if a movie and trying to extrapolate what it was about. most of the time you will be wrong because that single snapshot data point is less important than the desires and intentions that led to it.

 

[Spector1]

of course cost matters but at the end of the day, you just go where you get in.

 

[Law2Doc]

of course cost matters but at the end of the day, you just go where you get in.

Some people have choices.

 

[NotYou20]

Um no. This is bogus and reflects why I keep explaining why premeds shouldn't be looking at match lists. You can never have a clue whether a match list reflects people not getting certain things they wanted versus getting exactly what they wanted. A match list can look objectively great to a premed but in fact every match can reflect someone getting their fifth choice, while another match list can look quite pedestrian but in fact every person got their dream residency. How can you know? And how can you tell what a good match list is anyhow -- i doubt you actually know the pecking order of residencies in every specialty, and there are quite a few gems and rising stars that may not be common knowledge to premeds and even a number of brand names that are known in each specialty to be malignant. You find all this out from mentors later in med school but will be clueless as a premed. And do you seriously think the same person with eg the same interview skills, test scores research, and evaluations is going to have a hugely different experience on te residency trail coming from Tufts or UMass? I doubt there's much difference. Most US allomed schools do a pretty good job, and your board scores will be your own effort, so 20 spots on the rank list probably doesn't mean as much as some premeds seem to think. I'd say most US allo med schools are pretty good launching pads for any specialty, and the rest is up to you. But don't get fooled if the top student at X school ended up at IM at program Y, instead of derm or ortho, because there are so many reasons that student may have wanted IM at Y rather than derm or ortho. residency selection us about starting into the career you want, not the residency some premed perhaps sees as more prestigious. So in short DO NOT look at match lists for this reason. Guaranteed you will misinterpret what you see, and you shouldn't guide big decisions of your life with misunderstandings of how to interpret this data. I liken using match lists as a premed to coming into the last minute if a movie and trying to extrapolate what it was about. most of the time you will be wrong because that single snapshot data point is less important than the desires and intentions that led to it.

Do you think there's a little bit of value between do schools? Could a good amount of md university matches indicate that there are more mid our high tier places that think a school produces good students whereas a do school with very few could indicate that programs generally consider the schools students riskier, or at least are an unknown? So looking at them for, might this school hold me back rather than this school gives me an advantage.

 

[Spector1]

Some people have choices.

lucky for them

 

[gettheleadout]

lucky for them

 

[Law2Doc]

Do you think there's a little bit of value between do schools? Could a good amount of md university matches indicate that there are more mid our high tier places that think a school produces good students whereas a do school with very few could indicate that programs generally consider the schools students riskier, or at least are an unknown? So looking at them for, might this school hold me back rather than this school gives me an advantage.

First I was only limiting my discussion to US allo schools because I'm not a DO person and don't pretend to know much about the differences amongst those schools and the DO match and the like. But at least for US allo (and i dont know why it would be different for DO), I'm saying you can't draw those kinds of conclusions from match lists because even if you know what constitutes a Good match in each specialty, which is doubtful, you'll never the "why" behind where a person is putting various programs on their rank lists. Maybe someone is choosing IM in a particular region because that's the best they can get, but more often they're choosing it because they like IM and wanted to stay in that region. It's only the foolish undergrad mindset that leaps to the conclusion that that person would rather be doing derm in SF, and that his med school must have killed his chances. At this stage it's about choosing a career path you like, not collecting laurels, so your interpretation depends on knowing the story behind the list, not the end result.

 

[starlite911]

Um no. This is bogus and reflects why I keep explaining why premeds shouldn't be looking at match lists. You can never have a clue whether a match list reflects people not getting certain things they wanted versus getting exactly what they wanted. A match list can look objectively great to a premed but in fact every match can reflect someone getting their fifth choice, while another match list can look quite pedestrian but in fact every person got their dream residency. How can you know? And how can you tell what a good match list is anyhow -- i doubt you actually know the pecking order of residencies in every specialty, and there are quite a few gems and rising stars that may not be common knowledge to premeds and even a number of brand names that are known in each specialty to be malignant. You find all this out from mentors later in med school but will be clueless as a premed. And do you seriously think the same person with eg the same interview skills, test scores research, and evaluations is going to have a hugely different experience on te residency trail coming from Tufts or UMass? I doubt there's much difference. Most US allomed schools do a pretty good job, and your board scores will be your own effort, so 20 spots on the rank list probably doesn't mean as much as some premeds seem to think. I'd say most US allo med schools are pretty good launching pads for any specialty, and the rest is up to you. But don't get fooled if the top student at X school ended up at IM at program Y, instead of derm or ortho, because there are so many reasons that student may have wanted IM at Y rather than derm or ortho. residency selection us about starting into the career you want, not the residency some premed perhaps sees as more prestigious. So in short DO NOT look at match lists for this reason. Guaranteed you will misinterpret what you see, and you shouldn't guide big decisions of your life with misunderstandings of how to interpret this data. I liken using match lists as a premed to coming into the last minute if a movie and trying to extrapolate what it was about. most of the time you will be wrong because that single snapshot data point is less important than the desires and intentions that led to it.

Something I've found that is mildly helpful re: match lists--some schools list what percentage of students got into one of their top 3 residency choices.

 

[lmn]

Um no. This is bogus and reflects why I keep explaining why premeds shouldn't be looking at match lists. You can never have a clue whether a match list reflects people not getting certain things they wanted versus getting exactly what they wanted. A match list can look objectively great to a premed but in fact every match can reflect someone getting their fifth choice, while another match list can look quite pedestrian but in fact every person got their dream residency. How can you know? And how can you tell what a good match list is anyhow -- i doubt you actually know the pecking order of residencies in every specialty, and there are quite a few gems and rising stars that may not be common knowledge to premeds and even a number of brand names that are known in each specialty to be malignant. You find all this out from mentors later in med school but will be clueless as a premed. And do you seriously think the same person with eg the same interview skills, test scores research, and evaluations is going to have a hugely different experience on te residency trail coming from Tufts or UMass? I doubt there's much difference. Most US allomed schools do a pretty good job, and your board scores will be your own effort, so 20 spots on the rank list probably doesn't mean as much as some premeds seem to think. I'd say most US allo med schools are pretty good launching pads for any specialty, and the rest is up to you. But don't get fooled if the top student at X school ended up at IM at program Y, instead of derm or ortho, because there are so many reasons that student may have wanted IM at Y rather than derm or ortho. residency selection us about starting into the career you want, not the residency some premed perhaps sees as more prestigious. So in short DO NOT look at match lists for this reason. Guaranteed you will misinterpret what you see, and you shouldn't guide big decisions of your life with misunderstandings of how to interpret this data. I liken using match lists as a premed to coming into the last minute if a movie and trying to extrapolate what it was about. most of the time you will be wrong because that single snapshot data point is less important than the desires and intentions that led to it.

This is like saying I said that the match list was the end all be all in choosing a school and if they don't match half their class to MGH then the school is crap. I think the match list is extremely useful to use for applicants to choose between schools. If you are looking to match to a high desired location like California and the school consistently matches very few there, either you are running into a school where most people like to stay local (usually very easy to tell), or there is something else going on preventing people from matching to a region that is normally very popular. Also if you are considering competitive specialties and a school matches very few people into that specialty repeatedly, then either you are looking at a school that is heavily focused on say primary care (I hope you would already have this figured out by the time you apply/interview) or again there can be a school reason for that. You can also gain a lot of information about % of students matching their top choices, with those numbers and a program list, you can get a general feel for that school. And of course none of this should be the reason why you pick one program over another alone, but it can definitely help when choosing between a few schools. And of course your performance at any school is the biggest factor on how you can match, everyone knows that, but there are definitely some schools that tend to match better than others into certain areas/specialties/etc.

There is plenty of good info in match lists as long as you aren't just looking for names like MGH/Stanford/UCSF/Vanderbilt/Columbia/etc that some may just assume to be "good" residencies, and assuming schools that don't have those on their match list as being bad for residency placements. But if you're really stupid enough to just look at a match list like that, without reading anything else about match lists, then that is just bad judgment skills.

 

[mimelim]

This is like saying I said that the match list was the end all be all in choosing a school and if they don't match half their class to MGH then the school is crap. I think the match list is extremely useful to use for applicants to choose between schools. If you are looking to match to a high desired location like California and the school consistently matches very few there, either you are running into a school where most people like to stay local (usually very easy to tell), or there is something else going on preventing people from matching to a region that is normally very popular. Also if you are considering competitive specialties and a school matches very few people into that specialty repeatedly, then either you are looking at a school that is heavily focused on say primary care (I hope you would already have this figured out by the time you apply/interview) or again there can be a school reason for that. You can also gain a lot of information about % of students matching their top choices, with those numbers and a program list, you can get a general feel for that school. And of course none of this should be the reason why you pick one program over another alone, but it can definitely help when choosing between a few schools. And of course your performance at any school is the biggest factor on how you can match, everyone knows that, but there are definitely some schools that tend to match better than others into certain areas/specialties/etc.

There is plenty of good info in match lists as long as you aren't just looking for names like MGH/Stanford/UCSF/Vanderbilt/Columbia/etc that some may just assume to be "good" residencies, and assuming schools that don't have those on their match list as being bad for residency placements. But if you're really stupid enough to just look at a match list like that, without reading anything else about match lists, then that is just bad judgment skills.

Residents can barely read match lists in a reasonable manner. Maybe within their own specialty the reasonableness goes up, but generally? Not really. Pre-meds looking at match lists is a complete waste of time.

For starters, is is a single variable, "where everyone ended up", which is next to meaningless without knowing people's individual rank lists. Further, where other people go has little bearing on where an individual will end up at. I can see an argument for looking at locations/feeders, but you don't need to look at match lists for that. Geography alone is more than sufficient.

 

[lmn]

Residents can barely read match lists in a reasonable manner. Maybe within their own specialty the reasonableness goes up, but generally? Not really. Pre-meds looking at match lists is a complete waste of time.

For starters, is is a single variable, "where everyone ended up", which is next to meaningless without knowing people's individual rank lists. Further, where other people go has little bearing on where an individual will end up at. I can see an argument for looking at locations/feeders, but you don't need to look at match lists for that. Geography alone is more than sufficient.

Can you clarify by what you mean in terms of geography alone? I feel like other than state schools where more people plan on doing residency/staying afterwards to practice in, there are a lot of people coming from different areas of the country with plans to go back home, or to popular areas (NYC, Boston, California) afterwards. And I don't feel like just the school's location will really give you a great idea. Now if you mean what cities/states their graduates are matching to, then I feel like that is more informative. And of course nobody should just look at a single match list and believe that to be fully representative of a school.

Like I said previously, I don't think premeds should be using this as a tool as what school matches the most people to "prestigious" programs, and therefore that must be the best. But I think it can really help to at least give some kind of clue if there geographical target location is reasonable. Similarly, if a school doesn't even match anyone into Optho, it's good to look at that and then try to figure out if that's because people aren't interested, or because of some other reason. And of course this is all speculative information, and thus should play a small part in your overall decision on a school, but imo it can contribute some good food for thought type of information to your decision making and isn't completely useless like previously suggested.

 

[mimelim]

Can you clarify by what you mean in terms of geography alone? I feel like other than state schools where more people plan on doing residency/staying afterwards to practice in, there are a lot of people coming from different areas of the country with plans to go back home, or to popular areas (NYC, Boston, California) afterwards. And I don't feel like just the school's location will really give you a great idea. Now if you mean what cities/states their graduates are matching to, then I feel like that is more informative. And of course nobody should just look at a single match list and believe that to be fully representative of a school.

Like I said previously, I don't think premeds should be using this as a tool as what school matches the most people to "prestigious" programs, and therefore that must be the best. But I think it can really help to at least give some kind of clue if there geographical target location is reasonable. Similarly, if a school doesn't even match anyone into Optho, it's good to look at that and then try to figure out if that's because people aren't interested, or because of some other reason. And of course this is all speculative information, and thus should play a small part in your overall decision on a school, but imo it can contribute some good food for thought type of information to your decision making and isn't completely useless like previously suggested.

If you ultimately want to end up in California, schools in California are going to give you an edge over those from the East coast if you are applying to California programs. A school's location will give you a good idea of where people end up for residency. Starting with direct feeders into residencies at local/affiliated hospitals and the general, "people apply locally more often than not". Outside of that general information, what a match list tells you is next to meaningless. If a school doesn't match someone into Optho, it is meaningless. There is no way to know if nobody was interested in it, or people failed to match, etc. If you have a nascent interest in Optho, you shouldn't not go to a school because they haven't sent anyone in the past few years. For starters, the majority of people figure out what to go into while in medical school and secondly, what other students did before you means next to nothing about your chances of matching into that specialty.

There is no reason for pre-meds to look at a match list. You will be misled or misinterpret the information as much as you will be correct about things. And yes, it is definitely possible for those misinterpretations to send a student to a worse fitting school.

 

[Law2Doc]

Can you clarify by what you mean in terms of geography alone? I feel like other than state schools where more people plan on doing residency/staying afterwards to practice in, there are a lot of people coming from different areas of the country with plans to go back home, or to popular areas (NYC, Boston, California) afterwards. And I don't feel like just the school's location will really give you a great idea. Now if you mean what cities/states their graduates are matching to, then I feel like that is more informative. And of course nobody should just look at a single match list and believe that to be fully representative of a school.

Like I said previously, I don't think premeds should be using this as a tool as what school matches the most people to "prestigious" programs, and therefore that must be the best. But I think it can really help to at least give some kind of clue if there geographical target location is reasonable. Similarly, if a school doesn't even match anyone into Optho, it's good to look at that and then try to figure out if that's because people aren't interested, or because of some other reason. And of course this is all speculative information, and thus should play a small part in your overall decision on a school, but imo it can contribute some good food for thought type of information to your decision making and isn't completely useless like previously suggested.

See the post above this one. Yes it's speculative info but you don't even have enough good data ("clues") you need to draw the right conclusion. Again I know tons of people who didn't go into optho, derm, ortho not because they wouldn't get them, but because they weren't interested. But you are acting like a lack of matches in these competitive fields is some sort of clue that will tell you this isn't the right program if you dream of derm, optho, ortho. And I'm telling you from experience that more often than not that's simply the wrong presumption. You are reading things into the data points you have, or even worse the ones you don't have. And that's why match lists IMHO are worthless in most premeds hands. You think you have "clues" but really you don't -- you are essentially trying to extrapolate a line from a single data point.

 

[mimelim]

See the post above this one. Yes it's speculative info but you don't even have enough good data ("clues") you need to draw the right conclusion. Again I know tons of people who didn't go into optho, derm, ortho not because they wouldn't get them, but because they weren't interested. But you are acting like a lack of matches in these competitive fields is some sort of clue that will tell you this isn't the right program if you dream of derm, optho, ortho. And I'm telling you from experience that more often than not that's simply the wrong presumption. You are reading things into the data points you have, or even worse the ones you don't have. And that's why match lists IMHO are worthless in most premeds hands. You think you have "clues" but really you don't -- you are essentially trying to extrapolate a line from a single data point.

I'd add that this isn't a knock on pre-meds either. Even program directors are equally guilty of this kind of stuff.

 

[lmn]

If you ultimately want to end up in California, schools in California are going to give you an edge over those from the East coast if you are applying to California programs. A school's location will give you a good idea of where people end up for residency. Starting with direct feeders into residencies at local/affiliated hospitals and the general, "people apply locally more often than not". Outside of that general information, what a match list tells you is next to meaningless. If a school doesn't match someone into Optho, it is meaningless. There is no way to know if nobody was interested in it, or people failed to match, etc. If you have a nascent interest in Optho, you shouldn't not go to a school because they haven't sent anyone in the past few years. For starters, the majority of people figure out what to go into while in medical school and secondly, what other students did before you means next to nothing about your chances of matching into that specialty.

There is no reason for pre-meds to look at a match list. You will be misled or misinterpret the information as much as you will be correct about things. And yes, it is definitely possible for those misinterpretations to send a student to a worse fitting school.

I think there are many, many students that don't get to go to their in-state schools that would want to and do match back to their home states. So I agree for state schools, you can really get a good idea from the school location, but that doesn't work for many other schools.

See the post above this one. Yes it's speculative info but you don't even have enough good data ("clues") you need to draw the right conclusion. Again I know tons of people who didn't go into optho, derm, ortho not because they wouldn't get them, but because they weren't interested. But you are acting like a lack of matches in these competitive fields is some sort of clue that will tell you this isn't the right program if you dream of derm, optho, ortho. And I'm telling you from experience that more often than not that's simply the wrong presumption. You are reading things into the data points you have, or even worse the ones you don't have. And that's why match lists IMHO are worthless in most premeds hands. You think you have "clues" but really you don't -- you are essentially trying to extrapolate a line from a single data point.

In no way am I saying that just because you go to a certain school that it means that you can't match into a competitive specialty. Everyone knows that matching is very heavily based on step scores, rotation grades, LORs, and other things like research. But if I am choosing between two equal schools and one hasn't matched anyone in the last four years to a specialty that comes off as slightly odd. 4 years * ~150 odd students, you are bound to have a number of students that were interested in those specialties.

Sure you don't know how many individuals tried to match and their scores/etc, but if they consistently send no one, what is the reason? Is it an issue with residency programs not desiring their graduates? Are they not adequately providing exposure to those specialties to their students? Are they not counseling their students well to be competitive? Whatever the reason be, if I'm deciding between two equal schools and the other school has sent off people in that specialty to decent programs, I'm inclined to take the option that has proven it can put people into that specialty. Of course we don't know why nobody from the other program has went into that specialty, it could purely be the chance that nobody that was competitive for those specialties applied to them. But, given the option I personally would go to the program that has shown historically that they put people into a wide variety of specialties in order to keep my options open as best as possible. In any case, if you are so undecided between two programs that you are coming down to match lists to help make a decision I really don't think you are going to make a "bad" decision and go to a school that is "wrong" for you.

 

[Law2Doc]

I'd add that this isn't a knock on pre-meds either. Even program directors are equally guilty of this kind of stuff.

Agreed. but one would have a much better sense of what the data actually tells you, and doesn't, by the end of med school.

 

[Law2Doc]

...I'm inclined to take the option that has proven it can put people into that specialty...

Again, you are extrapolating without much in the way of data and assuming that your reasoning is sound. Trying to rationalize people's subjective decisions from an objective snapshot vantage point. When you do that you are rarely going to draw the right conclusion. You may think it's rational but if you revisit this further down the road you will realize your errors. A lot of us (myself included) tried to use match lists as premeds. In retrospect we were embarrassingly naive.

 

[Goro]

As I'm fond of pointing out, trying to read match lists is like divining the future from reading chicken guts.

Trust the wise mimelim and Law2doc on this one, kids. I do!

I'd add that this isn't a knock on pre-meds either. Even program directors are equally guilty of this kind of stuff.

 

[lmn]

Again, you are drawing conclusions without facts and assuming that your reasoning is sound.

What assumption? I'm not stating that since a school doesn't have people matched into ____, that it means you can't by any means. There are many reasons why people may not be matching. The vast majority may be just random and nothing related to you, but who knows if there isn't something else? It doesn't even have to mean their students aren't competitive/desirable by programs, they could have a really small department that students don't really know about/get much exposure to. But if nobody is matching into a specialty for multiple years, with hundreds of graduates, that seems odd to me.

I want to really be clear, that I don't believe any premed who "wants to do ortho at MGH" should be using a match list to try to choose a school. But I do think it gives a very general idea of what kind of areas schools match to (not applicable for state schools) and at least a general idea if a school is training their students in a way that exposes them and generates interest in a wide array of specialties, and whether or not their graduates are matching into all different specialties.

 

[Law2Doc]

What assumption? I already clearly said that the other program may just have not matched anyone simply b/c students weren't interested. I didn't even remotely say that any of this meant anything like "Oh if I go to ____, there is no way I will be able to match in ____."

you said you would infer better chances to various specialties based on a schools history. You also said you personally would choose a place that historically has had a wide variety of specialties represented because you think that will leave you more options. These are assumptions that give credence to extrapolizarions you are making from match lists that may not be supported by any useful data. It's a bad idea to use lists in this way -- the list not only doesn't tell you you'll have a bad or better chance at X specialty but also doesn't tell you which school lets you keep more options open. Pick a school based on things other than match lists.

 

[lmn]

you said you would infer better chances to various specialties based on a schools history. You also said you personally would choose a place that historically has had a wide variety of specialties represented because you think that will leave you more options. These are assumptions that give credence to extrapolizarions you are making from match lists that may not be supported by any useful data. It's a bad idea to use lists in this way -- the list not only doesn't tell you you'll have a bad or better chance at X specialty but also doesn't tell you which school lets you keep more options open. Pick a school based on things other than match lists.

I'm not trying to say that I think any of this means that you will have a better chance necessarily at one school rather than the other. There are enough variety of programs out there for decently competitive US MD graduates to have the option to train in a particular specialty. But if a school doesn't ever produce a certain type of specialist, why not? Is all just random luck that they have never had a student that was interested in and competitive for that specialty? Or is there some other reason why they haven't generated students interested in and competitive for those specialties? What would make multiple years of ~150 students graduating with none ever matching into ___?

In any case this has gone down a very specific rabbit hole that is straying pretty far from my original opinion that IMO when deciding between very equal programs, a match list with % matching top choices can give you a very broad/birds-eye overview of whether people from that school match to areas you want to be in and if a school does a good job of exposing and adequately preparing their students for a wide variety of specialties. I never was suggesting for a match list to be such a strong part of choosing your med school. I'm pretty sure most people are decided way before it even remotely becomes a thought, due to other more important factors such as fit, location, cost, etc.

But all in all, fair enough, I think you as well as mimelim are probably pushing a safer mentality for the majority of people looking at med schools. There is a lot that goes into match lists, and I'm sure without a lot of extra reading, the majority of premeds will pull incorrect conclusions and ignore the limitations of a match list. I doubt it would really make a difference in someone's training since all accredited US med schools will do a great job of training someone, but it would be unfortunate if someone picked a school they liked much less solely because of conclusions they came up with looking at a match list.

 

[Law2Doc]

I'm not trying to say that I think any of this means that you will have a better chance necessarily at one school rather than the other. There are enough variety of programs out there for decently competitive US MD graduates to have the option to train in a particular specialty. But if a school doesn't ever produce a certain type of specialist, why not? Is all just random luck that they have never had a student that was interested in and competitive for that specialty? Or is there some other reason why they haven't generated students interested in and competitive for those specialties? What would make multiple years of ~150 students graduating with none ever matching into ___?

In any case this has gone down a very specific rabbit hole that is straying pretty far from my original opinion that IMO when deciding between very equal programs, a match list with % matching top choices can give you a very broad/birds-eye overview of whether people from that school match to areas you want to be in and if a school does a good job of exposing and adequately preparing their students for a wide variety of specialties. I never was suggesting for a match list to be such a strong part of choosing your med school. I'm pretty sure most people are decided way before it even remotely becomes a thought, due to other more important factors such as fit, location, cost, etc.

But all in all, fair enough, I think you as well as mimelim are probably pushing a safer mentality for the majority of people looking at med schools. There is a lot that goes into match lists, and I'm sure without a lot of extra reading, the majority of premeds will pull incorrect conclusions and ignore the limitations of a match list. I doubt it would really make a difference in someone's training since all accredited US med schools will do a great job of training someone, but it would be unfortunate if someone picked a school they liked much less solely because of conclusions they came up with looking at a match list.

Addressing your first paragraph, just to hammer home my argument, Let's put it this way. (I'll use optho as an example because it was mentioned earlier). "Hypothetically", let's say I went to a med school where people rarely went into optho. Like 1 or 2 every 3 or 4 years. But pretty much 100% of the people historically who wanted optho from there got into top programs/first choices. You as a premed might look at a couple of years of match lists and conclude maybe this wasn't a great place if you wanted optho. But you'd be totally wrong. In your example you'd be wondering whether this school is doing something wrong because nobody is interested in this specialty for several year clips. But in fact it's not everyone's cup of tea and I don't know if the fact that those few people on the fence chose surgery or something more lifestyle should have as much impact on premeds in this way. And there are thousands of misinterpretations going on in people's heads when they try to use match lists without knowing the background that led to those data points. Which makes these lists extremely dangerous in the wrong hands because most of the time the conclusion a premed thinks is the obvious logical conclusion happens to be wrong. No data is sometimes better than misleading data, and I think that's often what we are talking about with these lists.

 

[Doug Underhill]

Should you mention cost of attendance in an interview? If I'm interviewing at State U and Private U in the same geographic area and the State U interviewer asks "why State U", is it OK to mention that State U is $100,000 cheaper than Private U, amongst other things?

 

[Law2Doc]

Should you mention cost of attendance in an interview? If I'm interviewing at State U and Private U in the same geographic area and the State U interviewer asks "why State U", is it OK to mention that State U is $100,000 cheaper than Private U, amongst other things?

There's probably a way to package that in with other reasons without sounding like you just want to attend the school because it's a bargain. Most schools like to think they have more to offer than price, so make sure this doesn't sound like your primary reason.

 

[WingedOx]

Should you mention cost of attendance in an interview? If I'm interviewing at State U and Private U in the same geographic area and the State U interviewer asks "why State U", is it OK to mention that State U is $100,000 cheaper than Private U, amongst other things?

why would you be bringing up another school at all?

 

[hallowmann]

What assumption? I'm not stating that since a school doesn't have people matched into ____, that it means you can't by any means. There are many reasons why people may not be matching. The vast majority may be just random and nothing related to you, but who knows if there isn't something else? It doesn't even have to mean their students aren't competitive/desirable by programs, they could have a really small department that students don't really know about/get much exposure to. But if nobody is matching into a specialty for multiple years, with hundreds of graduates, that seems odd to me.

I want to really be clear, that I don't believe any premed who "wants to do ortho at MGH" should be using a match list to try to choose a school. But I do think it gives a very general idea of what kind of areas schools match to (not applicable for state schools) and at least a general idea if a school is training their students in a way that exposes them and generates interest in a wide array of specialties, and whether or not their graduates are matching into all different specialties.

You're not getting it.

Addressing your first paragraph, just to hammer home my argument, Let's put it this way. (I'll use optho as an example because it was mentioned earlier). "Hypothetically", let's say I went to a med school where people rarely went into optho. Like 1 or 2 every 3 or 4 years. But pretty much 100% of the people historically who wanted optho from there got into top programs/first choices. You as a premed might look at a couple of years of match lists and conclude maybe this wasn't a great place if you wanted optho. But you'd be totally wrong. In your example you'd be wondering whether this school is doing something wrong because nobody is interested in this specialty for several year clips. But in fact it's not everyone's cup of tea and I don't know if the fact that those few people on the fence chose surgery or something more lifestyle should have as much impact on premeds in this way. And there are thousands of misinterpretations going on in people's heads when they try to use match lists without knowing the background that led to those data points. Which makes these lists extremely dangerous in the wrong hands because most of the time the conclusion a premed thinks is the obvious logical conclusion happens to be wrong. No data is sometimes better than misleading data, and I think that's often what we are talking about with these lists.

lmn isn't getting it.

I'll expand a bit on Law2Doc's example to make it even more clear. His school sends 1-2 grads/yr to Ophtho. Students interested in Ophtho at Law2Doc's school have a 100% match rate into Ophtho. Their match list only shows 1-2 Ophtho matches. My school sends 5-6 grads/yr to Ophtho. Students interested in Ophtho at my school have a 50% match rate (there's really 10-12 people who want to do Ophtho, but half don't match Ophtho and end up in a backup). You see match lists from my school and Law2Doc's school. You conclude, "woah, hallowmann's school sends 3 times as many people to Ophtho as Law2Doc's school, there must be something about it that makes grads better equipped to match Ophtho". You would be completely wrong. This is only one example of how your interpretation of the info could lead you astray.

 

[Mbekweni]

One difficulty with choosing schools is that the real cost is much more difficult to ascertain than the front end sticker price. Financial aid and other private scholarships as well as cost of living play a large component as well. Many elite private schools have a high sticker price but also generous financial aid programs. When I was applying for example, Harvard boasted about a cap of 25k in loans per year that a student who qualified for financial aid would have to take out. I hear rumours that Stanford was even more generous. I ended up at a rather well funded public school with a generous financial aid package, but found that their coverage of all students was rather spotty with some getting lucky and others decidedly less so.

Overall I think that the cost shouldn't influence initial applications too much though it should certainly be a factor in considering which school to attend if you are lucky to have multiple acceptances. Overall I think that medical students these days are far too comfortable with debt, and don't have a real understanding of what it would take to pay it all off. Overall, even with several hundred thousand dollars of debt medical school is still a good investment (for now) given the reimbursement rates for most specialties so long as you are willing to live like a resident and devote the first several years out of residency heavily laying into the student loan burden. But going to a high priced school and then living large with the stereotypical attending lifestyle in the face of high loan interest rates and declining reimbursements can be a quick recipe for working more that you want to, longer than you want to with a lot of disillusionment regarding the field of medicine. Additionally, many people are relying on the Public Service Loan Forgiveness program to make their debt disappear after 10 years in public service (aka academic medicine in most cases). The first recipients of this forgiveness will come through in 2017 ten years after the initial program started and it will be very interesting to see public reaction and potential restrictions that are placed after Joe Q Public reads stories about physicians making 250k per year getting 600k forgiven (300k plus 8% per year interest) all at taxpayers expense.

As expensive as medical school is, it's increasingly important to be financially savvy and to add a bit of this education to the rest of the medical education curriculum. You won't get it in classes for sure. I'd recommend whitecoatinvestor.com as a great starting resource if you haven't found it already.

 

[lmn]

You're not getting it.



lmn isn't getting it.

I'll expand a bit on Law2Doc's example to make it even more clear. His school sends 1-2 grads/yr to Ophtho. Students interested in Ophtho at Law2Doc's school have a 100% match rate into Ophtho. Their match list only shows 1-2 Ophtho matches. My school sends 5-6 grads/yr to Ophtho. Students interested in Ophtho at my school have a 50% match rate (there's really 10-12 people who want to do Ophtho, but half don't match Ophtho and end up in a backup). You see match lists from my school and Law2Doc's school. You conclude, "woah, hallowmann's school sends 3 times as many people to Ophtho as Law2Doc's school, there must be something about it that makes grads better equipped to match Ophtho". You would be completely wrong. This is only one example of how your interpretation of the info could lead you astray.

That's not what I was saying at all, but thanks for jumping on the bandwagon. I completely understand that very few applicants can still mean they statistically are successful at matching., that is really a big DUH point.... I even explicitly stated, multiple times, that a school not being competitive for a specialty was one possibility, and a very unlikely one at that. But thanks for missing that and just repeating exactly what Law2doc already stated.

I said multiple times that unless it is a school with a very strong mission (like one to train primary care), it would seem abnormal to me if they never match anyone into certain specialties (excluding rare ones). If you go to any normal medical school and sample their classes of ~150 people, I would absolutely expect to find multiple people each year interested in say Optho. Now if they are never matching anyone into Optho, is it because of some issue with the students actually matching (unlikely, but not something you can really definitively rule out), or is there some other weird event going on, for example very little exposure to Ophto leading to low interest/lack of applications. I have a hard time believing that nobody in multiple class years is interested enough in Optho to pursue it. This discussion has moved far away from "___ school doesn't match, they must be failures and their students must not be competitive", so please do not try to equate what I said above to that same point as I don't think I can be any clearer in saying that isn't what I am asking.

 

[hallowmann]

That's not what I was saying at all, but thanks for jumping on the bandwagon. I completely understand that very few applicants can still mean they statistically are successful at matching., that is really a big DUH point.... I even explicitly stated, multiple times, that a school not being competitive for a specialty was one possibility, and a very unlikely one at that. But thanks for missing that and just repeating exactly what Law2doc already stated.

I said multiple times that unless it is a school with a very strong mission (like one to train primary care), it would seem abnormal to me if they never match anyone into certain specialties (excluding rare ones). If you go to any normal medical school and sample their classes of ~150 people, I would absolutely expect to find multiple people each year interested in say Optho. Now if they are never matching anyone into Optho, is it because of some issue with the students actually matching, or is there some other weird event going on, for example very little exposure to Ophto leading to low interest/lack of applications. I have a hard time believing that nobody in multiple class years is interested enough in Optho to pursue it. This discussion has moved far away from "___ school doesn't match, they must be failures and their students must not be competitive", so please do not try to equate what I said above to that same point as I don't think I can be any clearer in saying that isn't what I am asking.

And you'd be wrong in feeling it was abnormal. All schools have a culture. That culture might be shaped by an explicitly stated mission, the region, etc. Students that attend such a medical school are already a subset of a small population, and in most cases are self-selected subset by that culture. As a result, there are many variables and factors that are simply not apparent to you, when you just look at a graduating class's match list. You assume that the 150 is a representative sample of all medical graduates, when in reality, it isn't, regardless of the qualities of the school.

You're still not getting it. Also, I never said competitive, I said "makes grads better equipped to match". Exposure to a field during medical school (the exact example you used) is something that might "make grads better equipped to match" in said specialty. The point is you have no idea. You have insufficient data to even come to that conclusion. You have a tiny snapshot of one small piece of a puzzle, and you're saying you can infer something about the picture from it. That is why its a poor metric to use in deciding where to go. For all you know, the reason you don't see a specific field in the match list might be a reason the school is a better fit for you. Bottom line is, you have no idea.

 

[WingedOx]

Yeah, sorry @lmn, stop digging.

 

[lmn]

And you'd be wrong in feeling it was abnormal. All schools have a culture. That culture might be shaped by an explicitly stated mission, the region, etc. Students that attend such a medical school are already a subset of a small population, and in most cases are self-selected subset by that culture. As a result, there are many variables and factors that are simply not apparent to you, when you just look at a graduating class's match list. You assume that the 150 is a representative sample of all medical graduates, when in reality, it isn't, regardless of the qualities of the school.

You're still not getting it. Also, I never said competitive, I said "makes grads better equipped to match". Exposure to a field during medical school (the exact example you used) is something that might "make grads better equipped to match" in said specialty. The point is you have no idea. You have insufficient data to even come to that conclusion. You have a tiny snapshot of one small piece of a puzzle, and you're saying you can infer something about the picture from it. That is why its a poor metric to use in deciding where to go. For all you know, the reason you don't see a specific field in the match list might be a reason the school is a better fit for you. Bottom line is, you have no idea.

I'm not even saying anything about being better equipped to match/more competitive/etc etc. But if you don't get exposed to a specialty at all, I highly doubt you're going to try to match into it unless you already had exposure to it before med school. I also clearly stated about schools with specific missions and then you try to throw that back at me like I'm stupid for not considering it? Are you even remotely reading what I write before replying? You keep on taking something that I say is very small possibility and extrapolating it into this belief that I'm trying to push something like "if you don't see people matching that it absolutely means that school doesn't do a good job making competitive applicants for that field." This whole discussion has regressed into pure stupidity, keep taking my statements out of context and twisting my words to think I'm trying to say match lists are the Bible about what schools can and cannot do if that pleases you, I'm not going to bother replying if you won't even read what I'm actually saying and keep exaggerating everything I say.

Yeah, sorry @lmn, stop digging.

I think people already formed opinions on what they think I'm trying to say without really paying attention to what I'm trying to convey. The entire discussion is worthless at this point.

 

[GreyTie]

I'm not even saying anything about being better equipped to match/more competitive/etc etc. But if you don't get exposed to a specialty at all, I highly doubt you're going to try to match into it unless you already had exposure to it before med school. I also clearly stated about schools with specific missions and then you try to throw that back at me like I'm stupid for not considering it? Are you even remotely reading what I write before replying? You keep on taking something that I say is very small possibility and extrapolating it into this belief that I'm trying to push something like "if you don't see people matching that it absolutely means that school doesn't do a good job making competitive applicants for that field." This whole discussion has regressed into pure stupidity, keep taking my statements out of context and twisting my words to think I'm trying to say match lists are the Bible about what schools can and cannot do if that pleases you, I'm not going to bother replying if you won't even read what I'm actually saying and keep exaggerating everything I say.


I think people already formed opinions on what they think I'm trying to say without really paying attention to what I'm trying to convey. The entire discussion is worthless at this point.

I know this is a month old, but I thought this conversation was interesting and wanted to add something. It certainly isn't the case in every school, but at the top 10 USNWR school my fiancee attends, people rarely match into Urology. The majority might say it's luck of the draw, but it is widely known on campus that the majority of the last several people who VERY MUCH wanted Urology were unable to match into it, despite being from a phenomenal school and having stats on par with the speciality's expectations. I don't know what this means, but it is a concrete example of a school that consistently fails to send students into programs that they want. Students who interpret this match list as being unfriendly to Urology applicants would be dead on. It may not happen with enough frequency to be a big deal to most, but don't dismiss match lists as being an invalid concern for premed students.