Cost vs Quality

[WoWdoc]

So I've had my interviews, toured the schools, and I'm waiting on the acceptance letters. For the purposes of this thread, I'm going to assume acceptances in both school. Here's my dilemma.

The school that impressed me the most was an out of state institution. The facilities, the city, the average Step 1 scores of the student body, EVERYTHING was perfect... except the cost. For me this institution would run about $46K a year just in tuition. I would either have to join the military, or take on a ton of debt to go here.

My in-state school is okay. I would be happy to go there if it was my only option, and it's tuition is about 16.4K a year.

My question: Does the school you want to go to matter that much in the long run, or at the end of the day is it best to just get the MD with as little debt as possible? Like I said I could go HPSP for the out of state school; I've been considering the military anyway. Without that scholarship though I personally would just be afraid I would be hating that debt in the long run. What do you guys think? Any older Docs that have been through the process and would be willing do dispense their wisdom?

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[PinkIvy08]

Hmm...in similar dilemma, except my state school costs like 22K in tuition. This is the way I'm leaning. I'm still waiting until financial aid stuff comes thru for both, but right now, I'm trying to ignore finances and evaluate the schools to see which one I will flourish at. There are major differences between the two and the private institution is definitely in the lead. At the moment, finances aside, there is a clear difference. Private school: P/F, an awesome simulation center, unique prgm for MPH, awesome city vs. Public School: letter grading, no sim center, horrible city, history of scandal, a student body that mostly comes from 2 IS feeder schools. The private schools is definitely in the lead.

Personally, I'm trying to decide how to justify the 100K difference in attending IS vv OOS, and I think I already have...

 

[jvesco22]

^^ good advice.

But yeh OP, you really should make a PRO & CON list and then decide if the tuition is worth it, like Pink said. It's kind of like buying an expensive car when you don't have the money for it. Yeh it's great when you first buy it, but after a few months/years when you are still paying a $1000/month car payment, you realize that it might not have been the best choice. Either way, many people say for you to go to a school where you know you'll be happy, so keep that in mind.

As a matter of fact, how about you not even worry AT ALL about which choice to make, given that you haven't even been accepted yet. You sound real confident and I don't doubt you, but if this is something that you are stressing over, just wait until you get those acceptance/rejection letters. You'll save yourself the heartache.

 

[Parts Unknown]

Any older Docs that have been through the process and would be willing do dispense their wisdom?

I will be beginning to repay my 150K state medical school debt in August, and I couldn't be happier. Some of my colleagues have debts of >250K, and it's very burdensome. They tell me it casts a pall on all of their major financial decisions, and can affect one's choice of specialty and location. I also feel that to an extent, but it's a much smaller pinch for me and my measly 150.

I understand that before medical school starts the next four years of your life seem like this long, shiny road of incredibly important discover, but it's really just the beginning (and a fairly standardized one, at that). Those 45 months will be over before you know it, and you likely won't regret *not* carrying around an enormous loan payment for decades to come. Certainly not when you enter residency and your training really begins.

 

[circulus vitios]

I don't mean to hijack your thread, but are there any cheap out of state schools? All of the schools in Pennsylvania are private aside from Penn State Hershey, which might as well be private because the tuition is so high.

 

[elektroshok]

I will be beginning to repay my 150K state medical school debt in August, and I couldn't be happier. Some of my colleagues have debts of >250K, and it's very burdensome. They tell me it casts a pall on all of their major financial decisions, and can affect one's choice of specialty and location. I also feel that to an extent, but it's a much smaller pinch for me and my measly 150.

I understand that before medical school starts the next four years of your life seem like this long, shiny road of incredibly important discover, but it's really just the beginning (and a fairly standardized one, at that). Those 45 months will be over before you know it, and you likely won't regret carrying around an enormous loan payment for decades to come. Certainly not when you enter residency and your training really begins.

Just to clarify:

It sounds like you are happy you took the state route (and have less debt than some of your friends). Are you saying in the second paragraph that if the more expensive school is better in your eyes, carrying the extra debt is worth it?
Thanks.

 

[Jolt21]

the way i see it...you can make up the difference in finances throughout the years, but you can never make up the quality in the education and the quality of life. i did the same for undergrad and I am more than satisfied with that decision.

i'd say go with the OOS school if the differences are what you say they are and you see yourself enjoying it more.

 

[Parts Unknown]

Just to clarify:

It sounds like you are happy you took the state route (and have less debt than some of your friends). Are you saying in the second paragraph that if the more expensive school is better in your eyes, carrying the extra debt is worth it?
Thanks.

Oh Hell, that was a typo that completely changed the intended meaning. I will fix it.

To answer your question, no, there are very few situations where I would consider a significant amount of debt as justifiable when picking one allopathic school over another.

 

[GoodmanBrown]

I don't mean to hijack your thread, but are there any cheap out of state schools? All of the schools in Pennsylvania are private aside from Penn State Hershey, which might as well be private because the tuition is so high.

Sadly, not really. If you're very concerned about cost, take a year off and move to a state that has low in-state tuition and gives preference to in-staters. North Carolina's a great bet because not only is UNC a great school, but Brody in the east takes only NCers. Besides, it'll give you a year to do other cool stuff to add to your app.

 

[orthomyxo]

I don't mean to hijack your thread, but are there any cheap out of state schools? All of the schools in Pennsylvania are private aside from Penn State Hershey, which might as well be private because the tuition is so high.

Tufts!

 

[Geekchick921]

If we were talking about a 10K difference in yearly tuition, I would probably choose the more expensive school if I liked it THAT much more.

But you're talking 30K, which will amount to $120K in debt that'll wind up being a lot more thanks to interest while you're paying it off. I think I'd have to have a serious problem with the cheaper option to not choose it.

 

[GoodmanBrown]

Oh Hell, that was a typo that completely changed the intended meaning. I will fix it.

To answer your question, no, there are very few situations where I would consider a significant amount of debt as justifiable when picking one allopathic school over another.

I totally agree with Parts. Universities may provide differing qualities of education, but medical education is *so* standardized that as long as you do well in school, you won't be limiting your options.

My only caveat would be for very, very competitive specialties. Rad onc comes to mind, and maybe derm or neurosurgery. In those specialties, having a strong home program could help your match chances significantly. Otherwise, leave med school with as little debt as possible.

 

[Parts Unknown]

So I've had my interviews, toured the schools, and I'm waiting on the acceptance letters. For the purposes of this thread, I'm going to assume acceptances in both school. Here's my dilemma.

I will also point out that the title of this thread "Cost vs. Quality" is a bit of a false dichotomy when talking about medical school. When we grow up we are conditioned to appreciate the obvious disparities between different educational institutions. It's difficult to ignore the gap between a poor inner city public school and a wealthy private high school in the hills of New Hampshire. This trend continues into university, when one mulls the chasm that separates Princeton from, say, The University of West Alabama.

It is no big surpise, then, when one reaches medical school and finds a very different situation. Every allopathic medical school in the country teaches pretty much the same subjects. Every student takes the same USMLE. Every school offers about the same core clinical rotations, and the experiences you derive from them are fairly interchangeable from one institution to the next.

So this really isn't about a difference in educational quality. This is about whether your impression of the more expensive school is worth feeding tens of thousands of dollars that you don't yet have. Probably not.

 

[circulus vitios]

Tufts!

$80,000 a year instate, what a bargain!

 

[DoctwoB]

I don't mean to hijack your thread, but are there any cheap out of state schools? All of the schools in Pennsylvania are private aside from Penn State Hershey, which might as well be private because the tuition is so high.

There's a couple.

Baylor is one, total cost of attendance for out of state is around 53k, which is only 4k/year more expensive than my state school.

Then there are schools which look expensive, but almost everyone who gets in gets merit based aid. Two that pop out to me are UChicago and Mayo (I know there are other school that offer merit aid, but these two schools appear to offer it to almost everyone). Uchicago is around 70k a year, but after a half-tuition scholarship you're looking at around 47k, right around state-school level

 

[lrkoehle]

If we were talking about a 10K difference in yearly tuition, I would probably choose the more expensive school if I liked it THAT much more.

But you're talking 30K, which will amount to $120K in debt that'll wind up being a lot more thanks to interest while you're paying it off. I think I'd have to have a serious problem with the cheaper option to not choose it.

I agree with this. You really have to ask yourself if you honestly think you will be a better doctor for all that extra money. In most cases, if you answer honestly, the answer is no. Things like pass/fail and simulation centers maybe nice, but they aren't necessary (hell the sim center is more for residents anyways). As with most things in life, if you are spending a significant amount of more money, you ought to be getting better returns for your investment. In this case, that is becoming a doctor, which is a primarily individual thing (ie the school matters very little). Plus as a previous poster said, real training doesn't start until residency anyways. As a med student, everyone has to learn the same pre-clinical stuff and then take the same basic 3rd and 4th year rotations. I say save the money, because no matter how you slice it, 120k + interest is a lot of money.

 

[RevMD]

I agree with this. You really have to ask yourself if you honestly think you will be a better doctor for all that extra money. In most cases, if you answer honestly, the answer is no. Things like pass/fail and simulation centers maybe nice, but they aren't necessary (hell the sim center is more for residents anyways). As with most things in life, if you are spending a significant amount of more money, you ought to be getting better returns for your investment. In this case, that is becoming a doctor, which is a primarily individual thing (ie the school matters very little). Plus as a previous poster said, real training doesn't start until residency anyways. As a med student, everyone has to learn the same pre-clinical stuff and then take the same basic 3rd and 4th year rotations. I say save the money, because no matter how you slice it, 120k + interest is a lot of money.

I have to disagree with this. For one, pass/fail grading systems have a significant advantage over letter grading since they reduce competitiveness within the class and promote focus more on understanding the material as well as teamwork (sharing notes, teaching other students, etc). This is a main reason more schools are switching to P/F systems fully or at least partially, like using P/F for MS1-2 and then letter grading for MS3-4. Secondly, having access to the latest tech, even if it means only getting limited use through clinical rotations, is still an advantage as this is the future. Getting early exposure to tech can give you a head start once residency rolls around and have to use the same tech on a regular basis. Other factors like city and student body all have direct impact on regular life outside of the hospital.

I would stay away from HPSP simply because I never really considered that as an option. Taking some loans may slow you down a little bit for a few years. Once you start practicing after residency, the debt will get payed down fast.

 

[FloatOn]

So I've had my interviews, toured the schools, and I'm waiting on the acceptance letters. For the purposes of this thread, I'm going to assume acceptances in both school. Here's my dilemma.

The school that impressed me the most was an out of state institution. The facilities, the city, the average Step 1 scores of the student body, EVERYTHING was perfect... except the cost. For me this institution would run about $46K a year just in tuition. I would either have to join the military, or take on a ton of debt to go here.

My in-state school is okay. I would be happy to go there if it was my only option, and it's tuition is about 16.4K a year.

My question: Does the school you want to go to matter that much in the long run, or at the end of the day is it best to just get the MD with as little debt as possible? Like I said I could go HPSP for the out of state school; I've been considering the military anyway. Without that scholarship though I personally would just be afraid I would be hating that debt in the long run. What do you guys think? Any older Docs that have been through the process and would be willing do dispense their wisdom?

This is a significant difference. Look into the in-state school more and list what you like about it, as you did with the other school. Maybe you'll see something you didn't before.

 

[BBender716]

I don't mean to hijack your thread, but are there any cheap out of state schools? All of the schools in Pennsylvania are private aside from Penn State Hershey, which might as well be private because the tuition is so high.

A not-so-obvious good deal is Ohio State. OOS tuition is high the first year, but you can easily get IS tuition for the next THREE years (they really work with OOSers). It's an awesome school with private school-esque resources, but after that first year, very affordable for OOSers.

 

[WoWdoc]

Well I guess the best thing to do is wait. No point in getting too excited until I get accepted somewhere.

If I get into both I'll prob head to the OOS school, as I've wanted to do military medicine for years now. The HPSP scholarship is worth a lot more to me up there then at my IS school. However, if I don't get into the OOS, but do the IS school I'll hold off on the military. I may do FAP later, but to be honest there would be no real reason to rush into the military if I go that route. It's not like I won't have the option later.

tl;dr I'll take a HPSP scholarship and go to the OOS given the opportunity, IS if it's my only option between the two.

 

[roaming]

I don't mean to hijack your thread, but are there any cheap out of state schools? All of the schools in Pennsylvania are private aside from Penn State Hershey, which might as well be private because the tuition is so high.

TEXAS SCHOOLS!

in state tuition 12-13k a year
out of state tuition around 23k a year BUT almost all out of staters get school based scholarships to offset the out of state tuition for the first year. then second year you can apply for texas residency. so basically out of staters pay in state tuition too.
rent is also cheap in texas. all in all, everything included 30k/year debt!!