Difference between 'top' medical schools and 'lower' tiered schools

[Whenwherewhy]

What are the differences between top medical schools like Harvard, UCSF etc. and other lower ranked schools? What advantages would I have in going to a top school vs a lower ranked school? Moreover, how are med schools even 'ranked'?

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[JeffWasHere]

It depends on your career goals and what you want to do. The top tier medical schools are going to give you the prestige and access and resources to be a leader in the field. If you want to just work at a random place and clock in and clock out, it doesn't really matter.

 

[Whenwherewhy]

What kinds of access/resources do top tier medical schools have that others don't?

 

[Stagg737]

The biggest things you'll get from a top tier school are the name recognition and better access to resources like research funding/grants and easier connections with other big name institutions. Depending on what your career goals are, tier of medical school may not matter. If you want to fast track yourself in research and academics, tier of medical school can play a role in what opportunities you may get and how attainable certain positions are. If you just want to practice clinical medicine then tier won't matter unless you're trying to get into an elite residency program. Even then it won't carry nearly as much weight as board scores, class rank, research, and how your interviews/audition rotations go.

There aren't really any "official" rankings of schools (US News is crap) and "tiers" aren't black and white. Most of it will revolve around reputation of the school, stats of the graduates (board scores, publications, etc), where the graduates match, as well as the general research that comes out of the school. A lot of people also associate strong residency programs with the actual med school, but that's somewhat misleading.

Edit: There's also regional bias involved in terms of tiers. The "Top tier" names like Harvard, Yale, Penn, Stanford, UCSF, WashU, etc. will carry weight anywhere in the country. Outside of that geographic region plays a much bigger role imo. Example, there's a school in my city whose residency programs are pretty competitive for most fields. I go to a DO school (which would be considered low tier when looking at all MD and DO programs), but we still match a couple people into most fields there every year. So it's easier for students from my school to match there than "mid" or "low" tier MD schools from other parts of the country. Imo, unless you can get into one of the "elite" schools, I wouldn't really worry about tier too much.

 

[Lollygag]

Agree with @JeffWasHere . It really comes down to what your goals are, "top medical schools" are very very research oriented, a perusal of MDApplicants will prove that the majority of the students who get accepted to these schools have research experience and tend to have very impressive extracurricular that demonstrate strong leadership capability. Their looking for people who will go the extra mile, people who want to be a doctor but also want to perform research, work in academic medicine, leaders in medicine, people who will reform policy, move up the ranks in health administration, serve as faculty for medical schools etc... Essentially going beyond just being a doctor. This is just what I've noticed, somebody with more experience will probably chime in.

If your goal is to match into your desired specialty and happily work at a hospital/private practice until retirement, then going to a top medical school is pretty pointless and a waste of money as the "top medical school name" carries more weight in the academic world, whereas in clinical practice, 99% of your patients won't care where you went to medical school. I sure don't know where any of mine went.

 

[ronnicus]

Agree with @JeffWasHere . It really comes down to what your goals are, "top medical schools" are very very research oriented, a perusal of MDApplicants will prove that the majority of the students who get accepted to these schools have research experience and tend to have very impressive extracurricular that demonstrate strong leadership capability. Their looking for people who will go the extra mile, people who want to be a doctor but also want to perform research, work in academic medicine, leaders in medicine, people who will reform policy, move up the ranks in health administration, serve as faculty for medical schools etc... Essentially going beyond just being a doctor. This is just what I've noticed, somebody with more experience will probably chime in.

If your goal is to match into your desired specialty and happily work at a hospital/private practice until retirement, then going to a top medical school is pretty pointless and a waste of money as the "top medical school name" carries more weight in the academic world, whereas in clinical practice, 99% of your patients won't care where you went to medical school. I sure don't know where any of mine went.

Thanks for saying that last sentence. I never believed the fact that most patients won't care where I go until I realized I didn't know where any of my personal physicians went. I know where all the doctors I do research with, shadow and learn from went though.

 

[Stagg737]

Thanks for saying that last sentence. I never believed the fact that most patients won't care where I go until I realized I didn't know where any of my personal physicians went. I know where all the doctors I do research with, shadow and learn from went though.

Another thing to add to this, if you talk to your physicians or with residents, they'll tell you that they learned everything of importance in residency and that where someone went to med school is pretty meaningless in terms of their clinical skills. Most of them I've talked to have said they learned more in the first 4 weeks of residency in terms of information they use as a physician than they did in all 4 years of med school. If you really want to know if your physician got the best training, don't ask where they went to med school. Ask them where they did their residency and fellowship.

Don't think of med school as the key step of becoming a physician. Think of it as a launchpad or stepping stone to the point of your medical training that is actually important for the rest of your career, residency.

 

[jpkb24]

What are the differences between top medical schools like Harvard, UCSF etc. and other lower ranked schools? What advantages would I have in going to a top school vs a lower ranked school? Moreover, how are med schools even 'ranked'?

Schools are generally ranked based on several factors - research being weighted most heavily. Unfortunately, that means that a lot of great schools that don't have strong basic science research (take Mayo for an example) don't get ranked as high as they are worth. If I were you, I'd recommend looking at the match lists - see where their students get to train for residency and what specialties they get into. That'll give you a better idea of which schools are a good 'top' fit or not.

 

[aldol16]

If you're asking why the top ranked schools are ranked as the top schools by USNews, then the best source to go for ranking methodology is USNews. I believe they even tell you their methodology on their website. It's quite heavily based on research and research funding, which may not have that big of a direct effect on your average med student at those schools.

Medicine is still quite a "good ol' boy club" profession. That is, top programs tend to take top people and make them into the top people in their field. It starts at college and never really stops. Sure, you can go to your state school and get into a top-ranked med school. But that doesn't mean that it's not easier for someone at a top college. Similarly, you can go to any med school and get into a top-ranked residency program. But that doesn't mean it's not easier for someone at a top med school. It's not even the name - it's the resources offered by the top schools, from phenomenal medical student research initiatives to the access to world-class faculty in whatever field you want to go into/do research in. All of these effects are compounded and magnify each other.

 

[pioneer22]

Schools are generally ranked based on several factors - research being weighted most heavily. Unfortunately, that means that a lot of great schools that don't have strong basic science research (take Mayo for an example) don't get ranked as high as they are worth. If I were you, I'd recommend looking at the match lists - see where their students get to train for residency and what specialties they get into. That'll give you a better idea of which schools are a good 'top' fit or not.

Mayo is one of, if not the, best hospitals in the world. Mayo medical school match rates at top-tier also. Mayo is not a weak school at all.

 

[RogueUnicorn]

Most of them I've talked to have said they learned more in the first 4 weeks of residency in terms of information they use as a physician than they did in all 4 years of med school.

That's absurd. If this were to be true then your acquaintances either go to a magical super-residency or didn't learn **** in school.

 

[Stagg737]

That's absurd. If this were to be true then your acquaintances either go to a magical super-residency or didn't learn **** in school.

I'm guessing it's probably closer to the latter, since many people I know say they feel like much of 3rd and 4th year of med school is a waste of time. That along with some good old exaggeration.

 

[aldol16]

Mayo is one of, if not the, best hospitals in the world. Mayo medical school match rates at top-tier also. Mayo is not a weak school at all.

Nobody is claiming that Mayo is a weak school. They're just explaining some of the reasons why Mayo is not top 10 as per US News rankings.

 

[clippersfan88]

Not a med student here but I've been told by friends who are that the big difference is in faculty. The "elite" schools attract the top people in their field because those people want to do research and have access to the resources the elite programs have readily.

That's not to say at "lower" schools the faculty aren't great. They absolutely are and clearly they produce quality physicians. The research component is just different.

 

[jpkb24]

Mayo is one of, if not the, best hospitals in the world. Mayo medical school match rates at top-tier also. Mayo is not a weak school at all.

Exactly my point. Mayo doesn't show up high on rankings and yet it is top five hands down.

 

[efle]

it is top five hands down

By rep? Survey of res directors puts it 20th between Pitt and UTSW, survey of peer med schools puts it 22nd between UCSD and Baylor. So a 24th total rank is just a bit low.

Don't get me wrong it's def a great school and very competitive to get into (small class size and tons of scholarships)!

 

[aalamruad]

By rep? Survey of res directors puts it 20th between Pitt and UTSW, survey of peer med schools puts it 22nd between UCSD and Baylor. So a 24th total rank is just a bit low.

Don't get me wrong it's def a great school and very competitive to get into (small class size and tons of scholarships)!

Could you link me to those sources?

 

[Psai]

Exactly my point. Mayo doesn't show up high on rankings and yet it is top five hands down.

Harvard hopkins penn washu ucsf

Guess not

 

[BurghStudent]

Not a med student here but I've been told by friends who are that the big difference is in faculty. The "elite" schools attract the top people in their field because those people want to do research and have access to the resources the elite programs have readily.

That's not to say at "lower" schools the faculty aren't great. They absolutely are and clearly they produce quality physicians. The research component is just different.

This. Prestige begets prestige.

However we do need a better definition of a "good medical school." Having been around top and mid-tier schools, I'd say research is one component. It really just depends on your priorities. You'll know what this means when you make your match list for residency. It's not just #1 Harvard, #2 Hopkins, #3 le sigh, Yale.

 

[Gurby]

Could you link me to those sources?

From 2014:
https://forums.studentdoctor.net/threads/residency-director-score.1064916/#post-15113603

 

[Gurby]

This is very anecdotal, but I felt a big difference in attitude and caliber of students when interviewing at top-tiers vs mid/low-tiers. At lower ranked schools I got this feeling that "it's not cool to work hard or be ambitious. You're interested in surgery? lol what a gunner". There was more of a "work hard play hard" vibe at higher ranked schools.

 

[787593]

This is very anecdotal, but I felt a big difference in attitude and caliber of students when interviewing at top-tiers vs mid/low-tiers. At lower ranked schools I got this feeling that "it's not cool to work hard or be ambitious. You're interested in surgery? lol what a gunner". There was more of a "work hard play hard" vibe at higher ranked schools.

I felt that vibe everywhere

 

[efle]

Could you link me to those sources?

You need the paid US News subscription to see the exact values for all the schools, but here are the current orders for the top few dozen

By PD assessment:

Harvard, Hopkins, UCSF
Stanford, Penn
WashU, Duke, Columbia
Michigan
Cornell, UCLA, U of Wash, Vandy
Northwestern, Yale
Baylor, Emory, U Chicago, Pitt
Mayo
UTSW, UVA
NYU, Oregon, UCSD, UNC
Brown, Case Western, Dartmouth, Gtown, Sinai, Rochester, USC, U of Wisconsin
Indiana, Tufts, Colorado, Iowa, U of Minnesota
Boston U, Ohio State, U of Alabama, Wake Forest, U of Utah
Miami, Einstein

By peer schools:

Harvard, Hopkins, UCSF
Stanford
WashU
Penn
Columbia, Duke, Michigan, U of Wash, Yale
Vandy
Cornell, UCLA, U Chicago
Northwestern, UNC, Pitt, UTSW
Emory, UCSD
Mayo
Baylor, NYU, Colorado, Iowa, Wisconsin
Sinai, Oregon, Alabama, UVA
Case Western, Dartmouth, Minnesota, Rochester
Brown, Indiana, Ohio State, USC

 

[aalamruad]

From 2014:
https://forums.studentdoctor.net/threads/residency-director-score.1064916/#post-15113603

You need the paid US News subscription to see the exact values for all the schools, but here are the current orders for the top few dozen

By PD assessment:

Harvard, Hopkins, UCSF
Stanford, Penn
WashU, Duke, Columbia
Michigan
Cornell, UCLA, U of Wash, Vandy
Northwestern, Yale
Baylor, Emory, U Chicago, Pitt
Mayo
UTSW, UVA
NYU, Oregon, UCSD, UNC
Brown, Case Western, Dartmouth, Gtown, Sinai, Rochester, USC, U of Wisconsin
Indiana, Tufts, Colorado, Iowa, U of Minnesota
Boston U, Ohio State, U of Alabama, Wake Forest, U of Utah
Miami, Einstein

By peer schools:

Harvard, Hopkins, UCSF
Stanford
WashU
Penn
Columbia, Duke, Michigan, U of Wash, Yale
Vandy
Cornell, UCLA, U Chicago
Northwestern, UNC, Pitt, UTSW
Emory, UCSD
Mayo
Baylor, NYU, Colorado, Iowa, Wisconsin
Sinai, Oregon, Alabama, UVA
Case Western, Dartmouth, Minnesota, Rochester
Brown, Indiana, Ohio State, USC

Thanks!

Are the residency director rankings or peer school rankings generally considered more important? I'd assume the residency director rankings, right?

 

[efle]

Thanks!

Are the residency director rankings or peer school rankings generally considered more important? I'd assume the residency director rankings, right?

I don't think there really is a general consensus about this stuff, it's kind of a hidden data set. Res and peer correlate extremely tightly (R^2 = .95) so I view them as one rep metric. Any differences you notice are very tiny (like 0.1-0.2 on a 5.0 point scale)

 

[787593]

I don't think there really is a general consensus about this stuff, it's kind of a hidden data set. Res and peer correlate extremely tightly (R^2 = .95) so I view them as one rep metric. Any differences you notice are very tiny (like 0.1-0.2 on a 5.0 point scale)

Data is so sexy...

 

[JoeCaputo]

What kinds of access/resources do top tier medical schools have that others don't?

Research dollars can be one. So state schools in states that invest a lot in research will rank highly even if they may not seem "prestigious" and vice versa, private schools that may seem prestigious, but can't compete with the amount of research money a state school gets may not rank as well as expected.

 

[jqueb29]

The only difference is the name impresses people who don't understand that you get the same education at 98.1% of all other American medical schools.

 

[aalamruad]

The only difference is the name impresses people who don't understand that you get the same education at 98.1% of all other American medical schools.

1) that's not the only difference

2) no one is claiming that the education is much better, people have been referencing the better research/funding/faculty connections/res director rankings/etc.

 

[efle]

The only difference is the name impresses people who don't understand that you get the same education at 98.1% of all other American medical schools.

I think names impress because of what kind of people get admitted there and what they go on to do after graduating, rather than differences in the education. When people are impressed that someone went to [famous fancy med school], it's not because they think they had better classes/rotations

 

[Lucca]

Everyone at a top 10 school is at least a hard 7. Below that it's all the same.

 

[aldol16]

By rep? Survey of res directors puts it 20th between Pitt and UTSW, survey of peer med schools puts it 22nd between UCSD and Baylor. So a 24th total rank is just a bit low.

Startclass has slightly better methodology than US News (at least for factors that you would care about as a student) and Mayo I believe is 10? Don't quote me on that though.

 

[aldol16]

This is very anecdotal, but I felt a big difference in attitude and caliber of students when interviewing at top-tiers vs mid/low-tiers. At lower ranked schools I got this feeling that "it's not cool to work hard or be ambitious. You're interested in surgery? lol what a gunner". There was more of a "work hard play hard" vibe at higher ranked schools.

I mean, I don't think anybody would disagree that the caliber of students at top-tiers are superior to that of students at mid/low-tiers. It's just how the world works.

 

[aalamruad]

Startclass has slightly better methodology than US News (at least for factors that you would care about as a student) and Mayo I believe is 10? Don't quote me on that though.

 

[Lawpy]

Exactly my point. Mayo doesn't show up high on rankings and yet it is top five hands down.

By rep? Survey of res directors puts it 20th between Pitt and UTSW, survey of peer med schools puts it 22nd between UCSD and Baylor. So a 24th total rank is just a bit low.

Don't get me wrong it's def a great school and very competitive to get into (small class size and tons of scholarships)!

Startclass has slightly better methodology than US News (at least for factors that you would care about as a student) and Mayo I believe is 10? Don't quote me on that though.

we should just rank medical schools based on SDN popularity

 

[efle]

Startclass has slightly better methodology than US News

Startclass has Stanford and WashU below UNC, and puts Duke and Columbia in the mid 20s with Iowa. I don't even think I've ever seen their methodology, what is it?

 

[aldol16]

Startclass has Stanford and WashU below UNC, and puts Duke and Columbia in the mid 20s with Iowa. I don't even think I've ever seen their methodology, what is it?

I should say "weights certain factors more heavily" rather than "methodology." They don't publish the weights they give to everything, but they start from US News and weight certain stats, faculty-to-student ratio, financial aid, etc. more heavily. Strange that WashU is that low given the elevated status given to stats by StartClass. No offense to your alma mater, but I think they're a bit over-valued due to stats padding. So is NYU.

 

[efle]

I should say "weights certain factors more heavily" rather than "methodology." They don't publish the weights they give to everything, but they start from US News and weight certain stats, faculty-to-student ratio, financial aid, etc. more heavily. Strange that WashU is that low given the elevated status given to stats by StartClass. No offense to your alma mater, but I think they're a bit over-valued due to stats padding. So is NYU.

NYU I'd agree, the US News rank is much higher than its reputation would put it, and just a few years ago it was like 10-15 spots lower. WashU though is exactly where peer schools and res directors view it and has been put in the top handful since the whole rankings phenomenon began. It's a "real" top MD school as far as I've ever seen despite loving high numbers (same goes for Penn)

They must be weighting tuition rather than financial aid because many of these high ranked state programs actually have higher average debt (WashU for example has the 2nd lowest average debt among borrowers of any program despite the high sticker price)

No offense to startclass but as far as I can see it's way, way off for many schools

 

[efle]

Wow they even have Yale in the 30s, right behind Rochester? I'd love to see their formula getting some of these positions

 

[787593]

we should just rank medical schools based on SDN popularity

Shameless plug 😎

 

[Redpancreas]

So in terms of education theoretically received I frankly think there's none.

In terms of pragmatism and matching, I think going to a prestigious medical school may help if you're applying to a prestigious field.


Sent from my iPhone using SDN mobile

 

[aldol16]

NYU I'd agree, the US News rank is much higher than its reputation would put it, and just a few years ago it was like 10-15 spots lower. WashU though is exactly where peer schools and res directors view it and has been put in the top handful since the whole rankings phenomenon began. It's a "real" top MD school as far as I've ever seen despite loving high numbers (same goes for Penn)

They must be weighting tuition rather than financial aid because many of these high ranked state programs actually have higher average debt (WashU for example has the 2nd lowest average debt among borrowers of any program despite the high sticker price)

No offense to startclass but as far as I can see it's way, way off for many schools

There's no such thing as "way off" because there's no standard. Unless you buy into US News. Or arbitrarily set something like residency director ranking to be the standard. As far as what I could tell, the quality of students at WashU was definitely lower than at Penn, but it could have been a non-representative cross-section.

What is WashU's average debt? I know two schools that are below 100k including undergrad debt.

Wow they even have Yale in the 30s, right behind Rochester? I'd love to see their formula getting some of these positions

I think Yale is a bit overvalued as well. Cornell should be higher up there, in my opinion.

 

[aalamruad]

There's no such thing as "way off" because there's no standard. Unless you buy into US News. Or arbitrarily set something like residency director ranking to be the standard. As far as what I could tell, the quality of students at WashU was definitely lower than at Penn, but it could have been a non-representative cross-section.

What is WashU's average debt? I know two schools that are below 100k including undergrad debt.



I think Yale is a bit overvalued as well. Cornell should be higher up there, in my opinion.

Residency director rankings aren't really arbitrary standards, their opinions are incredibly important

 

[aldol16]

Residency director rankings aren't really arbitrary standards, their opinions are incredibly important

I never said residency director rankings are arbitrary. I said that taking them as the "standard" ranking to which everything else should be compared is arbitrary. Because you are arbitrarily choosing one metric and using that to define a standard.

Residency director rankings are important for applying to residency. But other factors also matter a lot to the medical student experience, among them financial aid, student happiness ratings, etc. Match list doesn't determine student happiness. It could be a contributing factor, though.

 

[aalamruad]

I never said residency director rankings are arbitrary. I said that taking them as the "standard" ranking to which everything else should be compared is arbitrary. Because you are arbitrarily choosing one metric and using that to define a standard.

Residency director rankings are important for applying to residency. But other factors also matter a lot to the medical student experience, among them financial aid, student happiness ratings, etc. Match list doesn't determine student happiness. It could be a contributing factor, though.

I think you misread my post, I didn't say you said that res director rankings are arbitrary, I said that you said they're an arbitrary standard (which you did indeed say). Of course their rankings aren't arbitrary, it's not like they rank schools randomly.

Choosing res director rankings as the standard wouldn't be arbitrary, since it's based on the reasoning that the ultimate goal of medical school is to prepare students to become competent doctors in the specialties that they desire. Obviously there are a ton of other important factors in ranking medical schools, but choosing res director opinions of schools as one of the most important metrics isn't random.

 

[aldol16]

Choosing res director rankings as the standard wouldn't be arbitrary, since it's based on the reasoning that the ultimate goal of medical school is to prepare students to become competent doctors in the specialties that they desire. Obviously there are a ton of other important factors in ranking medical schools, but choosing res director opinions of schools as one of the most important metrics isn't random.

I'm also not saying it's random. I said it's arbitrary. The process can be rational but the end choice could still be arbitrary. You're arbitrarily choosing one standard when you can just as easily choose another. You could rank schools based on Step 1 score. You can rank med schools based on peer rankings. You can rank med schools based directly on student outcomes. Residency director ranking only reflects what residency directors think of graduates from that school, which can be affected by any number of things. The choice of using residency director ranking as some sort of standard is arbitrary because other metrics can be used to assess competency of graduates.

 

[aalamruad]

I'm also not saying it's random. I said it's arbitrary. You're arbitrarily choosing one standard when you can just as easily choose another. You could rank schools based on Step 1 score. You can rank med schools based on peer rankings. You can rank med schools based directly on student outcomes. Residency director ranking only reflects what residency directors think of graduates from that school, which can be affected by any number of things. The choice of using residency director ranking as some sort of standard is arbitrary because other metrics can be used to assess competency of graduates.

Oxford dictionary definition of arbitrary: "Based on random choice or personal whim, rather than any reason or system"

 

[aldol16]

I think you misread my post, I didn't say you said that res director rankings are arbitrary, I said that you said they're an arbitrary standard (which you did indeed say). Of course their rankings aren't arbitrary, it's not like they rank schools randomly.

And to illustrate my above argument, say that you want to choose the most competent chemist out of a group of 20 students. That's quite a rational thing to do, much like ranking schools. Just like you want to rank a school based on how well its graduate are trained, say I want to rank my students based on how well they understand the material. Rational. Now, I could go about this in many ways. I could administer some sort of standardized test. I could make my own exam and administer it. I could set up a practical exercise where the first to devise a practical synthesis of compound X is the most competent. I could put them all in a room and set them loose on each other. Which choice I make is arbitrary, assuming that these choices (save the last one) can measure competency roughly equally well. I could choose any one of them. The fact that I choose to make my own exams and administer them is an arbitrary choice I make. I could just as easily have made the lab practical the final exam.

 

[aldol16]

Oxford definition of arbitrary: "Based on random choice or personal whim, rather than any reason or system"

Again, your goal could be rational but the way you go about doing it could be arbitrary. Goal: rank schools based on the competency of graduates. Arbitrary choice: measure competency by residency director rating.

 

[efle]

There's no such thing as "way off" because there's no standard. Unless you buy into US News. Or arbitrarily set something like residency director ranking to be the standard. As far as what I could tell, the quality of students at WashU was definitely lower than at Penn, but it could have been a non-representative cross-section.

What is WashU's average debt? I know two schools that are below 100k including undergrad debt.

I think Yale is a bit overvalued as well. Cornell should be higher up there, in my opinion.

I'm also not saying it's random. I said it's arbitrary. The process can be rational but the end choice could still be arbitrary. You're arbitrarily choosing one standard when you can just as easily choose another. You could rank schools based on Step 1 score. You can rank med schools based on peer rankings. You can rank med schools based directly on student outcomes. Residency director ranking only reflects what residency directors think of graduates from that school, which can be affected by any number of things. The choice of using residency director ranking as some sort of standard is arbitrary because other metrics can be used to assess competency of graduates.

And to illustrate my above argument, say that you want to choose the most competent chemist out of a group of 20 students. That's quite a rational thing to do, much like ranking schools. Just like you want to rank a school based on how well its graduate are trained, say I want to rank my students based on how well they understand the material. Rational. Now, I could go about this in many ways. I could administer some sort of standardized test. I could make my own exam and administer it. I could set up a practical exercise where the first to devise a practical synthesis of compound X is the most competent. I could put them all in a room and set them loose on each other. Which choice I make is arbitrary, assuming that these choices (save the last one) can measure competency roughly equally well. I could choose any one of them. The fact that I choose to make my own exams and administer them is an arbitrary choice I make. I could just as easily have made the lab practical the final exam.

You've lost me a while ago on this one, if you think PD assessments are an arbitrary way to answer this question, and that schools like Duke, Columbia and Yale are similar to Iowa, Colorado and Rochester by any reasonable approach