Duke vs WashU

[corvuscardinalis]

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Duke
Pros
1. One year preclinical seems more appealing to me. I like learning by doing. I'm not sure if I'm going to be interested in a specialty that needs a lot of research productivity but it seems like the research year will give me the flexibility I need to focus on that. I am fairly confident I want to specialize.
2. Had a great experience at SLW, everyone was incredibly friendly and students struggled to come up with negative things about their experience.

Con
1. I'd need to take $25K/year in private loans on top of the max in fed loans, not including health insurance.

WashU
Pros
1. Institutional loan that's interest free until PGY-3. Brings my private lending down by half. Their mandatory health fee covers a lot of primary and specialty care so I most likely won't be paying for health insurance either.
2. I really enjoyed the culture at the med school and STL. I'm an outdoorsy kind of person and Forest Park was incredible.

Cons
1. I'm not a fan of cold weather.
2. Lengthier pre-clinical (16 months) and research spread out throughout M1-3. There is a month of research time after M1 and then 1-4 months of time during M3, but it's not the year that Duke offers. I don't know if this is as big of a con as I think, but I hesitate because if undergrad is any indicator, splitting my time between class and research might affect my productivity. Since clerkships start 4 months later than Duke, there's a chance I find my specialty of interest later and have to scramble.

Summary: Are the extra private loans at Duke (100k private loans TOTAL across all 4 years) vs. WashU (45k private + remaining institutional) worth the apparent benefits in curriculum and location? I'm pre-approved at rates that beat federal loans, but the horror stories about private loans make me nervous.

 

[YellowSalamander]

Disclosure: current WashU MD student

Congratulations on two great acceptances! You will do fantastic regardless of where you end up. A few things to consider:

1. The effective preclinical curriculum at WashU is closer to 12 months. In the 16 months you mentioned you have three clinical immersions, one explore (1 month research) and 4 weeks of dedicated for step 1. You are allowed to defer phase 2 by four months to conduct full-time research, which can bring your total dedicated research time to 5 months before phase 3. Immersions are great because they allow you to explore three specialties of your choosing (one surgical, one inpatient and one outpatient) during preclinical, and there is usually free time for research during immersions. You'll likely find your specialty sooner in this system.
2. 12 months of dedicated research time during M3 comes at the expense of something else.. How are you fitting away rotations and sub-internships into that shedule? Important for ERAS.
3. Role conflict between classes and research is not a big problem as most medical students do clinical research (frankly also case reports/series), which is far less time-consuming than bench research.
4. The winters are mild in St. Louis. We had 70 degrees in late December last year. The only months that are cold here are January and February (even those are quite mild) and probably not much colder than the mid-Atlantic region.
5. The mandatory health fee will cover all your medical expenses, and you will not need private insurance. Its remarkably comprehensive and will cover everything from surgery, advanced diagnostic imaging, physical therapy and specialist appointments ($20 copay) for no cost.

Are these 100k loans per year? As in 400k in private loans? Yeah, I would absolutely steer clear of taking out that much in private loans. If you can reduce that by taking out only 200k in private loans by attending WashU then that is a sound decision. I'd also encourage you to negotiate a bit with WashU.

 

[corvuscardinalis]

Disclosure: current WashU MD student

Congratulations on two great acceptances! You will do fantastic regardless of where you end up. A few things to consider:

1. The effective preclinical curriculum at WashU is closer to 12 months. In the 16 months you mentioned you have three clinical immersions, one explore (1 month research) and 4 weeks of dedicated for step 1. You are allowed to defer phase 2 by four months to conduct full-time research, which can bring your total dedicated research time to 5 months before phase 3. Immersions are great because they allow you to explore three specialties of your choosing (one surgical, one inpatient and one outpatient) during preclinical, and there is usually free time for research during immersions. You'll likely find your specialty sooner in this system.
2. 12 months of dedicated research time during M3 comes at the expense of something else.. How are you fitting away rotations and sub-internships into that shedule? Important for ERAS.
3. Role conflict between classes and research is not a big problem as most medical students do clinical research (frankly also case reports/series), which is far less time-consuming than bench research.
4. The winters are mild in St. Louis. We had 70 degrees in late December last year. The only months that are cold here are January and February (even those are quite mild) and probably not much colder than the mid-Atlantic region.
5. The mandatory health fee will cover all your medical expenses, and you will not need private insurance. Its remarkably comprehensive and will cover everything from surgery, advanced diagnostic imaging, physical therapy and specialist appointments ($20 copay) for no cost.

Are these 100k loans per year? As in 400k in private loans? Yeah, I would absolutely steer clear of taking out that much in private loans. If you can reduce that by taking out only 200k in private loans by attending WashU then that is a sound decision. I'd also encourage you to negotiate a bit with WashU.

Edited for clarity.

 

[riv_jordan]

Are the extra private loans at Duke... worth the apparent benefits in curriculum and location?

Honestly, no. You may be able to qualify for private loans with good terms, but nothing will beat the terms of an institutional loan that doesn't gain interest until PGY-3. And even if you do get good terms on a private loan, they come with other risks that are worth considering (i.e. if your credit score changes, so could your terms and you may even get rejected one year, and of course these loans aren't subject to PSLF). In your case, private loans aren't avoidable but it's still worth reducing your burden as much as possible.

Though the actual COA difference is small, the difference between 45k and 100k in private loans is significant, and the cons you've listed for WashU over Duke just do not justify that tradeoff. Either way you'll be graduating from a top school and will likely have a good experience (even with chillier WashU summers).

 

[corvuscardinalis]

Honestly, no. You may be able to qualify for private loans with good terms, but nothing will beat the terms of an institutional loan that doesn't gain interest until PGY-3. And even if you do get good terms on a private loan, they come with other risks that are worth considering (i.e. if your credit score changes, so could your terms and you may even get rejected one year, and of course these loans aren't subject to PSLF). In your case, private loans aren't avoidable but it's still worth reducing your burden as much as possible.

Though the actual COA difference is small, the difference between 45k and 100k in private loans is significant, and the cons you've listed for WashU over Duke just do not justify that tradeoff. Either way you'll be graduating from a top school and will likely have a good experience (even with chillier WashU summers).

If private loans weren't in the picture (say I got family support beyond fed and institutional loans), do my pros and cons suggest Duke might be better? Would the reputational advantage if any favor Duke?

 

[rob120]

Current Duke Student--the M3 research year can be 9-12 months, so you are able to fit in your away rotations!
Also, if you get financial aid, health insurance premium will be 60% covered!

 

[rob120]

If private loans weren't in the picture (say I got family support beyond fed and institutional loans), do my pros and cons suggest Duke might be better? Would the reputational advantage if any favor Duke?

if this is the case, duke 100%!

 

[LoverOfSpices]

If private loans weren't in the picture (say I got family support beyond fed and institutional loans), do my pros and cons suggest Duke might be better? Would the reputational advantage if any favor Duke?

No difference in reputation and pedigree between WashU and Duke! They are both perennial T10 programs.

I agree with @riv_jordan. Reduce your private loan burden!

If you are interested in health equity and underserved urban health, WashU is the best option! Duke University Hospital is not a safety net hospital. Barnes-Jewish on the other hand is a tertiary referral center, an urban safety net hospital and serves a much more diverse patient population.

 

[riv_jordan]

If private loans weren't in the picture (say I got family support beyond fed and institutional loans), do my pros and cons suggest Duke might be better? Would the reputational advantage if any favor Duke?

If private loans weren't in the picture, then just follow your preferences I suppose. There is no reputation advantage to going to Duke but you clearly prefer Duke so that's as good a reason as any (again, if private loans aren't a factor).