Factors to Consider a When Deciding on Med School

[PhoenixAZ]

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There is a recent thread on the importance of ranking when choosing med school to attend. I want to expand on this to understand the factors that I should consider when making the final decision. I have been very fortune in having choices and am very grateful (not meant to brag). I am just a bit at a loss as to how best to decide. I would appreciate inputs from anyone, esp. current med students, physicians, and adcoms. Here are several that I have been thinking, but welcome any other suggestions and details/reasoning.

1. Ranking? I am not into academic medicine, and am not talking about having to choose Harvard, Stanford, Hopkins, kind of school. More like mid and low tier private vs. state schools.

2. Step 1 scores? Is that even a place like MSAR to check different schools Step scores? Is this even a consideration?

3 Historical match results? Again, is there a clearing house like MSAR that you can find the info if the schools don't provide it? Is this a consideration?

4. Reputation?

5. location? Does it matter that much? Will I even have enough free time to care? Also specifically, how important is closer to family matter (I have a very good relationship with my parents)? How important is the support system while in med school?

6 Curriculum? What specifically to look for? I read about team-based, problems-based, and evidence-based, system-based, but frankly I have no idea what they all mean or whether one is better than the other in preparing me for Step and as a future physician.

7. Anything else I should consider?

 

[NotASerialKiller]

Only you can decide how important it is for you to be close to your family. For me having them as a support system means calling them if something comes up and not being within reasonable driving distance. Also remember location can dramatically affect rent and other living expenses.

 

[New_Slang]

For me one of the biggest factors is the atmosphere. I don't want competition, I want collaboration. I do not see myself in a hyper-competitive or high-tier school for personality reasons. I think I would flounder.

Biggest plus for me in the particular school I've decided on is the lifestyle/schedule. Class from 8-12, 1 or 2 afternoon activities a week, and then the rest of the time is for studying. I'm a non-trad and married, so it makes me happy that I'll have so much dedicated studying time during the daytime so I can have a shred of normalcy in the evenings over a meal. A few schools at which I interviewed had activities from 8-5, then the students went home and studied all night. Sounds awful.

 

[familyaerospace]

Pick one where there are other members of your culture/religion (if your culture is important to you). I am a part of two cultures, NEITHER of them are where I am right now so I feel incredibly lonely.

 

[Ostallopathic]

A few schools at which I interviewed had activities from 8-5, then the students went home and studied all night. Sounds awful.

Oh God why...

 

[TheLionheart]

What cannot be emphasized enough is the atmosphere of the school and how happy the current students are. I'm very happy I chose a school where the class above us seemed significantly happier than what I saw elsewhere.

 

[SOMBound13]

There is a recent thread on the importance of ranking when choosing med school to attend. I want to expand on this to understand the factors that I should consider when making the final decision. I have been very fortune in having choices and am very grateful (not meant to brag). I am just a bit at a loss as to how best to decide. I would appreciate inputs from anyone, esp. current med students, physicians, and adcoms. Here are several that I have been thinking, but welcome any other suggestions and details/reasoning.

1. Ranking? I am not into academic medicine, and am not talking about having to choose Harvard, Stanford, Hopkins, kind of school. More like mid and low tier private vs. state schools.

2. Step 1 scores? Is that even a place like MSAR to check different schools Step scores? Is this even a consideration?

3 Historical match results? Again, is there a clearing house like MSAR that you can find the info if the schools don't provide it? Is this a consideration?

4. Reputation?

5. location? Does it matter that much? Will I even have enough free time to care? Also specifically, how important is closer to family matter (I have a very good relationship with my parents)? How important is the support system while in med school?

6 Curriculum? What specifically to look for? I read about team-based, problems-based, and evidence-based, system-based, but frankly I have no idea what they all mean or whether one is better than the other in preparing me for Step and as a future physician.

7. Anything else I should consider?

Ranking is not a big concern when not MD/PhD, but if you're down to deciding between two likeable schools, then obviously go with the higher rank. I immediately discarded the priciest acceptance because it wasn't in a great area, weather was a concern, and the ranking was just ok. Of course I would have happily enrolled if it had been the only acceptance.

When I was then down to two choices, locations didn't tip the scales, cost was about the same, so I went with ranking....one being well-ranked and the other unranked (but still a very nice med school).

Re: Family - I am close to my family, so in the end it has turned out better that my chosen school is only an hour away from them. It makes it easy to visit during a rare free weekend, and when I had a car issue, my parents were easily able to lend me one of theirs while mine was being repaired.

 

[Affiche]

$$$$ and atmosphere

 

[Clockwork Biology]

Personally, if I have the opportunity to choose between schools, I will be choosing mainly based on location, curriculum, atmosphere, and residency programs affiliated with that school - oh and cost, of course.

Location - Location is huge for me for two reasons: 1) I think that students generally end up in an area near their medical school for residency since these residencies will know their school much better than say a Utah residency would know a Virginia medical school. You can still go wherever you want, but I believe it's easier to stay in the same geographic region for medical school and residency. 2) I'm so sick and tired of paying for flights, and flying in general, just to go home and see family/my SO. ****'s expensive as hell. 3) Yes it might be easier to study if you go to a school that has ****ty weather, but it would also be easier to study and do well at a location that makes you happy.

Curriculum - This would be grading system, standardized patients, clinical skills. From what I've picked up on from SDN, pre-clinical grades are important but not end-all-be-all so I'd like to attend a school that focus on developing my clinical skills through standardized patients and really prepares me for the hospital during my pre-clinical years. Whether that be through H&P, patient interviewing, practicing basic common procedures, practicing physical exam, introduction of tools like ultrasound, etc.

Atmosphere - Obviously med school is going to be tough so pick a place where you know you will fit in with the students. Making good friends along the way will make the process at least a little easier than trying to go it alone. Collaboration > competition, especially in todays multi-disciplinary medical environment. I'm picking a place where my peers will be actual human beings, not a class full of gunners. You should enjoy the next four years, and the people you surround yourself with will have a huge influence on that.

Residency Programs - You have a slightly better chance to match to a residency program that is affiliated with your medical school (this goes along with location point). So if you already have some idea of what you want to do then you should lean towards a school that has a well developed residency program for that speciality.

Cost - cheaper is obviously better, but cost would be weighed in with what other opportunities the school offers.

I'm not really counting on STEPs or Match Rates/placements since a lot of that varies from class to class and is really up to how hard you are going to bust your ass over the next four years. Plus, every school seems to boast average to above-average match/STEP scores... not sure where the below average schools are? Maybe the Caribbean. Meh.

Just my rambling 2 cents, I'm sure others will place different emphasis for valid reasons.

 

[NickNaylor]

Everyone is going to offer different advice based on their own experiences. That being said, I'll throw my thoughts into the ring.

1) I do think ranking matters to some degree. If nothing else, it can help open doors in the residency application process. The real question is whether the typically higher cost associated with "higher" ranked schools is worth it. That's a difficult question which has resulted in many pages of spilled ink and SDNers getting quite excited over, so I will forgo that discussion for now. In general, though, I do think rank matters, but I don't think it should be the primary factor in choosing a school with the exception of very particular circumstances (e.g., planning to do research as a significant component of your career, planning to do academics with an aspiration to be a "big wig," e.g., head of a department).

2) Step 1 scores should not be used to pick a school, period. Step 1 performance is largely an individual effort. This is why Caribbean students can kill step 1 despite not being able to get into an MD school and likely in spite of what I would guess isn't the highest quality education. If you are motivated and have a strong work ethic, you can do well on step 1, perhaps even in spite of the quality of your school. Just because a school might have an average of 240+ doesn't mean that YOU will get a 240+. If anything, I think that just points to the type of students that that school has among its ranks.

3) Match results are also not important IMO. Too much goes into any one individual's decisions for the match to make it a useful comparison. As with #1, though, many pages of ink have been spilled on this topic, so I would encourage you to search the forum to see others' thoughts on this seemingly controversial point.

4) See #1 for reputation. It matters, it may be helpful in the future, but how much it's "worth" is an individual question to which there isn't a single answer.

5) The importance of location is an individual decision. Is it important to YOU that you end up near family, in a big city, or in a certain part of the country? It's impossible for me to say whether location is important or not to you because I'm not you. Personally, location did play a role in my ultimate medical school pick, but that's because it was a factor for me. Others don't necessarily care as much.

6) I think it's important to be aware of the different curricula in existence and think about what kind of system you want, but that's a difficult thing to discuss generally. "Traditional" curricula typically follow the 2-year pre-clinical curriculum and 2-year clinical curriculum splitting of training. There are variations on this theme, with the latest fad to be to crunch pre-clinical time into a year and a half or even a year to give you additional time to do things like clinical electives and research. I think there are pros and cons to that kind of format, but I didn't experience it personally so I don't have much to really add to it. "Problem-based learning" is a teaching format that focuses more on small group discussion and independent learning, usually in the form of being given a case/topic/whatever to research the night before a discussion and then discuss the case with a faculty facilitator to ensure that you take away the key points from the discussion. IMO, this is a learning style that could be extremely effective but is highly dependent on those in your group and, especially, the quality of the facilitator. In reality, most schools have a combination of both, predominantly with a traditional format and supplemental PBL-like small group sessions. Some schools do, however, forgo traditional lectures entirely and do all of their teaching in the PBL format. It's anyone's guess which is better so I don't think there's a clear answer to which type of format you should be looking for. It's dependent on your own learning style and what you think will be effective for you.

7) More than anything I think it's important to try and understand what your clinical experiences will be like. The pre-clinical experience is pretty much the same at all institutions. You will learn the same material and likely use the same books and certainly take the same tests (step 1 +/- NBME subject exams) as many other students in the country. What will really differentiate your educational experience, though, is what you do on the wards. I would look for a school that really encourages students to jump in and be responsible for their patients. The clinical experience is not glorified shadowing. You should be seeing patients independently, writing notes, and "making" management decisions (or, at the very least, being given an opportunity to hazard a guess at management and then be told why you're wrong). That's really where the quality of your education becomes important. You don't want to go into residency having never really done anything independently. Most schools seem to do this well, but I've heard anecdotes both in person and on SDN which really make me wonder what some schools are doing to train their students clinically.

 

[jl lin]

What cannot be emphasized enough is the atmosphere of the school and how happy the current students are. I'm very happy I chose a school where the class above us seemed significantly happier than what I saw elsewhere.

I think you make a great point. How do you, however, fully evaluate this though? During interview season, I suppose there will be those that are on their best behavior. It's sort of like interviewing for a position and being shown around. Everyone pretty much feels an obligation to smile and present like all is well.

 

[NickNaylor]

I should say that while atmosphere is important and should be considered, it can be a very difficult thing to assess and is pretty much just your gut shot reaction to interacting with what is ultimately a very small portion of the institution. There will be gunners at the most "friendly" of institutions and there will be normal people at even the most competitive of programs. I do think there's value in trying to figure out which kind of environment you prefer, but ultimately it's something that's impossible to assess. Not to mention the fact that it's your classmates that will play the biggest part in that experience, and you have no idea who will be in your class before you start. And neither does the school for that matter, though they can certainly select for people with certain temperaments, goals, etc..

 

[familyaerospace]

Oh God why...

My school does that frequently as well.

 

[Psai]

For me one of the biggest factors is the atmosphere. I don't want competition, I want collaboration. I do not see myself in a hyper-competitive or high-tier school for personality reasons. I think I would flounder.

Biggest plus for me in the particular school I've decided on is the lifestyle/schedule. Class from 8-12, 1 or 2 afternoon activities a week, and then the rest of the time is for studying. I'm a non-trad and married, so it makes me happy that I'll have so much dedicated studying time during the daytime so I can have a shred of normalcy in the evenings over a meal. A few schools at which I interviewed had activities from 8-5, then the students went home and studied all night. Sounds awful.

8-5
No thanks.

 

[New_Slang]

My school does that frequently as well.

That sounds awful! I'm glad I paid attention and asked about "daily life".

 

[Law2Doc]

1. Match lists are not important for reasons that have been discussed ad nauseum in other threads. They reflect people's "wants" far more than what was attainable, and premeds are notoriously bad at reading match lists to boot. Did the person with top grades and step scores who really wanted to do peds near her family in Alabama and got her first choice there really match worse than the guy with identical stats who ended up in his last choice program for ENT and is actually a bit unhappy about the result? How do you read anything into data like that where personal goals and story dictate end results?
2. STEP scores are problematic because programs by tacit agreement are not officially supposed to release those, there's no accepted methodology for how programs report retakes, failures, people moving into and out of particular years etc. So you only get "unaudited" word of mouth data on SDN and the like which is often sketchy and self serving. Honestly everyone studies for these from the same First Aid and other books so I'd bet the biggest influence on scores is not anything the school does but how long they give you to study for it. So I'd say rather than step 1 scores, asking about how long people have to prepare for step 1 might be useful data.
3. Things like curriculum, whether it's full or part day lectures, whether attendance is mandatory, whether you can stream lectures remotely are all big things to consider.
4. Location is important for some.
5. Ranking-- probably less important than premeds think. Sure Harvard might open more doors than the school ranked 100, but if you are looking at ranking when comparing the place ranked 35 to 55, you are putting too much weight on this.
6. Money/cost should always be considered, but maybe not drive the decision.

At the end of the day you want a place where you will thrive, work hard and do well. That might mean beautiful surroundings, or avoiding distractions.

 

[Goro]

Many good point shave been mentioned already. I advise people to consider:

cost of living; curriculum, your gut feelings with each school you interview, what the current students feel about their schools (you can pick a vibe when students are happy or unhappy); the localities the schools are in. And as my wise colleague Law2Doc points out: Keep in mind that match lists are like reading tea leaves, if not chicken guts.

 

[TheLionheart]

I think you make a great point. How do you, however, fully evaluate this though? During interview season, I suppose there will be those that are on their best behavior. It's sort of like interviewing for a position and being shown around. Everyone pretty much feels an obligation to smile and present like all is well.

It depends on what the school allows you to see, really. At my interview day and second look, I interacted with plenty of students outside of the official Ambassadors, and to a man they all seemed happy and enjoying life. Now that I'm here and ~5 months in, having finished almost 2 blocks and clinical anatomy, I see what they were talking about. I had friends that attended second looks at schools that were boring and didn't seem very well planned, and it left a negative impression relative to those with great second looks. I interviewed at schools where even the tour guides didn't seem very happy. That wasn't encouraging.

Second Look is where you really get to see what your class could/likely will look like. If you have the means and/or desire, I recommend attending the second looks of the schools you're interested in. They'll happen in April most likely.

Other people have mentioned good things here too. Curriculum, dedicated Step 1 time, etc. I will also add that some schools (like mine) have a very nice longitudinal Doctoring course that we participate in every other week for the entire pre-clinical curriculum, and it really prepares our students well for rotations/Step 2 CS since we have regular OSCEs. It lets us practice our physical exam maneuvers, documentation, and plan forming skills long before it actually matters on standardized patients and is set up to keep pace with our organ systems. For example, we're in our Neuromusculoskeletal block right now, and in Doctoring, we've learned the physical exam elements related to NMS as well as how to document them in a SOAP note. Our next OSCE will likely feature 1 patient coming in with an NMS complaint.

If you're up in the air about schools that you really like, it's things like that that can tip the scales one way or the other.

 

[PhoenixAZ]

Thanks so much for the thoughtful and insightful feedbacks. Your comments have helped clarified my thinking tremendously. I now realized how wrong I was before in being "obsessed" about the tier level and name recognition of a school. Based on what I have read, looks like the name and the tier doesn't matter as much ( it matters some but not too much). It is really the soft side like the fit and the feel that I should focus more on. Thank you once again to everyone for spending your time in responding. I can't tell you how much this had helped me.

 

[IgEdoc]

School ranking is simply a matter of pride as we all aspire to the "best" and who doesn't enjoy a little bragging right when asked "what med school did you went to".

Matching for me was being close to family and salary was a factor but having experienced various teaching hospital styles during residency (prestigious academic versus reputable private versus government hospitals) I found the learning far best where you had much more autonomy (government)