Do medical students and doctors generally advise premedical students to attend the most affordable school possible? I know this is apples to oranges but dentists generally advise predental students to attend the least expensive school and I was wondering if the same were true for MD's. My guess is no because name probably matters more for patients choosing doctors than choosing dentists.
General consensus on attending the most affordable medical school
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SDN dogma is to go to the most affordable school, regardless of ranking/prestige, but IRL med students & physicians advised me to go to the best school I could get into. Fortunately, the most affordable was also the best school for me, so I didn't really have to decide.
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It doesn't really matter where you do medical school. But, it does matter where you do your residency. That's what is most important and where you really learn how to become a physician. That being said, going to a good medical school helps you get a good residency, but it isn't the most important thing by far.
That being said, in most cases I advocate going to a more affordable school. But, it depends on your situation. Rich parents that help financially and single? Go big. Have kids and no family help? Go affordable. Also, I wouldn't turn down somewhere like Harvard for some crappy state school just for money. On the other hand, in my situation, I would have turned down Harvard for a solid, mid-upper tier state school.
That being said, in most cases I advocate going to a more affordable school. But, it depends on your situation. Rich parents that help financially and single? Go big. Have kids and no family help? Go affordable. Also, I wouldn't turn down somewhere like Harvard for some crappy state school just for money. On the other hand, in my situation, I would have turned down Harvard for a solid, mid-upper tier state school.
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I think for med school it doesn't really matter where you go.
I always hear from attendings that nobody will care where you went to undergrad or med school....generally its all about where you did your residency and/or fellowship. Considering you can match the top tier residencies programs for most all fields from ANY US allopathic school it makes sense for most people to choose the most affordable option.
I always hear from attendings that nobody will care where you went to undergrad or med school....generally its all about where you did your residency and/or fellowship. Considering you can match the top tier residencies programs for most all fields from ANY US allopathic school it makes sense for most people to choose the most affordable option.
I think that its completely ignorant to say where you go to medical school has no impact on your medical training. I do agree that your residency training will be more important, but your initial exposure to medical training, research, and peers are established in medical school. Most of the top medical schools are also affiliated with top hospitals, so I would think that your experiences between going to University of New Mexico vs Harvard will be very different. Regardless of your career goals, medical school will be the place where you ultimately decide on your specialty and that directly comes from your interactions with peers and mentors in medical school.
Go to the best school you can. It makes it significantly easier to get a good residency in any field which provides much better fellowship options which lead to better jobs in the end. I have heard through the grape vine that residencies will rank students from better schools higher for better or worse. A person from harvard is more desirable than a person from average state school even if that person from the avg school has better board scores. Both will very likely pass the field's board exams. Also better schools have better research opportunities which help a lot. Some good research can really bump up an applicant.
Now obviously you can still get a good residency in any field by going to avg state school. But I tell you what, you have to prove yourself coming from a school like that far more than the harvard grad.
and as the guy above me says, top schools are associated with top residency programs. It is usually easier to stay at your home institution, especially if it is already high ranked, than it is to apply as an outside person to a high ranked program that has no prior knowledge of you.
Now obviously you can still get a good residency in any field by going to avg state school. But I tell you what, you have to prove yourself coming from a school like that far more than the harvard grad.
and as the guy above me says, top schools are associated with top residency programs. It is usually easier to stay at your home institution, especially if it is already high ranked, than it is to apply as an outside person to a high ranked program that has no prior knowledge of you.
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True to an extent. But alot of "top residencies" aren't always at top med schools. I could name several "state school" affiliated residencies in a handful of fields which are considered the best in the nation (better than Harvard for that field).
It really comes down to what you are interested.
Also don't kid yourself, top med schools are ranked highest because they have the best researchers and therefore have the most funding. Top med schools don't always have the best educators, especially in a clinical setting where there are a dozen residents/fellows in between you and the attending. You might actually get more hands-on learning and one-on-one interaction with an attending at University of New Mexico vs. Harvard.
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Cheapest. I go to a lower tier state school and I am sure I could match into any specialty. Your step 1/2 scores are entirely independent of school; you can find research anywhere (sure, it's not the best research, but do you really think a med student is going to be curing cancer?); also, if you need big name letters, you can always do aways - plus, I've always heard an outstanding letter from a no-name vs. a form letter from a big name. Sorry for the run on sentence.
I'll be graduating with under $100,000 and I couldn't be happier.
The ONLY people that should be trying to go to the big name schools are those that think they want to go into high level academics.
I'll be graduating with under $100,000 and I couldn't be happier.
The ONLY people that should be trying to go to the big name schools are those that think they want to go into high level academics.
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Your school matters a lot, anyone who says otherwise either went to a low-tier school or has no practical experience in the field. The difference in competence so far in residency between interns from top tier and low tier schools is so drastic it's actually comedic.
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Since when was FSU a low tier state school? Its the second or third best in florida after UM and possibly UF
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The fact that you would know enough to try to compare medical school rankings as a sophomore in high schools tells me you need to spend time off SDN.
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Not that you are wrong, but how do know this is not mainly accounted for by the fact they are more likely more intelligent and harder working in the first place, hence the top tier school?
I went to the cheapest school. I saved over a hundred grand and live like a king while in med school. Going to a more expensive top-tier school is not worth it unless you are trying to get into a top residency. Even then, I find it highly unlikely that going to a higher tier school will provide that "extra edge" for getting into your top choice residency. It's how well you do on clinicals and step 1 that matters.
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One thing is pretty apparent from reading many attending threads over the past few years.... employers could care less where you went med school and often don't even care where you went to residency. The vibe I get from multiple threads is if you are not an idiot and have a license you will be able to get any job in the private practice world.
I think some people in this thread are under the false delusion that a better med school or even residency somehow equals a better or higher paying job. Unless you stay in academics, this seems to not be the case.
But then again doctors are notoriously terrible at managing money, that is congruent with the sediments of this thread imo.
I think some people in this thread are under the false delusion that a better med school or even residency somehow equals a better or higher paying job. Unless you stay in academics, this seems to not be the case.
But then again doctors are notoriously terrible at managing money, that is congruent with the sediments of this thread imo.
C
cowme
Eh, people said the same thing about college when I was in high school. People said this about med school when I was choosing which college to go to. Now that I am a resident, all everyone says is that where I do will my fellowship will be the most important piece to getting a job. I'm sure when I land my fellowship, people will say that all that really matters is where I ultimately work. People have a way of overestimating the importance of "the next step," when in reality, getting what you wants depends more on you than where you schooled/trained. The harder you work, and more likeable you are, the more likely it is you will get where you want to be, regardless of the prestige of the places you trained at all the way.
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I'd imagine that a lot of that difference is due to the type of student the Harvards of the world tend to attract. The patients are plenty sick at Low-tier U, so it's not like the learning opportunities aren't there. Incidentally, the two seniors I've had so far - both second years - have been awesome and extremely knowledgeable. One is from the Caribbean, and one is a DO.
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For most people it matters little or none, for a few it matters a lot. Depending on which perspective you approach this question from, a very different answer is yielded. Hence the endless and occasionally bitter debates on this topic.
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The best luck we had with residents was generally those from mid-tier programs. They're smart but weren't as coddled as many of the top-tier people. In fact, the worst intern I can presently recall came from a top 3 school. I'm sure this individual could run rings around me on standardized tests, but had the common sense of a rotten turnip.
there are so many misplaced comments that are frequently posted to justify a person not getting into a top medical school or choosing not to attend one.
First, medical rankings are not just based on research funding, its around 30%? of the ranking? All the rest comes from student stats, faculty/student ratio...etc. Furthermore, research funding is a key component of medicine, and hence why although the US healthcare system may not be the best, people from all over the world choose to come to Hopkins, MGH for care. US medicine, is the driver for novel therapeutics and understanding of disease. Your exposure and training to these assets are no doubt valuable.
Second, the best schools are not the most expensive. Most of the top tier schools offer huge amounts of financial aid (usually because they have a powerful alumni association). In fact I'm pretty sure if you took the avg debt of a student from a top 10 medical school it would be lower than the national avg.
Third, people consistently argue that quality of professors can't be judged by ranking of medical schools. That is completely false considering that most physicians who choose to practice at top academic centers have their goals set on becoming the BEST ACADEMIC physicians, ie they will either be awesome at TEACHING or conducting RESEARCH.
People are just defensive about their decisions, because they need to justify their choices. Go where you want to go. But its extremely foolish to say where you go to medical school is not a significant part of your medical education is just completely ridiculous.
On a practical note, I would also say that one thing I've realized that is going into a top medical school, you don't have to prove yourself all over again when applying for residency. I would say going to a non top school will not put you in a disadvantage for residency, but you'll have to find ways to distinguish yourself...ie obtaining AOA...etc.
First, medical rankings are not just based on research funding, its around 30%? of the ranking? All the rest comes from student stats, faculty/student ratio...etc. Furthermore, research funding is a key component of medicine, and hence why although the US healthcare system may not be the best, people from all over the world choose to come to Hopkins, MGH for care. US medicine, is the driver for novel therapeutics and understanding of disease. Your exposure and training to these assets are no doubt valuable.
Second, the best schools are not the most expensive. Most of the top tier schools offer huge amounts of financial aid (usually because they have a powerful alumni association). In fact I'm pretty sure if you took the avg debt of a student from a top 10 medical school it would be lower than the national avg.
Third, people consistently argue that quality of professors can't be judged by ranking of medical schools. That is completely false considering that most physicians who choose to practice at top academic centers have their goals set on becoming the BEST ACADEMIC physicians, ie they will either be awesome at TEACHING or conducting RESEARCH.
People are just defensive about their decisions, because they need to justify their choices. Go where you want to go. But its extremely foolish to say where you go to medical school is not a significant part of your medical education is just completely ridiculous.
On a practical note, I would also say that one thing I've realized that is going into a top medical school, you don't have to prove yourself all over again when applying for residency. I would say going to a non top school will not put you in a disadvantage for residency, but you'll have to find ways to distinguish yourself...ie obtaining AOA...etc.
K
kpcrew
Can you expand on this?
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And the answer is . . . it depends.
It depends on your financial situation.
It depends on how big the $$ gap is.
It depends on the gap between schools you're looking at. Are we talking no-name state school vs. harvard/hopkins or no-name state school vs. a lower top 20-30 program?
It depends on what you want to do with your life. If you're aiming for a family med residency, you can get a great one out of any school. If you're gunning for derm, plastics, ortho, rad onc, etc. you CAN get there from any school, but the path will be easier from a top school. Is that additional help worth 100k? See items 1-3.
It depends on you. Are you comfortable picking the "lower tier" school, or would you always be asking yourself what if? You need to be honest with yourself.
It depends on your financial situation.
It depends on how big the $$ gap is.
It depends on the gap between schools you're looking at. Are we talking no-name state school vs. harvard/hopkins or no-name state school vs. a lower top 20-30 program?
It depends on what you want to do with your life. If you're aiming for a family med residency, you can get a great one out of any school. If you're gunning for derm, plastics, ortho, rad onc, etc. you CAN get there from any school, but the path will be easier from a top school. Is that additional help worth 100k? See items 1-3.
It depends on you. Are you comfortable picking the "lower tier" school, or would you always be asking yourself what if? You need to be honest with yourself.
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This x 1000
People have a frequent tendency to talk out of their rear ends when it comes to this topic due to a combination of defensiveness, egotism, or need for validation.
More than likely will going to Harvard or Hopkins help you get into a good residency? Of course it will. It'll probably even make the process a bit easier since there are still some residency directors who want to pad their resumes with those sorts of graduates.
Will it *guarantee* you a good residency? Probably not.
For what it's worth, I enjoyed my medical school and it's no Harvard. I liked going to a place where the competition wasn't so cutthroat people are constantly gunning over each other. And I'm damn happy that I got a top class clinical education.
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Too generalized to be a useful statement, although partially true.
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The main one everyone quotes off US news world report is far more than 30% research. Its actually like 60% of the ranking.
People are defensive about choosing to spend lots more money for a "high-tier" school. When it comes down to it, don't most of us learn on our own in the library with the same review books? Regardless if you are in Boston or Montana the materials are likely to be the same. The variable is the individual, not the school.
Also if top-tier schools had the "best educators" then why aren't creating their own books or courses? Its because were choose for their clinical/research skills not their teaching skills. Was goljan from a top-tier med school? No.
Whatever, I will be laughing all the way to the bank. To each their own.
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Don't be a douche. We're not (all) being defensive. I will graduate with a total of <80k in debt and my wife and I have plenty of money in the bank. I'll be debt free by my 2nd to 3rd year of residency (wife works too).
Further (and probably more importantly), I'm proud of my med school and the training that I am getting. I've had plenty of research; I've been treated well; and I have awesome relationships with almost all of my attendings (how many people here were given a Cuban Cohiba and restaurant gift card or a nice wedding gift from an attending just because he or she liked having you on their service?). Both of my step scores were > 1SD above national average and all of my shelf exams (except ob/gyn) were >90%. Last week I intubated 4 patients, started 3 central lines, tapped an infected joint and sutured a couple wounds.
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For someone (like me) who has no interest in being the director of a residency program, or a dean, or head of his own research lab I think attending the most affordable medical school is the right decision. I see myself in private practice, so minimizing debt was high on my list. However, what I think is most important is going somewhere where you will be happy.
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You don't need to justify yourself. That's admission that his values are significant to you.
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Eh, I come from a family of lawyers, I like defending my point, lol. Nice name.
You need to get into a top high school to get into a top college....top college to get into a top med school...top med school to get into a top residency...top residency to get into a top fellowship. Where does the insanity end?
C
cowme
when you get buried in a prestigious cemetery
Several mistakes:
From US news
Research activity (weighted by 0.30 in the research medical school model only; not used in primary-care medical school ranking model)
I think you mistook the subsection that .15 is on total research and .15 is on total funding per faculty as an additional 30%.
If you're obtaining your entire education simply from books, then you are not getting the point of medical school to begin with. You might as well home school for medical school.
An top tier schools do generate the best educators. Look at the top residency programs at top schools, I don't think a boards review teacher is a good example of a top educator...no doubt he's great at teaching to boards...
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I think spending more money to attend a more prestigious school is highly dependent on one's own goals. I personally don't see the advantage of digging yourself 100k deeper into debt unless you're set on an academic career or are interested in a specialty with a derm or rad-onc level of competitiveness.
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45408
I'd say otherwise, and I went to a respectable school and have sat through meetings for resident selection. I was even accepted to your medical school, and actually chose the more expensive one...
I'd say to go to the cheapest school that is a good fit, which includes location, teaching style, and other things. I could've gone to a cheaper school that had a higher US News ranking, but I wanted to stay near family, and I preferred the clinical education of my school to the other one. In the end, it's hard to say how much it matters. There are many many factors involved, and people who go to prestigious research schools will be not-very-subtly encouraged to apply for prestigious research-oriented residencies, so you'll see a lot of those people in those programs.
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Yeah, no. The highest ranked departments at top academic centers don't get there and stay there by teaching. Faculty who expend too much effort teaching will actually be reprimanded because it cuts into grant-writing, paper writing, and/or clinical revenue-generating time.
Your average academic physician will spend a few hours a year, at most, delivering didactic instruction to medical students. Your tuition dollars make up a tiny percentage of the institution's overall budget. Hence, you can be one of the best and brightest, training as part of the new generation of physicians at some renown medical school, and nobody inside the place really gives a f-k about you.
Students arguably stand a better chance of quality teaching at a mid or lower tier center, where the faculty (many of whom trained at top institutions) have fewer publishing and grant-writing demands.
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You know of an actual case of a reprimand being given to a faculty member at a major academic institution because they put too much "effort" into teaching? Were they told something like "limit the time you spend on creating ppt talks to 2 hours." Does this include bedside teaching too on rounds, etc? I'd love to know where that happened and stay far away from there.
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I have seen it come up in faculty promotion reviews. As in "we noticed you missed the last R01 deadline, but have been spending an awful lot of time teaching small groups..."
Check your PM.
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This is misleading. Not every academic physician is research-track at top ranking institutions, there are plenty of high quality instructors without significant research commitments. The research faculty that "earn" a school's USNWR rating often aren't the ones giving didactic lectures and running small groups.
Perfect example is Husain Sattar at U Chicago. This guy created Pathoma and it a total boss, but has next to no research footprint. Anecdotally, I spent time at the Brigham as a pre-med and saw plenty of high quality bedside teaching. Big name institutions have no shortage of teaching talent, despite all the Haterade that is poured on them in these threads.
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Good for you, but neither are they some candle to which educationally-oriented faculty are drawn. The good teachers you take advantage of are generally people who have a genuine love for education and huge academic cojones. If the cojones shrivel they get kicked out the door same as the next guy.
Oh, and for every Husain Sattar there are about 170 who would give you a Philly root canal and sell your kidneys for even a K08.
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See, this bolded statement is where I disagree. I'm only at a "top 20" USNWR school, and I've seen a handful of our excellent, award-winning didactic lecturers get snatched by the big dogs in the "top 5." These schools are definitely a magnet for all different types of talent for a variety of reasons, and if we've had talented teachers seek them out, I'm sure other schools have too.
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Allow me to rephrase. There is no money in teaching, so over the long haul you will have to earn your keep a different way. And the hour glass at top flight places is generally pretty small.
A paper in Cell? That's probably worth an eye and a pinky finger.
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It depends on what you're looking for. I don't think it is unreasonable to choose your school given family situation; that being said, you're not exactly deciding between a top tier and bottom tier school in that case. However, I will say that at least in my field, our graduates have done better in the match the last several years. I can't speak to gsurg, etc. My cousin went to mcw and graduated last year and is also doing rads so I have a good sense how the cycle went for grads of both schools. Does that matter in terms of getting jobs? Certainly at academic programs, and IMO pedigree matters for some of the prestigious practice groups. The radiology group near where I lived in Newport beach had almost all ucsf, Stanford, and Ucla grads. As far as getting A job? I think you should be able to do that from most residencies. As far as matching into competitive residencies, the data shows that graduates of top 40 programs match better. This discrepancy is even larger at top programs in any specialty.
I'd say otherwise, and I went to a respectable school and have sat through meetings for resident selection. I was even accepted to your medical school, and actually chose the more expensive one...
I'd say to go to the cheapest school that is a good fit, which includes location, teaching style, and other things. I could've gone to a cheaper school that had a higher US News ranking, but I wanted to stay near family, and I preferred the clinical education of my school to the other one. In the end, it's hard to say how much it matters. There are many many factors involved, and people who go to prestigious research schools will be not-very-subtly encouraged to apply for prestigious research-oriented residencies, so you'll see a lot of those people in those programs.
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Don't talk about the data. The data is totally confounded. Expound like the rest of us, just don't pretend it's driven by real numbers.
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So when you and drizz start arguing about the importance of medical school prestige for residency competitiveness, will that be the 5th or 6th time?
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There is nothing wrong with plunging through well worn territory over and over again. Just ask my sister.
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You are absolutely wrong about the job market and the importance of where you train Link.
Doing well in school, taking advantage of all the opportunities available to you for research, letters, etc that is the most important thing you can do wherever you go to school. Attending a highly regarded school will make these opportunities easier to find as they are generally more available to students. You guys are right about the USMLE, Harvard or Eastern Virginia, you still have to put in the work to get a great score. Ultimately everyone must sit down with the final cost analysis, after any aid, and figure out what school is the best fit for them and determine their own cost-benefit analysis of the $$ difference between them.
Trying to get a great letter of rec from a 4 week block away rotation vs being involved with the department for years, who gets the edge on that? I think you know.😉
Once you are in your chosen residency and find yourself looking for a great job or a very competitive fellowship you will discover that where you train is critically important. Much more important than where you went to school. There is great variability in Resident quality and training between programs, though they all have to meet minimum standards to be accredited. Everyone who works with residents from different programs or hires new staff knows that. Do you want a program that just meets the minimum numbers, our one that doubles and triples them, or more. Great residencies usually produce superior clinicians. For specialty fields, surgery, anesthesia, etc. consistent exposure to very complex pathology is critical for superior clinical training. It's what separates the men from the boys. Exposure to these cases varies greatly from hospital to hospital. If your medical center has many nationally and globally known faculty, these cases come to you every day, at the community hospital you're never going to see some of those cases, they'll never go there. You might see one at an out rotation though.🙄 Becoming comfortable with the tough cases makes you a better clinician and gives you more experience with managing disasters, even if you don't do those kind of complex cases again as an attending.
When it's time to use your Resident/fellowship alumni network to help score the great job etc. having the connections from a program known to produce superior clinicians is pure gold. No, it's platinum. Obviously (?) some jobs are much better than others. There's infinite variability. Location, money, vacation time, leadership, reputation, colleagues it's all variable. Nobody wants to work in a crappy location, understaffed, overworked, and full of Medicaid and no pay patients. I'll take the wealthy suburban hospital with mostly privately insured patents, thanks. Good luck working at the best places with the best groups with a shady residency and no fellowship on your CV. You won't get a call back.
Of note, superior residencies and fellowships are not always associated with the same top 20 major medical centers we all know. It's very field specific, and can change rapidly with the addition or loss of a few key faculty. And there are plenty of regionally known programs that consistently turn out superior clinicians that have no trouble landing competitive jobs and fellowships. You have to do your homework.
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45408
Again, if you're big on research-oriented academic programs and want to end up in a prestigious cemetery some day, then you should stay with those. Otherwise, I think it matters a lot less.
