High School Rank or High USMLE Step 1

[Nommonnom]

Suppose you have the option between going to a low cost, rank 100 type school in a minor metropolitan area and a high cost rank 20 type school in a major metropolitan area. Because of your personal preferences and study habits, your step 1 score will be approximately 10 points higher at the lower cost lower rank school than it would be at the high cost rank 20 type school. Which school is better for residency placement and which school would you choose to attend?

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[samac]

. . . Wat?

I can't even guarantee my board scores as a second year, so I have no idea how I would be able to pick a school based on board scores.

Any decision I make would be based on cost and location. Lower cost better location would win for me.

 

[ScottTenorman54]

I definitely read this as a question about the ranking of my high school

 

[Nommonnom]

Its a hypothetical, just assume you know yourself well and that is what will happen.

 

[samac]

I definitely read this as a question about the ranking of my high school

I did too at first.
I read it as a comparison of high school rank vs board scores and thought SDN had hit a new all time low.

 

[Nommonnom]

I definitely read this as a question about the ranking of my high school

I added an option for you guys.

 

[samac]

Its a hypothetical, just assume you know yourself well and that is what will happen.

Nope. If you're trying to make a decision, which it appears to be what you're doing, that's not the deciding factor.
Higher board scores are always better. That's about all I can say.

 

[Nommonnom]

Nope. If you're trying to make a decision, which it appears to be what you're doing, that's not the deciding factor.
Higher board scores are always better. That's about all I can say.

Then assume you have really poor judgment and roll with it. You can always pick the high school option if it's calling to you.

 

[CyrilFiggis]

Why is this a thing? Every residency program director in every specialty has a different standard that they ascribe to certain criteria. If you look through the NRMP's 2014 Program Director Survey, you'll see that for the all specialties, only 48% of directors in those programs cited "Graduate of highly regarded medical school" as a contributing factor to interview and only 36% for ranking. That's in comparison to 94% of directors citing STEP 1 scores as being a contributing factor. This is why we all want high board scores, but I posit that a school's preparation for STEP 1 is less important than the student's individual prep.

 

[Nommonnom]

Why is this a thing? Every residency program director in every specialty has a different standard that they ascribe to certain criteria. If you look through the NRMP's 2014 Program Director Survey, you'll see that for the all specialties, only 48% of directors in those programs cited "Graduate of highly regarded medical school" as a contributing factor to interview and only 36% for ranking. That's in comparison to 94% of directors citing STEP 1 scores as being a contributing factor. This is why we all want high board scores, but I posit that a school's preparation for STEP 1 is less important than the student's individual prep.

Those data points go more to getting a residency than quality of residency unfortunately.

 

[Doggo]

Why is this a thing? Every residency program director in every specialty has a different standard that they ascribe to certain criteria. If you look through the NRMP's 2014 Program Director Survey, you'll see that for the all specialties, only 48% of directors in those programs cited "Graduate of highly regarded medical school" as a contributing factor to interview and only 36% for ranking. That's in comparison to 94% of directors citing STEP 1 scores as being a contributing factor. This is why we all want high board scores, but I posit that a school's preparation for STEP 1 is less important than the student's individual prep.

Woah, 48% seems really high for the "highly regarded med school" factor (I'm not doubting your data I'm just surprised). I thought med school education was more standardized.

 

[libertyyne]

How do you even evaluate residency placement to differentiate these schools? Reading match lists? Also are you adjusting the High USMLE scores for the High MCAT scores that the schools have ?

 

[Nommonnom]

How do you even evaluate residency placement to differentiate these schools? Reading match lists? Also are you adjusting the High USMLE scores for the High MCAT scores that the schools have ?

It's a hypothetical regarding a single individual who will have higher USMLE scores at a particular school which is lower ranked. The residency part is phrased about expectation about better placement (dependent variable) and is with respect to the same single individual just varying the school and USMLE score (independent variable).

 

[Nommonnom]

So far the vote is tied between it being a question about high schools and a question about medical schools. Make your voice heard!

 

[Goro]

Indeed. Trying to interpret a match list is pretty much a fool's errand.

How do you even evaluate residency placement to differentiate these schools? Reading match lists? Also are you adjusting the High USMLE scores for the High MCAT scores that the schools have ?

 

[IsleyOfTheNorth]

Because of your personal preferences and study habits, your step 1 score will be approximately 10 points higher at the lower cost lower rank school than it would be at the high cost rank 20 type school.

Why would a lower ranked school give you a better USMLE score or affect your study habits? Why couldn't you use the same study habits at a higher-ranked school?

 

[efle]

Please don't use either of these two things as your deciding factor

 

[mmmcdowe]

Go where you will be happier. That will be what most impacts your step 1 and grades.

 

[Doggo]

Can someone talk about how much Residency Directors care about med school prestige?

 

[libertyyne]

Can someone talk about how much Residency Directors care about med school prestige?

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

 

[aldol16]

You can't really talk about residency placement because first, there is an incredible amount of incest between med programs and their schools' residencies and second, many more factors go into residency placement than simple rank. If you're deciding where to go for residency at that point in your life based only on rank, then you're probably doing life wrong.

 

[Doggo]

http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf

Thanks.

So I guess going to a brand name school is on average statistically more important than volunteering and research

 

[efle]

Thanks.
View attachment 211490
So I guess going to a brand name school is on average statistically more important than volunteering and research

It varies a lot with specialty too, the percent citing it ranges from like the 20s to the 70s

I'm sure there is also a difference between the big competitive academic centers in cities vs community/rural/etc

 

[sliceofbread136]

Why is this a thing? Every residency program director in every specialty has a different standard that they ascribe to certain criteria. If you look through the NRMP's 2014 Program Director Survey, you'll see that for the all specialties, only 48% of directors in those programs cited "Graduate of highly regarded medical school" as a contributing factor to interview and only 36% for ranking. That's in comparison to 94% of directors citing STEP 1 scores as being a contributing factor. This is why we all want high board scores, but I posit that a school's preparation for STEP 1 is less important than the student's individual prep.

Wrong way of thinking about it. This isn't the importance of step 1 overall, but of simply 10 points on step 1.

This question depends on a lot of variables. What specialty are we looking at? What region is the school? Is it a 200 vs 210, 230 vs 240, 260 vs 270 etc etc.

Really impossible to say.

 

[sliceofbread136]

You can't really talk about residency placement because first, there is an incredible amount of incest between med programs and their schools' residencies and second, many more factors go into residency placement than simple rank. If you're deciding where to go for residency at that point in your life based only on rank, then you're probably doing life wrong.

Plenty of people put a lot of stock into the prestige of their residency choices. Why would there be anything wrong with that?

 

[Nommonnom]

Plenty of people put a lot of stock into the prestige of their residency choices. Why would there be anything wrong with that?

The concept of the question is which option will give the person the widest range of residency options.

 

[Nommonnom]

Wrong way of thinking about it. This isn't the importance of step 1 overall, but of simply 10 points on step 1.

This question depends on a lot of variables. What specialty are we looking at? What region is the school? Is it a 200 vs 210, 230 vs 240, 260 vs 270 etc etc.

Really impossible to say.

The concept of the question was that the 10 points won't impact the ability to place somewhere, but may limit options as to where the person places.

 

[sliceofbread136]

Thank you for so thoroughly explaining the concept of the question.

Doesn't really affect what I said, but still thanks!

 

[aldol16]

Plenty of people put a lot of stock into the prestige of their residency choices. Why would there be anything wrong with that?

I didn't say "if you put a lot of stock into the prestige of your residency choices, then you're doing life wrong." Prestige can be a factor. But if it's your only factor, then you're doing life wrong. That's just my opinion.

 

[sliceofbread136]

I didn't say "if you put a lot of stock into the prestige of your residency choices, then you're doing life wrong." Prestige can be a factor. But if it's your only factor, then you're doing life wrong. That's just my opinion.

there are a lot of ambitious people out there, I try not to judge their life choices

And if there is ever a time to go for prestige then it is residency. Higher career impact than med school and undergrad combined

 

[libertyyne]

there are a lot of ambitious people out there, I try not to judge their life choices

And if there is ever a time to go for prestige then it is residency. Higher career impact than med school and undergrad combined

Does it though? I mean i would love to train at a prestigious institution, but wouldnt going to medical school there be equally effective? Plus Employers probably dont care where you went to residency for compared to what field you completed your residency in. I bet an employer doesnt care if you completed your Derm residency at Harvard or at X state school, all they want is a dermatologist that are short in supply.

 

[aldol16]

there are a lot of ambitious people out there, I try not to judge their life choices

And if there is ever a time to go for prestige then it is residency. Higher career impact than med school and undergrad combined

Of course. But at that stage in your life, there are most likely many other factors to consider. Some of them being location of family/significant other, simply where you want to be for the next 3, 4, 5, 6, etc. years of your life, etc. This is the problem with talking about something like residency placement with pre-medical students. Most pre-medical students and even medical students are in the 20-24 age range and at that age, it really is all about you. You can choose medical schools solely based on your wants and desires. It's hard to imagine doing anything but what you want. But once you get to those upper twenties, early thirties age range, it becomes more... complicated. Wife/husband, children, family, etc. become important considerations. Especially when those people aren't in medicine - it's very difficult to uproot a home to go somewhere else because the significant other has to find a job as well. But maybe at that stage in your life, you're not there yet. If so, then you have the luxury of making those decisions based only on you. I guess it's because I'm non-traditional and am a career-changer that makes me think about all of these things. They're more important to me than prestige - by a long shot.

 

[sliceofbread136]

Of course. But at that stage in your life, there are most likely many other factors to consider. Some of them being location of family/significant other, simply where you want to be for the next 3, 4, 5, 6, etc. years of your life, etc.

Many people are single. 3 years really isn't that long in the grand scheme of things. Ran into multiple residents on the peds trail who said they just went to the highest rank place they could.

 

[aldol16]

Many people are single. 3 years really isn't that long in the grand scheme of things. Ran into multiple residents on the peds trail who said they just went to the highest rank place they could.

See my edit above. Yeah, if you're single, you have that luxury. But a larger and larger proportion of the people around you in medicine are married or in long-term relationships the older you get. That's just a fact of life. A few of my high school friends married out of high school. More married out of college. Many more married while I was in graduate school. I myself am in a long-term relationship. So that's why I think the way I do.

 

[libertyyne]

Of course. But at that stage in your life, there are most likely many other factors to consider. Some of them being location of family/significant other, simply where you want to be for the next 3, 4, 5, 6, etc. years of your life, etc. This is the problem with talking about something like residency placement with pre-medical students. Most pre-medical students and even medical students are in the 20-24 age range and at that age, it really is all about you. You can choose medical schools solely based on your wants and desires. It's hard to imagine doing anything but what you want. But once you get to those upper twenties, early thirties age range, it becomes more... complicated. Wife/husband, children, family, etc. become important considerations. Especially when those people aren't in medicine - it's very difficult to uproot a home to go somewhere else because the significant other has to find a job as well. But maybe at that stage in your life, you're not there yet. If so, then you have the luxury of making those decisions based only on you. I guess it's because I'm non-traditional and am a career-changer that makes me think about all of these things. They're more important to me than prestige - by a long shot.

Wow @aldol16, we actually agree on something.

 

[sliceofbread136]

See my edit above. Yeah, if you're single, you have that luxury. But a larger and larger proportion of the people around you in medicine are married or in long-term relationships the older you get. That's just a fact of life. A few of my high school friends married out of high school. More married out of college. Many more married while I was in graduate school. I myself am in a long-term relationship. So that's why I think the way I do.

That's fine, doesn't mean others are "doing life wrong". I'd say most residencies are 50/50 married/singles, atleast in peds

 

[aldol16]

That's fine, doesn't mean others are "doing life wrong". I'd say most residencies are 50/50 married/singles, atleast in peds

Your definition of "wrong" and mine don't have to coincide.

 

[sliceofbread136]

Your definition of "wrong" and mine don't have to coincide.

Haha, be sure to let your single resident colleagues know what you think when you there. I'm sure they'll be very happy to hear your relationship views

 

[aldol16]

Haha, be sure to let your single resident colleagues know what you think when you there. I'm sure they'll be very happy to hear your relationship views

I don't converse casually with people who can't accept there are views other than their own.

 

[CyrilFiggis]

Wrong way of thinking about it. This isn't the importance of step 1 overall, but of simply 10 points on step 1.

This question depends on a lot of variables. What specialty are we looking at? What region is the school? Is it a 200 vs 210, 230 vs 240, 260 vs 270 etc etc.

Really impossible to say.

Whatever. It still doesn't address why initial question which is, why do even care? 10 points is not a do-or-die for an applicant. For the majority of specialties - outside of ENT, Derm, Rad Onc, Neuro Surg - The SD for matched applicants is 10 points or greater. And honestly those bounds are going to be affected more by the 20 other criteria the program is looking at.

 

[Nommonnom]

Whatever. It still doesn't address why initial question which is, why do even care? 10 points is not a do-or-die for an applicant. For the majority of specialties - outside of ENT, Derm, Rad Onc, Neuro Surg - The SD for matched applicants is 10 points or greater. And honestly those bounds are going to be affected more by the 20 other criteria the program is looking at.

How many point difference would it take for you to care? About 1/3 of people here so far think 10 pts is significant. What amount of points do you think would be significant?

 

[libertyyne]

Ok, I am thoroughly confused. USMLE score is independent of the school you go to so that should be eliminated form the options, then you state that lower rank school is still able to provide you with better residency placement. Are you asking if going to a higher ranked school will provide you with better chances of better residency placement?

 

[Nommonnom]

Ok, I am thoroughly confused. USMLE score is independent of the school you go to so that should be eliminated form the options, then you state that lower rank school is still able to provide you with better residency placement. Are you asking if going to a higher ranked school will provide you with better chances of better residency placement?

First Post:
Suppose you have the option between going to a low cost, rank 100 type school in a minor metropolitan area and a high cost rank 20 type school in a major metropolitan area. Because of your personal preferences and study habits, your step 1 score will be approximately 10 points higher at the lower cost lower rank school than it would be at the high cost rank 20 type school. Which school is better for residency placement and which school would you choose to attend?

 

[libertyyne]

First Post:
Suppose you have the option between going to a low cost, rank 100 type school in a minor metropolitan area and a high cost rank 20 type school in a major metropolitan area. Because of your personal preferences and study habits, your step 1 score will be approximately 10 points higher at the lower cost lower rank school than it would be at the high cost rank 20 type school. Which school is better for residency placement and which school would you choose to attend?

Thanks. Why wouldn't you go to the school where you would be able to perform better? How are you accurately predicting your step performance?

 

[Nommonnom]

Thanks. Why wouldn't you go to the school where you would be able to perform better? How are you accurately predicting your step performance?

Well that's the question, will performing better by 10 points lead to a better result or does school overwhelm the performance difference. Most people seem to think school matters more apparently.

I chose 10 points because it seemed like a reasonable performance difference based on one school favoring one style of learning over another.

 

[libertyyne]

Well that's the question, will performing better by 10 points lead to a better result or does school overwhelm the performance difference. Most people seem to think school matters more apparently.

I chose 10 points because seemed like a reasonable performance difference based on one school favoring one style of learning over another.

Is the curriculum TBL or something?

 

[Nommonnom]

Is the curriculum TBL or something?

Haha, it's a hypothetical! If TBL is good or bad for you use that as the reason the step 1 will be different!

 

[libertyyne]

Haha, it's a hypothetical! If TBL is good or bad for you use that as the reason the step 1 will be different!

higher ranked schools apparently matter more then research, so I would do that, there is variation in step scores, also higher ranked schools tend to have better step scores compared to their peers on average. Provided the COA difference isnt more than 10K per year.

 

[Nommonnom]

higher ranked schools apparently matter more then research, so I would do that, there is variation in step scores, also higher ranked schools tend to have better step scores compared to their peers on average. Provided the COA difference isnt more than 10K per year.

Yeah I would have emphasized cost more in the question, but I was at the character limit. I don't think anyone read the first post.

I was thinking more like a 40k/year difference.

 

[libertyyne]

Yeah I would have emphasized cost more in the question, but I was at the character limit. I don't think anyone read the first post.

I was thinking more like a 40k/year difference.

Thats the problem, COA at differences like this become larger considerations IMHO.