Institution Choice Anxiety

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NeuroRed

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Hi all,

I've been having a lot of anxiety regarding a critical decision I made several years prior.

When I was a senior in high school, I received admission to a school that now ranks among the Top 3 public universities in the United States. Although I did receive a small scholarship (several thousand), it would have put me into significant debt. I instead opted for a much smaller school (which ranks between 150-200) that was generous enough to endow me with a full-tuition merit scholarship. I would not like to understate how grateful I always was for this.

At the time, I thought it was a great idea to minimize debt for medical school, with the assumption that I would do well enough to matriculate into a T20 MD school.

I would like to make a point that I am a 1st generation American, as well as the 1st in my family in 3+ generations to even attend college. Attending a prestigious university is deeply personal life goal of mine -- I don't mean to portray an element of narcissism.

Thus far, I have fulfilled that assumption academically (GPA is 3.98; I am a Junior and have finished all Pre-Reqs, currently excelling in many upper-division science courses), but fear that I doomed myself to stagnate extracurricularlly. I have an ever-present fear that no matter how hard I work to attain objective standards (high GPA and MCAT), I will always be overshadowed by those who were able to attend elite undergraduate institutions and develop their own subjective "uniqueness". I have activities, but none of them have a particular "Wow" Factor (high ranking internship, research with someone / somewhere famous, starting a non-profit, etc.). Even worse, I feel that COVID-19 will ultimately benefit those who attend high-ranking institutions and can leverage their connections to secure what remains of extracurricular positions.

My question is: how do I overcome these anxieties? No matter what I tell myself -- "Medical schools won't care about school ranking" -- I can't shake these feelings. I feel like I've clipped my own wings.

Any perspective on this topic is appreciated -- I'm just looking for opinions other than the ones I've been bouncing around in my own head.

Cheers.

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Hi all,

I've been having a lot of anxiety regarding a critical decision I made several years prior.

When I was a senior in high school, I received admission to a school that now ranks among the Top 3 public universities in the United States. Although I did receive a small scholarship (several thousand), it would have put me into significant debt. I instead opted for a much smaller school (which ranks between 150-200) that was generous enough to endow me with a full-tuition merit scholarship. I would not like to understate how grateful I always was for this.

At the time, I thought it was a great idea to minimize debt for medical school, with the assumption that I would do well enough to matriculate into a T20 MD school.

I would like to make a point that I am a 1st generation American, as well as the 1st in my family in 3+ generations to even attend college. Attending a prestigious university is deeply personal life goal of mine -- I don't mean to portray an element of narcissism.

Thus far, I have fulfilled that assumption academically (GPA is 3.98; I am a Junior and have finished all Pre-Reqs, currently excelling in many upper-division science courses), but fear that I doomed myself to stagnate extracurricularlly. I have an ever-present fear that no matter how hard I work to attain objective standards (high GPA and MCAT), I will always be overshadowed by those who were able to attend elite undergraduate institutions and develop their own subjective "uniqueness". I have activities, but none of them have a particular "Wow" Factor (high ranking internship, research with someone / somewhere famous, starting a non-profit, etc.). Even worse, I feel that COVID-19 will ultimately benefit those who attend high-ranking institutions and can leverage their connections to secure what remains of extracurricular positions.

My question is: how do I overcome these anxieties? No matter what I tell myself -- "Medical schools won't care about school ranking" -- I can't shake these feelings. I feel like I've clipped my own wings.

Any perspective on this topic is appreciated -- I'm just looking for opinions other than the ones I've been bouncing around in my own head.

Cheers.
Well, I'm in a similar situation. The bottom line is to try not to dwell on things you can't control. Several people here have given me the same advice. It's easier for me to say it to you than to follow it myself. :cool:

Medical schools definitely care about UG prestige. The question is "how much?" and the answer varies. Top 3 public is nowhere near T3, so you didn't give up as much as you think, although T150-200 might as well be T3,000. You wisely spared yourself significant debt not to chase a name, and now you are in a GREAT position, maybe not to attend T20, but to get a MD degree. So, you do your best, you take your shot, and maybe you sacrifice your deep personal goal, because, beyond doing your best, the decision is ultimately out of your hands.

Maybe a stupid question, but, if you could do it over again, would you do it differently? I ask not just to make you reflect on it, but also because you might be faced with that same decision again. If a much lower ranked MD school offered you significant money but a T20 didn't, just how deep is your goal to attend a prestigious university? $100,000 deep? $200,000 deep? $300,000 deep? More? That's also worth thinking about. I think about it all the time, and don't really know what I would do, but I HAVE been thinking about it. Your answer might help mitigate your anxiety.
 
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I’m sure it’s a factor but N=1, I got into Mayo without any prestigious work (at least in my opinion) and even any research experience. As long as your stats are good and you spend your time doing something meaningful, you definitely have a shot. I’m not saying stats are enough. You definitely need ECs but I don’t think you need “published 3 times” ECs. Meaningful volunteering or leadership plus deep self-reflection goes a long way.

I would also just caution about caring so much about the name (whether you’re 1st gen or not). I passed over Mayo for another school that was closer and don’t regret it a bit. I’ve had a great experience so far!

Edit: to speak more on selecting a school (assuming you have options), consider the schedule (some schools apparently have class from 8-5 which sounds miserable), location, and if you think you’ll enjoy the environment. It’s 4 years of your life and you don’t want to be miserable about it.
 
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Hi all,

I've been having a lot of anxiety regarding a critical decision I made several years prior.

When I was a senior in high school, I received admission to a school that now ranks among the Top 3 public universities in the United States. Although I did receive a small scholarship (several thousand), it would have put me into significant debt. I instead opted for a much smaller school (which ranks between 150-200) that was generous enough to endow me with a full-tuition merit scholarship. I would not like to understate how grateful I always was for this.

At the time, I thought it was a great idea to minimize debt for medical school, with the assumption that I would do well enough to matriculate into a T20 MD school.

I would like to make a point that I am a 1st generation American, as well as the 1st in my family in 3+ generations to even attend college. Attending a prestigious university is deeply personal life goal of mine -- I don't mean to portray an element of narcissism.

Thus far, I have fulfilled that assumption academically (GPA is 3.98; I am a Junior and have finished all Pre-Reqs, currently excelling in many upper-division science courses), but fear that I doomed myself to stagnate extracurricularlly. I have an ever-present fear that no matter how hard I work to attain objective standards (high GPA and MCAT), I will always be overshadowed by those who were able to attend elite undergraduate institutions and develop their own subjective "uniqueness". I have activities, but none of them have a particular "Wow" Factor (high ranking internship, research with someone / somewhere famous, starting a non-profit, etc.). Even worse, I feel that COVID-19 will ultimately benefit those who attend high-ranking institutions and can leverage their connections to secure what remains of extracurricular positions.

My question is: how do I overcome these anxieties? No matter what I tell myself -- "Medical schools won't care about school ranking" -- I can't shake these feelings. I feel like I've clipped my own wings.

Any perspective on this topic is appreciated -- I'm just looking for opinions other than the ones I've been bouncing around in my own head.

Cheers.
You don't need to win the Nobel Prize or cure cancer. Just do what you love and love what you do.
 
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I feel you’re falling into a pitfall a lot of us first-gens go through - no matter how hard we work there’s always the person who has more money, privilege etc. that will be by default, “better”. Unfortunately it is no lie that better outcomes can be somewhat skewed towards those from elite colleges, although that’s not the be-all-end-all of med school admissions. You’ve done a fantastic job so far — don’t cut yourself short! You still have quite some time to go as well, and time to set yourself up for a competitive MCAT.
Remember, first-gen status is always a boost on apps. I was also browsing through another thread that brought up the AMCAS app asks how much scholarship money you received. Basically, put down your amount of a full scholarship and an adcom can more or less deduce that you were likely competitive for top schools but obviously chose a free ride.
Your extracurriculars don’t sound too shabby either. I would highly recommend starting to think about crafting your personal statement towards a goal in medicine and how your extracurriculars can tie into it to build a narrative. In my opinion that shows motivation like no other and makes you more “unique” even with relatively common experiences. Remember when you are applying, that individual schools will also want individualized responses (through secondaries, interview questions etc.) in why you want to attend and how you will succeed at that particular school. Of course saying the school is prestigious or something generic like “there are a lot of opportunities here” is not a great answer. Ask yourself what your goals really are in medicine.
I don’t want to tell you what or how to think, but chasing a status will leave you constantly exhausted and disappointed. There’s always going to be the person who got into Harvard, then the person who got a full scholarship to Harvard, then someone like Jonathan Kim... you get the point. Wouldn’t make you anything less of a fantastic physician.
I humbly say this as someone who got into what’s considered top schools from a no-name public school (and I know several others who did the same! Don’t be discouraged!).
 
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The prestige of one’s undergraduate school matters, but certainly is not dispositive. At the top medical schools, you will see a lot of people from top colleges, but you will also see a lot of people that did not attend a top school. Work hard at making yourself a great doctor and let the chips fall where they may. That way, regardless of how much prestige you attain, you will have enjoyed the journey. I will leave you with this old corny saw: Do you know what they call the person who graduated last from the worst medical school in the country? Doctor.
 
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To be clear, is your anxiety here about whether you'll get into a top 20 MD program? Most pre-meds have anxiety about getting in anywhere; worrying about specifically going to one of the most elite programs is not a relatable problem. Not sure what you want us to say. Few applicants get into these schools and it is very possible you will not be one of them.
 
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Please don't neglect life outside of medicine. Do things you enjoy! If you spend all your time on activities that you think will impress an Ivy-League AdCom, and then don't get into a top-tier school, will you feel that you have wasted your undergrad years?
 
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You may think you are behind with the mid-tier UG, but in reality, being able to say “full-tuition scholarship award” at a mid-tier school is definitely impressive. On top of that, the only schools that would really help you prestige-wise are Harvard, Yale, Princeton, and Stanford. Going to UCLA/UCB/UMich for undergrad wouldn’t do as much for you.

In other words, saying “I received a full-tuition scholarship to Mich St“ might be just as cool, if not cooler, than saying “I went to UMich.”
 
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I’d argue that you have the ability to forge your own unique EC path at your public UG university than at a smaller elite private school. There are many top 10/20 med schools that prefer service and leadership over cutting edge research accomplishments. Many admins have often indicated here in SDN that research EC is more for the research experience, not the subject matter.
 
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You may think you are behind with the mid-tier UG, but in reality, being able to say “full-tuition scholarship award” at a mid-tier school is definitely impressive. On top of that, the only schools that would really help you prestige-wise are Harvard, Yale, Princeton, and Stanford. Going to UCLA/UCB/UMich for undergrad wouldn’t do as much for you.

In other words, saying “I received a full-tuition scholarship to Mich St“ might be just as cool, if not cooler, than saying “I went to UMich.”

Not true. U Mich Medical School, for example, accepts a lot of U Mich undergrads.
 
You may think you are behind with the mid-tier UG, but in reality, being able to say “full-tuition scholarship award” at a mid-tier school is definitely impressive. On top of that, the only schools that would really help you prestige-wise are Harvard, Yale, Princeton, and Stanford. Going to UCLA/UCB/UMich for undergrad wouldn’t do as much for you.

In other words, saying “I received a full-tuition scholarship to Mich St“ might be just as cool, if not cooler, than saying “I went to UMich.”
I LOVE this response, but please keep in mind Michigan State is NOT T150-200 (it's #80!). The US News rankings only contain 389 national universities. Is there really no difference between UCLA, the #1 ranked public, and Cal St - Fresno, Indiana University-Purdue University Indianapolis, Towson University, University of Puerto Rico-Rio Piedras, and University of Wyoming, all tied for #196? This is really what OP is asking.

The answer is, of course there is a difference, but UCLA isn't Harvard, he did receive the monetary benefit (nothing in life is free, after all!), and, most importantly, there is nothing to be gained by stressing over a decision made years ago that cannot be undone. For the record, I am in a similar boat, and do not consider my school "mid tier" by any reasonable definition of that term.

Maybe I'm a bit of a snob (although I certainly have no right to be!!! :)), but, to me, mid tier is T30-50, not T150-200! Sure, technically, anything around 195 is in the middle of a list containing 389 schools, but I don't think that's how most people look at the rankings. After T50 or so, there really is no more "prestige," other than whatever schools manufacture for marketing (e.g., the #1 school in Kutztown, PA! :)).
 
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Not true. U Mich Medical School, for example, accepts a lot of U Mich undergrads.
Kind of missing the point. UMich was simply an example of my more broad point—which is that a full tuition scholarship also looks great on an application, possibly just as good as a high tier school. I’m saying BROADLY, going to UMich will not really be a huge “prestige-factor” for Harvard SOM, Northwestern, or WashU. Certainly if you go to UMich, you may have a better shot at UMich SOM, so it may decrease your chances at one specific med school, but I don’t think that it will overall.
 
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Kind of missing the point. UMich was simply an example of my more broad point—which is that a full tuition scholarship also looks great on an application, possibly just as good as a high tier school. I’m saying BROADLY, going to UMich will not really be a huge “prestige-factor” for Harvard SOM, Northwestern, or WashU. Certainly if you go to UMich, you may have a better shot at UMich SOM, so it may decrease your chances at one specific med school, but I don’t think that it will overall.

My point (and this has been demonstrated by studies carried out by @efle of SDN using publicly available data) that a lot of the top tier medical schools favor their own undergrads. U Mich is one example but it's far from the only one. Harvard Med takes a ton of Harvard undergrads. And so on and so on.

And the adcoms from the elite medical schools that post here do seem to think undergrad prestige matters in that they feel that competition is fiercer at those undergrads in STEM.

Full tuition scholarships look great especially if they're given out by undergrad institutions that are already very highly regarded, e.g. Vanderbilt, to capture students who otherwise would have attended HYPSM.
 
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My point (and this has been demonstrated by studies carried out by @efle of SDN using publicly available data) that a lot of the top tier medical schools favor their own undergrads. U Mich is one example but it's far from the only one. Harvard Med takes a ton of Harvard undergrads. And so on and so on.

And the adcoms from the elite medical schools that post here do seem to think undergrad prestige matters in that they feel that competition is fiercer at those undergrads in STEM.

Full tuition scholarships look great especially if they're given out by undergrad institutions that are already very highly regarded, e.g. Vanderbilt, to capture students who otherwise would have attended HYPSM.
So, full tuition (or full ride) scholarships don't look so great if they're given out by undergrad institutions that are not very highly regarded, e.g. Alabama, to capture students who otherwise would have attended HYPSM? :laugh: :laugh: :laugh: :laugh: Exactly what is the source of your expertise on this point? @LizzyM stated otherwise, and she's actually an adcom at one of these elite schools.
 
Don't recall anyone ever saying that full rides to Bama are regarded the same as full rides to Vandy.

Which university has academically better prepared students?
 
Don't recall anyone ever saying that full rides to Bama are regarded the same as full rides to Vandy.

Which university has academically better prepared students?

Look at post #27 in the attached link. By the way, you participated in that thread, less than 3 hours after the referenced comment was made, less than a week ago, so your powers of recollection are quite limited. :cool:

Who said anything about comparing one full ride to another, or about comparing full tuition at one school to a full ride at another? You referenced full tuition at a school like Vandy as an alternative to HYPSM, and excluded undergrad institutions that are not very highly regarded. A T10 adcom disagrees with you, a premed. Keep arguing to try to salvage a point.
 
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Look at post #27.

Who said anything about comparing one full ride to another, or about comparing full tuition at one school to a full ride at another. You referenced full tuition at a school like Vandy as an alternative to HYPSM, and excluded undergrad institutions that are not very highly regarded. A T10 adcom disagrees with you, a premed. Keep arguing to try to salvage a point.

You have so much vested in this argument. I'll let have the final word, which I understand to be: the competitiveness of your undergrad student body doesn't matter when deciding how much weight to give your GPA.
 
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You have so much vested in this argument. I'll let have the final word, which I understand to be: the competitiveness of your undergrad student body doesn't matter when deciding how much weight to give your GPA.
Not at all. My die is cast. Convincing you one way or the other isn't going to do anything for my application. I'm just trying to do my part to reduce the amount of misinformation posted here for anyone else who might be reading this, now or in the future.

I'm going with the AAMC table stating that UG selectivity is a factor of "lowest importance," not "no importance," and with @LizzyM saying adcoms are very aware that people make UG choices for reasons other than prestige, like money. So, they look for other indicia, such as merit scholarships, at all tiers of schools, not just "undergrad institutions that are already very highly regarded, e.g. Vanderbilt," to determine who went to Alabama for the football and who went for the money and the honors college opportunities, research, etc. And then, who fully took advantage of those opportunities and performed at the level of someone who attended "undergrad institutions that are already very highly regarded, e.g. Vanderbilt."

My understanding is that top schools (really, all schools) are seeking to build the best class, not the best class from among the best UG schools, and that they are aware that there are literally thousands of people, spread throughout the country at all tiers of school, that could have gone T20 UG if money were no object, and that they would love to have them, assuming their applications are good enough, notwithstanding their failure to attend "undergrad institutions that are already very highly regarded, e.g. Vanderbilt."
 
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Not at all. My die is cast. Convincing you one way or the other isn't going to do anything for my application. I'm just trying to do my part to reduce the amount of disinformation posted here for anyone else who might be reading this, now or in the future.

I'm going with the AAMC table stating that UG selectivity is a factor of "lowest importance," not "no importance," and with @LizzyM saying adcoms are very aware that people make UG choices for reasons other than prestige, like money. So, they look for other indicia, such as merit scholarships, at all tiers of schools, not just "undergrad institutions that are already very highly regarded, e.g. Vanderbilt," to determine who went to Alabama for the football and who went for the money and the honors college opportunities, research, etc. And then, who fully took advantage of those opportunities and performed at the level of someone who attended "undergrad institutions that are already very highly regarded, e.g. Vanderbilt."

My understanding is that top schools (really, all schools) are seeking to build the best class, not the best class from among the best UG schools, and that they are aware that there are literally thousands of people, spread throughout the country at all tiers of school, that could have gone T20 UG if money were no object, and that they would love to have them, assuming their applications are good enough, notwithstanding their failure to attend "undergrad institutions that are already very highly regarded, e.g. Vanderbilt."

Word to the wise: individual schools or ad com members aren't required to believe in accordance with the received wisdom on these surveys.
 
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Look at post #27 in the attached link. By the way, you participated in that thread, less than 3 hours after the referenced comment was made, less than a week ago, so your powers of recollection are quite limited. :cool:

Who said anything about comparing one full ride to another, or about comparing full tuition at one school to a full ride at another? You referenced full tuition at a school like Vandy as an alternative to HYPSM, and excluded undergrad institutions that are not very highly regarded. A T10 adcom disagrees with you, a premed. Keep arguing to try to salvage a point.
Not to beat a dead horse, but this still completely disregards the factors that actually make top UGs more appealing and more likely to produce top tier MD applicants. I don't think anyone is arguing that the name of a school will make a difference, but many other factors do. Things like exponentially better research programs (usually school-specific that guarantee a poster/pub and independent project), high-achieving like-minded peers, better LORs, etc...all these things culminate in the end. These points seem to assume that students from each school will be identical (in which case the school name wouldn't matter and it would come down to interviews provided they got them in the first place) but this is not the norm.
 
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Word to the wise: individual schools or ad com members aren't required to believe in accordance with the received wisdom on these surveys.
Yes, of course. That goes both ways. They can do what they want. Some might prefer high achievers from no name schools to those from prestigious UGs with chips on their shoulders, regardless of their institution's or other adcoms' preference for those from name brand schools. So, let's grasp for n=1 exceptions to any data point we don't like. :cool:

By the way, no one is suggesting that anyone has to follow the wisdom of the survey. The point is that the survey represents the collective wisdom of those surveyed. So don't believe it. That's fine with me. The only question is, assuming from your posts that you attend an elite school with something less than a 4.0/528, how shocked will you be when someone from Alabama with better stats and ECs than you fares better than you in the admission lottery???
 
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Not to beat a dead horse, but this still completely disregards the factors that actually make top UGs more appealing and more likely to produce top tier MD applicants. I don't think anyone is arguing that the name of a school will make a difference, but many other factors do. Things like exponentially better research programs (usually school-specific that guarantee a poster/pub and independent project), high-achieving like-minded peers, better LORs, etc...all these things culminate in the end. These points seem to assume that students from each school will be identical (in which case the school name wouldn't matter and it would come down to interviews provided they got them in the first place) but this is not the norm.
Absolutely. The argument goes around and around. Nobody is denying that excellent candidates are disproportionately found at elite schools. The question is whether merely good candidates from prestigious schools edge out excellent candidates from lesser schools.

Some people do really well on the MCAT even when they come from low SES backgrounds without access to the best of everything. Similarly, some premeds do really well at no name schools, even without exponentially better research programs, high achieving peers, etc. The evidence that they are not summarily shut out isn't in the fact that Harvard UG is disproportionately represented in the T20. Rather, it is in the fact that those schools have any matriculants at all from lower tier schools, while the Ivies collectively send hundreds each year to DO, the Caribbean and reapplicant status. Look it up; it's true!! :cool:
 
Even schools that go for prestigious undergrad schools and that take many of their own thanks to BS/MD programs will end up recruiting from a large number of undergrad institutions.

See: Entering Class Profile

160 students from 57 undergrad institutions! (Also insanely high GPA and MCAT).
 
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Even schools that go for prestigious undergrad schools and that take many of their own thanks to BS/MD programs will end up recruiting from a large number of undergrad institutions.

See: Entering Class Profile

160 students from 57 undergrad institutions! (Also insanely high GPA and MCAT).
I believe this school takes around 20-25 thru BSMD only unlike Brown which our esteemed @Goro compares to Alabama trailer park :)
 
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I believe this school takes around 20-25 thru BSMD only unlike Brown which our esteemed @Goro compares to Alabama trailer park :)
Even so, her point remains. That's a lot, in addition to their regular premeds, to still be pulling from 57 different UGs, which by definition, even @Goro's :), is far beyond T20!!!
 
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Looks like lot of Vanderbilt fans here. Is it Peoria of medical school admissions?
 
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Even so, her point remains. That's a lot, in addition to their regular premeds, to still be pulling from 57 different UGs, which by definition, even @Goro's :), is far beyond T20!!!
Even our trailer park pulled from 56 UGs despite 40% from BSMD. Interesting stat is 41% from BSMD program but 60% had 1 or more gap years? so couple of 8 year BSMD program students took gap years or they are bad at math?

 
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Even our trailer park pulled from 56 UGs despite 40% from BSMD.

But, it doesn't count because it's not T20. :laugh: :laugh: :laugh: :laugh:

Seriously, this is exactly @LizzyM's point. Most schools' diversity extends to UGs. That's why this whole argument is kind of pointless. Elite schools definitely have an edge, but it is not absolute, and we have no way to know for sure whether it's because they have a disproportionate amount of superlative candidates, or whether merely decent candidates are deemed superlative by virtue of having a transcript from them.
 
I think it may be important to clarify: I am not denying that students at prestigious institutions are typically more intelligent, ambitious, and endowed with the opportunity to demonstrate their most positive qualities. I do not believe that I deserve a spot in a T20 by merit of my good grades alone -- it's obviously a competition. I didn't mean to insinuate that I don't have extracurriculars of my own ... I have many and I tie them into a very cohesive story about why I want to get into medicine. I understand the rat-race and put myself out there.

My fear stems from the face that any objective qualities (GPA, MCAT) of my application will be undermined by the subjective nature of the LoR and extracurricular prestige enjoyed by those who had attended a more prestigious institution, which I forewent due to financial reasons (which I inevitably had to do given my socioeconomic position; the alternative was to accept life-crippling debt). In other words, I fear that subjective standards will effectively overrule objective ones instead of complementing them, rendering all my hard work in vain.

My worst fear is that T20 admissions operate on a faux-meritocracy whereby the subjective quality of an applicant is used to justify accepting only the cream of the crop (who undoubtedly, will be dominated by generational pre-meds and other well-endowed groups that were groomed from a young age to take on this academic role) and the occasional, extraordinary, self-made star-student.

Otherwise, I sincerely appreciate everyone's input.
 
Treating medical school admissions like college admissions (T20 or bust) is a setup for mental instability and failure. Many students who consider themselves 'exceptional' (whether from having 3.8+/520+ or for whatever other reason) get denied from top medical schools - and medical school in general - all the time. Stop worrying about noise.
 
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My fear stems from the face that any objective qualities (GPA, MCAT) of my application will be undermined by the subjective nature of the LoR and extracurricular prestige enjoyed by those who had attended a more prestigious institution, which I forewent due to financial reasons (which I inevitably had to do given my socioeconomic position; the alternative was to accept life-crippling debt). In other words, I fear that subjective standards will effectively overrule objective ones instead of complementing them, rendering all my hard work in vain.

My worst fear is that T20 admissions operate on a faux-meritocracy whereby the subjective quality of an applicant
is used to justify accepting only the cream of the crop (who undoubtedly, will be dominated by generational pre-meds and other well-endowed groups that were groomed from a young age to take on this academic role) and the occasional, extraordinary, self-made star-student.

My question is: how do I overcome these anxieties? No matter what I tell myself -- "Medical schools won't care about school ranking" -- I can't shake these feelings. I feel like I've clipped my own wings.


There are several concerning things in your posts.
1) You are clearly tying your self-worth and value as a human being to getting into a T20 school. You haven't even taken the MCAT, right? If so, that will be a far greater determinant of where you end up as opposed to a some LORs or 250 hrs of working in a clinic. What if your only accept is at Drexel, Albany, EVMS or PCOM or Western, for that matter? Will you give up on Medicine???

2) This is a very human process and the quantifiable metrics (your stats) are the only ones that are truly quantifiable. EVERYTHING else is subjective. LizzyM thinks that working in a nursing home isn't patient contact, but I do. I may think that as an interviewer you were great, but Dr Smith thought you were terrible (leading the Adcom to ask us if we were in the same room with you). EVERYTHING except your class rank and Board scores are subjective, and so for the rest of your life, you'll be dependent upon subjective assessment of your career development (except publications and extramural grants, if you go that route.

3) All this is giving you anxiety. How are you going to handle medical school, which is a furnace??? How are you going to handle NOT being a doctor? 60% of applicants do not get accepted.
 
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I think it may be important to clarify: I am not denying that students at prestigious institutions are typically more intelligent, ambitious, and endowed with the opportunity to demonstrate their most positive qualities. I do not believe that I deserve a spot in a T20 by merit of my good grades alone -- it's obviously a competition. I didn't mean to insinuate that I don't have extracurriculars of my own ... I have many and I tie them into a very cohesive story about why I want to get into medicine. I understand the rat-race and put myself out there.

My fear stems from the face that any objective qualities (GPA, MCAT) of my application will be undermined by the subjective nature of the LoR and extracurricular prestige enjoyed by those who had attended a more prestigious institution, which I forewent due to financial reasons (which I inevitably had to do given my socioeconomic position; the alternative was to accept life-crippling debt). In other words, I fear that subjective standards will effectively overrule objective ones instead of complementing them, rendering all my hard work in vain.

My worst fear is that T20 admissions operate on a faux-meritocracy whereby the subjective quality of an applicant is used to justify accepting only the cream of the crop (who undoubtedly, will be dominated by generational pre-meds and other well-endowed groups that were groomed from a young age to take on this academic role) and the occasional, extraordinary, self-made star-student.

Otherwise, I sincerely appreciate everyone's input.
This spurred a good conversation and it’s great to be concerned about how the institutions in our nation function, but I agree that it seems like you have a lot of developing to do.

Life isn’t fair and there’s a lot in this world that does not work the way it is supposed to be working. It’s okay to have dreams but the way you’re using your words, it appears that you’re too invested in something that is honestly not that important. Attending a T20 med school as opposed to another is not something to fear. I don’t really know you so I might be off the mark but just a word of caution: keep priorities in check.
 
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Even schools that go for prestigious undergrad schools and that take many of their own thanks to BS/MD programs will end up recruiting from a large number of undergrad institutions.

See: Entering Class Profile

160 students from 57 undergrad institutions! (Also insanely high GPA and MCAT).
57 undergrad institutions! By definition, at least 37 of these are not "top 20" :)
 
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Even when it comes to medical school choice, there are some who will attend state school rather than a more expensive "top tier" school. There were one or two in my class who turned down Harvard for financial reasons (and ended up in the Harvard system as residents or attendings later).
 
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57 undergrad institutions! By definition, at least 37 of these are not "top 20" :)
As @Goro says there are 30 T20 schools. USNWR has separate rankings for research , primary care and then there are other ranking systems.
 
All I Know is I have this same fear I turned down NYU that would've put me in 350,000+ debt to stay close to home on full scholarship and go to a school ranked in the 170-200 range on US News. My only hope is that the MCAT is the real equalizer.
MCAT and ECs. If you are interested in research, try for good summer research programs.
 
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All I Know is I have this same fear I turned down NYU that would've put me in 350,000+ debt to stay close to home on full scholarship and go to a school ranked in the 170-200 range on US News. My only hope is that the MCAT is the real equalizer.
Get a 4.0 at Kutztown State and have a decent MCAT and ECs, and you will be a doctor.

And whether you go to med school at ACOM or Yale, U HI or Harvard, U WA or Miami, you'll all end up making the same salaries as attendings.
 
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What a stressful situation. We should do a big group activity to help you calm down. Maybe we can get together and lock up the entirety of US News and World Report in a box and just chuck it into the ocean?

To be clear to mods: I am not advocating violence. We would do this by convincing them of the value of being inside the giant box, which would be well-stocked with a lifetime of amenities but does not permit communication with the outside world or publishing lists for the neurotic.
 
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What a stressful situation. We should do a big group activity to help you calm down. Maybe we can get together and lock up the entirety of US News and World Report in a box and just chuck it into the ocean?

To be clear to mods: I am not advocating violence. We would do this by convincing them of the value of being inside the giant box, which would be well-stocked with a lifetime of amenities but does not permit communication with the outside world or publishing lists for the neurotic.
What about PD report? :)
 
Get a 4.0 at Kutztown State and have a decent MCAT and ECs, and you will be a doctor.

And whether you go to med school at ACOM or Yale, U HI or Harvard, U WA or Miami, you'll all end up making the same salaries as attendings.

That is very true about making the same salaries, whether you are T30 or regular MD or DO it probably doesn't matter much.

Where the Top 30 schools make a difference is mainly in three areas.

1. if you want to be academic superstar and land up being the chairman of a department at a medical college, you are better off having graduated from a top 30 school.

2. Getting into residencies, especially with the step I USMLE going pass/fail, will probably be easier from a T30 school when it comes to prestigious residency programs and also more sought after specialties (radiation oncology, dermatology, orthopedics, ENT, opthalmology, urology, plastic surgery etc)

3. Research is divided into 3 areas-- clinical, translational and basic science. Mainly translational science and basic science research is much easier to get in T30 programs. Harvard for instance has 3 times research funding as any other comparable medical school.
 
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