Is it harder to do well in higher ranked med. schools?

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I may have read prior posts incorrectly, but I don't think anyone was actually trying to make such a sweeping statement. It is an entirely reasonable theory that the student populations are overlapping bell curves in which case the bottom kid at the top school isn't performing as well in his/her classes as the top kid from the "lesser" school.

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"The top schools don't work their students as hard as the lower ranked schools. From what I've heard, I'd rather have someone who went to a lower ranked school taking care of me than some Harvard-educated kid who rode the school name to a top residency. "

this was the point i took issue with. maybe he wasn't speaking generally, but more in terms of a few kids here and there, in which case i'm sure there are a few who slack off in all schools (top and lower ranked both). it just seemed like he was saying that docs coming from lower ranked schools are inherently better, which i think is a ridiculous statement to make.
 
i don't see anyone slacking off now that they are here - most people seem to have either continued the undergrad work ethic that got them here or have stepped their effort up compared to undergrad.

If ANY people at your school are "continuing the undergrad work ethic" as opposed to "stepping their effort up compared to undergrad", then there are people at your school who probably aren't working that hard compared to other schools, and you are perhaps seeing what I observed in law. Most people I've come across have to work a heck of a lot harder in med school than undergrad.
 
i'm sure there are a few who slack off in all schools (top and lower ranked both).

Again, this probably doesn't happen as much at the schools who are unafraid to fail people and make them retake courses as it does at the top schools at which F's are never given. Self preservation is one of the greatest motivators.
 
If ANY people at your school are "continuing the undergrad work ethic" as opposed to "stepping their effort up compared to undergrad", then there are people at your school who probably aren't working that hard compared to other schools, and you are perhaps seeing what I observed in law. Most people I've come across have to work a heck of a lot harder in med school than undergrad.

Talk about a generalization. What about those kids who were triple majors, athletes, etc etc etc? Some kids worked insanely hard in undergrad. That is probably part of the reason they ended up at top schools. There is nothing to say medical school has to be much harder if someone worked their tail off in undergrad with tons of hours and 8 million ECs. I had a buddy in Ugrad who did his bachelors + masters in nuclear engineering, worked as a paid researcher for the nuclear engineering department, had like 4 minors, and did a lot of EC stuff, esp. with music. He had to get special permission every single semester to take all the hours he was taking. He did all this in 4 years. He is now doing med school and dental school. Think school is harder for him now? I seriously doubt it. Or what about the kid in my class who started college at 15, went through a very prestigious university in two years, and just celebrated his 18th bday in November of his first year in med school. At top schools [and I would guess ALL med schools] there are people who will probably be working the same as they did in undergrad. Even I think med school is easier than undergrad in some respects. I have WAAAAY less BS to deal with. In undergrad, I had to go to all those pointless classes and pointless labs. I would be taking rigorous science courses and doing research, and then the proff of some required class would schedule a group project or something that would always end up as a nightmare for me. Try maintaining a 4.0 at a state school when you're assigned a 30 page group paper and some of your group members turn in like 2.5 pages of complete gargabe. I don't have to deal with any of that stuff here. And when I do work with my classmates, they are all very smart, considerate, polite, and thoughtful. I don't have to go to class if I don't want. I don't have to go to lab if I don't want [I am in the minority of students who do not attend gross anatomy lab]. So I have a lot more to learn, but in some respects it is easier.

Point: your generalization about students at top schools is pretty silly.
 
at the top schools at which F's are never given.

Top schools do fail people. Or I know Duke will. But it is actually pretty hard to fail here. Why? B/c they provide the resources to make sure if you want to pass, you will pass. We have free tutors [and you do not have to be failing to use them]. We all have Dean's groups, so there is someone high up in administration who knows each of us personally and who we could turn to for advice, help, etc. If you engage yourself in the program here, you will not fail. Does that mean Duke takes it easy on us? No, not at all. It just means we have a good program designed to support us and make sure we have the resources to become the physicians we want to be.

Maybe it is different at other schools, but that is just my experience at Duke. I am under no illusion that I can make failing grades and not fail here.
 
Top schools do fail people. Or I know Duke will. But it is actually pretty hard to fail here. Why? B/c they provide the resources to make sure if you want to pass, you will pass. We have free tutors [and you do not have to be failing to use them]. We all have Dean's groups, so there is someone high up in administration who knows each of us personally and who we could turn to for advice, help, etc. If you engage yourself in the program here, you will not fail. Does that mean Duke takes it easy on us? No, not at all. It just means we have a good program designed to support us and make sure we have the resources to become the physicians we want to be.

Maybe it is different at other schools, but that is just my experience at Duke. I am under no illusion that I can make failing grades and not fail here.

There are certain top schools where no one in the history of the school has ever failed or had to repeat a course and all the students know that the worst that can happen is having to have a chat with someone. So rather than P/F they have P.
 
There are certain top schools where no one in the history of the school has ever failed or had to repeat a course and all the students know that the worst that can happen is having to have a chat with someone. So rather than P/F they have P.

Interesting. I'll have to hand it to you and say I did not know that.
 
There are certain top schools where no one in the history of the school has ever failed or had to repeat a course and all the students know that the worst that can happen is having to have a chat with someone. So rather than P/F they have P.

i'm just curious which schools do this. i definitely know that you can fail at washu and duke, i am just curious which schools won't fail anyone? (its not that i don't believe you, i am just genuinely interested).

and about your above post about people who might be "continuing their undergrad work ethic" at med school - when i said that i was referring to the type of people who absolutely worked their tail off in undergrad to get here. they are just continuing to work their tail off here. i know there are people here who didn't work all that hard in undergrad who have had to step things up seriously now that they are here, but i really don't know of anyone who has done the opposite.
 
I may be one of the few people here who can actually answer this question based on experience. Tulane, although well-respected private school, hasn't broken the top 50 in many years. After Hurricane Katrina most of us did rotations at other schools, and some of the preclinical students took classes elsewhere for a short time.

So I've actually attended two other schools in addition to my own, one an unranked state school, considered #3 in the state, and the other a top 20 or so private school. And while I wouldn't say there's a difference in the difficulty of the coursework, there is a significant difference in the caliber of students. The average student at the ranked school was generally smarter than our average student and the variation in quality was pretty narrow. Compared to the state school, our average student was probably smarter, and our variation in quality narrower. Basically, at the state school, there was a huge variation in the caliber of students. Many were smarter than the average student at either of the other schools, but many were nowhere near it. The top students at any of the schools were approximately of the same caliber. The difference lay in the average and the range.

And anecdotally, I heard that our students ran circles around the students from the lower ranked state schools, which resulted in several of our borderline top-quartile students getting lots of honors clinically, with comparable students getting Passes and High Passes at the higher ranked schools.

As an aside, I'm very curious how they can even compare us to determine who gets AOA.
 
uh, simultaneously?

You do one before the other [I think dental first]. Then when you do the med part, I think you just do the two years of rotations. He wants to be some weird kind of face surgeon...I know, it sounds crazy to me too. But his dad is absolutely loaded from some sort of dental stuff, so I assume he knows what he is doing.
 
uh, simultaneously?

You do one before the other [I think dental first]. Then when you do the med part, I think you just do the two years of rotations. He wants to be some weird kind of face surgeon...I know, it sounds crazy to me too. But his dad is absolutely loaded from some sort of dental stuff, so I assume he knows what he is doing.
You do dental school, then apply to Oral and Maxillofacial Surgery programs (applying to med schools). Then you do second and third years of med school, followed by an OMFS residency. All the OMFS residents I've met have been ridiculously brilliant.
 
It's pretty widely accepted that if you work hard in high school and go to a highly ranked college, you'll have to work harder at that college than you would at a lower ranked one. Does this sort of logic apply to med. school? I guess in med. schools terms - is it harder to pass, or get good evaluations during the clinical years because of the generally higher ability of the other students?

i would say that every accreditted medical school teaches the same material so the subject matter is equally as difficult. However, at a higher ranked school, it is more difficult to stand out. it would be more difficult to have a higher class rank and more difficult to get AOA b/c your classmates are just that much more ambitious.
 
I graduated from the best medical school in the world...ever. I was 1st in my class, extrema maxima cum laude in fact, an honors level unknown to most medical schools....Please pull your heads beyond the dentate line and get over yourselves, these pissing contests always end with the dentists getting their feelings hurt. I mean because we can all agree that we're better than them right?
 
I graduated from the best medical school in the world...ever. I was 1st in my class, extrema maxima cum laude in fact, an honors level unknown to most medical schools....Please pull your heads beyond the dentate line and get over yourselves, these pissing contests always end with the dentists getting their feelings hurt. I mean because we can all agree that we're better than them right?

Yeah, the poor dentists have a high enough suicide rate as it is
 
It's pretty widely accepted that if you work hard in high school and go to a highly ranked college, you'll have to work harder at that college than you would at a lower ranked one. Does this sort of logic apply to med. school? I guess in med. schools terms - is it harder to pass, or get good evaluations during the clinical years because of the generally higher ability of the other students?

Yes, the logic does transfer. In fact, it is a little known secret that Harvard med students get a big gold sash to wear to their residency interviews. This sash is a subtle hint to the residency director to skip the interview and automatically offer this student a spot in next year's intern class. Clearly, this Harvard student worked SO MUCH harder to become an MD than any of the other people interviewing that day, so he automatically deserves a spot.

(Sigh.) Look, threads like these are kind of insulting and sort of pointless. Everyone who goes to med school has to work hard to stay in and finish successfully, regardless of which school they go to.

The main point of your question seems to be asking about the importance of student-student competition - i.e., is it harder to do well at a higher ranked school because the competition between students should be that much more fierce? Since so many schools are now H/P/F and do not use a curve, the element of competition between students is no longer important. That's WHY so many schools switched to this grading system - the point was to create an atmosphere that fostered teamwork, not cutthroat competition. Furthermore, most schools do not numerically rank their students - they just say that you were top third/top 25%, etc. How well you do and how high you pass is now dependent almost solely on you. I guess you could argue that there's more ambition among the students at a big-name school, but that's debateable and there's no evidence to prove it.

Really, these kind of threads are sort of insulting. It implies that students who are currently at state schools are kind of coasting on the way to becoming MDs because the bar is lower. (Before you jump down my throat, I know that you didn't mean to be offensive - that's just how it sounds to me, and I don't even go to a state school!) Everyone has to work hard to finish med school, end of story. I doubt that I'd have more free time at a lower ranked school, and I'm not sure how I'd be able to have less free time at a higher ranked school.

Finally, a word of caution when applying to med school. Don't assume that students at higher ranking schools are intrinsically more capable than people at lower ranking schools. There might be some truth to that assumption, but there ARE a lot more external factors in deciding where to go for med school than there are in deciding where to go for undergrad. A lot more people in med school are married and have families, so going to a really expensive Ivy League school is out of the question for them, even if they were to get in. Some people choose to go to a school close to home so that they can save some money by living with their parents. In their case, going to an expensive med school just defeats the purpose. It's a much more complicated decision than deciding where to go to college.
 
Finally, a word of caution when applying to med school. Don't assume that students at higher ranking schools are intrinsically more capable than people at lower ranking schools. There might be some truth to that assumption, but there ARE a lot more external factors in deciding where to go for med school than there are in deciding where to go for undergrad. A lot more people in med school are married and have families, so going to a really expensive Ivy League school is out of the question for them, even if they were to get in. Some people choose to go to a school close to home so that they can save some money by living with their parents. In their case, going to an expensive med school just defeats the purpose. It's a much more complicated decision than deciding where to go to college.

Also scholarships and financial aid packages play a role. As does trying to attend schools close to girlfriends/boyfriends/spouses. Staying local to be near ill relatives. etc.
 
Duke's average step 1 in the past has been in the low to mid 230s. However, the school suggests that that's because we have our clinical rotations second year, before we take step 1.
Don;t you guys finish the pre-clinical curriculum in 1.5 years, though? You can spend more time studying for step 1 than many other students, no?
 
Don;t you guys finish the pre-clinical curriculum in 1.5 years, though? You can spend more time studying for step 1 than many other students, no?

Yes, a better study schedule would a factor. It's not the only factor, as listed above, but it is certainly a factor.
 
Don;t you guys finish the pre-clinical curriculum in 1.5 years, though? You can spend more time studying for step 1 than many other students, no?

We only have one year of the basic science curriculum (August until the end of June), then we have rotations during second year. Most students therefore take Step 1 after our clinical rotations (either between years 2 and 3 or during year 3). Third year is research, so depending upon the research project you undertake, you may or may not have more time to study for the boards.

Our school actually has done a study on the whole thing. They give us a practice step 1 after first year, without any preparation, and everyone does terrible. Then they give us another practice step 1 at the end of second year, again without and prep, and everyone's score goes up significantly. Of course, its nowhere near the 230 average, which is obviously a result of studying, but they claim that this suggests that having clinical rotations before taking the boards improves board scores.
 
We only have one year of the basic science curriculum (August until the end of June), then we have rotations during second year. Most students therefore take Step 1 after our clinical rotations (either between years 2 and 3 or during year 3). Third year is research, so depending upon the research project you undertake, you may or may not have more time to study for the boards.

Our school actually has done a study on the whole thing. They give us a practice step 1 after first year, without any preparation, and everyone does terrible. Then they give us another practice step 1 at the end of second year, again without and prep, and everyone's score goes up significantly. Of course, its nowhere near the 230 average, which is obviously a result of studying, but they claim that this suggests that having clinical rotations before taking the boards improves board scores.

Interesting. My school does something similar as well. After the end of preclinical couses, we take an National End of Basic Science exam 🙂eek: ), and then we can take Step one whenever we want to (at least before June of our 4th year) and have as much time to study for it. We kinda think that the reason students do so well (mid 230s) is that we have had a year+ of clinical work. This year there are numerous 4th years (double digits) walking around with 260s+, and apparently the average is closer to 240.
 
Yes, the logic does transfer. In fact, it is a little known secret that Harvard med students get a big gold sash to wear to their residency interviews. This sash is a subtle hint to the residency director to skip the interview and automatically offer this student a spot in next year's intern class. Clearly, this Harvard student worked SO MUCH harder to become an MD than any of the other people interviewing that day, so he automatically deserves a spot.

(Sigh.) Look, threads like these are kind of insulting and sort of pointless. Everyone who goes to med school has to work hard to stay in and finish successfully, regardless of which school they go to.

The main point of your question seems to be asking about the importance of student-student competition - i.e., is it harder to do well at a higher ranked school because the competition between students should be that much more fierce? Since so many schools are now H/P/F and do not use a curve, the element of competition between students is no longer important. That's WHY so many schools switched to this grading system - the point was to create an atmosphere that fostered teamwork, not cutthroat competition. Furthermore, most schools do not numerically rank their students - they just say that you were top third/top 25%, etc. How well you do and how high you pass is now dependent almost solely on you. I guess you could argue that there's more ambition among the students at a big-name school, but that's debateable and there's no evidence to prove it.

Really, these kind of threads are sort of insulting. It implies that students who are currently at state schools are kind of coasting on the way to becoming MDs because the bar is lower. (Before you jump down my throat, I know that you didn't mean to be offensive - that's just how it sounds to me, and I don't even go to a state school!) Everyone has to work hard to finish med school, end of story. I doubt that I'd have more free time at a lower ranked school, and I'm not sure how I'd be able to have less free time at a higher ranked school.

Finally, a word of caution when applying to med school. Don't assume that students at higher ranking schools are intrinsically more capable than people at lower ranking schools. There might be some truth to that assumption, but there ARE a lot more external factors in deciding where to go for med school than there are in deciding where to go for undergrad. A lot more people in med school are married and have families, so going to a really expensive Ivy League school is out of the question for them, even if they were to get in. Some people choose to go to a school close to home so that they can save some money by living with their parents. In their case, going to an expensive med school just defeats the purpose. It's a much more complicated decision than deciding where to go to college.
You're focusing on the preclinical years, which on the whole matter very little. And to the extent that they matter, they are completely trumped by your step I score.

It's the clinical years where you see the difference in caliber emerge, and there are VERY FEW schools that are P/F in those years. Most are at least H/P/F, and whether you get Honors on the wards is largely dependent on how you perform in relation to your classmates. If you happen to get in a group where everyone is an Honors student, on a rotation where they simply will not give honors to the whole group (which is the unwritten policy at some schools), chances are it won't be you. And the more students of that caliber there are at your school, the harder it is for any one of them to stand out.
 
There's at least one school without grades during the first two years. Hard to fail if there's no grades...
Yale comes to mind...
 
It's the clinical years where you see the difference in caliber emerge, and there are VERY FEW schools that are P/F in those years. Most are at least H/P/F, and whether you get Honors on the wards is largely dependent on how you perform in relation to your classmates. If you happen to get in a group where everyone is an Honors student, on a rotation where they simply will not give honors to the whole group (which is the unwritten policy at some schools), chances are it won't be you. And the more students of that caliber there are at your school, the harder it is for any one of them to stand out.
I can't imagine that your undergrad performance is much of an indicator of your clinical years. They're very different, I would think. I'm only an M1 though...
 
Here is a thought, high ranking schools are more difficult because they ignore us. They assume that we are all super nerds and so they can do a poor job of instruction. Some of the lower tier schools that I interviewed at seemed to have a tremendous amount of their resources dedicated to making their students lives easier, or at least more efficient. I am good school and if instructor concern/preperation are really the top of med schools I sure feel sorry for people in lower tier schools. Oh ya, one more thing. I have observed what I like to call the "expert phenom", it is well known that people love to talk about what they do--ad noseum. SO what happen when you arrange to have lots of lectures given by an "expert",--very very bad very very boring things.
 
Law2Doc said:
There are certain top schools where no one in the history of the school has ever failed or had to repeat a course and all the students know that the worst that can happen is having to have a chat with someone. So rather than P/F they have P.
My school (well ranked, Canadian) can and does fail people; I know two people that are repeating their year, and every year about four students (from all four years) are outright dismissed.

And I do worry about failing. Unrealistically, of course - I'm doing fine; but I worry anyway... It's pass/fail, all I have to do is pass really (I've made a conscious decision to not shoot for the top 10%, it's not worth my quality of life). Pass/fail does make people pretty collaborative, we're not cutthroat at all.

No grades... now that would be sweeeet.
 
I can't imagine that your undergrad performance is much of an indicator of your clinical years. They're very different, I would think. I'm only an M1 though...
Clinical performance is a function of knowledge, critical thinking (i.e. how well you apply your knowledge), and social skills. Your undergrad performance demonstrates the first two, and your extracurriculars show the last two. So you actually can predict a student's potential in the clinical years better than you might think.

There are always people whose record gives a false impression one way or the other. But in retrospect you can always figure out why it did so.
 
The only people who take it easy during medical school either 1) just don't care (P=MD) or 2) are unbelievably smart. Otherwise you are going to be working hard if you are at HMS or ECU. Why does everyone work hard, simple, because everyone knows that residency is looming. That's why students might not work as hard in Law School, because there isn't as much competition after. There is a lot of overlap in residencies, it depends on subspecialty and program but in general the guy that makes AOA, aces boards, and does research at the low tier school is going to come out on even, if not ahead of, the average student from the upper tier school.
 
Clinical performance is a function of knowledge, critical thinking (i.e. how well you apply your knowledge), and social skills. Your undergrad performance demonstrates the first two, and your extracurriculars show the last two. So you actually can predict a student's potential in the clinical years better than you might think.
I disagree with the critical thinking part. Undergrad has some of that, but not that much. And people without social skills can still get into a research lab, do volunteering, be a TA, etc. I know, because I worked with people in a lab with poor antisocial skills, and I've had TAs with horrible social skills, etc.
 
I may be one of the few people here who can actually answer this question based on experience. Tulane, although well-respected private school, hasn't broken the top 50 in many years. After Hurricane Katrina most of us did rotations at other schools, and some of the preclinical students took classes elsewhere for a short time.

So I've actually attended two other schools in addition to my own, one an unranked state school, considered #3 in the state, and the other a top 20 or so private school. And while I wouldn't say there's a difference in the difficulty of the coursework, there is a significant difference in the caliber of students. The average student at the ranked school was generally smarter than our average student and the variation in quality was pretty narrow. Compared to the state school, our average student was probably smarter, and our variation in quality narrower. Basically, at the state school, there was a huge variation in the caliber of students. Many were smarter than the average student at either of the other schools, but many were nowhere near it. The top students at any of the schools were approximately of the same caliber. The difference lay in the average and the range.

And anecdotally, I heard that our students ran circles around the students from the lower ranked state schools, which resulted in several of our borderline top-quartile students getting lots of honors clinically, with comparable students getting Passes and High Passes at the higher ranked schools.

As an aside, I'm very curious how they can even compare us to determine who gets AOA.

Thanks for introducing some evidence to this discussion. It's not enough from which to draw general conclusions, but it sure beats the pants off mere conjecture. Intuitively it makes more sense, too.
 
The best thing you can do is work as hard as possible, regardless of where you go to school.
 
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I am at a state school. Last time I checked it was the overall highest ranked medical school in the nation.

What?? You're not talking about UW are you? That's definately not the highest ranked...not by a long shot. Only people in Washington think that's the best school in the nation.
 
Maybe they meant in primary care rankings. 😉
 
Wait! Yale doesn't give grades? How are their students judged during pre-clinical years then? Don't they have exams and tests?
 
Wait! Yale doesn't give grades? How are their students judged during pre-clinical years then? Don't they have exams and tests?
Nope, no grades. Oh, their tests? Optional and anonymous. Yeah, you figure that one out.
 
Wait! Yale doesn't give grades? How are their students judged during pre-clinical years then? Don't they have exams and tests?

Professors give you written evaluations based on your PBL and small group discussions, where they apparently often ask you direct questions. Letters of rec are especially important at schools with no pre-clinical grades. And at the end you're judged just like everyone else: Step I.
 
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