Is there a point in which prestige is no longer worth the money for you?

[Dream of the Endless]

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Loaded post, thank you for anyone that takes the time to read, vote, comment!

I was having a friendly conversation with my friend this morning concerning her medical school admittance. She will be attending a very prestigious university at a very high cost of living state. Which I understood... until I dug a little deeper. Turns out she was also sitting on a full-ride to the best school in our state, but the school she will be attending is offering her little in comparison. Parents not paying for it.

When questioned, nothing in particular in her responses made it seem like she really wanted to go there, besides the name. Location/student body/curriculum etc. meh answers. Hopes of matching competitively, naturally. No clear goal for herself at this point, which is understandable. Of course, my goal was not for her to justify herself and her choices to me. I was more curious about how she arrived at her decision. I'm about to plunge into that tsunami myself for this upcoming cycle.

The total is looking like a pretty 300k for x4 years. After the conversation, I began to think at what point is prestige not worth it for myself? Would I have made the same decision? I ended up deciding that I would not have which I think has a lot to do with my own humble upbringing. I can't even imagine that much money much less consider taking it on as debt.

So my question to you is how much is prestige worth to you? Is it really -that important- to choose a T10 over a T50 state school if you wanted to match say... ENT/Plastics/Derm/Ortho? Before SDN I used to think a reasonably competitive program could get me just as far if I put forth the effort and made myself competitive. Is that not the way to think about it? I'm putting the finishing touches on my school list, so any insight would be greatly appreciated.

 

[965978]

Honestly I never cared about prestige when I was in college. I focused a lot on my girlfriend, fitness, and hanging out with my friends.

Although now I’m sitting on top of 3WL so it kinda backfired a little bit 😳

But to answer your question, I would take a full ride to a mid tier in a heartbeat.

 

[AnatomyGrey12]

Is it really -that important- to choose a T10 over a T50 state school if you wanted to match say... ENT/Plastics/Derm/Ortho?

Yes.

 

[863168]

@Dream of the Endless This is an impossible question to answer when you don't have a focus on any specialty. In my view, I think it's wrong to plot this as an x-y function of "cost of debt" relative to "prestige." Going into a better school usually translates into having easier involvement in relevant clinical research, opportunities to obtain LORs from letter writers known to most program directors, and an edge over students within the same SD when it comes to Step scores. If you're someone who is interested in something like spinal procedures e.g. decompression for indications of stenosis then it is much easier to point you towards taking the high price tag school because you will likely be en route to apply for NSG/ortho where every small advantage may matter when all the applicants are very competitive.

 

[stickgirl390]

I personally would take a full ride at the worst ranked school over six figure debt any day of the week. But I don’t come from a wealthy family, and am a nontrad with too much debt from undergrad already, so I have lots of personal experience affecting my decisions.

 

[Kpw101]

I'd take the scholarship every time. Going to a T10-T20 is great and would for sure help you specialty wise, but there's no M.D school in the country that would keep you out of a specialty provided that they have great career advising resources. (something you should probe for when you're at a school during interview season).

 

[RNthenDoc]

Entirely dependent on if you think you want a super competitive specialty.

For example: if I knew I wanted dermatology, I would be willing to fork over the quarter mil difference of it meant matching a year earlier (lots of derm applicants need a research year to be competitive, and maybe being in a T20 could make up enough difference that they can get by without one).

That year in saved time/not having to apply more than once/whatever the situation may be is worth a lot more than the quarter mil.

If you feel strongly that you want something less competitive or not competitive, I would take the free ride every time and never look back.

 

[NITRAS]

I went to a state school in a poor state. I did well on the MCAT with no dedicated training, had decent EC. I got into med school no problem.

School prestige means very little in the real world. If you put it in terms of return on investment, spending 10x on undergrad for no real benefit has very little utility. I’d call it stupid to spend an extra $250,000 you don’t have on something you don’t need.

The reality is that most people who are “premed” don’t go to med school. Most of medical students aren’t at the top of their class. Most docs don’t make $500k out of residency. Even still, that’s a lot of money that will effect your decisions for decades.

 

[Goro]

You can still get into an uber-residency if you went to Mercer, Albany, Drexel or U KS. I'd always recommend the free ride.

 

[Med Ed]

Is it really -that important- to choose a T10 over a T50 state school if you wanted to match say... ENT/Plastics/Derm/Ortho?

I pulled together some data from school with publicly available 2019 match lists.

Top 5-10 schools (4 private, 1 public):

Median metrics:
Columbia: 3.89/520
UCLA: 3.88/518
Cornell: 3.9/519
NYU: 3.94/522

2019 matches:
Columbia (138 starting): 5 ortho, 3 ENT, 7 dermatology, 5 neurosurgery, 9 ophthalmology, 2 plastic surgery
UCLA (175 starting): 6 ortho, 2 ENT, 5 dermatology, 1 neurosurgery, 3 ophthalmology
Cornell (106 starting): 4 ortho, 2 ENT, 3 dermatology, 1 neurosurgery, 1 ophthalmology, 1 plastic surgery
NYU (101 starting): 6 ortho, 3 ENT, 5 dermatology, 2 neurosurgery, 9 ophthalmology, 6 plastic surgery

Top 45-50 schools (3 private, 4 public):

Median metrics:
U of Florida: 3.87/515
U of Minnesota: 3.8/512
Dartmouth: 3.74/516
U Mass: 3.78/516
Georgetown: 3.79/513
Illinois: 3.79/514
Wake Forest: 3.73/512

2019 matches:
Florida (134 starting): 7 ortho, 2 ENT, 3 dermatology, 2 neurosurgery, 5 ophthalmology
Minnesota (240 starting): 8 ortho, 3 ENT, 3 dermatology, 3 ophthalmology
Dartmouth (92 starting): 1 ortho, 2 ENT, 3 dermatology, 2 neurosurgery, 1 ophthalmology, 2 plastic surgery
U Mass (162 starting): 5 ortho, 4 ENT, 2 dermatology, 2 integrated plastics
Georgetown (200 starting): 16 ortho, 6 ENT, 3 dermatology, 3 neurosurgery, 4 ophthalmology, 3 plastic surgery
Illinois (310 starting): 6 ortho, 3 ENT, 4 dermatology, 1 neurosurgery, 2 ophthalmology
Wake Forest (140 starting): 7 ortho, 1 ENT, 3 dermatology, 1 neurosurgery

The data are consistent with higher ranked schools having larger proportions of their respective student bodies going into competitive fields. The major confounders are differences in school mission, individual student goals, and academic strength (see the metrics).

 

[differentiating]

You can do competitive specialties from any school, though a higher ranked school will definitely give you an advantage. Having that name behind you helps in residency applications in general, regardless of your specialty.

Of course, personal preferences and fit will also come into play here. I'd have been willing to choose my current school over a school that was cheaper because it was where I wanted to be and where I felt like I would succeed the most, even ignoring the prestige factor.

 

[Hopeful_Doc123]

I pulled together some data from school with publicly available 2019 match lists.

Top 5-10 schools (4 private, 1 public):

Median metrics:
Columbia: 3.89/520
UCLA: 3.88/518
Cornell: 3.9/519
NYU: 3.94/522

2019 matches:
Columbia (138 starting): 5 ortho, 3 ENT, 7 dermatology, 5 neurosurgery, 9 ophthalmology, 2 plastic surgery
UCLA (175 starting): 6 ortho, 2 ENT, 5 dermatology, 1 neurosurgery, 3 ophthalmology
Cornell (106 starting): 4 ortho, 2 ENT, 3 dermatology, 1 neurosurgery, 1 ophthalmology, 1 plastic surgery
NYU (101 starting): 6 ortho, 3 ENT, 5 dermatology, 2 neurosurgery, 9 ophthalmology, 6 plastic surgery

Top 45-50 schools (3 private, 4 public):

Median metrics:
U of Florida: 3.87/515
U of Minnesota: 3.8/512
Dartmouth: 3.74/516
U Mass: 3.78/516
Georgetown: 3.79/513
Illinois: 3.79/514
Wake Forest: 3.73/512

2019 matches:
Florida (134 starting): 7 ortho, 2 ENT, 3 dermatology, 2 neurosurgery, 5 ophthalmology
Minnesota (240 starting): 8 ortho, 3 ENT, 3 dermatology, 3 ophthalmology
Dartmouth (92 starting): 1 ortho, 2 ENT, 3 dermatology, 2 neurosurgery, 1 ophthalmology, 2 plastic surgery
U Mass (162 starting): 5 ortho, 4 ENT, 2 dermatology, 2 integrated plastics
Georgetown (200 starting): 16 ortho, 6 ENT, 3 dermatology, 3 neurosurgery, 4 ophthalmology, 3 plastic surgery
Illinois (310 starting): 6 ortho, 3 ENT, 4 dermatology, 1 neurosurgery, 2 ophthalmology
Wake Forest (140 starting): 7 ortho, 1 ENT, 3 dermatology, 1 neurosurgery

The data are consistent with higher ranked schools having larger proportions of their respective student bodies going into competitive fields. The major confounders are differences in school mission, individual student goals, and academic strength (see the metrics).

Would you say this holds true for those who are interesting in pursuing a competitive IM residency and completing a fellowship afterward (Cards/GI/Onc)?

 

[OrthoTraumaMD]

I matched Ortho from a state school. Just my 2 cents. Work your butt off and it’s possible— though probably easier if you have more resources.

 

[863168]

I matched Ortho from a state school. Just my 2 cents. Work your butt off and it’s possible— though probably easier if you have more resources.

You're such a beast.

 

[965978]

You're such a beast.

Oh and she’s a gamer.

I’ll probably be scared if I were to meet her in real life.

 

[OrthoTraumaMD]

Oh and she’s a gamer.

I’ll probably be scared if I were to meet her in real life.

Nah I’m pretty friendly.
“Nothing is true; everything is permitted.”

 

[MaxPlancker]

Beyond specialty choice, I think another important factor to consider is having the power to match where you want, not just into a specialty. A lot of people are in serious relationships and have big reasons for preferring specific locations by the time they're applying for residency. Unless your family is rich, many of the top schools also provide better financial aid that most state schools. Prestige follows you for a lifetime, whatever that's worth, and can open up many doors that you've never thought of; the 250K? It'll be taken care of, and we aren't going into medicine for the money anyways (or prestige).

 

[907914]

Beyond specialty choice, I think another important factor to consider is having the power to match where you want, not just into a specialty. A lot of people are in serious relationships and have big reasons for preferring specific locations by the time they're applying for residency. Unless your family is rich, many of the top schools also provide better financial aid that most state schools. Prestige follows you for a lifetime, whatever that's worth, and can open up many doors that you've never thought of; the 250K? It'll be taken care of, and we aren't going into medicine for the money anyways (or prestige).

This is/will be my concern. I still don't know what I want to do, ranging from PM&R to Pathology, but I damn well know I would like to match In one of a few particular areas of the country.

 

[Dream of the Endless]

Thank you, everyone, for your responses!

To be frank, prestige means hardly anything to me. But I understand that it means something to the people who select students for residency positions. Which, at the end of the day, is probably the only thing that matters.

The data are consistent with higher ranked schools having larger proportions of their respective student bodies going into competitive fields. The major confounders are differences in school mission, individual student goals, and academic strength (see the metrics)

Thanks for taking the time to stockpile that. I like numbers, they make sense. I'm all for not limiting my chances, but I didn't think the difference would be that significant.

I matched Ortho from a state school. Just my 2 cents. Work your butt off and it’s possible— though probably easier if you have more resources.

This is how I had it in my mind. Go to a decent school, work hard, get results. All while, ideally, paying as little as possible in an environment I can enjoy/tolerate for x4 years.

I made the OP to see other perspectives on the matter. My school list currently looks like this: my state programs (many), several HBCUs, 4 reaches, and the rest "target" for 27 schools. I made it with the intent of "having a solid chance of matriculating and likely receiving aid" (in a perfect world) vs. only looking to get into the best program possible... if that makes sense. Another list I have that looks more like: state, 1 HBCU, 6 "target" and the rest are reaches.

 

[907914]

Thank you, everyone, for your responses!

To be frank, prestige means hardly anything to me. But I understand that it means something to the people who select students for residency positions. Which, at the end of the day, is probably the only thing that matters.



Thanks for taking the time to stockpile that. I like numbers, they make sense. I'm all for not limiting my chances, but I didn't think the difference would be that significant.



This is how I had it in my mind. Go to a decent school, work hard, get results. All while, ideally, paying as little as possible in an environment I can enjoy/tolerate for x4 years.

I made the OP to see other perspectives on the matter. My school list currently looks like this: my state programs (many), several HBCUs, 4 reaches, and the rest "target" for 27 schools. I made it with the intent of "having a solid chance of matriculating and likely receiving aid" (in a perfect world) vs. only looking to get into the best program possible... if that makes sense. Another list I have that looks more like: state, 1 HBCU, 6 "target" and the rest are reaches.

Aren’t the top programs well known for also being the most supportive of their students AND providing the most financial aid? Or is that really only T10 types?

 

[Dream of the Endless]

Aren’t the top programs well known for also being the most supportive of their students AND providing the most financial aid? Or is that really only T10 types?

That's what I've been hearing, but when I was scrolling through the different T10 pages there weren't many people reporting good financial aid packages vs.when scrolling through the mid tiers I saw that more often.

 

[907914]

That's what I've been hearing, but when I was scrolling through the different T10 pages there weren't many people reporting good financial aid packages vs.when scrolling through the mid tiers I saw that more often.

That, to me, is likely because people expect good FA from T10s. People may not report it, but it is very clear on the average graduate debt on MSAR.

 

[MaxPlancker]

Aren’t the top programs well known for also being the most supportive of their students AND providing the most financial aid? Or is that really only T10 types?

Yes but a lot of them are need-based so the posters may simply be the well-off who would not qualify for aid. Your best bet is to call/Google each school you're interested in - no better substitute.

 

[907914]

Yes but a lot of them are need-based so the posters may simply be the well-off who would not qualify for aid. Your best bet is to call/Google each school you're interested in - no better substitute.

Definitely hoping for that sweet sweet need based. Parents make around $120K, but I make like $12K and have 2 dependents.

Google is certainly a much better resource than the school specific SDN forums

 

[EdgeTrimmer]

Hard to say as a parent until my son gets into that situation 🙂 We had that situation for UG, he gave one 1 Ivy and another top 10 school for top 15 school due to full-tuition scholarship and thriving.

 

[MexicanMamba]

I had this decision for med school. Full ride to state school versus T25 program that provided 1 year free tuition. I selected the T25 school. I’ll let you know how it works out in about 10 years.

 

[Med Ed]

Thanks for taking the time to stockpile that. I like numbers, they make sense. I'm all for not limiting my chances, but I didn't think the difference would be that significant.

Interesting you say that, because to my eye the differences aren't that significant. Well, they aren't after you factor in self-selection.

 

[MaxPlancker]

Interesting you say that, because to my eye the differences aren't that significant. Well, they aren't after you factor in self-selection.

Agreed. I'd imagine the main difference is location (how desirable).

 

[SchoolBoy30]

SAVE THAT MONEY. I ended up going to a top tier california school after going to an absolutely 2nd rate medical school. No one cares where you go to medical school or even residency, unless you want to do neurosurgery. And even then its going to be tough to get in coming from tough places. In all honesty there is almost no reason to go to an expensive school unless you are rich, have the money, parents are rich, or you get a scholarship. Residency will be 3-6 years and it is likely you will graduate with 250,000 in loans. This is all for little to no added value. And believe me, its not like they even try to teach you during medical school, they just expect you to know whats on the test. Save that money and get that MD. P=MD

 

[EdgeTrimmer]

This is the advice I gave to BS/MD students "Don't finance dreams with loans". I think it applies to everyone.

 

[907914]

This is the advice I gave to BS/MD students "Don't finance dreams with loans". I think it applies to everyone.

If only some were so lucky......

 

[EdgeTrimmer]

If only some were so lucky......

I meant additional loans to go to dream schools. I understand most have to take some loans to go to any medical school.

 

[907914]

I meant additional loans to go to dream schools. I understand most have to take some loans to go to any medical school.

GOOOTCHA, yah that makes sense. I was having this conversation with my wife just yesterday.

"I would like to stay in Washington state, but if a school like Harvard accepts me with better financial aid, then I go there. With the same financial aid, I still go there. With worse financial aid? I am not sure, we would need to talk about it!"

 

[EdgeTrimmer]

BTW, Elmo was my son's favorite muppet when he was little 🙂 Even now if I see some Elmo stuff I take a photo and send it to him (he is as a rising junior in college).

 

[907914]

BTW, Elmo was my son's favorite muppet when he was little 🙂 Even now if I see some Elmo stuff I take a photo and send it to him (he is as a rising junior in college).

He will love this then: