Is there truly a difference between the top 10 schools?

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Yes, there are plenty of differences across the Top 10, Top 20, Top X schools.

In fact there are so many differences, it would be futile to even try to list all the differentiating details.

In regards to your specific filters of choice (ie "Do residencies care?" and "Are Harvard and Hopkins in a league of their own?")... here are my thoughts from what I have heard/seen/felt over the past few years:

Yes, residencies care about pedigree. To a degree. The residency folks that rank their applicants are, in fact, human... if two applicants are very similar, it is naive to think that the applicant from Harvard wouldn't be ranked over the applicant from State U. That's just how life is. People like pretty things. Great applicants being equal -- having top schools fill your residency spots is pretty in the eye of the Residency-PD-beholder.

In regards to "are Harvard/Hopkins in a league of their own"...it depends on who's perspective we care about.

Graduating med students? No, they aren't. It is common sense that there are plenty of reasons one might want to complete residency at another institution. The ace from State U that rocked out in med school likely isn't intimidated by you or basking in your glory just because you went to Harvard/Hopkins... Those Harvard/Hopkins students might be in fact basking in his.

Residency PD's? No, they aren't. Residency directors, unlike the general public (ie outside medicine bubble), know what UCSF is (for example) and that it wields a kickass rep. Pedigree is pedigree, albeit preferences persist on a subjective spectrum.

General public? I would say Harvard is in a league of its own among all medical schools. Not everyone has heard of Johns Hopkins (albeit many, many, many have). Hell, I bet out of those that have heard of it -- more think it's called "John Hopkins" than the actual name. Not everyone has heard of Stanford. Many confuse UPenn for Penn State. "Oh, Columbia for medical school? I always wanted to go to South America!" On the other hand, Harvard is pretty much 100% global in name recognition. Whether you are in law, medicine, business, plumbing, or fast food... Whether you are in Seattle or Augusta... If you know anything about higher level education, you know what Harvard is and you know it is equated with "high-end whatever you studied there".

They ("they") say you are only as good as the last place you trained... so if you are hell-bent on wearing the big crimson H sweater to your X-mas party, it is more important to get to Boston for residency/fellowship than for med school.

Go to whatever school makes you happiest.
 
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