Kaiser vs. UMichigan vs. UCSF JMP

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ana.stomosis

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Help!
Context:
  • Nontrad in mid30s hoping to live alone so my partner can stay as much as they like, but we will not be moving together
  • Cal resident but not originally from here (ties to Atlanta, Chicago, NYC, SoCal and NorCal so I am not necessarily attached to staying here)
  • Will likely want to stay and do residency wherever I am educated, as I have moved many times and prefer not uprooting again and again into middle age
  • Priorities include not struggling with survival-based things (financial stress has impacted all of my adult life, and dealing with more of the same during med school when I cannot simply take on extra work to make up the difference is a huge stressor), going to a program that suits my learning style (e.g. I do not flourish in flipped classroom models, prefer traditional lecture options, and as a very independent and introverted adult student, I find the mandatory daily TBL stuff not only incongruent with how I learn but also kind of paternalistic?), and living in a place that is bikeable/walkable - I am trying to be cognizant of my sedentary time so I can remain healthy into my 40s and my habits during med school could make or break that.
  • Low income and still waiting on financial aid info from the UCSF JMP. Financial concerns are paramount.

UCSF-JMP
Pros:
-Anti-racism as core value, and health equity as core focus of MS, would be very aligned with how I already think and interact in clinical spaces; the program draws the kind of people I'd want to navigate such a difficult political environment with
-Staying in CA and rotating through the many affiliated community hospitals and health centers means I'd be able to continue treating Medicaid patients & my target population (urban health equity is my bag)
-I'm deeply involved in local food production and street medicine, both of which are amply available in the bay area
-Definitely the "best" MD school of all my choices
-I love the bay, and my sibling is close
-STEP 1 & 2 taken back-to-back after more prep time
-JMP students have said they felt really well prepared for STEP and that the extra year takes the pressure off
-Again, extra year of preclin allows for exploration of other interests and time to be a person (to an extent)


Cons:
-IT. IS. SO. EXPENSIVE. THERE. - I get super depressed looking for housing
-5 years (meaning extra year before practicing, and extra year of extremely high COL)
-Probably the least generous of these schools re: fin aid, and have anecdotally heard that they don't respond to requests to match other offers : (
-TBL and PBL are also mandatory and frequent (3 days/week) during the 2.5 preclinical years
-JMP class size a little too small? 16 students... so not likely to have anyone else in the cohort who's in a similar life stage. I make friends with people younger than me, but it's not the same as having the relatability of a common generation.



Kaiser
Pros:
-Full COA offer
-Decent to strong match list
-Excellent faculty who are really into what Kaiser is doing
-Class size of 50 so strong mentorship and close faculty relationships possible
-Have heard positive things from docs here
-I really enjoyed some of the other admitted students and M1s I met during 2nd Look
-Partner will not be moving with, so this would be the most realistic place for maintaining relationship. Still, I am not sure a LDR is something I'm willing to take on so not sure how much of a factor this is

Cons:
-Still feels like a bit of an experiment
-"nothing in life is free"
- COL budget allocates ~1900 for rent when analyzing breakdown - challenging to live alone on this in pasadena
- Any additional COL funds needed would have to be accessed through private loans
- 4 days/ week mandatory PBL
- 1 day/week @ clinical site during M1. Site is not chosen and we do not get assignment for until matriculation (could end up as far as Long Beach or Anaheim (potentially 3 hours/day wasted on commute, and yes some people can study while commuting, but I study at a standing desk to avoid being sedentary)
- 4 days/week at clinical site in M2, meaning that is where you're supposed to live for that year. That means attending Kaiser can potentially mean you will commit to living in a much less desirable area than Pasadena/East LA for at least a year; also am a commuting cycling and hope to be able to bike to my required things while in school
- no uni associated for clinical/bench/translational research connections (population level research easily accessible tho)
- no cadaveric dissection
-I really want to live in a walkable/bikeable area and LA/Pasadena is...not that

UMich
Pros:
-Full tuition merit scholarship already awarded, with an additional institutional grant, making my total COA ~88k for 4 years. Sounds manageable, but with interest and unsubsidized loans that will add up.
-Excellent research institution in p much everything
-Excellent match list, probably better than UCSF for non-primary care specialty matching
-Huge university with amazing professional schools, so would be around other professional students in different disciplines, lots of opportunity for cross-disciplinary collaboration (policy, public health, law)
-Very supportive alumni network
-No challenge getting exposure to various specialties, subspecialties, research (clinical and translational research access would probably be better here than at the other two since at UCSF I wouldn't be there until my clinical rotations)
-More of the traditional educational environment I thrive in
-I like seasonal weather and have no gripe with real winters
-Disability focus and advocacy for physical mental health and wellbeing seems to reflect common values that are important to me, and I don't encounter a lot of schools that are as active in this arena particularly. This struck a very positive chord for me.


Cons:
-Feels like I'd get lost in the student body there...huge university has a downside too, including not very responsive to my emails re: financial aid and admissions qs, impossible to reach anyone by phone : (
-Not sure how easy it is to connect w mentors given the size of the institution
-Still some flipped classes and PBL work, but less than the other two programs I believe
-Any debt with the current interest rates and unpredictability in job markets is a questionable financial choice if I have a full ride?

Waitlisted at Yale and WashU. Gave up other seats. On hold at OHSU. Yale is my top for every reason (curriculum and IRL lectures, location close to family and I miss temperate climates, have friends completing PhDs there, strong research, likely to qualify for great financial aid offer based on income), but I am not holding out hope bc.. well..it's Yale. Also, I wish this went without saying but it's the internet so: I am obviously aware that this is a very good problem to have, and I do know I'm really fortunate.
 
Prestige: UCSF > UMich >> Kaiser
Research Opportunities: UCSF = UMich >> Kaiser
Match: UCSF >= UMich (though UCSF greater for coastal) >> Kaiser
Cost: Kaiser > UMich >? UCSF
Location: UCSF > Kaiser > UMich
Fit: that's up to you!

If it were me, I would do UCSF if total COA is like 40k a year (only 20k a year over UMich). Then I'd choose UMich if I don't need to be in California, since 22k a year over Kaiser is worth it.
 
It sounds like finances, learning approach, and location are the most important aspects to you.

Finances

Kaiser > UMich > UCSF

With everything going on in the administration, having a full COA scholarship is huge! I am not too familiar with the Pasadena area but many medical schools have local connections to secure below-market rate housing. Worse case scenario you take out a (small) loan to secure solo housing but even that would be much much less than UMich loans. I would be curious to see UCSF financial aid as I do think if the cost difference between UMich and UCSF is small enough, UCSF would make sense from an opportunities perspective.

Learning Approach
Kaiser > UCSF > UMich

It seems like you value a traditional lecture experience and do not flourish in flipped classrooms. All have required in-person TBL sessions. Out of the three, Kaiser would be the most "traditional" with a 2-year pre-clinical curriculum along with the TBL you mentioned. UCSF is 2.5 years and obviously has the small group environment. UMich is the most non-traditional as it has a 1-year preclinical and the first year curriculum is all flipped classroom (asynchronous lectures) with mandatory small group TBL, so it is definitely the most accelerated of the three

Location
UCSF>Kaiser>UMich

There are the concerns you listed (walkability) but I would also point to other things you brought up that are important to consider: support system, proximity to SO, long-term thoughts, patient population. You mentioned your sister (and it sounds like your SO) is California. Think about what it would look like to have your SO visit you - a closer/driveable location means it’s easier for them to pop by for a weekend or leave if you need to study. This is compared to UMich where they would (I assume) fly in and it can be stressful to have someone in your space when you have competing priorities with medical school. You also mentioned you would like to stay long-term whereever you study. Pasadena and SF are a very different environment to the collegetown of Ann Arbor. Get a feel for what you want. Likewise with patient population, you mentioned urban health equity being “your bag” - oppurtunities and patient population for that is much easier to interact with in a Pasadena or SF than Ann Arbor.
 
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I will add that the JMP program at UCSF adds a year to your training which is an enormous cost -- likely on the order of $300,000-$750,000 depending what specialty you choose. It's a great school but you have to really want it. You didn't really explain what your preferences are for residency and how competitive the residency will be. Do you want academic medicine?
 
I’m a current M1 at Michigan - feel free to message if you have specific questions. I love it here and I think it has an appropriate amount of in-person mandatory programming.
 
I will add that the JMP program at UCSF adds a year to your training which is an enormous cost -- likely on the order of $300,000-$750,000 depending what specialty you choose. It's a great school but you have to really want it. You didn't really explain what your preferences are for residency and how competitive the residency will be. Do you want academic medicine?
Yes, and I am less concerned about loss of income than I am of gaining debt, but unfortunately I just got my fin aid and the cost alone makes it highly unrealistic for my particular circumstances.
 
New info: my approximate COA for the JMP is 300k - does this change the perspectives of anyone commenting above? Seems like it is the better program, but at that cost, I'm not sure I can make it make sense. I also may not be eligible for any federal loans based on prior borrowing, but there is still some confusion on this. Still, there's a potential for it to be 300k in private loans which just makes me feel trapped and sick. Interests include EM/IM combined, and surgical subs like ENT, OB/GYN, even neuro, (but I am very open to having my mind changed by clinical rotations) so yes, a better program with more residency match history matters to an extend but....still...
 
UMich seems like the choice from your factors but there are some institutional/curricular issues there. Personally I would probably lean UCSF, it doesn't seem like the cost difference is that huge esp with in-state tuition and the school actually sets you up in a position to be able to match competitively. Although I'd say that if you really can't get federal loans then I'd probably at least consider Kaiser over both
 
UMich seems like the choice from your factors but there are some institutional/curricular issues there. Personally I would probably lean UCSF, it doesn't seem like the cost difference is that huge esp with in-state tuition and the school actually sets you up in a position to be able to match competitively. Although I'd say that if you really can't get federal loans then I'd probably at least consider Kaiser over both

I appreciate the feedback from you both. Can I ask you to clarify what you're referring to re: institutional/curricular issues? I am visiting next weekend and would like to be armed with the info so I know what to ask current students about their experiences/so I know what to look out for.
 
I’m a current M1 at Michigan - feel free to message if you have specific questions. I love it here and I think it has an appropriate amount of in-person mandatory programming.
Hi Orphaneyez,
I think we have spoken before, and I was really encouraged by the things you shared. I feel like Michigan offers the right balance considering my concerns, but of course I can't be sure of anything until I am *in it.* I'm wondering if any students you know at the med school are able to do assistantships or other paid academic work to supplement their financial aid? I know most schools don't advise working during med school, but I'd like to figure out what the realistic possibilities are. UCB/UCSF does encourage taking on an assistantship during the preclinical years but it would never pay enough to offset the debt I'm set to leave with sadly.
 
I appreciate the feedback from you both. Can I ask you to clarify what you're referring to re: institutional/curricular issues? I am visiting next weekend and would like to be armed with the info so I know what to ask current students about their experiences/so I know what to look out for.
More along the lines that Michigan has historically always been considered a pretty difficult and competitive environment for medical students, relative to its peers (there's plenty of stories and ancedotes about this out there and on SDN). In particular the clerkship curriculum and clinical environment- the grading system has been undergoing major changes over the last few years, and the admin has been pretty open about the fact that their aim is to decrease the amount of students recieving honors (which current M2s have confirmed is actively happening).

Compared to a school like UCSF which is fully P/F and doesn't have any of these issues. Is the extra year worth it? I'd say so personally.
 
Yes, and I am less concerned about loss of income than I am of gaining debt, but unfortunately I just got my fin aid and the cost alone makes it highly unrealistic for my particular circumstances.
Lost income should be viewed the same as debt in your decision. Easy choice to drop UCSF unless being in San Francisco for four years is worth ~1MM by the end of residency and fellowship.
 
Lost income should be viewed the same as debt in your decision. Easy choice to drop UCSF unless being in San Francisco for four years is worth ~1MM by the end of residency and fellowship.
I understand money is fungible so in some way it's the same, however incurring debt isn't quite the same as not making money because debt comes with the ball and chain of interest and owing someone. Not making much money is just how I've been living for years. I think I get your point, though, and materially it's not so different in the end. I arrived at a similar conclusion about UCSF unfortunately.
 
I understand money is fungible so in some way it's the same, however incurring debt isn't quite the same as not making money because debt comes with the ball and chain of interest and owing someone. Not making much money is just how I've been living for years. I think I get your point, though, and materially it's not so different in the end. I arrived at a similar conclusion about UCSF unfortunately.
I am with you. I know rationally lost income is similar to debt, but I would rather have lost income than go into similar debt. Like you said, debt limits your freedom while not going into debt can be done for personal reasons to maintain your freedom. At the end of the day, it's more of a personal than financial decision. I similarly would rather take a gap year doing something I love and don't see the opportunity cost as similar to taking on debt.
 
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