Prestige of Medical School Less Important for Academic Medicine

[JohnMadden]

Does the prestige of your medical school have a larger impact for those who enter private practice, where they may be able to leverage the name more?

In my anecdotal experience, a signficant amount of the private practice physicians who are in competitive specialties went to "prestigious" medical schools, whereas at AMCs, there is a wider representation of schools.

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[Stolenspatulas]

Does the prestige of your medical school have a larger impact for those who enter private practice, where they may be able to leverage the name more?

In my anecdotal experience, a signficant amount of the private practice physicians who are in competitive specialties went to "prestigious" medical schools, whereas at AMCs, there is a wider representation of schools.

I would argue the opposite. If you want to go into Academia, school name will be somewhat useful. If you want to go into private practice, does it really matter if you learn from a topnotch academic institution?

 

[HreComesTheSun]

opposite

 

[Doctor~Detroit]

yeah, you got the common wisdom backwards.

one thing that i wonder about is even though academia appreciates prestige, the job market is easier in academia than in private practice, right? so although academic jobs will like to see prestige, i wonder how choosy they can be. it should of course vary be specialty.

 

[foofish]

ditto x4....most patients don't even bother to know what med school their doctor went to. I mean, before you were interested in medicine, did *you* even know or care?

 

[JohnMadden]

yeah, you got the common wisdom backwards.

one thing that i wonder about is even though academia appreciates prestige, the job market is easier in academia than in private practice, right? so although academic jobs will like to see prestige, i wonder how choosy they can be. it should of course vary be specialty.

I understand the "common wisdom", but having worked at a couple of "prestigious" academic medical centers, I don't see it in practice.

My question is: why would you pay a considerable amount MORE to go to a prestigious medical school to earn LESS as an academic physician?

If you think research is the reason, then you're wrong. A number of top medical schools have more of their graduates go into PRIVATE PRACTICE than academic medicine. This is a problem that the top schools have been battling with for a few years now.

I agree that the specialty has a lot to do with it... Academic medical centers aren't that choosy for the majority of specialties. Most top academic medical centers have a REALLY hard time recruiting faculty from competitive specialties because they go into private practice. All things being equal, what schools send the largest number of students to competitive specialties?

 

[QuantumMechanic]

I was under the impression that going to a top school will help you land a more academic residency. Graduates from these residencies don't necessarily go into academic medicine.

 

[NonTradMed]

From what I've seen, people who go into academic medicine tend to go to prestige schools more so than people in private practice. Of course, this may not be a direct correlation. People who attend top notch schools tend to land academic residencies, may do more research or are more research oriented (as research helps you to land top notch specialities at academic centers) and from those pool of applicant is where many academic docs are from. Also, I've noticed, among my friends, those that are interested in the academic side of things, who want to be more research focused, tend to pick the prestige schools, moreso than students who just want to be plain ol' docs. But that is my personal experience.

So what I see is that most people in top schools tend to do private practice but academic medicine sees a disproportionate number entering from that pool of applicant. Case in point, I looked at my undergrad's PhD/MD candidates and where they went after graduation. The program is very hard to get into and the candidates are students who would have gotten into top med schools anyway. The biggest chunk went into private practice but the second biggest went into academic practice.

 

[soco]

I understand the "common wisdom", but having worked at a couple of "prestigious" academic medical centers, I don't see it in practice.

My question is: why would you pay a considerable amount MORE to go to a prestigious medical school to earn LESS as an academic physician?

At a certain level you have to ask: what is money for? A lot depends on what you value.

For example, our family tradition is to will off about half our money to the academic institutions we attended. The other half goes to college funds for grandchildren. So, for me, it doesn't really matter how much a school costs because they are going to get it all in the end anyways. Education comes first, and then with whatever left over money the amenities of life. At a certain level, you can't explain behaviors with economics, especially if people don't even take salaries/finances into consideration when making educational decisions.

 

[Gabujabu]

I think this is what happens:

1) Many people enter the top research schools with an intention of going into academic medicine/research.

2) They graduate from said institution with $250k debt.

3) They go to a competitive residency program.

4) They get their job offers coming out and realize that they'll make 1/2-1/3 less in academic medicine than in private practice, and with their debt that has ballooned to absurd proportions, they choose private practice.

In fact, whether the school is Harvard or Duke or Yale or Penn, the majority of grads from all these institutions will NOT go into academic medicine.

 

[notaroche]

How do you know you want to go into academic medicine? You want to teach/research it, yet you haven't learned anything about it yet. Not trying to be snippy, just curious.

 

[riceman04]

Does the prestige of your medical school have a larger impact for those who enter private practice, where they may be able to leverage the name more?

In my anecdotal experience, a signficant amount of the private practice physicians who are in competitive specialties went to "prestigious" medical schools, whereas at AMCs, there is a wider representation of schools.

 

[Doctor~Detroit]

I think this is what happens:

1) Many people enter the top research schools with an intention of going into academic medicine/research.

2) They graduate from said institution with $250k debt.

3) They go to a competitive residency program.

4) They get their job offers coming out and realize that they'll make 1/2-1/3 less in academic medicine than in private practice, and with their debt that has ballooned to absurd proportions, they choose private practice.

In fact, whether the school is Harvard or Duke or Yale or Penn, the majority of grads from all these institutions will NOT go into academic medicine.

haha. i wonder what the association is between debt level and going into academia . . .

 

[crimsonkid85]

I think this is what happens:

1) Many people enter the top research schools with an intention of going into academic medicine/research.

2) They graduate from said institution with $250k debt.

3) They go to a competitive residency program.

4) They get their job offers coming out and realize that they'll make 1/2-1/3 less in academic medicine than in private practice, and with their debt that has ballooned to absurd proportions, they choose private practice.

In fact, whether the school is Harvard or Duke or Yale or Penn, the majority of grads from all these institutions will NOT go into academic medicine.

this is what the MD/PhD program is for; it eliminates debt so there is more of an incentive to do academic medicine

 

[Gabujabu]

this is what the MD/PhD program is for; it eliminates debt so there is more of an incentive to do academic medicine

True, but if you factor in the opportunity cost of foregoing 3-5 years of a physician's salary, that is actually much greater than the full tuition + stipend that these programs offer. There are many great reasons to do MD/PhD, but finances absolutely should not be one of them.

 

[Stolenspatulas]

True, but if you factor in the opportunity cost of foregoing 3-5 years of a physician's salary, that is actually much greater than the full tuition + stipend that these programs offer. There are many great reasons to do MD/PhD, but finances absolutely should not be one of them.

agreed. thank you. everyone forgets opportunity cost.

and some mstp students take years upon years to finish...

 

[Law2Doc]

agreed. thank you. everyone forgets opportunity cost.
.

Agreed. The PhD's are leveraging a decent salary a few years down the road for a very minor stipend now. If your goal is to maximize lifelong income, you are better off foregoing the PhD and stipend, borrowing more and working sooner, even in academic medicine.
So that isn't going to be the motivation for the PhD track.

 

[Gut Shot]

Does the prestige of your medical school have a larger impact for those who enter private practice, where they may be able to leverage the name more?

In my anecdotal experience, a signficant amount of the private practice physicians who are in competitive specialties went to "prestigious" medical schools, whereas at AMCs, there is a wider representation of schools.

When people discuss prestige in academics, they're likely thinking of the hardcore researchers. There other end of the spectrum are the myriad academic clinicians who spend 95-99% of their time doing straight clinical work.

 

[exmike]

haha. i wonder what the association is between debt level and going into academia . . .

I believe the AAMC has published a paper addressing this exact issue in the past

 

[Guile]

I was under the impression that going to a top school will help you land a more academic residency. Graduates from these residencies don't necessarily go into academic medicine.

Most prestigious academic residencies get very upset if you try to enter private practice after finishing. I'm not sure there is any real way to stop you, but they rank you high in the belief that you will enter academia upon completion of the residency. I know this from talking with some people who matched at competitive places this year.

 

[old_boy]

Most prestigious academic residencies get very upset if you try to enter private practice after finishing. I'm not sure there is any real way to stop you, but they rank you high in the belief that you will enter academia upon completion of the residency. I know this from talking with some people who matched at competitive places this year.

I understand where residency directors are coming from, but they are being silly. If they want to keep people in academics, then they can pay them more. There continues to be resistence to vast pay differences between different specialities in academic centers. But as the cardiology and radiology departments in academic centers are learning, you need to pay these folks more than the docs in the family med dept.

I think this is what happens:
1) Many people enter the top research schools with an intention of going into academic medicine/research.
2) They graduate from said institution with $250k debt.
3) They go to a competitive residency program.
4) They get their job offers coming out and realize that they'll make 1/2-1/3 less in academic medicine than in private practice, and with their debt that has ballooned to absurd proportions, they choose private practice.

I disagree. I think many, if not most, docs who go into private practice from top residencies had this in mind all along, no matter what they said on their interview trail. It's not like they wake up one day and wonder where the debt came from.

Despite what this sounds like, I have great respect for academic medicine and hope to go into academic medicine myself. But, even if I wanted to go into private practice, I'd be saying the same exact thing. See my point?

 

[JohnMadden]

Similarly, I am also interested in a career in academic plastic surgery...

 

[eastcoastyall]

Most prestigious academic residencies get very upset if you try to enter private practice after finishing. I'm not sure there is any real way to stop you, but they rank you high in the belief that you will enter academia upon completion of the residency. I know this from talking with some people who matched at competitive places this year.

This is totally correct. For example, most of the top surgery programs only had 1 or 2 people in recent memory who had gone into private practice. They were mentioned as a very rare exception to the rule.

Think of it this way. Almost all people from top medical schools go to top residency programs because that is the feeder route. Supplement that with the top students from the other medical schools. Most graduates of these top residency programs take prestigious fellowships and go into academia. By transitive property, you see what happens. Well, that and by the end of 4 years at a top research oriented medical school, you are so brainwashed into tracking into the top programs you don't even know the others exist.

 

[eastcoastyall]

Most prestigious academic residencies get very upset if you try to enter private practice after finishing. I'm not sure there is any real way to stop you, but they rank you high in the belief that you will enter academia upon completion of the residency. I know this from talking with some people who matched at competitive places this year.

This is totally correct. For example, most of the top surgery programs only had 1 or 2 people in recent memory who had gone into private practice. They were mentioned as a very rare exception to the rule.

Think of it this way. Almost all people from top medical schools go to top residency programs because that is the feeder route. Supplement that with the top students from the other medical schools. Most graduates of these top residency programs take prestigious fellowships and go into academia. By transitive property, you see what happens. Well, that and by the end of 4 years at a top research oriented medical school, you are so brainwashed into tracking into the top programs you don't even know the others exist.