State School (120k) vs. Top 20 (320k)

[TheMostHolistic]

Hey everyone! First post here, let me know if I missed a rule and I'll strive to correct the mistake. I apologize for vagueness, I'm super nervous about maintaining anonymity.

I'm very lucky to be juggling two acceptances, I think either would be a great opportunity.

The first is my State School:

Pros:
-Merit aid reducing the 4 year cost of attendance to 120k (before interest)
-Closer to undergraduate friends
-Already somewhat connected on campus
-Match list looks promising, many students matching into competitive specialties
-I know the city pretty well

Cons:
-Curriculum is traditional and not true pass/fail.
-Ranked below #60, worried about research opportunities
-I know the city pretty well

The next is a Top 20 School:

Pros:
-True pass/fail and an accelerated pre-clinical curriculum
-City is nicer than any I've lived in
-More research opportunities than you can shake a stick at
-Matching is ezpz (relatively)

Cons:
-Expected COA is 320k over 4 years (before interest)
-Further from current friends


I haven't decided on a specialty yet. I know that the more competitive I plan to go, the more the top 20 school is the attractive option. Looking for any insights you folks might have.

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[Bryant088]

State school. That is a massive difference in COA.

 

[SuaveCardigans]

Comfort/support system + 200k without interest... I would go to state school.

 

[TheMostHolistic]

State school. That is a massive difference in COA.

Comfort/support system + 200k without interest... I would go to state school.

Thank you both for the perspective. I agree, the price tag is the biggest difference between the two... and it's a scary number. I do wonder at what point it's worth it, and for what career reasons I might consider going to the top 20. Right now, I'm leaning in the same direction as you, but it kind of feels like a "missed opportunity", you know?

 

[Bryant088]

Thank you both for the perspective. I agree, the price tag is the biggest difference between the two... and it's a scary number. I do wonder at what point it's worth it, and for what career reasons I might consider going to the top 20. Right now, I'm leaning in the same direction as you, but it kind of feels like a "missed opportunity", you know?

I definitely understand. If you absolutely needed to do neurosurgery at UCSF (or something super competitive), then I would go to the top 20. But for the most part the state school should be able to get you where you want to go, as long as you work for it.

 

[scienceguy95]

Depends on what your goals and priorities are. If you want to go into academic medicine, a competitive specialty, or competitive residency programs in general, then attending a top 20 would be helpful in getting research opportunities and letters (not to mention the benefits of a boosted reputation). Of course achieving all of this is possible from any MD school, but you'll have to work a bit harder for it.

If on the other hand you would be happy with any residency and understand you will need to work a bit harder than students at top schools, then by all means choose the cheaper state school. Definitely choose the cheaper school if you simply want to enter private practice.

 

[Magus5454]

Having that family close can not be underestimated

 

[TheMostHolistic]

Depends on what your goals and priorities are. If you want to go into academic medicine, a competitive specialty, or competitive residency programs in general, then attending a top 20 would be helpful in getting research opportunities and letters (not to mention the benefits of a boosted reputation). Of course achieving all of this is possible from any MD school, but you'll have to work a bit harder for it.

If on the other hand you would be happy with any residency and understand you will need to work a bit harder than students at top schools, then by all means choose the cheaper state school. Definitely choose the cheaper school if you simply want to enter private practice.

Thank you for the depth of this answer. It's reassuring that competitive options remain on the table at the state school... am I wrong in thinking that the state school might be the best bet if there's ambiguity in my career plans?

Having that family close can not be underestimated

It's complicated, but my family is going to be far away no matter where I go.

 

[Magus5454]

It's complicated, but my family is going to be far away no matter where I go.

Alright, family, friends, support system. You know what im getting at

 

[cresume]

I go to a state school, and I would recommend the top 20. We have a good match list, but even then, your life will be easier with a new curriculum, true P/F, and shortened preclinical years. And when you're matching, if you do want to go competitive, you can get interviews with a 240 to many places that you couldn't get if you were at the state school with the same score.

And if you're already well connected, just keep up the connections. Also, a change of location would be nice and can also help you match in a new area. 200K difference with interest is a lot, but you'll be fine paying that off as an attending.

 

[DubbiDoctor]

Unless you have no interest in radiology, derm or any surgical subspeciality, go the top 20. If you want to go into something competitive, you should avail yourself of every possible advantage.

 

[TheMostHolistic]

I go to a state school, and I would recommend the top 20. We have a good match list, but even then, your life will be easier with a new curriculum, true P/F, and shortened preclinical years. And when you're matching, if you do want to go competitive, you can get interviews with a 240 to many places that you couldn't get if you were at the state school with the same score.

And if you're already well connected, just keep up the connections. Also, a change of location would be nice and can also help you match in a new area. 200K difference with interest is a lot, but you'll be fine paying that off as an attending.

Thank you for the advice, it's good to hear your perspective as someone who's already a bit down the road. I think it's good to think of comfort while in school, and I agree that I think the curriculum would make life easier over there. On the flip side, I'd be pinching pennies at the top 20 to try to minimize my debt load, while this wouldn't really be a worry at the state school.

Unless you have no interest in radiology, derm or any surgical subspeciality, go the top 20. If you want to go into something competitive, you should avail yourself of every possible advantage.

A fair point. I don't have a strong interest in surgery, but I've heard that you don't really know until you get some experience. I also worry that by attending the more expensive school I'd be preemptively making primary care an unattractive option. Am I overthinking the debt burden?

 

[SuaveCardigans]

A fair point. I don't have a strong interest in surgery, but I've heard that you don't really know until you get some experience. I also worry that by attending the more expensive school I'd be preemptively making primary care an unattractive option. Am I overthinking the debt burden?

No I think thats a very real concern for students who take on that kind of debt, they feel obligated to pursue something higher paying

 

[Nucleophile1]

I would 100% choose the Top20 school. Even if your state school has good opportunities, there will be far more opportunities available to you at the Top 20 school. Also, if you do decide to enter a competitive specialty, you will be glad you chose the Top20 school. True pass/fail is also a big stress reliever and will likely make your experience more enjoyable.

 

[NITRAS]

Do well on step 1 and no one cares if you went to a state school.

Not worth it.

 

[cresume]

Thank you for the advice, it's good to hear your perspective as someone who's already a bit down the road. I think it's good to think of comfort while in school, and I agree that I think the curriculum would make life easier over there. On the flip side, I'd be pinching pennies at the top 20 to try to minimize my debt load, while this wouldn't really be a worry at the state school.

Yeah, I think minimizing debt load is a good idea, but surviving on 20K if you just have to support yourself is not too bad. Honestly, if I were given a choice, I would 100% take the top 20. People say to score well on step 1, but prestige matters. It'll make applying to residency much easier down the road, and pinching pennies at this point is not worth it if you can set yourself up for a better future.

 

[CyrusHabs7695]

People match neurosurg and derm from state schools every year, if they can do that you can go into whatever you want with a strong CV. Save the money


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[TheMostHolistic]

I want to again thank everyone again for their input. My biggest takeaway from this thread is that there are a number of valid perspectives which lead folks in one direction or the other. While at first I was frustrated that I wasn't able to arrive at a clear choice even with help from the internet, I'm content to move forward knowing that there isn't really a strictly "wrong" option here. It's interesting to me reading into the background/goals/point-in-career of everyone that's weighed in, and I'm glad that there's been some diversity in that respect.

I've decided to go to the top 20 school. Some specifics that went into that decision would absolutely compromise my anonymity, so I'm sorry that I can't be too in-depth. Generally, I came to the conclusion that if I went to the state school and ended up feeling that doors were closed to me or even more difficult to open down the line, it would haunt me for life. I'd rather be haunted by the debt burden! A big part of this is that I do not want to end up practicing in this state. I also genuinely believe that I'll be happier for the 4 years I spend at the school I'll be attending. Here's to hoping that RePAYE is still around when I need it .

Good luck to everyone reading this as you move forward in your education and career!

 

[NITRAS]

Good luck to you. I hope you still feel this way when you graduate residency with almost a half million in debt.

Just remember, you are ultimately responsible for your own destiny and a fancy name school won’t substitute for....anything really.

 

[SuaveCardigans]

Good luck to you. I hope you still feel this way when you graduate residency with almost a half million in debt.

Just remember, you are ultimately responsible for your own destiny and a fancy name school won’t substitute for....anything really.

they made their decision, no need to be a prick