T20 vs. >T50

[tunaktunak]

What are the advantages of going to a higher ranked school? If a T70 school is thousands $$$ less to attend than a T20, which would you choose?

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[KnightDoc]

What are the advantages of going to a higher ranked school? If a T70 school is thousands $$$ less to attend than a T20, which would you choose?

In reality, very few people ever have to worry about this. If you haven't seen the stats, only around 20% of all applicants ever see more than one A. What's more, what I am seeing from my kind of large sampling of friends and acquaintances from both last cycle and this one, is that schools are pretty good at yield protecting. My high stat friends just haven't been getting a lot of love from schools outside the T20, and, of course, lower stat people don't have a lot of success with T20.

So, other than IS public schools (where low tuition is an attraction and yield protection seems to be less of a factor), there is really very little overlap between the two. Beyond that, depending on what you want to do and how many thousands of $$$ you are talking about, decisions can be justified both ways.

It might be counterintuitive, but it turns out that the T20 have much larger endowments, so $$$ really isn't determined by rank, and higher ranked schools often offer better merit scholarships AND better need based aid. If you want to be a practicing pediatrician, there is nothing wrong with saving money. If you think you might want academic medicine or maybe a more competitive specialty, making the investment in yourself can be a smart choice.

Like UG, or really anything else in life, better schools will provide more and better opportunities, but your success will ultimately depend on what you do with them. There is no rule that says very successful people cannot come from lower ranked schools. It is, however, easier coming from higher ranked ones, as evidenced by the numbers.

 

[EdgeTrimmer]

What are the advantages of going to a higher ranked school? If a T70 school is thousands $$$ less to attend than a T20, which would you choose?

Depends on the school, how it's financed and your career goals. However, no use in debating unless you have a T20 in hand.

 

[KnightDoc]

Depends on the school, how it's financed and your career goals. However, no use in debating unless you have a T20 in hand.

....AND a T70!!!

 

[Doctoscope]

Apparently if your goal is to work in academic medicine, or want to land a top residency in a pedigree-w***ring program like IM (supposedly IM is like THE most pedigree-driven field for top programs?), it's very beneficial to go to a high-ranked medical school.

This is just what I read on SDN, and have no data to back it up.

 

[deleted1075353]

Personally I think most t20 schools are in suboptimal locations with high costs of living and a low quality of life. This is a sufficient reason for me to prefer a lot of lower ranked schools over top ones.

 

[Goro]

Years of reading comments from our wise SDN medical students and attendings have me say this:
1) T50 = every MD school in the USA
2) There are some 30 schools in the T20, and if ask five people what they are, you'll get six different answers.

3a) As mentioned above, if you are interested in a career in Academic Medicine, the the research Powerhouses (ie, the Harvard/Stanford and Einstein/Keck/Emory classes) are for you.
3b) Even if you go to a Drexel/Albany or a Miami/Wake class school, you can still get into Academic Medicine

4a) If you are gunning for an uber-competitive residency location, like MGH, then the inbreeding of the research powerhouses can help.
4b) But you can still get into these places as per 3b

5) Lastly and most importantly, if you're interested in just a regular career as an attending, it doesn't matter as your salary will be the same if you go JAB in HI or Harvard, U WA or Miami, Albany or Yale.

The only people are care about rankings are starry eyed premeds and med school Deans.

 

[EdgeTrimmer]

....AND a T70!!!

True, but if you are T20 caliber you may be yield protected by T70s.

 

[tunaktunak]

Years of reading comments from our wise SDN medical students and attendings have me say this:
1) T50 = every MD school in the USA
2) There are some 30 schools in the T20, and if ask five people what they are, you'll get six different answers.

3a) As mentioned above, if you are interested in a career in Academic Medicine, the the research Powerhouses (ie, the Harvard/Stanford and Einstein/Keck/Emory classes) are for you.
3b) Even if you go to a Drexel/Albany or a Miami/Wake class school, you can still get into Academic Medicine

4a) If you are gunning for an uber-competitive residency location, like MGH, then the inbreeding of the research powerhouses can help.
4b) But you can still get into these places as per 3b

5) Lastly and most importantly, if you're interested in just a regular career as an attending, it doesn't matter as your salary will be the same if you go JAB in HI or Harvard, U WA or Miami, Albany or Yale.

The only people are care about rankings are starry eyed premeds and med school Deans.

So what you're saying is, if you're not totally set on Academic Medicine, then there really isn't a difference going to Harvard Med vs. Drexel Med for example?

 

[KnightDoc]

So what you're saying is, if you're not totally set on Academic Medicine, then there really isn't a difference going to Harvard Med vs. Drexel Med for example?

Sure... no difference at all!

 

[EdgeTrimmer]

So what you're saying is, if you're not totally set on Academic Medicine, then there really isn't a difference going to Harvard Med vs. Drexel Med for example?

or any foreign medical school as long as you can get residency if you are only looking at $$$s.

 

[KnightDoc]

or any foreign medical school as long as you can get residency if you are only looking at $$$s.

To be fair, that's a huge "as long as"!!

 

[Rogue42]

So what you're saying is, if you're not totally set on Academic Medicine, then there really isn't a difference going to Harvard Med vs. Drexel Med for example?

What he's saying is that the difference only comes from how badly you want someone to go, "Oh you went to Harvard, you must be smart." You can get into any specialty, at nearly any residency program from almost any school. You can get into academic medicine from almost any medical school as well.
Like stated, some of the bigger, more well known schools will have more opportunities to their students, but they come at that cost $. But ultimately, a graduate from Meharry medical and a graduate from Harvard medical will more than likely make the same salary so long as they're in the same specialty.

 

[EdgeTrimmer]

To be fair, that's a huge "as long as"!!

Is it longer than premed -> medical school? remember 60% don't get admissions sales pitch. All my N > 1 IMGs this year got residencies.

 

[EdgeTrimmer]

What he's saying is that the difference only comes from how badly you want someone to go, "Oh you went to Harvard, you must be smart." You can get into any specialty, at nearly any residency program from almost any school. You can get into academic medicine from almost any medical school as well.
Like stated, some of the bigger, more well known schools will have more opportunities to their students, but they come at that cost $. But ultimately, a graduate from Meharry medical and a graduate from Harvard medical will more than likely make the same salary so long as they're in the same specialty.

Yeah, you have residency and fellowship to prove you are smart if you want to be compared to Harvard grads

 

[KnightDoc]

Is it longer than premed -> medical school? remember 60% don't get admissions sales pitch. All my N > 1 IMGs this year got residencies.

Yeah, because you're talking about the 60%! Extrapolate your N=1s over the entire population, and all FMGs match, so Caribbean is legit, right??? All you really said is that "so long as everything works out, everything will be fine." Other than ignoring the fact that the majority don't match, what you said is very true.

 

[EdgeTrimmer]

Yeah, because you're talking about the 60%! Extrapolate your N=1s over the entire population, and all FMGs match, so Caribbean is legit, right??? All you really said is that "so long as everything works out, everything will be fine." Other than ignoring the fact that the majority don't match, what you said is very true.

Caribbean is legit, but what percentage survive is different. Those who survived get same compensation as Harvard grads.

 

[KnightDoc]

Caribbean is legit, but what percentage survive is different. Those who survived get same compensation as Harvard grads.

If you say so. Apparently, our definitions of legit are different, and your logic is circular. By my definition, it's not legit if it is not possible, even theoretically, for 100% to survive, since 100% certainly pay tuition. And any system that does not have a rotation spot ready and waiting for every student who begins the program is not legit. PERIOD!!!!

 

[EdgeTrimmer]

If you say so. Apparently, our definitions of legit are different, and your logic is circular. By my definition, it's not legit if it is not possible, even theoretically, for 100% to survive, since 100% certainly pay tuition. And any system that does not have a rotation spot ready and waiting for every student who begins the program is not legit. PERIOD!!!!

If you say so To me it's legal business but an improper one i.e. giving admissions knowing 50% or more fail.

 

[deleted1075353]

Caribbean is legit, but what percentage survive is different. Those who survived get same compensation as Harvard grads.

What happens to Caribbean people that don't match? Can they do residency in other countries (maybe in the Caribbean or Latin America)? Or are they just boned?

 

[KnightDoc]

If you say so To me it's legal business but an improper one i.e. giving admissions knowing 50% or more fail.

Well, yeah, obviously it's a legal business, since it hasn't been shut down. So is payday lending. Also not legit, since it preys on the weak and vulnerable. By the way, what's the difference to you between not legit and improper, since it sounds like way are saying the same thing?

 

[KnightDoc]

What happens to Caribbean people that don't match? Can they do residency in other countries (maybe in the Caribbean or Latin America)? Or are they just boned?

Nope, they are boned. The students are predominantly American (with, I think, some Canadians mixed in), and the schools are set up to allow their students to qualify for licensing in the US or Canada, as appropriate. I am not aware of any foreign countries, particularly the schools' host countries, that take their graduates.

It bears keeping in mind that these schools are not organic to their home countries. They were set up there, like banks in tax havens, due to lax licensing and accreditation requirements. Their target is American and Canadian students. They are not designed to be part of their host countries' health care systems. None of those schools would be allowed to open their doors in any US state with their current business and education practices. So, they do their thing in the Caribbean, and the lucky few who survive get to be American (or Canadian) MDs.

 

[EdgeTrimmer]

Well, yeah, obviously it's a legal business, since it hasn't been shut down. So is payday lending. Also not legit, since it preys on the weak and vulnerable. By the way, what's the difference to you between not legit and improper, since it sounds like way are saying the same thing?

We are saying same thing but using different terminology For me legit means legitimate or legal. Same goes with my backyard school CNU

 

[Goro]

So what you're saying is, if you're not totally set on Academic Medicine, then there really isn't a difference going to Harvard Med vs. Drexel Med for example?

Yup

 

[Goro]

What happens to Caribbean people that don't match? Can they do residency in other countries (maybe in the Caribbean or Latin America)? Or are they just boned?

They're driving for Uber now.

 

[EdgeTrimmer]

They're driving for Uber now.

what about those flunked out of MD and DO?

 

[JustAUser]

what about those flunked out of MD and DO?

They drive for Lyft

 

[LunaOri]

So what you're saying is, if you're not totally set on Academic Medicine, then there really isn't a difference going to Harvard Med vs. Drexel Med for example?

No, there's still a difference. Your options for clinical rotation sites will be different, plus a school with a larger endowment may have nicer facilities. Also, if you finish at the bottom of your class at Harvard, you will still be able to get a good residency spot (not so true of Drexel).

 

[Banco]

Don't underestimate the value of a big name for residency applications; it matters, especially when looking to get into big name academic residencies. Location/region also often matter. I feel like these things were not told to me on this board when I was at this stage but going through medical school made me privy to them. If you don't believe me, check out the medical schools of residents of "top academic residencies" - lots of factors are at play, but you will notice that 1) lots of big names and in-breeding/regional self-selection and/or bias and 2) lots of non-T20 as well.

Now if you're deciding between "T70" (whatever that even means) and "T20" and there are financial/personal considerations at play, that also matters quite a bit, and everyone is in a different situation. Rarely does it come down to an "all else equal" situation.

 

[drducky.]

With Step 1 going p/f, DONT CHEAP OUT AND GO TO THE HIGHEST RANK SCHOOL YOU CAN.

 

[Lucca]

everyone on sdn b like school rank dont matter until the yearly match thread and we have the inevitable group "Oh....it do be like that huh"

school rank matters for your career outcomes, anyone saying otherwise is in a fantasy land. But the extent to which it matters and how much it matters *for you* is not obvious or easy to ascertain. For 9 out of 10 premeds, I would say take the money/happiness/wellness decision and forget about prestige or rank or whatever *as long as you are deciding between two US MD schools*.

I will also say that *in general*, the higher rank school you go to the less you will have to worry about competing with your classmates for distinction if you in fact want to do something uber-competitive but obviously its hard to make universal statements about 100+ schools. While it is true you can do anything from anywhere -- absolutely its true -- there's lots of * on that statement and its hard to understand how much med school will ask of u in general until youre in it. What I'm saying is don't assume that just because you got into a Top X school and choose to go to the Top X+1 that you will automatically be among the best students at Top X+1.

 

[EdgeTrimmer]

so basically all the advise you get on SDN is generic and ultimately you have to decide based on what's important to you.

 

[Lucca]

so basically all the advise you get on SDN is generic and ultimately you have to decide based on what's important to you.

The more you know yourself the easier every decisión you ever make will be. But I still want to be clear: less COA good is good advice in virtually every case.

 

[KnightDoc]

so basically all the advise you get on SDN is generic and ultimately you have to decide based on what's important to you.

Ya think???

 

[Hzreio]

So what you're saying is, if you're not totally set on Academic Medicine, then there really isn't a difference going to Harvard Med vs. Drexel Med for example?

That’s not what he’s saying... he’s saying that you will have a shot at a good career at both institutions. Yes, it may help to go to Harvard Med but it’s not like you can’t do anything academically if you go to Drexel Med.

 

[KnightDoc]

That’s not what he’s saying... he’s saying that you will have a shot at a good career at both institutions. Yes, it may help to go to Harvard Med but it’s not like you can’t do anything academically if you go to Drexel Med.

Actually, that's exactly what he was saying!

T20 vs. >T50

 

[nommers99x]

One physician I know said it this way: "what school you go to isn't as life-defining as you think. It does affect the slope of the hill you'll be walking in some sense (e.g., research opportunities, school name recognition), but the slope isn't as steep as you think". There has been some speculation that the school name may be increasingly important as step 1 goes P/F. But i know a ton of examples of people who went to lower tier schools and they went off to good residencies and fellowships because they got it done when they were med students.

 

[EdgeTrimmer]

But I still want to be clear: less COA good is good advice in virtually every case.

unless you have parents willing to pay and prestige matters to them more than checkbook

 

[deleted1065184]

What are the advantages of going to a higher ranked school? If a T70 school is thousands $$$ less to attend than a T20, which would you choose?

Well, you have to consider what goes into the rankings. T20 medical schools are not actually better at teaching medicine than other schools by virtue of their ranking. The research rankings, which most people follow, are hella focused on research funding, publications, etc. So if you want to go into research, then that's where the benefit of a T20 comes in. Otherwise, I don't think it really makes a difference. Especially in primary care, where most T20 schools are not ranked well (aside from like UCSF, UCLA, UWash, UMich). And then there's the fact that the T20 is constantly in flux. Like think about how quickly NYU just jumped to the T5 after paying for tuition. Is NYU actually that much better of a school that quickly or do the rankings just really suck? lol

 

[Banco]

Well, you have to consider what goes into the rankings. T20 medical schools are not actually better at teaching medicine than other schools by virtue of their ranking. The research rankings, which most people follow, are hella focused on research funding, publications, etc. So if you want to go into research, then that's where the benefit of a T20 comes in. Otherwise, I don't think it really makes a difference. Especially in primary care, where most T20 schools are not ranked well (aside from like UCSF, UCLA, UWash, UMich). And then there's the fact that the T20 is constantly in flux. Like think about how quickly NYU just jumped to the T5 after paying for tuition. Is NYU actually that much better of a school that quickly or do the rankings just really suck? lol

This is the exact thing I heard when I was applying for medical school. Fast forward 5 years, school name definitely matters, and big names will help you get into big names. None of this has anything to do with teaching quality, which is relatively standardized. It is in part a self fulfilling prophecy, but don't underestimate how much academic programs value other famous academic names on the CV. Now is it enough to take on 200k more in loans or move across the country from your significant other etc.? This is too personal to generalize (with your NYU example though, I don't see how you can lose, considering it's free and highly ranked). Will you be able to be successful from all MD schools and get a residency spot and practice medicine? Absolutely.

Think of it like having to climb a mountain but you start at the bottom or half-way up the slope. What the peak actually is is up to you to decide.

 

[deleted1065184]

This is the exact thing I heard when I was applying for medical school. Fast forward 5 years, school name definitely matters, and big names will help you get into big names. None of this has anything to do with teaching quality, which is relatively standardized. It is in part a self fulfilling prophecy, but don't underestimate how much academic programs value other famous academic names on the CV. Now is it enough to take on 200k more in loans or move across the country from your significant other etc.? This is too personal to generalize (with your NYU example though, I don't see how you can lose, considering it's free and highly ranked). Will you be able to be successful from all MD schools and get a residency spot and practice medicine? Absolutely.

Think of it like having to climb a mountain but you start at the bottom or half-way up the slope. What the peak actually is is up to you to decide.

Eh I still stick by what I said. Being at a big name school will absolutely help you get into other big name residencies, but that's a very circular argument that requires your definition of success to be "going to a big name school". Like I said, this is helpful for academic medicine and being at these institutions will help for research...or maybe a *slight* advantage if you're applying into a super duper competitive residency. But other than that, it just really doesn't make much of a difference. Like my partner went to a T3 school for medical school and chose to do family medicine for residency. Her program is packed with people from all sorts of non-prestiguous programs. Her pedigree didn't really matter at all for her residency.

 

[deleted1065184]

Think of it like having to climb a mountain but you start at the bottom or half-way up the slope. What the peak actually is is up to you to decide.

Yes, the peak is definitely up for the person to decide. And if your peak isn't research career or ultra competitive residency, you're not actually starting any lower than non-T20 schools.

I'm somebody who plans to have a career as a physician-scientist, so I'm planning to do a T20-T30 for that reason...but if I weren't, I honestly wouldn't care because I'm not interested in the ultracompetitive specialties.

 

[Banco]

Eh I still stick by what I said. Being at a big name school will absolutely help you get into other big name residencies, but that's a very circular argument that requires your definition of success to be "going to a big name school". Like I said, this is helpful for academic medicine and being at these institutions will help for research...or maybe a *slight* advantage if you're applying into a super duper competitive residency. But other than that, it just really doesn't make much of a difference. Like my partner went to a T3 school for medical school and chose to do family medicine for residency. Her program is packed with people from all sorts of non-prestiguous programs. Her pedigree didn't really matter at all for her residency.

Yes, the peak is definitely up for the person to decide. And if your peak isn't research career or ultra competitive residency, you're not actually starting any lower than non-T20 schools.

I'm somebody who plans to have a career as a physician-scientist, so I'm planning to do a T20-T30 for that reason...but if I weren't, I honestly wouldn't care because I'm not interested in the ultracompetitive specialties.

You bring up good points and I agree overall. I just wanted to push a bit against the idea that gets propagated here often and generalized; I think in many situations the prestige is advantageous. And If you are the type of person to be truly stressing about Top X vs. Top X then something tells me you will be stressing about ranking/prestige when it comes to residency time too - which is a personal consideration many people have to make with some introspection.

 

[TheDataKing]

Where you go to school matters, especially with step 1 becoming pass/fail. If you have the choice between 2 US MD schools which 50% of matriculants don't have, unless you're looking at a huge difference in COA (like one is 350k for 4 years and one is 200k for 4 years), go to the higher-ranked one. If you're interested in a competitive specialty and the COA is looking like it's going to be that large but one is a T20 and one is unranked, I'd go to the T20. That's my 2 cents

link: The Change of USMLE Step 1 to Pass/Fail: Perspectives of the Surgery Program Director