$$$ vs. School Prestige for Academics

[begginandpleadin]

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Hi everyone,

I am an incoming med student for next year and am interested in potentially pursuing Radiation Oncology. I have the choice of a top 3 school with about 60-80k of debt OR Vanderbilt with no debt at graduation. My ultimate goal is to be an academic physician doing research at a renowned medical center on the west coast.

I wanted to know how program directors and attendings generally view Vanderbilt med's reputation in relation to Top 3 schools like UCSF or Harvard. I am wondering whether it is best for me to save the money and attend Vandy or go into debt for a much higher ranked school? Is anything in the T20 is essentially equivalent or are there significant advantages to attending a higher ranked school in terms of getting better residencies and later better academic appointments? Or should I avoid debt at all costs and go with the cheaper option given the lower salaries in academia?

Thank you all!

 

[medgator]

Vandy

 

[begginandpleadin]

Vandy

Thank you, would you mind expanding on the reasons why and Vandy's reputation in the field?

 

[TheIllusionist]

60-80k debt is nothing. go to a top ranked place with a ton of institutional incest. such up to the department. get the harvard pedigree. go to academia in west coast. vandy is nice but going to a place like harvard and sucking up early will give you a guaranteed path to a strong academic track.

 

[maruchan]

I have to disagree with medgator here.

If your goal is specifically to be an academic physician, going to a top 3 institution will benefit you a lot. It is much easier to match at your home institution regardless of specialty. While there is some variance among specialties, in general during the academic job search your residency pedigree (and the associated connections) matter a lot. Vandy has a good reputation but there's still quite a significant gap in reputation compared to a top 3 school.

Also, if your goal is specifically to be an academic physician, I would strongly recommend going into field other than radiation oncology. The number of academic positions is extremely low and the competition for them is tough. Additionally, you may have to make serious sacrifices in terms of geography and compensation (true of many other fields as well, but arguably more true in this one). Research funding is scarce, and research funding for basic science research even scarcer. There are a lot of people in this field who would have made great academics in other specialties, but end up going into private practice for various reasons. Fortunately you're still very early on and have plenty of time to investigate your options in medical school and decide if this is truly the specialty for you.

Back to the original question though. If your goal is to be happy in life or to be a good doctor then vandy is a good choice. But if you're specifically optimizing for a future academic position, in my view you're definitely costing yourself if you don't go to the top 3 school.

 

[littleemma]

If only 60-80 K after 4 years of school, go top 3 for sure!

 

[BozoSparky]

 

[medgator]

Thank you, would you mind expanding on the reasons why and Vandy's reputation in the field?

Good enough, esp in the southeast and no debt.

Then again, it's not a huge amount to graduate with, debt wise

 

[deleted18755]

Hi everyone,

I am an incoming med student for next year and am interested in potentially pursuing Radiation Oncology. I have the choice of a top 3 school with about 60-80k of debt OR Vanderbilt with no debt at graduation. My ultimate goal is to be an academic physician doing research at a renowned medical center on the west coast.

I wanted to know how program directors and attendings generally view Vanderbilt med's reputation in relation to Top 3 schools like UCSF or Harvard. I am wondering whether it is best for me to save the money and attend Vandy or go into debt for a much higher ranked school? Is anything in the T20 is essentially equivalent or are there significant advantages to attending a higher ranked school in terms of getting better residencies and later better academic appointments? Or should I avoid debt at all costs and go with the cheaper option given the lower salaries in academia?

Thank you all!

Vanderbilt is one of those Universities that is a regional superstar but for whatever reason is hardly known as a top school outside the south/southwest. People in villages in rural Asia and Africa know Harvard and other top 3-5 or whatever schools in the US. No question here over $60-$80k and especially since you are so young that your interests will likely change so keep your options as open as possible.

I agree that if you are interested in oncology research and/or a big time academic career then radiation oncology isn't your best bet. However, rather than listen to anonymous people on an internet forum just go hang out in academic departments. From what I understand, for many years (over a decade?) radiation oncology had the highest percentage of MD/PhD's and residents who published as medical students. If they were receiving adequate mentoring and support by academic departments most, or at least many, should be successfully running labs with independent grants, laboratory space/protected time, etc. From what I understand, instead many are babysitting satellite centers just sitting around waiting to check a CBCT while contouring a prostate and goofing off online (like I'm doing right now . . . but I ain't go to no Harvard - not even the Harvard of second tier state schools!).

Seriously though, go talk to recent graduates and senior residents with PhD's or who otherwise were superstars planning on academic careers and see what they are actually doing. If they are on track for their goals please report back immediately to set the record straight because that is not what most, at least on here, are saying.

 

[Sheldor]

I thought for sure I'd open this up and everyone would be saying Vandy!

Vanderbilt is a top tier medical school and their med students who have gone on to radiation oncology consistently match to top 5 institutions: Harvard, MSKCC, Penn, MD Anderson. Thats just from people I met on the interview trail. If I could go back in time and have no medical school debt I'd do it in an instant.

Remember, its not 80k. Its 80k, then compounded for 5 years at 6+% Interest. Maybe it was a subpar medical school, or some unknown states school, but Vanderbilt is consistently considered one of the top medical schools in the country.

 

[Neuronix]

Thread moved to pre-allo.

Reminder: Pre-med questions belong in the pre-medical forums. Also, cross-posting (asking the same question in multiple forums) is not allowed.

 

[Med Ed]

Hi everyone,

I am an incoming med student for next year and am interested in potentially pursuing Radiation Oncology. I have the choice of a top 3 school with about 60-80k of debt OR Vanderbilt with no debt at graduation. My ultimate goal is to be an academic physician doing research at a renowned medical center on the west coast.

I wanted to know how program directors and attendings generally view Vanderbilt med's reputation in relation to Top 3 schools like UCSF or Harvard. I am wondering whether it is best for me to save the money and attend Vandy or go into debt for a much higher ranked school? Is anything in the T20 is essentially equivalent or are there significant advantages to attending a higher ranked school in terms of getting better residencies and later better academic appointments? Or should I avoid debt at all costs and go with the cheaper option given the lower salaries in academia?

Thank you all!

My rule of thumb is fairly simple: if you want to match into a competitive specialty you can do that from any allopathic school in the US. If you want to match into specific programs, however, you will find that path easier coming from a top 5-ish institution. Since your goal is the most competitive specialty, practiced in a top flight academic setting in one region of the country, I would suck up the debt and go top 3.

Please bear in mind that my advice is to be completely debt averse in 99% of cases, so this is an exception. I do recommend you re-crunch the numbers to verify that 60-80K would be your real debt load. Sometimes the estimates are overly optimistic.

 

[Radiator20]

In my limited experience, Vanderbilt is a great institution. However, as others have said, what you're buying with that $80k (plus compounded interest, yes) is not so much an intrinsically better med school, as (a) pedigree as perceived by others and (b) connections to more big names. Those can have a huge impact on career. For that price, I would go Top 3.

Also:
a) The fact that you want to go into rad onc is nearly irrelevant to your decision here. Should be the same for nearly any competitive specialty, and even if you were interested in IM, the above factors are still true and can have big influence on career down the road.
b) For goodness sake keep your eyes open during med school wherever you go and don't be blindly focused on rad onc (thought it's a great field). Ok to have a soft plan/interest and start setting up some research etc, but enjoy med school and whatever it brings, and make an unbiased evaluation come MS3. Med school is 4 years. Field is, potentially, the rest of your career.

 

[Rachapkis]

The decision boils down to what the $60-80k buys you above and beyond what Vandy can offer. I suspect that Vandy's reputation is sufficient, even when compared to a Top 3 school, that there will be little marginal difference in your chances of matching. Your Step 1 scores, your research, and the relationships/recommendations you garner will, in my opinion, be more dispositive than school ranking. I hope that you are considering fit and happiness in the equation too, because happiness is important in of itself and also plays a role in your success.

 

[deleted18755]

My rule of thumb is fairly simple: if you want to match into a competitive specialty you can do that from any allopathic school in the US. If you want to match into specific programs, however, you will find that path easier coming from a top 5-ish institution. Since your goal is the most competitive specialty, practiced in a top flight academic setting in one region of the country, I would suck up the debt and go top 3.

Please bear in mind that my advice is to be completely debt averse in 99% of cases, so this is an exception. I do recommend you re-crunch the numbers to verify that 60-80K would be your real debt load. Sometimes the estimates are overly optimistic.

Just to clarify yes Vanderbilt is indeed an exceptional medical school and if you're good enough to get into a top 3 or whatever medical school then I assume you will be at the top of Vanderbilt as well and have way more opportunities than the average graduate. But as noted above, if you are really set on being at a top institution in a very specific (and ultra-competitive region like the West Coast nonetheless) then I'd recommend $60k in debt (again as noted above check your numbers since isn't that hardly living expenses in a big city, which is where most top schools are located) at a top institution on the West Coast (especially if it's the exact institution where you would love to ultimately work . . . it certainly can only help to start networking and everything from the first year of medical school through residency etc). A lot can change between now and when you ultimately apply for residency with regards to your interests but again if you crush it at Vanderbilt you're the cream of the crop regardless. Best of luck my friend!

 

[Radiator20]

Vandy's reputation is sufficient, even when compared to a Top 3 school, that there will be little marginal difference in your chances of matching

your research, and the relationships/recommendations you garner

True as stated for outcome of match vs don't match. Not necessarily true with respect to where you match. Not because of intrinsic quality of school but because of the research and relationships, which will be more plentiful at Top 3.

 

[Broseiden]

One of my classmates from Vandy matched at a top institution for rad onc literally last year. So I highly doubt you would be inhibited regardless of what you choose, but it would surely be easier if you have your eyes set on going to a residency at that specific institution. Its always easiest to match to a particular institution when you actually attend it for school.

However, I chose Vandy over a higher ranked public institution against the advice of people here, as did some of my peers here. I can definitely see why its a tough choice, but for me I was more interested in the curriculum and what it could offer me, the resources, and how lax it is here (among other things). Moreover, the student environment is really unique in comparison to other institutions. Plus our faculty are very renowned as well, at least from my experience working with a few specific departments.

So just know that at the end of the day, you are obviously an excellent student whether you go to Vandy or Stanford or UCSF, and residencies will see that. The most important element is you being exceptional, which will not change wherever you go. You can build a compelling CV and in the end it won't really matter.

 

[Lucca]

Since top 3 on the east havent released yet, I suppose your acceptance is on the west coast. You want to end up at the west coast long term. Choose the top 3.

 

[dodolol21]

Top 3 no competition. The price difference is small for the huge prestige boost. Especially if its UCSF or Stanford like no competition at all

 

[Lexdiamondz]

I have to disagree with medgator here.

If your goal is specifically to be an academic physician, going to a top 3 institution will benefit you a lot. It is much easier to match at your home institution regardless of specialty. While there is some variance among specialties, in general during the academic job search your residency pedigree (and the associated connections) matter a lot. Vandy has a good reputation but there's still quite a significant gap in reputation compared to a top 3 school.

Also, if your goal is specifically to be an academic physician, I would strongly recommend going into field other than radiation oncology. The number of academic positions is extremely low and the competition for them is tough. Additionally, you may have to make serious sacrifices in terms of geography and compensation (true of many other fields as well, but arguably more true in this one). Research funding is scarce, and research funding for basic science research even scarcer. There are a lot of people in this field who would have made great academics in other specialties, but end up going into private practice for various reasons. Fortunately you're still very early on and have plenty of time to investigate your options in medical school and decide if this is truly the specialty for you.

Back to the original question though. If your goal is to be happy in life or to be a good doctor then vandy is a good choice. But if you're specifically optimizing for a future academic position, in my view you're definitely costing yourself if you don't go to the top 3 school.

I'm sorry but I disagree here.

While there is a reputation gap between Vandy and a top 3, there is nothing really preventing a Vandy grad from pursuing an academic career at a relatively prestigious institution given that they are at least a half decent student w/o red flags on their app. Take a glance at their match list - the majority of their students match at prestigious academic programmes in a wide range of specialties. Truthfully, if you're unable to land an academic residency out of Vandy then there's a strong argument you might not have made it out of Harvard, Stanford or Hopkins either (NYU isn't a real top 3, lets just get that out of the way right now).

If your choice is a free T-20 vs paying nearly 100k after interest and COL at a top 3, I'd go to a T-20 for free every time. Nobody in the real world is as granular as the posters on SDN about the differences between top tier programmes - it's not like the people at MGH are chucking out applications from Cornell students because they aren't up to their standard of prestige.

Also consider the fact that if you're going into academia, you're going to be on a very long and poorly-compensated career track (especially if you're fixated on being in a high COL and saturated market like most of the west coast). Having six figure debt around your neck accruing interest for up to a decade can significantly derail you financially - especially when that debt could have been avoided for a similar outcome.

 

[jarednogeek]

If your goal is academia then go to the top 3. If your goal is to work and make $$ then go to vandy.

 

[deleted18755]

I'm sorry but I disagree here.

While there is a reputation gap between Vandy and a top 3, there is nothing really preventing a Vandy grad from pursuing an academic career at a relatively prestigious institution given that they are at least a half decent student w/o red flags on their app. Take a glance at their match list - the majority of their students match at prestigious academic programmes in a wide range of specialties. Truthfully, if you're unable to land an academic residency out of Vandy then there's a strong argument you might not have made it out of Harvard, Stanford or Hopkins either (NYU isn't a real top 3, lets just get that out of the way right now).

If your choice is a free T-20 vs paying nearly 100k after interest and COL at a top 3, I'd go to a T-20 for free every time. Nobody in the real world is as granular as the posters on SDN about the differences between top tier programmes - it's not like the people at MGH are chucking out applications from Cornell students because they aren't up to their standard of prestige.

Also consider the fact that if you're going into academia, you're going to be on a very long and poorly-compensated career track (especially if you're fixated on being in a high COL and saturated market like most of the west coast). Having six figure debt around your neck accruing interest for up to a decade can significantly derail you financially - especially when that debt could have been avoided for a similar outcome.

While this may be true for most fields (if not the vast majority of fields) in medicine, radiation oncology is a very, very small field with limited positions available in general but especially if one is looking for a particular institution or even region of the country, and there are many objective and subjective reasons to believe that it will only be more so in the years ahead.

It doesn't even have to do with reputation so much as making connections early on . . . in fact if the OP said his goal in life is to be an academic radiation oncologist at Vandy and it was flipped (Vandy cost him $60,000-$80,000 more than Harvard), as crazy as it may sound, it may be advisable to turn down Harvard and pay more to go to Vandy to get a head start on securing a position there.

Crazy supply/demand situations can happen in very small fields like radiation oncology, especially if one is looking to land in a specific region, let alone a specific institution, in a very desirable location with further supply/demand issues clearly forecast for the future.

 

[DokterMom]

Since top 3 on the east havent released yet, I suppose your acceptance is on the west coast. You want to end up at the west coast long term. Choose the top 3.

Brilliant deduction.

 

[Lexdiamondz]

Honestly OP, just look at the match lists of the two schools over the last few years and see where their grads go, and pick accordingly.

While this may be true for most fields (if not the vast majority of fields) in medicine, radiation oncology is a very, very small field with limited positions available in general but especially if one is looking for a particular institution or even region of the country, and there are many objective and subjective reasons to believe that it will only be more so in the years ahead.

Fair, and yet in the last 5 years Vandy has sent people to UCSF, MD Anderson and Penn for Rad Onc. By all measures it doesn't seem like being at Vandy closes that many, if any, doors in that respect.


OTOH, deciding to take on 5-6 figure debt based off of the possibility of embarking on a career with a very finite number of training spots seems foolish. Taking on debt to do Rad Onc when you don't even know if you'll do well on Step 1 can lead to a bad time. Sure, everyone pays off their loans, but no debt beats loan payments every time in the context of an arguably marginal benefit obtained from going to a more prestigious institution.

 

[931408]

Since top 3 on the east havent released yet, I suppose your acceptance is on the west coast. You want to end up at the west coast long term. Choose the top 3.

Brilliant deduction.

Is this true? Hopkins is a top 3 and has released acceptances. Not sure if NYU is classified as top 3, but they have also released acceptances.

OP, I think this is a matter of personal preferences. If I were you, I would be happy to go to Vandy and move on in my career without any debt. If you are in a position to debate between these types of choices, you will be successful at any of the T20s. At the same time, I wouldn't mind attending any strong research institution across the country for my residency. Limiting yourself to top centers in the west coast makes it more challenging.

You can search RadOnc residents from UCSF and UCLA, which are arguably the top two medical centers on the west coast.

UCLA: Current Residents - UCLA Radiation Oncology, Los Angeles, Santa Monica, CA

UCSF: Current Residents | Medical Residency Program, Radiation Oncology Department

Searching profiles, it seems to me that most of the residents are from top 5 schools (UPenn, Harvard, UCSF). I definitely see plenty of others from fantastic schools (UMich, Northwestern, UCLA) that aren't in the upper echelon, and I would classify Vandy right there. You might get more assurance by attending a T5. If that is something that appeals to you, I'd recommend going to your T5.

 

[deleted18755]

Honestly OP, just look at the match lists of the two schools over the last few years and see where their grads go, and pick accordingly.



Fair, and yet in the last 5 years Vandy has sent people to UCSF, MD Anderson and Penn for Rad Onc. By all measures it doesn't seem like being at Vandy closes that many, if any, doors in that respect.


OTOH, deciding to take on 5-6 figure debt based off of the possibility of embarking on a career with a very finite number of training spots seems foolish. Taking on debt to do Rad Onc when you don't even know if you'll do well on Step 1 can lead to a bad time. Sure, everyone pays off their loans, but no debt beats loan payments every time in the context of an arguably marginal benefit obtained from going to a more prestigious institution.

I agree with all of this but along the lines of things quickly changing and in general being "weird" relative to the rest of medicine in small fields: the issue is securing a job, not a training spot/residency (when I applied it was all foreign grads but more recently radiation oncology was among the most competitive residencies in all of medicine for years . . . this year there are literally more spots than applicants so anybody who wants a residency position can have one (obviously not the case for top programs).

 

[Lexdiamondz]

I agree with all of this but along the lines of things quickly changing and in general being "weird" relative to the rest of medicine in small fields: the issue is securing a job, not a training spot/residency (when I applied it was all foreign grads but more recently radiation oncology was among the most competitive residencies in all of medicine for years . . . this year there are literally more spots than applicants so anybody who wants a residency position can have one (obviously not the case for top programs).

Which IMO is even more reason to avoid taking on any debt in the first place, especially if the no-debt option is only marginally worse. Entering a small, fickle job market after a long period of training doesn't bode well for someone carrying a 6 figure albatross around their neck.

 

[WedgeDawg]

Vandy is a well respected school will not close any doors, but top 3 will open ones up you didn’t even know existed. Academic medicine is very prestige-conscious. Given your goals, I would choose the top 3 school.

 

[Goro]

I'm sorry but I disagree here.

While there is a reputation gap between Vandy and a top 3, there is nothing really preventing a Vandy grad from pursuing an academic career at a relatively prestigious institution given that they are at least a half decent student w/o red flags on their app. Take a glance at their match list - the majority of their students match at prestigious academic programmes in a wide range of specialties. Truthfully, if you're unable to land an academic residency out of Vandy then there's a strong argument you might not have made it out of Harvard, Stanford or Hopkins either (NYU isn't a real top 3, lets just get that out of the way right now).

If your choice is a free T-20 vs paying nearly 100k after interest and COL at a top 3, I'd go to a T-20 for free every time. Nobody in the real world is as granular as the posters on SDN about the differences between top tier programmes - it's not like the people at MGH are chucking out applications from Cornell students because they aren't up to their standard of prestige.

Also consider the fact that if you're going into academia, you're going to be on a very long and poorly-compensated career track (especially if you're fixated on being in a high COL and saturated market like most of the west coast). Having six figure debt around your neck accruing interest for up to a decade can significantly derail you financially - especially when that debt could have been avoided for a similar outcome.

100% agree. If one gets shut out of Rad Once or any other speciality, it's not because they went to Vandy.

OP, go Vandy.

 

[Lucca]

Is this true? Hopkins is a top 3 and has released acceptances. Not sure if NYU is classified as top 3, but they have also released acceptances.

OP, I think this is a matter of personal preferences. If I were you, I would be happy to go to Vandy and move on in my career without any debt. If you are in a position to debate between these types of choices, you will be successful at any of the T20s. At the same time, I wouldn't mind attending any strong research institution across the country for my residency. Limiting yourself to top centers in the west coast makes it more challenging.

You can search RadOnc residents from UCSF and UCLA, which are arguably the top two medical centers on the west coast.

UCLA: Current Residents - UCLA Radiation Oncology, Los Angeles, Santa Monica, CA

UCSF: Current Residents | Medical Residency Program, Radiation Oncology Department

Searching profiles, it seems to me that most of the residents are from top 5 schools (UPenn, Harvard, UCSF). I definitely see plenty of others from fantastic schools (UMich, Northwestern, UCLA) that aren't in the upper echelon, and I would classify Vandy right there. You might get more assurance by attending a T5. If that is something that appeals to you, I'd recommend going to your T5.

Oh I forgot about Hopkins since they rejected me lol, u right u right. NYU is not reaaaaaally top 3 *ducks under desk*

 

[NITRAS]

Sorry if I missed it, but is this med school or undergrad?

Even if it’s med school I’d still go to Vanderbilt. You are a long ways from rad onc.

 

[begginandpleadin]

Sorry if I missed it, but is this med school or undergrad?

Even if it’s med school I’d still go to Vanderbilt. You are a long ways from rad onc.

For med school, and I’m interested in the discussion relating to academic medicine in general as well outside rad onc

 

[stickflip723]

If you're enough of a superstar to potentially be graduating debt free, I'm sure you'll have your choice of residency when it comes time. Why not get the prestigious residency then, when they're paying you and not the other way around? I was debating this question myself recently, but after looking up some of the faculty in departments of places I might like to work in someday (yes, even places like Harvard or Hopkins), there are tons of people who went to schools way less well known than Vandy and then matched somewhere like Hopkins from there.

To me it seems that residency matters just as much if not more, and that the connections you'll make there should be more than sufficient to propel your career in academia. Sure, there might be an argument to be made that getting into such a residency spot might be significantly easier coming from the Harvards or Hopkins of the world, but it's already been pointed out that Vandy kids match to these places all the time.

Of course, this is just one naive also-soon-to-be-M1's opinion, so take it with a barrel of salt. I'm willing to be convinced otherwise.

 

[Neuronix]

Vandy is a well respected school will not close any doors, but top 3 will open ones up you didn’t even know existed.

I went to a top 3, could you let me know where these doors are?

I would say to go to Vandy. Very strong rad onc program and still a strong medical school. If it's free take it.

But it's hard to know what opportunities or whatever I had just because I went where I did. I don't feel like it's gotten me much special, but who knows maybe it did and I just don't know it ?

 

[WedgeDawg]

I went to a top 3, could you let me know where these doors are?

I would say to go to Vandy. Very strong rad onc program and still a strong medical school. If it's free take it.

But it's hard to know what opportunities or whatever I had just because I went where I did. I don't feel like it's gotten me much special, but who knows maybe it did and I just don't know it ?

^^^ this guy knows better than me so listen to him.

It also will sometimes depend on the specific school. Not all top 3s or top 10s or top 20s are created equal, and can certainly be specialty dependent. In my specialty of interest, there are some “less prestigious” med schools with very strong home departments that match their students better than some top 10 schools, and there are some schools that feed to some programs; this is often more true in smaller specialties, which is why I extrapolated to rad onc, which is also one of the smaller fields. However, different dynamics may certainly be in play.

All I know is that if I were in that situation, I would take the top 3 school as long as I think I would be happy there. Whether that’s the right move for everyone is up for debate, but for my goals and situation, I think it would be the right move. For anyone else, I can’t say for sure.

 

[Dwight Snoot]

same

 

[differentiating]

I went to a top 3, could you let me know where these doors are?

I would say to go to Vandy. Very strong rad onc program and still a strong medical school. If it's free take it.

But it's hard to know what opportunities or whatever I had just because I went where I did. I don't feel like it's gotten me much special, but who knows maybe it did and I just don't know it ?

Also at an aforementioned top 3 school, and I disagree a little with this. My school’s name carries weight. I was specifically advised not to do aways for a less competitive specialty because the name + my app is strong on paper, so I’d only have room to drop in estimation. Others applying in the same specialty from less known schools needed at least one. There’s other factors- the fact that OP wants to be on the west coast, and that my school is incestuous for residency (can’t speak for the other) - but I don’t think the value of top name is insignificant.

Vandy may be a decent school (I know nothing about it), but imo, for such a low debt this is a situation where you go for the name.

 

[Lexdiamondz]

This is completely wrong. You really think Vanderbilt will get you the same places as Stanford? The name alone raises eyebrows. 60-80K debt is nothing- if it were double that, I’d argue that the top 3 isn’t worth it, but this is barely 40% of what you’ll make as a first year attending. Take the top 3 OP and don’t heed this advice lol.

Dude I went to a T-10. I Interviewed with students from Vandy at interviews at several "prestigious" institutions - literally look at Vandy's match list and compare it to any T-10, they're mostly going to the same calibre of residency. You literally don't know what you're talking about.

You're also forgetting that's 60-80k debt plus accrued interest, plus the astronomical COL of living in the Bay - OP would be paying a pretty significant opportunity cost for the possibility of matching Rad Onc at a prestigious programme in the West Coast (which, considering Vandy sent a grad to UCSF for Rad Onc last year, obviously is within the realm of possibilities).

 

[Lexdiamondz]

If we’re gonna measure up, I was recently admitted to a T-3, and have been weighing its prestige against a cheaper in state option, so I think I’ve done my research. Vanderbilt is no doubt a very solid school, but to the average layperson as well as to the academic community, the likes of Stanford and UCSF carry much more weight. Plus they receive more money in NIH funding, which means better faculty and more impactful output. Finally, Vandy’s name doesn’t carry through to the West Coast the way these elite schools will. If his/her goal is to stay there, s/he should go to the T3. The cost difference is under 100K, which on a doctors salary is very reasonable to pay off.

Good for you.

Nobody cares what the average layperson thinks - they're not the ones hiring academics, and in the community nobody really cares where you went to medical school. Yes, in academia Stanford and UCSF carry more "weight" and have more research opportunities but the difference isn't astronomical - as I've already said, people from Vandy match at prestigious programmes on both coasts all the time. Obviously Stanford and UCSF place better on the West Coast since they are geographically located there but only OP can decide if thats worth 100k - I personally dont

 

[NITRAS]

This is completely wrong. You really think Vanderbilt will get you the same places as Stanford? The name alone raises eyebrows. 60-80K debt is nothing- if it were double that, I’d argue that the top 3 isn’t worth it, but this is barely 40% of what you’ll make as a first year attending. Take the top 3 OP and don’t heed this advice lol.

Don’t be so flippant with debt. The nine years of training, and the amount will almost double. You want to really be sick? Plug $60,000 into a financial calculator for 30 years at an interest rate the markets have made...... its over a million dollars.

That’s the true cost of student loans.

 

[fds86]

As cliche as the statement sounds, I think you can't go wrong here - you'll be fine either way. I would choose based more on lifestyle, fit, and geography. I think the difference between the schools might have become a little bit more binarized and quantitative (i.e. "money vs. prestige", debt figures, rankings, T--, match lists, etc.) than it actually is. 60-80k is not bad debt, and vice versa, there is not that much of a prestige drop between the schools. I feel like you should evaluate qualitative elements in this situation.

Of course, you should still give consideration to the money, career prospects, etc. As an aside, I would also say it sort of depends on what you actually mean by academic medicine. If it means you think there's a good chance that you'll chase the K->R award track and end up with an 80:20 split as a neurologist/other lower paying specialty, then debt might be something you might be more motivated to avoid. But there are also loan repayment programs if you go that route, which could knockout that debt pretty quick without you every having to devote much of your income. But if you just mean being a clinical assistant professor at an academic medical center, or joining a high compensation specialty that doesn't really end up pursuing grants (like rad onc) then money is slightly less important.

For prestige, both schools match to top programs. The difference seems to be that Vanderbilt feeds more into top programs on the east-coast, whereas west-coast feeds into west-coast (obviously). Probably a combination of real factors and selection bias (since the student populations are drawn from certain places.

So if you're a west-coast person, you love being there, all your people are there, you want to be faculty at UCSF one day, and you're dreading the idea of leaving, it would be very reasonable to go with the T3 program. Or maybe you thrive on competition, and want to be running side-by-side with the brainest brains and unique-iest of unique-ees right off the bat. The money situation isn't bad. If you have these options right now, you've worked very hard for the last few years - hard enough to afford yourself the ability to choose something that will make you just enjoy your life more, even if it is a little bit "quantitatively irrational".

On the other hand, lifestyle could go the other way too. Maybe you like the idea of having a lower stress experience during med school, and supporting yourself in a bunch of ways so you can put your best foot forward and come out intact on the other side. Maybe even though you know the debt situation would work out in the end, it still makes you very worried - being debt free could avoid that "qualitative" psychological burden. Similarly, maybe you come from a less stable family financial situation, and having things all squared away would be a big load off your shoulders. Also, from the students I know at Vanderbilt, it seems to be a uniquely supportive, noncompetitive, and friendly environment. Perhaps you feel like you would do best in a setting where your classmates are still motivated and top-tier students, but slightly less intense or more interested in lifestyle balance; maybe you'd also appreciate being in a low-key city where it might be easier to be a student. That would be a reasonable choice too. (There's some stereotyping in there obviously, but I've been told similar things by a number of people who spent time at both Vanderbilt and coastal T3s at some point between med school/residency/young faculty stages).

Long post, but to sum up, I think the quantitative factors are close enough that you should make a qualitative decision based on fit.

 

[begginandpleadin]

As cliche as the statement sounds, I think you can't go wrong here - you'll be fine either way. I would choose based more on lifestyle, fit, and geography. I think the difference between the schools might have become a little bit more binarized and quantitative (i.e. "money vs. prestige", debt figures, rankings, T--, match lists, etc.) than it actually is. 60-80k is not bad debt, and vice versa, there is not that much of a prestige drop between the schools. I feel like you should evaluate qualitative elements in this situation.

Of course, you should still give consideration to the money, career prospects, etc. As an aside, I would also say it sort of depends on what you actually mean by academic medicine. If it means you think there's a good chance that you'll chase the K->R award track and end up with an 80:20 split as a neurologist/other lower paying specialty, then debt might be something you might be more motivated to avoid. But there are also loan repayment programs if you go that route, which could knockout that debt pretty quick without you every having to devote much of your income. But if you just mean being a clinical assistant professor at an academic medical center, or joining a high compensation specialty that doesn't really end up pursuing grants (like rad onc) then money is slightly less important.

For prestige, both schools match to top programs. The difference seems to be that Vanderbilt feeds more into top programs on the east-coast, whereas west-coast feeds into west-coast (obviously). Probably a combination of real factors and selection bias (since the student populations are drawn from certain places.

So if you're a west-coast person, you love being there, all your people are there, you want to be faculty at UCSF one day, and you're dreading the idea of leaving, it would be very reasonable to go with the T3 program. Or maybe you thrive on competition, and want to be running side-by-side with the brainest brains and unique-iest of unique-ees right off the bat. The money situation isn't bad. If you have these options right now, you've worked very hard for the last few years - hard enough to afford yourself the ability to choose something that will make you just enjoy your life more, even if it is a little bit "quantitatively irrational".

On the other hand, lifestyle could go the other way too. Maybe you like the idea of having a lower stress experience during med school, and supporting yourself in a bunch of ways so you can put your best foot forward and come out intact on the other side. Maybe even though you know the debt situation would work out in the end, it still makes you very worried - being debt free could avoid that "qualitative" psychological burden. Similarly, maybe you come from a less stable family financial situation, and having things all squared away would be a big load off your shoulders. Also, from the students I know at Vanderbilt, it seems to be a uniquely supportive, noncompetitive, and friendly environment. Perhaps you feel like you would do best in a setting where your classmates are still motivated and top-tier students, but slightly less intense or more interested in lifestyle balance; maybe you'd also appreciate being in a low-key city where it might be easier to be a student. That would be a reasonable choice too. (There's some stereotyping in there obviously, but I've been told similar things by a number of people who spent time at both Vanderbilt and coastal T3s at some point between med school/residency/young faculty stages).

Long post, but to sum up, I think the quantitative factors are close enough that you should make a qualitative decision based on fit.

Thank you so much for writing all of this out, I hadn't really considered the qualititative factor and it is undoubtdedly hugely important!

 

[Sheldor]

I just want to weigh in one more time:

Be wary of advice on this topic from people still in medical school. I remember so distinctly being SO concerned about prestige and rank lists. I would often post and lurk in the Rad Onc rakings thread. The further I've gotten in this career the more I've realized that it just does not matter as much as you think it does. You know what helps you go into academics with a salary half that of private practice? NO DEBT.

Seriously, prestige and "top 3" vs "Top 10" is only something pre-meds and medical students worry about. I know because it used to be me!

Caveat: Obviously going to a bottom tier medical school may hurt your eventual goals in academics, but the difference between 3-15 is not as big as it feels, I promise.

 

[qwerty89]

Don’t be so flippant with debt. The nine years of training, and the amount will almost double. You want to really be sick? Plug $60,000 into a financial calculator for 30 years at an interest rate the markets have made...... its over a million dollars.

That’s the true cost of student loans.

It's like people don't understand compound interest...

 

[Naruhodo]

n=1 but the person from my undergrad lab who took the full ride to Vandy med school subsequently matched NSG at MGH. Ultimately it's your call to weigh your personal values here, but I agree with those saying a med degree from Vandy won't close any doors.

 

[OrthoTraumaMD]

No debt = win. I would do vandy.

 

[Tenk]

Vandy for sure. You act like academic jobs are hard to land as an attending. They aren't. The pay is crap and the workload is absurd. You'll want to be debt free if you want to enjoy whatever small amount of free time you will have out of work. Vandy is a great school and you can match any specialty from there if you work hard and are smart enough.

 

[Lexdiamondz]

The only reason I mentioned my school is because you did as well, as if it proved your point.





@qwerty89 the problem with trying too hard to sound smarter than everyone else is that it usually backfires. I’m painfully aware that debt carries interest. You can check out my post history as proof.

@NITRAS I think that’s a disingenuous argument because no doctor needs 30 years to pay off a $60K debt. So it’s not going to turn into a million dollars. At most, assuming no payments during ~4 years of residency, it becomes $68K. This really is not a lot if you’re making 200-500K lmao. You can scrounge a bit for 2-3 years and come up with that. If your debt = income, then there’s an issue, but as it stands, I’d definitely invest 68K into a Stanford education.

Again, you're neglecting interest accrual during medical school, loans needed to cover COL in Palo Alto - where the average studio apt costs $3k/month in rent, never mind groceries, clothes, transport and incidentals - board review materials, exam fees, medical insurance (which they force you to have) etc. Never mind the fact that OP wants to do something hyper-academic and likely will need to do a research year to make their app competitive - that's another year of tuition. There's no way OP is walking away with only 68k in debt if they choose to go to Stanford.

People who actually finished medical school are telling you that debt is not something to sneeze at. Regardless of how well-read you think you are, you don't actually have any personal point of reference for this. Medical school is almost always more expensive than you think it is.

 

[Neuronix]

Vandy for sure. You act like academic jobs are hard to land as an attending. They aren't. The pay is crap and the workload is absurd.

I'm in academics, and I wish I could disagree with you.

 

[Lexdiamondz]

Debt calculations usually done by looking at how much you’ll need to borrow compared to the total COA, which includes meals and incidentals as well as exams in your second and third year. On top of that, OP is not taking out $60K as a lump sum at the beginning of med school. She will ACCRUE debt over the course of 4 years and have 60K once she GRADUATES. Therefore, it wouldn’t make sense to calculate interest for all 4 years of med school. In addition, educational loans don’t accumulate interest while you’re in school. So the 75K number is very accurate, unless she does a 10-year residency like neurosurgery. If you’re going to call me out on not being well-read, please do your research. Also, it’s not a given that OP will need to do a research year and as far as I’ve heard (although you have more expertise in this than me), other than for derm/neurosurg applicants, a research year seems uncommon.

Again, I agree that loans are not ideal. But with reasonable calculations the total amount even with interest is under 100K, which personally for an academic powerhouse like Stanford is worth it. The ultimate arbitrator will be OP of course.

OP in their original post gave a range of 60-80k - why you insist on choosing the lowest possible number to make your point doesn't really make sense. I'm well aware the calculations come from presumed COL - I'm also well aware that those calculations often undershoot what your actual COA considerably, most notoriously at places with a high COL. If you can manage to live frugally sure, great for you. But there are lots of incidentals that don't always get accounted for, and the vast majority of people leave medical school with more debt than they expected.

Also, there are many types of educational loans that do accrue interest during school at the graduate level.

As for the research year not being a given, at T-10s they are actually quite common - almost 40% of my class took a research year and that wasn't out of the norm at all. OP stated they intended to pursue a highly specialised field of medicine arguably dominated by MD/PhDs with a very small number of spots at an élite institution in arguably the most competitive geographic region in the country. There's a very good chance they will be taking a research year regardless of their school's pedigree, which means more money spent (and borrowed).