What are the "tiers" of schools?

[roca88]

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[jjmack]

It really all depends on what you want to study. Some schools have great neuroscience, but weaker genetics. Others great immuno and not so good neuro.

 

[Reimat]

Hi all,

I'm considering where to apply for MD/PhD programs, and many of you have made allusions to "upper-tier" or "lower-tier" schools, etc. Just for purposes of clarification, does anybody know of any site which may rank the schools according to upper-tier or lower-tier? If not, can somebody reply with their perceptions of the upper-, mid-, and lower-tier programs to get an idea of what is a reach and what is realistic? Thanks.

They're not the best source of info, but look at the usnews rankings for research focused med schools. Also, if you read a bunch of the forums around here, you'll get the general impression of what is considered 'top-tier'. My impression has been that Harvard, Wash U, Johns Hopkins, and UPenn to name a few are some of the top tier schools. Lower tier schools tend to include schools that don't have official MSTP funding from the NIH and instead offer MD/PhD programs that are partially funded.

At least this is what I think is the case- other people please correct me if what I'm saying is inaccurate.

 

[roca88]

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[Neuronix]

I agree with the above. The USNews rankings are probably the closest thing you can make to accurate. They take overall research funding heavily into account, which is something were interested in. Add some points to competitiveness for schools in desirable locals, like fun cities or California, and remove some points for competitiveness for schools in less desireable locals like the midwest. Hey, I have nothing against the midwest, it´s just that alot of people don´t wanna live there.

In general, MSTP schools are more competitive than non-MSTP schools for a reason. It´s good to have a student-friendly body looking over the program once and awhile to make sure they´re doing a good job. If you look at the USnews rankings, something like the top 30 schools are MSTP and there´s only 30some MSTP funded schools.

I´m pulling some of this out of my memory instead of resorting to facts, as I´m currently in Guatemala. I´ll be around from time to time until I return in August if anyone needs anything or if the forum explodes.

 

[1Path]

My question, however, was really just how to assess whether a school is "lower-tier" and less competitive as opposed to "upper-tier" and more ferocious in terms of the competition for the spots. Any more responses would be greatly appreciated!!

I've personally thrown out the idea of "tiers" as I apply MD/PhD this year. My main concern is can I get a residency in a field I want (pathology) in a place I want to live. I looked at where students ended up after school (both MD and MD/PhD students) in relationshp to residency placement and made my decisions based a LOT on this ( I have a family and won't be free to move around too much).

Now I know this could very well change of the next 7 years it will probably take me to finish. However, I learned the hard way that "rankings" don't me jack if you're not happy where your at.

 

[tedrik]

1Path brings up two good points:

I looked at where students ended up after school (both MD and MD/PhD students) in relationshp to residency placement and made my decisions based a LOT on this ( I have a family and won't be free to move around too much).

Schools normally like to brag about where their MSTP grads end up for residency, so this info should be on their website somewhere. A good school will have students matching at good residencies, so this is a good way to assign tiers.

However, I learned the hard way that "rankings" don't me jack if you're not happy where your at.

Well said

 

[roca88]

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[Neuronix]

It´s obvious my post wasn´t particularly PC, as I got all the ¨go where you´ll be happy¨responses. Yeah, I think that´s obvious. One word of caution: good luck figuring out where you´re going to be happy for 8 years from one interview and maybe one second look.

Still, if you want non-competitive, the inverse of what I posted above applies. Non-MSTP MD/PhD programs, fully-funded more competitive than not. You can also try lower ranked MSTPs as well. Generally this is the case, though obviously not always.

In response to tedrik, as far as residencies go, MD/PhDs from anywhere do exceptionally well in the match. It´s got way more to do with the individuals and their interests than the programs. A better way to assess happiness may be the dropout rate at a particular program, but good luck getting that out of anyone. As for Pathology--it´s just not a competitive residency and as such you´ll get a great residency with an MD/PhD from anywhere as long as there´s not something really wrong with you. That´s kinda true for all the traditional MD/PhD residencies (IM, Peds, Path), though I know I´m going to get flamed for saying it...

 

[1Path]

It´s obvious my post wasn´t particularly PC, as I got all the ¨go where you´ll be happy¨responses. Yeah, I think that´s obvious. One word of caution: good luck figuring out where you´re going to be happy for 8 years from one interview and maybe one second look....

I actually thought your post was right on, just something else folks need to think about in thinking through this process. Certainily not an attempt to put you on the defensive so if it came out that way, my apologies.

However, I think it can be said that for the unltracompetitve types MD/PhD applicants tend to be, the focus is primarily on getting the "best" education you can and that usually means US News rankings. My point was simply that in going to top schools you may very well be sacrificing something else far more important to you like closeness to a SO/family or location. Or even morals.

In my case, I'm applying to schools in all three "tiers" but I'm basing this on a particular interest in Pathology and location. It also appears that other MD/PhD applicants base some of their choice of school on a particular area they want to concentrate in. This tends to help narrow ones choices down somewhat.

 

[b&ierstiefel]

I've read the previous replies to the OP here. And in many respects, I agree with them. Look, everybody is different. For some people, the prestige of perceived rankings are going to matter a lot. Maybe these people don't have significant family issues or other personal issues that outweigh prestige issues. For some people, personal issues do outweigh prestige issues. Regardless of what may be the case, MD/PhD graduates pretty much get the residency placements of their choice.

When you finish your MD/PhD, you will quickly realize that you automatically fall into a different tier of applicants. You WILL be more qualified than your MD counterparts. So don't worry about residency match lists. Plus, the match lists don't necessarily reflect prestige; you can't really go on them to judge programs.

So yes, go where you will be happy. The fact that you have an MD/PhD will outweigh where you attended the program...assuming that you performed reasonably well. If you published nothing during your PhD phase, yeah that might become a problem. If you totally blew off med school, yeah that's gonna be a problem too regardless of where you did your training. Regardless of where you go, you will see some people who are total f*ckups. They will not do as well when it comes down to the residency match process.

As for pathology, pathology is nowhere near the point where it is picky to discriminate between MD/PhDs from different institutions. The fact is that if you have an MD/PhD, you're pretty much a shoe-in to one of your top choices.

 

[1Path]

The fact that you have an MD/PhD will outweigh where you attended the program...assuming that you performed reasonably well.

I'll be honest, the only place I ever here this is on SDN. And I'm split on whether or not I beleive it. It does make some sense that getting an MD/PhD from anyhwere university puts you in a better position to get the residency of your choice but none of the practicing pathologists I know, both MD's and MD/PhD's seem to agree with this. They all say for the mot part "go for the biggest name" in your area of interest. For example, is an MD/PhD from a primary care school which are typically ranked lower, really going to put you on the same "playing field" for a spot at MGH as someone from Hopkins all things being equal? Realistically, it's just hard to imagine that it will.

 

[Dr. Chiquita]

Apply to your state med school MD/PhD programs. As long as you are not from California, your state med school is pretty much your best shot. Following is just from my experience as a NJ resident. I found Drexel, SUNY-Downstate, and Tufts to be relatively easy to get interviews & accepted. The schools that I haven't tried, but heard is relatively easy to get into are off the top of my head: Rosalind Franklin and U of Illinois. You will get in somewhere. Don't freak out too much. Good luck!

 

[b&ierstiefel]

I'll be honest, the only place I ever here this is on SDN. And I'm split on whether or not I beleive it. It does make some sense that getting an MD/PhD from anyhwere university puts you in a better position to get the residency of your choice but none of the practicing pathologists I know, both MD's and MD/PhD's seem to agree with this. They all say for the mot part "go for the biggest name" in your area of interest. For example, is an MD/PhD from a primary care school which are typically ranked lower, really going to put you on the same "playing field" for a spot at MGH as someone from Hopkins all things being equal? Realistically, it's just hard to imagine that it will.

I agree. There is too much encouragement and less realism that goes on in SDN. The rah-rah cheerleading attitude (e.g., "oh you have a 2.8, you'll get into medical school if that is your dream" bullsh*t) just reeks in certain parts of SDN. On the other vein, I don't see the point of being too snobby on SDN either (and trust me, I am a snob). There needs to be an increased sense of plain realism on these forums though (reading some of the garbage in pre-allo just drives me nuts).

With that being said, pathology is one of the least competitive residencies and matching in this field is pretty easy. Pathology is not in the position to be too picky. You see people from a variety of medical schools landing at the top pathology programs. You have good connections with Hopkins pathology don't ya? Look at their match list and see where people came from. You'll see some folks from Ivy league medical institutions and you'll see people from state schools. Regardless, people who do match at these top institutions tend to be very smart no matter where they came from. Having just met my residency classmates and those senior to me at the Brigham, I am in the company of very sharp and cool folks!

When and if pathology becomes more competitive, then the top path programs will be in the position to be choosy. But at this point in time, pathology is just not there yet. You're not gonna be seeing these "all things being equal" situations very often; there just isn't enough applicants. Hence, for pathology, I stick with my belief that if you are an MD/PhD, you are very very qualified.

 

[1Path]

You have good connections with Hopkins pathology don't ya?

Yeah, but the problem is that I don't want to BE at Hopkins at this stage of the game (I'm heading back home after 20 years), hence the thrilled with the coursework/research not so thrilled with the "environment". I will however keep them in mind when fellowship time rolls around although I'll be honest, I'll probaby be shooting for the big "H" by that time!

Sorry to get off topic, OP. But I think Dr.Andy brings up a good point. Have you EVER met a "dumb" person with an MD/PhD from ANYWHERE? I know I certainly haven't. And for the record, my top choice is a state school too!

 

[b&ierstiefel]

Yeah, but the problem is that I don't want to BE at Hopkins at this stage of the game (I'm heading back home after 20 years), hence the thrilled with the coursework/research not so thrilled with the "environment". I will however keep them in mind when fellowship time rolls around although I'll be honest, I'll probaby be shooting for the big "H" by that time!

Sorry to get off topic, OP. But I think Dr.Andy brings up a good point. Have you EVER met a "dumb" person with an MD/PhD from ANYWHERE? I know I certainly haven't. And for the record, my top choice is a state school too!

Regardless, for the very competitive residencies, where you did your MD/PhD seems to matter. Past pedigrees can help foster placement into future successful pedigrees (duh, it's called "track record"). If you have pathology at the least competitive aspect of the spectrum, take a look at Harvard Rad Onc. The majority of them are MD/PhDs from Harvard, Hopkins, and other Ivy League medical schools. Gawd-damn-diculous.

OK so this thread is off topic as 1Path pointed out. You wanted people to stratify programs into upper, mid, lower tiers. I doubt people are gonna do this. That's a f*ckin' death trap just itchin' for flaming posts. I certainly am not going to "publicly" come out and express my opinions either. These conversations are best reserved for the bar.

 

[1Path]

If you have pathology at the least competitive aspect of the spectrum, take a look at Harvard Rad Onc. The majority of them are MD/PhDs from Harvard, Hopkins, and other Ivy League medical schools. Gawd-damn-diculous..

OK, so now I think I'm starting to understand. If you're shooting for one of the more competitive specialities, then where you get your MD/PhD matters more than if you're shooting for a noncompetitive specialty. The problem is that I'm hearing that path is becoming more and more competitive each day.

 

[b&ierstiefel]

OK, so now I think I'm starting to understand. If you're shooting for one of the more competitive specialities, then where you get your MD/PhD matters more than if you're shooting for a noncompetitive specialty. The problem is that I'm hearing that path is becoming more and more competitive each day.

You're right. Pathology is becoming more competitive relative to previous years. Still, however, relative to other uber-competitive specialties, pathology is still not competitive. IMHO, pathology has yet to reach the competitiveness of derm, opthalmology, radiation oncology, or radiology...and it's not gonna get there anytime soon. I might be wrong though. But I was having this very discussion with one of my colleagues the other day. Pathology is not going to be uber-competitive anytime soon because of the perceived horrible job market (you can make a ton of money being a private practice pathologist; but for you to get these jobs is not by any means guaranteed) and the fact that pathologists are not perceived by the lay public as "real doctors" (pathology isn't a very glamorous field in medicine). Furthermore, the numbers of MD/PhDs, wishing to pursue academic research careers, applying to pathology has remained relatively steady. It's the # of AMG straight MD applicants that has been steadily rising.

 

[Neuronix]

Pathology is not going to be uber-competitive anytime soon because of the perceived horrible job market (you can make a ton of money being a private practice pathologist; but for you to get these jobs is not by any means guaranteed) and the fact that pathologists are not perceived by the lay public as "real doctors" (pathology isn't a very glamorous field in medicine).

This is wayyyyyy off topic, but an interesting topic for me because I'm beginning to have the Rads v. Path war inside my brain since I've done my 6 months of clinics. Too much nonsense involved with seeing patients, and I think I enjoy the science behind medicine more than anything else. Lifestyle is important too. Yeah, I'm not graduating for another 5-6 years, but I like to think about it

Anyways, Radiologists are not perceived as real doctors and dont deal with patients, yet still it's a competitive residency. With all the shows like CSI on TV anymore, I think Pathology is way more glamorous than Rads. I meet people on the street now who want to be forensic pathologists (who don't even know they need to go to med school, but still). Pathology probably even has a better lifestyle than rads, especially during residency. I think the difference between the two comes down to one thing: money. Double the average salary of a practicing Pathologist and I bet it will instantly become as competitive as Radiology. I don't think that's going to happen, so it's going to remain uncompetitive. It's probably more likely that Radiologists will have their pay slashed in half eventually, and it will go back to being as uncompetitive as it was say 20 years ago. Maybe I'm just cynical... But, think about why Rads is way more competitive than Path and what other conclusion could there be?

 

[b&ierstiefel]

Agreed Neuronix. The salary difference between rads and path was what I had in mind as well when I made the initial part of the statement you quoted in your post. And I wasn't just thinking of starting pay either. It seems that you can make a ton of bank as a [private practice] pathologist but these jobs are more upper level and management type of positions that are not as abundant. It seems that a radiologist can make just as much money doing more routine stuff and these types of jobs are more abundant. In either case, doing rads or path is great because, albeit from different perspectives, you think a ton about pathophysiology which can satisfy the intellectual curiosities that drive many of us to even pursue a career in medicine.