What do you value more, P/F grading or lower tuition?

[EdgeTrimmer]

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In a similar situation as OP, but with slight differences. In this case both schools are P/F with similar Step2 scores.

School A:
- Approx $40K/year in low COL area
- T80
- Class is entirely ranked

School B:
- Approx $60K/year in a high COL area
- T30
- No internal ranking whatsoever

I’m honestly waffling back and forth since $80K+ is no pocket change, but I don’t want to shoot myself in the foot if I spontaneously became interested in a competitive specialty later on.

I’d love to hear some opinions on which you guys think is better!

Go with T30 if you are thinking of competitive specialties.

 

[Putkernerinthehall]

I HATE telling other people how to spend their money, but this really doesn't seem that close at all to me.

$80K is very definitely pocket change, even with accrued interest, when spread over a lifetime of MD earnings. If School B truly has no internal ranking, that $80K is buying you insurance against being ranked near the bottom of the class at School A, plus whatever prestige is associated with T30 vs. T80. For less than a $100K difference spread over 4 years, that's a huge bargain and this looks like a no-brainer to me. If the money is that important to you, then there is no reason to look at anything other than money, and there is nothing to waffle over.

I completely agree. Easy choice here. School B.

 

[Goro]

In a similar situation as OP, but with slight differences. In this case both schools are P/F with similar Step2 scores.

School A:
- Approx $40K/year in low COL area
- T80
- Class is entirely ranked

School B:
- Approx $60K/year in a high COL area
- T30
- No internal ranking whatsoever

I’m honestly waffling back and forth since $80K+ is no pocket change, but I don’t want to shoot myself in the foot if I spontaneously became interested in a competitive specialty later on.

I’d love to hear some opinions on which you guys think is better!

School A

 

[ampersandwich]

Thanks everyone. I’m leaning towards School B but will do some serious soul-searching (and financial planning haha) before the end of April.

 

[Matthew9Thirtyfive]

In a similar situation as OP, but with slight differences. In this case both schools are P/F with similar Step2 scores.

School A:
- Approx $40K/year in low COL area
- T80
- Class is entirely ranked

School B:
- Approx $60K/year in a high COL area
- T30
- No internal ranking whatsoever

I’m honestly waffling back and forth since $80K+ is no pocket change, but I don’t want to shoot myself in the foot if I spontaneously became interested in a competitive specialty later on.

I’d love to hear some opinions on which you guys think is better!

Do you like them both? The area? The curriculum? Etc?

School A will not hold you back from any specialty. Might be harder to match mass gen, but it’d be hard from a T30 too.

Ranking isn’t that big of a deal IMO. Save the $80k in tuition and the COL money which will add up.

 

[Putkernerinthehall]

Do you like them both? The area? The curriculum? Etc?

School A will not hold you back from any specialty. Might be harder to match mass gen, but it’d be hard from a T30 too.

Ranking isn’t that big of a deal IMO. Save the $80k in tuition and the COL money which will add up.

Live like a resident for your first year as an attending and that $80k will be gone in no time.

 

[Matthew9Thirtyfive]

Live like a resident for your first year as an attending and that $80k will be gone in no time.

It’s not just $80k. A higher cost of living will inflate that into 6 figures. If they like both schools the same, I’d pick the cheaper school. It doesn’t matter if you can pay off that debt. It’s still debt and the difference between a T80 or a T30 is not going to be that big of a deal unless they are thinking academic medicine at top programs. Just my opinion.

 

[KnightDoc]

It’s not just $80k. A higher cost of living will inflate that into 6 figures. If they like both schools the same, I’d pick the cheaper school. It doesn’t matter if you can pay off that debt. It’s still debt and the difference between a T80 or a T30 is not going to be that big of a deal unless they are thinking academic medicine at top programs. Just my opinion.

You're in school and I'm not, so you are way closer to it than me. I also know that your experience at USUHS, and your opportunities coming out, will be atypical, but still, while you say ranking isn't that big of a deal, do you know if that is true for someone in the bottom 25% at a T80?

If not, is the insurance maybe worth it for an ORM non-trad reapplicant with a 63 LM from UG and a 70 LM from a SMP? I don't know, which is why I'm asking, but I'd be nervous about full ranking at a T80 if I had the chance to avoid that at a T30 just by taking on some extra debt. Especially if I didn't have high stats to start. After all, someone has to be in the bottom of a class. Who's to say it would be me, or the poster? Does being ranked near the bottom really not matter, even at a T80? If not, why rank at all? What do you think, given these details?

 

[Matthew9Thirtyfive]

You're in school and I'm not, so you are way closer to it than me. I also know that your experience at USUHS, and your opportunities coming out, will be atypical, but still, while you say ranking isn't that big of a deal, do you know if that is true for someone in the bottom 25% at a T80?

If not, is the insurance maybe worth it for an ORM non-trad reapplicant with a 63 LM from UG and a 70 LM from a SMP? I don't know, which is why I'm asking, but I'd be nervous about full ranking at a T80 if I had the chance to avoid that at a T30 just by taking on some extra debt. Especially if I didn't have high stats to start. After all, someone has to be in the bottom of a class. Who's to say it would be me, or the poster? Does being ranked near the bottom really not matter, even at a T80? If not, why rank at all? What do you think, given these details?

I guess ideally unranked would be better than ranked. One thing though is that being at the bottom of the class ranked or unranked makes it more likely you’ll score lower on step (step 2 now, which PDs have said they’ll look at more now that step 1 will be p/f). A low step score will hurt you whether you go to a ranked or unranked school.

My personal opinion is to save the money. But that might be because I’m 36 and have seen what debt can do.

 

[Putkernerinthehall]

It’s not just $80k. A higher cost of living will inflate that into 6 figures. If they like both schools the same, I’d pick the cheaper school. It doesn’t matter if you can pay off that debt. It’s still debt and the difference between a T80 or a T30 is not going to be that big of a deal unless they are thinking academic medicine at top programs. Just my opinion.

Inflation is running well less than 2% and will be for some time to come. You come out making maybe $220k. Pay your taxes and you're left with maybe $175k. $75k to live on that first year and $100k to apply to that debt. Easy. I'd choose B in heartbeat, all else equal.

 

[Matthew9Thirtyfive]

Inflation is running well less than 2% and will be for some time to come. You come out making maybe $220k. Pay your taxes and you're left with maybe $175k. $75k to live on that first year and $100k to apply to that debt. Easy. I'd choose B in heartbeat, all else equal.

Not inflate as inflation. I meant inflate as in ballooning the cost with extra expenses.

 

[KnightDoc]

I guess ideally unranked would be better than ranked. One thing though is that being at the bottom of the class ranked or unranked makes it more likely you’ll score lower on step (step 2 now, which PDs have said they’ll look at more now that step 1 will be p/f). A low step score will hurt you whether you go to a ranked or unranked school.

My personal opinion is to save the money. But that might be because I’m 36 and have seen what debt can do.

I hear you, but your situation is unique in more ways than one. Given your history and commitment, do you plan on ever entering private practice?

 

[Putkernerinthehall]

Not inflate as inflation. I meant inflate as in ballooning the cost with extra expenses.

Oh, you mean what my father refers to as "lifestyle creep." That was exactly my point. Live as one did as a resident during your first year as an attending and pay off the additional debt. Discipline.