Why is important to go to a top ranked medical school?

[carlosc1dbz]

I have been reading the forums for a while now, and I can see everyone wants to go to a top school, so that they can get the residency of their choice. I am not sure I understand that. Does that mean that if I go to a low ranked school, lets say Texas Tech for example, I wont be able to be a surgeon or something? I am a little confused about what it means to choose residency.

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[Robizzle]

What you just said is actually completely the opposite of the conclusions that these boards come to.

You can do whatever residency you want regardless of what medical school you go to, just as long as you do well. It's kinda like undergrad. The name gives you a slight edge, but that's where it ends.

 

[Fiddlergirl]

It doesn't matter. I talked to the head of Orthopedics at Johns Hopkins a few months ago, and he told me it doesn't matter where you go. It only matters how hard you work once you get in.

 

[braluk]

Ive heard this is how residency decisions break down:

10-20%: M1 and M2 grades (AOA, etc..etc..)
Rest: Step 1 Scores (major factor), Dean recommendation and letters of rec from your clinical years, research


Attending a prestigious school may affect the letters of rec and deans letters, given that their names may be more well published and may have more connections, but regardless, its a moot point because no one really knows how much this factors in- the strength of the letter goes further than the name of the person writing it. Research may also be improved to a degree if you pursue that route given that higher ranked research schools have a larger amount of NIH funds. However, Step scores and obtaining fantastic recommendations in general can be acquired anywhere in the US regardless of school and can help u with residencies, for the most part, anywhere you apply to.

In short: name recognition may help to a degree, but will only carry you so far. A good majority of those selected to a residency locaiton of their choice is highly dependent their own work ethic.

 

[Towelie]

I have been reading the forums for a while now, and I can see everyone wants to go to a top school, so that they can get the residency of their choice. I am not sure I understand that. Does that mean that if I go to a low ranked school, lets say Texas Tech for example, I wont be able to be a surgeon or something? I am a little confused about what it means to choose residency.

This question should be asked in the residency forums, not here. Pre-meds really don't know much about this subject.

 

[TheMightyAngus]

It will help you nail hot chicks.

References:
Angus TM. The Association between Medical School Prestige and Spousal Attractiveness Score. Arch Med Educ 2006. 15(2):1-16.

Angus TM. Sexual Satisfaction Among Medical School Graduates. Ann Sex Med 2005. 3(4):152-156.

Angus TM. The Preferences of Playboy Playmates and Reef Bikini Models for Graduates of Prestigious Medical Schools over Professional Athletes: A Randomized Controlled Trial. Brazil J Med 2007. 1(1): 21-30.

 

[Dookter]

Going to a top school will have its advantages. The problem is that it is hard to identify these advantages or say really how much of an advantage it will give you. Students from top schools do better when it comes to residency placement, etc., but it is almost impossible to know WHY they do better. The name of the school probably has less to do with it than some people think. Having the most dedicated, highest achieving students out of undergrad probably has something to do with it. Some of these kids know how to make it work, either through brilliance or [most often] by busting @$$. They keep it up in med school and do better in the end....but they'd have probably done this at ANY med school. Then there are the research opportunities, the reputation of the students that have already graduated [some kids who bust @$$ in residency and are brilliant from your school will give you a leg up for residency if you're from the same school], etc etc. There's really no way to come up with a great answer to your question. You CAN do anything from almost anywhere. The odds are just higher from a better school. I personally think much of it has to do with the things I listed above [better schools selecting for better students and these better students going on to give future students of their schools good reputations]. In the end you just have to ask yourself how much that "top" education is worth. On a related note, keep in mind that sometimes top schools are as cheap as state schools with scholarships/finaid.....

 

[Stolenspatulas]

chicks, babes, money, power, pride, success, swagger, hotties

 

[dutchman]

Go wherever you like, just keep an eye on the price tag.

 

[braluk]

Going to a top school will have its advantages. The problem is that it is hard to identify these advantages or say really how much of an advantage it will give you. Students from top schools do better when it comes to residency placement, etc., but it is almost impossible to know WHY they do better. The name of the school probably has less to do with it than some people think. Having the most dedicated, highest achieving students out of undergrad probably has something to do with it. Some of these kids know how to make it work, either through brilliance or [most often] by busting @$$. They keep it up in med school and do better in the end....but they'd have probably done this at ANY med school. Then there are the research opportunities, the reputation of the students that have already graduated [some kids who bust @$$ in residency and are brilliant from your school will give you a leg up for residency if you're from the same school], etc etc. There's really no way to come up with a great answer to your question. You CAN do anything from almost anywhere. The odds are just higher from a better school. I personally think much of it has to do with the things I listed above [better schools selecting for better students and these better students going on to give future students of their schools good reputations]. In the end you just have to ask yourself how much that "top" education is worth. On a related note, keep in mind that sometimes top schools are as cheap as state schools with scholarships/finaid.....

Agree. Higher ranked schools may have better placements on the sheet fact that they accept students that are amazing to begin with and their placement may not necessarily be where they attended, but what they did when they got there.

 

[coffeebythelake]

For your ego.

 

[tinypun2]

I think the biggest advantage of going to a top school may be if you want to do academic medicine and be faculty at a top school. Other than that I don't think it matters THAT much

 

[Law2Doc]

Ive heard this is how residency decisions break down:

10-20%: M1 and M2 grades (AOA, etc..etc..)

According to advisors I have talked to it's generally not even 10%, which is why some schools can get away with no grades, no ranking etc. Your boards and clinical years will decide your residency. And to the extent the basic science year grades factor in, second year counts far more than first, which is why it is emphasized on step 1.


As for prestige -- sure it helps, but far less than any of these other factors. Folks would trade a top name for a top step 1 score any day. Your achievements will decide where you end up.

 

[Wizard of Oz]

For your ego.

Ding Ding! Increased prestige often correlates with decreases in money left in one's pocket after the tuition bill has been paid.

 

[braluk]

According to advisors I have talked to it's generally not even 10%, which is why some schools can get away with no grades, no ranking etc. Your boards and clinical years will decide your residency. And to the extent the basic science year grades factor in, second year counts far more than first, which is why it is emphasized on step 1.


As for prestige -- sure it helps, but far less than any of these other factors. Folks would trade a top name for a top step 1 score any day. Your achievements will decide where you end up.

Good point- I just factored in AOA in there and bumped it up a few percentage points

 

[Law2Doc]

Good point- I just factored in AOA in there and bumped it up a few percentage points

I guess, although if you have everything else a lack of AOA probably won't be much of a barrier, though it looks nice if you have it.
One thing to note though is that although the basic science year grades don't mean that much, they tend to be good prep and the best indicator for how you will perform on Step 1, so you will still have an incentive to lock down the info and do well.

 

[CaramelDlite]

Probably just the "Benefit of the Doubt" factor. Sure, if you do great on the boards you can get top residencies anywhere. But what if you don't do great? Then what? I met a student at Harvard who told me that she did pretty terribly on the boards (how terrible is terrible for a Harvard student? I don't know, but it didn't seem too great..) but that she was still getting pretty good responses from top residency directors and she knew this was a result of attending a top school. Most likely if she had gone to Texas Tech she would not be afforded this luxury. This is influence can be seen in the pretty impeccable match lists top schools have. Surely not EVERYONE scored in the 95th percentile, but it seems that directors feel that if they were intelligent enough to get into Hopkins, Penn, UCSF, etc. they're probably pretty competent.

 

[Law2Doc]

This is influence can be seen in the pretty impeccable match lists top schools have.

Your statement certainly is supported by some anecdotal evidence here and there, but you are making the same leap of faith that others on this board tend to regularly make; that the worst people at a top schools still match competitively as a rule. I sure haven't seen data to support this, and folks further along than pre-allo will generally tell you the opposite (that school name simply doesn't matter all that much); it is considered but is a minor factor. Folks in pre-allo tend to have the worst vantage point in terms of this, and are often so focused on getting into the best programs they can, that they tend not to be receptive to the notion that it doesn't matter all that much.

I'm not sure what conclusions you can draw unless (1) you actually know the range of Step scores involved (i.e. if the worst harvard student still has a relatively competitive score, then that doesn't mean the harvard part makes a difference, even assuming arguendo that their match list is better), and (2) unless you have the ability to know which programs on a match list are good in which specialties (they don't track the US News med school rankings), it is impossible to compare match lists. (A school with a big name may actually have a lousy program in a particular specialty, so I wouldn't draw a conclusion that a list is good just because there are a lot of top 20 school names represented.) Food for thought.

 

[braluk]

Lol, I can also imagine that a student at Harvard is mostly Type A and a "terribly score" is probably one that can earn them a pretty good residency regardless.

 

[JohnMadden]

Biggest benefit is social/alumni network, although that can't be qualified. It may be more valuable in academic medicine as it relates to competing for research grants, etc...

 

[MrBurns10]

The thing that I find interesting is that average step 1 scores for top schools really aren't much better (if any at all) than more middle-tier schools (for example, UF is ranked between 45-50 but has an avg step 1 of about 230, which is damn good), yet the match lists for top schools seem to overall be really impressive with very few exceptions. If step 1 scores matter the most to residency directors, why do you guys think this is true (or not true, if you disagree)?

That's an honest question, by the way. There's no hidden point I'm trying to prove, I'm just curious if maybe school name (for whatever reason) matters more than we on here think, or maybe it's some other factor that's making the match lists generally impressive...?

 

[Khanal007]

One argument for going to a highly ranked school that I don't hear much: if you want to go into policy, international health, etc, I really feel having a big name school will open doors with connections, etc. It's not great, but nepotism and connections can go far.

For example, in international health, Hopkins has sooo many connections/contacts all over the world. Of course from any medschool, one can research and find contacts, but it's just easier when those things are already in place for you.

 

[Navicular]

The thing that I find interesting is that average step 1 scores for top schools really aren't much better (if any at all) than more middle-tier schools (for example, UF is ranked between 45-50 but has an avg step 1 of about 230, which is damn good), yet the match lists for top schools seem to overall be really impressive with very few exceptions. If step 1 scores matter the most to residency directors, why do you guys think this is true (or not true, if you disagree)?

That's an honest question, by the way. There's no hidden point I'm trying to prove, I'm just curious if maybe school name (for whatever reason) matters more than we on here think, or maybe it's some other factor that's making the match lists generally impressive...?

Some applicants choose not to attend the top-tier school they were offered an acceptance to due to location, price, and financial aid incentives from lower ranked schools.

 

[MrBurns10]

Some applicants choose not to attend the top-tier school they were offered an acceptance to due to location, price, and financial aid incentives from lower ranked schools.

True, but not every student at UF or whatever school you want to use as a comparison will be in this category. And if the class step 1 averages are the same or pretty close, then obviously both schools produce a highly capable "average" med student (i.e. someone in the median of their step 1 scores, if this is in fact the most important factor), so I'm wondering where the difference comes from. And granted it's hard to grade match lists, but there sometimes seems to be a difference in the match for the "average" student from each school, if that makes sense.

I agree with everyone else, though. I think it matters less than some people might think, I was just curious.

 

[JohnMadden]

The thing that I find interesting is that average step 1 scores for top schools really aren't much better (if any at all) than more middle-tier schools (for example, UF is ranked between 45-50 but has an avg step 1 of about 230, which is damn good), yet the match lists for top schools seem to overall be really impressive with very few exceptions. If step 1 scores matter the most to residency directors, why do you guys think this is true (or not true, if you disagree)?

How do you know the average Step 1 score for UF is 230?

 

[MrBurns10]

How do you know the average Step 1 score for UF is 230?

When I interviewed there last year, they made a huge deal of showing the interviewees all the data and graphs of their scores and how they were one of the best in the country. It was really impressive, albeit a bit on the cocky side...but I guess they were trying to sell the school after all.

 

[JohnMadden]

When I interviewed there last year, they made a huge deal of showing the interviewees all the data and graphs of their scores and how they were one of the best in the country. It was really impressive, albeit a bit on the cocky side...but I guess they were trying to sell the school after all.

Let me preface this by saying that UF is a great institution. However, I imagine it's easy to concentrate on Step 1 when you're in Gainesville...

 

[Navicular]

I think the similar Step I scores are probably due to the pool of students being rather equal at each institution. Don't get me wrong... a Harvard Medical student is probably a notch above a student at their state instituion. Due to the competition to get into medical school these days the range of aptitude is probably quite small when comparing instiutions. All medical students are capable of scoring high. This contrasts the undergraduate instituions where a Harvard Undergrad is leagues above a "no name" state school.

 

[da8s0859q]

I have been reading the forums for a while now, and I can see everyone wants to go to a top school, so that they can get the residency of their choice. I am not sure I understand that. Does that mean that if I go to a low ranked school, lets say Texas Tech for example, I wont be able to be a surgeon or something? I am a little confused about what it means to choose residency.

What you just said is actually completely the opposite of the conclusions that these boards come to.

You can do whatever residency you want regardless of what medical school you go to, just as long as you do well. It's kinda like undergrad. The name gives you a slight edge, but that's where it ends.

Go wherever you like, just keep an eye on the price tag.

And that, boys and squirrels, is that. Should I concretely decide on medicine and go through the hoops remaining in front of me, the cost of degree from any particular university will be right at the top of my list of priorities. That, USMLE-S1 scores, presence or absence of PBL, so forth, but the money is a bigger player than the name for me.

 

[MrBurns10]

I think the similar Step I scores are probably due to the pool of students being rather equal at each institution. Don't get me wrong... a Harvard Medical student is probably a notch above a student at their state instituion. Due to the competition to get into medical school these days the range of aptitude is probably quite small when comparing instiutions. All medical students are capable of scoring high. This contrasts the undergraduate instituions where a Harvard Undergrad is leagues above a "no name" state school.

I guess that's more where my question comes from...if every medical student is capable of doing well (which I believe is completely true...otherwise they wouldn't be in medical school), then why are the top schools' match lists, on average, so impressive, if the students really aren't all that different ability-wise?

 

[etf]

so that you won't end up making $70k a year.

 

[Auron]

so that you won't end up making $70k a year.

Is there any truth to this? That a top ranked med shool graduate would earn considerably more than a graduate from a state shool?

 

[Towelie]

Don't mean to be repetitive here, but maybe this thread should be moved to the residency forums? That way, the respondents might at least have some idea what they're talking about.

Just a thought.

The only way to get an accurate answer to your question will be to speak to current residents, or (even more preferably) residency directors.

 

[ICCONFETTI]

Is there any truth to this? That a top ranked med shool graduate would earn considerably more than a graduate from a state shool?

is this a serious question?

this is ridiculous what people will believe.

Answer; Of course not.

 

[braluk]

lol no. The shortage of doctors in this country will mean that business should always be available. Where you go will not affect how much you make assuming that you do what it takes to get the job done.

 

[Law2Doc]

How do you know the average Step 1 score for UF is 230?

This is actually one of the 3 or so schools who post their Step 1 scores on the web. None of the top schools do.

 

[Dookter]

Don't mean to be repetitive here, but maybe this thread should be moved to the residency forums? That way, the respondents might at least have some idea what they're talking about.

Just a thought.

The only way to get an accurate answer to your question will be to speak to current residents, or (even more preferably) residency directors.

That's where you're wrong. There isn't an accurate answer to this question. Why? We all know there is an advantage to attending a top school, but there is no way to pin down how much of an advantage exists or exactly why the advantage exists. Talking to a residency director wouldn't really even help unless you're talking about the advantage of going to a top school when it comes to that particular residency program.

 

[Law2Doc]

Is there any truth to this? That a top ranked med shool graduate would earn considerably more than a graduate from a state shool?

Residencies all pay about the same amount ($40ish to start). And once you get past residency, they only look at where you did your residency, not your med school. In medicine you are "only as good as the last place youve been". So if you did med school at XYZ and residency at PDQ, you are forever the dude from PDQ (unless you do a fellowship or another residency).

 

[pyrois]

I have been reading the forums for a while now, and I can see everyone wants to go to a top school, so that they can get the residency of their choice. I am not sure I understand that. Does that mean that if I go to a low ranked school, lets say Texas Tech for example, I wont be able to be a surgeon or something? I am a little confused about what it means to choose residency.

Although seemingly dissimilar, this has much to do with pass/no pass programs versus ranked or high honors/honors/pass/low pass/fail programs.

Say there's 2 derm spots at Mass Gen at Harvard (I think that number is rather generous, but we'll use it for the sake of argument). You get somebody from School A with scores of "Pass" and somebody from School B who's ranked "Number 1" in his class.

All else held equal, the guy from School B sounds better.

Now, let's say you're comparing two ranked schools. You get somebody from USC who's ranked "Number 1" in his class. Then you get somebody from Harvard who's ranked "Number 1" in his class.

All else held equal, who would you choose?

I didn't bother to check which schools rank and which schools don't so, don't waste your time "calling me out" on those details. This is just a thought experiment.

In the end, the reason why people say it "doesn't matter" where you go is that most residency programs (even highly competitive ones) have multiple slots available. So they have room to take the "Number 1" students from each school, essentially getting potentially the best of the best. But if you want to match into derm at a particularly competitive program... well yeah... you need to be the best. Period. In that sense, you have to go to a top ranking medical school and finish at the top of your class.

For everybody else... primary care, internal medicine, what have you, it matters much less because there are many more spots available. It still matters, mind you, but the end result may be the same regardless of which school you attend.

 

[pyrois]

I guess that's more where my question comes from...if every medical student is capable of doing well (which I believe is completely true...otherwise they wouldn't be in medical school), then why are the top schools' match lists, on average, so impressive, if the students really aren't all that different ability-wise?

With medical school (and this is most likely true of all graduate/higher level learning programs), despite the fact that all medical students are "about equal" the residency match program inherently puts a magnifying glass over those subtle differences.

When we applied to college, we were one of many. Kind of like a marathon race where each person finishes at drastically different times.

From college to medical school, it's more like a school or state-wide running competition, where everybody places within a minute of each other.

From medical school to residency, it is like the olympics, where ten runners may all finish within a fraction of a second from each other.

And yet still there is Gold, Silver, Bronze, and "not even on the podium." For competitive residencies, you have to be Gold material. For non-competitive residencies, you need to be Silver or Bronze material. And if you're not even on the podium, you don't get a residency spot.

 

[Law2Doc]

And if you're not even on the podium, you don't get a residency spot.

There are quite a few more residency spots than US allo spots. You have to be pretty far off that podium to not get something, as that means you are losing out to many many offshore students.

 

[pyrois]

There are quite a few more residency spots than US allo spots. You have to be pretty far off that podium to not get something, as that means you are losing out to many many offshore students.

Whoops, yeah. I was thinking about this doc in India who was stationed directly to an obscure clinic without any residency training due to her poor performance in med school (crappy policy IMO).

In the US everybody gets some sort of spot.

 

[Lests55]

I hear "If you are in medical school, then you are good enough to do XYZ." That is a flawed argument. Why is that necessarily the case? There might be 10,000 people capable of XYZ out of ~17,000 students. Was there the same number 5 years ago when there were fewer medical students? Will there all of a sudden be 5% of a class that is less than capable when class sizes get better? It is impossible to tell who has the ability (in this case we are assuming people reach their potential, an even harder to quality to quantify, let alone qualify) and who does not.

 

[searun]

Whoops, yeah. I was thinking about this doc in India who was stationed directly to an obscure clinic without any residency training due to her poor performance in med school (crappy policy IMO).

In the US everybody gets some sort of spot.

of US Allopathic med schools to fill residency positions, and that it is necessary to recruit from foreign med schools to fill these positions, then why did you make such a stupid statement - i.e. unless you get a bronze medal in this Olympic Competition, you are screwed. That is an ignorant and absurd comment. Do your homework before you spout off.

 

[xylem29]

I guess that's more where my question comes from...if every medical student is capable of doing well (which I believe is completely true...otherwise they wouldn't be in medical school), then why are the top schools' match lists, on average, so impressive, if the students really aren't all that different ability-wise?

If what you are saying is true, that there is a difference in match lists - I'd also like to know why this is so, if there is an explanation at all...are these top school's really worth the money or not?

 

[45408]

I guess, although if you have everything else a lack of AOA probably won't be much of a barrier, though it looks nice if you have it.
One thing to note though is that although the basic science year grades don't mean that much, they tend to be good prep and the best indicator for how you will perform on Step 1, so you will still have an incentive to lock down the info and do well.

And because 4 years of undergrad has conditioned you to want to get the highest possible grade on every exam, even though only one person will actually have the best grades in the class.

 

[45408]

then why are the top schools' match lists, on average, so impressive, if the students really aren't all that different ability-wise?

Top schools are very selective, and they pick people who have done a lot and done it well. Surprise, surprise, these people will continue to do a lot and continue to do well, so they match into good programs. However, that doesn't mean that their med school had much to do with it, so if you're accepted into two schools, you don't have to pick the higher-ranked one just to get a good residency. Also, what a "good" match list is to you might not be to the next guy. If someone is interested in primary care, then why do they care if half of the class matches into derm?

 

[MrBurns10]

Top schools are very selective, and they pick people who have done a lot and done it well. Surprise, surprise, these people will continue to do a lot and continue to do well, so they match into good programs. However, that doesn't mean that their med school had much to do with it, so if you're accepted into two schools, you don't have to pick the higher-ranked one just to get a good residency. Also, what a "good" match list is to you might not be to the next guy. If someone is interested in primary care, then why do they care if half of the class matches into derm?

My original point was that top tier schools' avg. step 1 scores aren't that much better (if at all) than middle tier schools, yet their match lists are more impressive. So that leads me to one of two conclusions: 1) either the quality of students is similar at both schools and the match lists come from some other factor, or 2) the quality of the students at the top school is better (as you say) yet some factor other than what people argue is the single most important factor (board scores) is what is determining the placement...along these same lines, I really doubt that students at top schools end up doing more ECs or research projects than students at other schools, especially if they're both gunning for the same specialty, so this is probably not the differentiating factor. In fact, the opposite might be true...last year when I was planning on going to my state school over a couple much higher ranked schools, I knew I would have to make myself stand out more. Anyway, that was just my logic. Maybe I'm missing something here.

Also, sure match list quality may be subjective to a certain degree, but I think there is an objectivity to it as well. How many students are placing in competitive residencies, and for those in less competitive residencies, where are they placing?

Again, I don't want to make it seem like I'm arguing to some conclusion, I just don't think I was completely clear with my initial question. I think Dookter is right when he said we just don't know how much name matters (and I'm sure the degree to which it matters differs for every residency director)...so I guess moral of the story, there's no point to arguing any of this because nobody knows

 

[xylem29]

Yeah, but primary care isn't necessarily without competition - I thought that the program is what makes it competitive. For instance, if all the UCSF students who matched into primary care programs at say Hopkins or Harvard, and all the primary care applicants from Albany matched to say Loma Linda - then the UCSF kids had a more impressive match if you ask me.

There is a difference b/w matching into a good derm program and a bad derm program with little money and research activity. Right?

Anyway, one thing to throw out there is the idea that maybe these higher ranking programs wish to somehow maintain their "image" by taking in students from high ranking schools??

 

[jayhawk07]

Why is important to go to a top ranked medical school?

Braggin' rights, son. Braggin' rights!