Hospital cafeteria food. Malignancy or benign-ness. Patient population seen in the third and fourth years. A medical school interview provides a fusillade of data points to consider, and an applicant can feel overwhelmed. But what criteria actually matter in the long run? Doctors can debate this question endlessly, but here, in no particular order, are the five criteria I believe to be essential considerations when making this all-important decision.
1. Location. Location holds critical importance for a number of reasons. You are more likely to attend residency and practice in a state in which you attended medical school or in a state you have lived before. This can be a deciding factor for some students to choose a less prestigious school.Family or other social support can be key in medical school success. Some medical students turned down other programs in order to be near parents or in-laws. I had a classmate who did this, and she had a peaceful home a quick drive away from school where she could study and eat home-cooked meals. The time she saved prepping and cooking food translated into better grades.Finally, proximity to a certain secondary recreational activity or career opportunity can be a consideration, though it probably should not be the primary consideration. For example, a future pharmaceutical industry executive would do well to go to school in New Jersey, where a part-time job or internship with a pharmaceutical company would be easy to find. A lifelong surfer may turn down a scholarship at the University of Texas to go to school in Florida, because she knows her mental and physical health will be better if she can surf regularly.
2. Cost. Even though the number of medical students graduating with no debt (i.e. Mom and Dad have a trust fund/fat checkbook) has sharply risen, that’s not the future of many prospective students. For applicants who have never summered on the family yacht, saying no to a University of Southern California (high cost of living, high cost of tuition, need to have a car all four years) may be the reality when offered a spot at a school like the Texas Christian University/University of North Texas Health Science Center School of Medicine, with (at least initially) a free year of tuition and low cost of living. While saying no to a more “name” school can be guilt-inducing, financial stress can negatively affect concentration and, therefore, school performance, which is the entire point. That being said…
3. Prestige. Especially for students trying to train in competitive specialties, an ongoing reality is that average students coming from prestigious medical schools may have an easier time in the residency match than very good students coming from average medical schools. This “prestige halo” continues through fellowship applications, applications for second degrees like the MBA or MPH, and on to job applications. A well-regarded training trajectory may lead to a high-paying job that helps with paying off the potential debt incurred by training at a prestigious school.
4. Medical school class size and makeup. This is something that’s rarely discussed, but is a real issue. Medical school classmates know you inside and out; these are the people that will vouch for you and say that they would be willing to have you treat their grandmother. Guess what? Classmates turn into medical directors and department heads, and can be absolutely invaluable when you are trying to make a job change or even a training swap. The more allies you have out there in the world, the better; the more people in your loyal alumni network, the better. I always advise my medical school essay tutees to go for the larger school, all other things being equal. My medical school class started with about 80 people. We lost about 6 or 7 to attrition. The small class had three major “groups”: the insular Middle Eastern group, the “diverse” group of people in their 30s and 40s who had small children and did not spend much time socializing, and a motley crew of everyone else. It is no wonder that our school did not have as much cohesion or bonding or school pride as the larger school in our region.
5. Home Program. Students with dreams of pediatric surgery or another subspecialty should ideally not attend a school without good exposure to that specialty. Who is going to be your mentor and advocate, without an established academic program in your specialty? Key questions to ask: How many doctors in [Specialty X] are there at your hospitals? How much research do they do and are they medical school faculty (i.e. with a title of Professor)? Or are they members of independent physician groups who just happen to see patients at the hospital? The former group will be expected to teach, do research, and help medical students. The latter group has no obligations to you as a student. One caveat: Look into the stability of the department. If you want to go into anesthesia, and the anesthesia department at your school of interest is large but has been ridden with scandals causing the departure of three chairs in as many years, think carefully before choosing that school.
For those students with the luxury of choosing among acceptances, making a medical school choice is ultimately a business decision. Looking objectively at these five factors will help to maximize the return on this four-year investment.
About the Author
Monya De, MD MPH is an internal medicine physician, journalist, and speaker in Los Angeles. She has been a reporter for the ABC News Medical Unit, a commentator for the television show “Hopkins,” and a script consultant for shows including “Harry’s Law”, “The Ghost Whisperer”, “Brothers and Sisters”, “House”, “The Firm”, and “black-ish”. Dr. De attended Stanford University and graduated with distinction from the University of California, Irvine School of Medicine. She is the co-author of the 2016 book Minerals:The Forgotten Nutrient. Find her on Twitter @medjournalist.