What Really Matters When Choosing Your Medical School

Last Updated on June 26, 2022 by Laura Turner

Many students don’t realize that the residency match should be top of mind when choosing their medical school. Even though residency is several years away, your time spent as a medical student will determine the fate of your residency. This is because residency directors have various criteria that they look for in their future residents, and these criteria come from specific factors acquired in medical school.

Therefore, when deciding which school is right for you, be sure to think about more than just location and class size. Do your research. Not all medical schools are designed the same, and some will prepare you for residency more than others.

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Residency programs vary just like medical schools—each one with its own priority list of criteria for future residents. However, there are several factors that all residency directors focus on when starting the residency-match process.

Step 1 Scores
The NRMP’s report has shown year after year, the number one criteria have almost always been, and will likely remain Step 1 score. Seek out a school that not only integrates Step 1 preparation into the curriculum but that the curriculum itself is designed to help students succeed. Look closely at how the classes are scheduled, when shelf exams take place, and how the whole experience is structured. A great sign that a student is in a school that’s interested in their success is how that school evaluates student outcomes and adjusts accordingly to not only incorporate the latest, best practices but to give them the best possible opportunity to absorb and apply the material.

Letters of Recommendation
So much of clinical rotations can be about performing under pressure and realizing that you are being evaluated at all times. At the same time, almost paradoxically, a major concern of medical students is whether or not their performance is being noticed at all, and how that will be reflected in letters of recommendation. A school with heavy, active clinical observation and experience as early as possible in your basic science terms, (shoot for weekly if you can) is an indicator that you won’t just get noticed, you’ll impress.

The MSPE or Dean’s Letter
Typically, an MSPE is a form letter compiled through grades and faculty evaluations. Some schools build these one piece at a time over the course of a student’s time at the school. In other cases, they’re written at the conclusion—both are valid. What matters here, though, as far as really moving the dial, is how well the dean will know you personally. Students at smaller schools and students who rise to leadership positions are at an advantage. Being a face and not just a number on a spreadsheet is a cliché, but it can push a student’s letter from formulaic and pat to genuinely impactful.

Something often overlooked is whether or not a school has enough seats in its core rotations for every student without relying on heavy attrition. This will ensure that students can proceed upon passing Step 1 as soon as possible and maintain their momentum and avoid drastic changes in the cost of living, loan repayment, etc. Another key priority should be looking for all of those rotations in the same city. Some schools spread their clinical years across states and even countries. This is intensely disruptive to student learning and should be avoided at all costs. Look for faculty that also works with students, even by providing career guidance on many other areas of professional development—not the least of which is residency selection strategy.

Personal Statement
While a student’s personal statement is acknowledged as a critical element to success in The Match, what goes into properly shaping the person crafting that statement is frequently missed. Students should make sure their school has an active culture in and around medicine and volunteer opportunities. (Sorry, the benefits in this area don’t stop with undergrad. In fact, the NMRP report even breaks down, by specialty, how much was too much, what was enough, and where there was room for more). Continued experience helping others, especially in and around a future profession, only serves to enrich education with relevancy and shape students into the doctor they want to ultimately become. If medical students can manage to maintain a full, healthy life and keep up with their studies, they will be able to develop a personal statement that stands above the competition.

It’s All in the Experience
When it comes down to it, almost every factor in residency match success comes from the student: USMLE Step scores, attributes highlighted in letters of recommendation, and a dean’s letter that captures who they are, not just what they’ve done. These personal achievements come from the environment that shaped them, the faculty that taught them and the experiences that were made available. It’s on medical students to make the right choices for themselves, but at the same time, it’s on the medical school to make sure it offers the singular best opportunity it can for those students.

Medical students don’t thrive in a vacuum. They need a curriculum, faculty, support structure, living environment, extracurricular opportunities, even a student body that is shaped to help them succeed. It’s about providing the best context possible for medical students to absorb and learn to apply an enormous amount of information. A school shouldn’t just provide that information, it should help students develop on a personal level into the sort of physician a residency director wants on their team and, ultimately, caring for their community.

12 thoughts on “What Really Matters When Choosing Your Medical School”

  1. Valid points, seems a little odd that’s this is coming from a carribean medical school administrator lol

  2. shouldn't this be over in the pre med forum…after all residents have already been though med school.

  3. @gonnif Most Caribbean schools establish a large set of in-house corpus literature on residency placements, statistics, and other factoids that are targeted towards interested premeds. The long con is that they can reference their own literature with footnotes because they know that the lay man usually doesn't bother with checking the references cited.

  4. Valid points, seems a little odd that’s this is coming from a Caribbean medical school administrator lol

    I would usually agree but perhaps some of the offshore schools are trying to differentiate themselves by seemingly fewer diploma mills. They also may be trying to firm up a reputation and the expected shake-up in 2023 when EMCFG will require that all offshore schools be accredited by somebody. Trinity may be trying to make a push behind a different body.

  5. Ah, so it goes under the “see we know what we are talking about” con where the mark says “well if they know what they are talking about they must be doing the right thing”

  6. To clarify, I remember seeing a Ross infographic on the Unit’s campus board about match placements with footnotes backing up their data. I was bored enough to pull up the infographic and found that the annotations were just other infographics that the school released that had no background sources. Perhaps I’m overreacting, but I think that it's the semblance of institutional integrity they are trying to imitate with articles like these which a recruiter can use to put a foothold in a marks mind that “x school has some standards as they have y literature.”

  7. Kinda disappointed this is an "official" SDN-supported article, since it honestly reads more like a post on "the major elements needed to have a competitive residency application" that doesn't say much of anything, rather than discussing the specific factors at each school that enable you to accomplish those things, and that you need to evaluate/compare. The broad strokes advice given for how to achieve things like good Step 1 Scores, LORs etc. (that no one needs to be told are important for the residency match…) really seems overly generic and not that helpful too, since basically every school strongly touts that they offer the best environment to achieve all of this, frequently using the exact same type of language (how do you even evaluate something as vague as "Look for faculty that works with students, even by providing career guidance on many other areas of professional development"? literary every school says they have this, regardless of how true it is in reality). Like, saying things like "you need to find a school with a curriculum that is designed to help you succeed in Step 1" is obviously true, but pretty meaningless without going into the details of what this exactly entails (which at least for me in terms of "helping you succeed in Step 1", were practical things like pass/fail vs. graded pre-clinicals, unranked vs. ranked, mandatory lectures vs. optional, availability of recorded lectures online, flexibility in taking Step 1, time given for dedicated, and on and on).

    The advice given for what to look at in terms of rotations at schools seems kinda off too – "whether or not a school has enough seats in their core rotations for every student without relying on heavy attrition" being the first key priority really does not seem to be an issue that will affect the vast majority (all?) of US MD/DO programs, and listing "looking for all rotations in the same city" as the second key priority is interesting – many of the schools I interviewed at (including the one I eventually decided to attend) touted having rotations in different cities/multiple training sites as a strength instead, in terms of giving more robust clinical training, and greater exposure to different patient populations. Also looking back at what the author wrote about Step 1, how does "look at when shelf exams take place" have any relevance to Step 1 success specifically, or am I missing something?

    Surprised that research (availability of opportunities, MS1 summer research options, if there is a structured way to undertake research or if you're on your own blindly e-mailing researchers, program flexibility in terms of taking a research year, funding options etc.) wasn't mentioned even once either, since the importance of research for competitive residencies has been basically beaten into my head over the last few months by admissions faculty during interview days and second looks.

  8. Great. How tf do you expect a premed to predict which school will give all of this to them?

  9. Also the different cities for rotations can be a pain I'm sure but it also gives you an opportunity to see different parts of the country and different patient populations which will be a benefit in the long run. Most medical schools aren't in some huge metropolis where you get a very diverse patient population. Most of the rest of that post is common knowledge though

    Also….the author is the recruitment person for a Caribbean school which should set off all sorts of red flags and alarm bells for any informed person. I would recommend listening to zero of what people who are associated with those money grab scams say. Its bad they prey on the neurotic nature of pre-meds as a whole to give them a 50/50 shot of not ruining their lives. Immediately loses almost all credibility in my book

  10. I think we should add "Consider that Match rates, across the board, and in competitive specialties, from Caribbean schools are generally worse than any MD or DO school in the US" to that list, given the affiliations of the author.

  11. Pretty sure this is only “overlooked” because it’s only an issue for foreign med schools. I would bet 0 LCME allopathic schools do this and I think 0 DO schools do this as well?

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