Abstract: Undergraduate college ranking plays only a minor role in medical school admissions. GPA and MCAT scores are far more important, with interviews, letters, and holistic qualities (like service, mission fit, and communication skills) increasingly decisive. Institutional prestige may help contextualize GPA but is not a deciding factor in admissions outcomes.
Introduction
For many premed students, choosing an undergraduate institution feels like a decision that could make or break their medical school prospects. The question often comes up: Does going to a highly ranked college actually improve your chances of getting into medical school?
The evidence suggests the answer is: not as much as you might think. While some older studies gave institutional ranking a prominent role in admissions decisions, most modern research shows that medical schools care far more about GPA, MCAT scores, and non-academic qualities than the prestige of your undergraduate college.
What the Research Shows
The role of undergraduate institution ranking has changed over time.
In the 1990s and early 2000s, a few studies suggested it could matter quite a bit. Hall and Bailey (1992) found that the selectivity of a student’s college correlated strongly with first-year medical school performance, putting it on par with MCAT scores and science GPA.1 Elam and colleagues (2002) also reported that institutional prestige carried significant weight in admissions committee discussions, although GPA, MCAT, and interviews remained central.2 Blue et al. (2000) described it as moderately important, noting that committees often used college selectivity to “contextualize GPA”—essentially, to judge whether a 3.6 from one school was equivalent to a 3.6 from another.3
But these were the exceptions. The majority of studies—seven out of ten reviewed—either did not mention undergraduate ranking at all or treated it as a background factor. Instead, they found that committees consistently relied on GPA, MCAT, interviews, and letters of recommendation as the key decision-makers.4
The Shift Toward Holistic Review
The move toward holistic admissions in the 2010s and beyond has pushed institutional ranking even further to the margins. Holistic review emphasizes not just numbers, but the whole person: values, service, communication skills, mission alignment, and the potential to contribute to medicine in unique ways.
Monroe et al. (2013) found that in schools using staged admissions processes, college prestige rarely factored into final decisions. Early screening relied on GPA and MCAT, but interviews and letters became the deciding elements later on.5 Stratton and Elam (2014) observed that admissions committees were increasingly looking at traits like professionalism and personality in predicting student success, with no mention of institutional ranking.6 Most recently, Bergemann and colleagues (2024) showed that undergraduate prestige wasn’t even included in regression models predicting applicant success; non-academic measures and traditional academic metrics carried the real weight.7
Taken together, these studies indicate that the more holistic a school’s admissions process, the less emphasis is placed on institutional ranking. Instead, prestige is only occasionally used to give context to an applicant’s academic record.
Why Committees Still Look at Prestige (Sometimes)
While ranking is not decisive, it is not irrelevant either. Committees sometimes take undergraduate selectivity into account when interpreting transcripts. For example, a strong GPA from a school with grade deflation might be weighed differently from an identical GPA at a school known for inflation. Elam et al. (2002) noted that committee deliberations could shift depending on members’ backgrounds and perceptions of certain institutions.8
But the predictive validity of prestige is weak compared to GPA and MCAT. AAMC data and other studies confirm that GPA and MCAT are much stronger predictors of medical school success, licensing exam scores, and even induction into honor societies like Alpha Omega Alpha.9 10
What This Means for Applicants
For students anxious about whether they chose the “right” college, the research offers reassurance. Medical schools are not systematically giving preference to Ivy League graduates or punishing applicants from regional public universities. What matters most is how well you did where you were.
- Strong performance at any school. A solid GPA backed by strong MCAT scores is far more valuable than attending a prestigious institution with middling results.
- Holistic factors are rising in importance. Service, leadership, communication skills, and mission alignment with the school can carry significant weight, especially in interviews.
- Context still matters. If you attended a less well-known or less selective school, aim to show rigor in your coursework and meaningful extracurricular commitments. Committees may use institutional reputation to interpret your record, but it won’t define it.
Ultimately, admissions committees want future physicians who can succeed academically and demonstrate qualities like compassion, resilience, and adaptability. College ranking doesn’t tell them that, but your application as a whole can.
Conclusion
The evidence base is not perfect as many of the available studies are single-institution and dated, but the trend is consistent. Historically, undergraduate prestige may have played a moderate role. Today, under holistic review, it has become a minor, contextual factor.
Applicants should take heart: success in medical admissions is not determined by the institution name on your diploma. It is determined by your performance, your preparation, and your ability to demonstrate the qualities that make a great physician.
Frequently Asked Questions
No. Ivy League graduates do not have an automatic advantage. Strong GPA and MCAT scores are still the most important academic factors, regardless of the institution’s name.
Not necessarily. Committees mainly look at what you achieved where you were. A high GPA and strong extracurricular record from a smaller or less selective school can still be very competitive.
There’s no evidence that DO schools systematically use institutional ranking any differently. Both MD and DO programs rely heavily on GPA, MCAT, and holistic factors like service, mission alignment, and interviews.
Generally, no. Transferring just for prestige rarely pays off in admissions outcomes. It’s more important to excel academically, pursue meaningful extracurriculars, and prepare well for the MCAT.
Primarily when committees want to contextualize GPA. For example, a 3.6 at a school with known grade deflation may be seen as comparable to a 3.8 elsewhere.
References
- Hall, F. R., & Bailey, B. A. (1992). Correlating students’ undergraduate science GPAs, their MCAT scores, and the academic caliber of their undergraduate colleges with their first‐year academic performances across five classes at Dartmouth Medical School. Academic Medicine. ↩︎
- Elam, C., Stratton, T., Wilson, J. F., Scott, K. L., & Lieber, A. (2002). Review, deliberation, and voting: A study of selection decisions in a medical school admission committee. Teaching and Learning in Medicine. ↩︎
- Blue, A. V., Gilbert, G., Elam, C., & Basco, W. (2000). Does institutional selectivity aid in the prediction of medical school performance? Academic Medicine. ↩︎
- Stratton, T., & Elam, C. (2014). A holistic review of the medical school admission process: examining correlates of academic underperformance. Medical Education Online. ↩︎
- Monroe, A., Quinn, E., Samuelson, W., Dunleavy, D., & Dowd, K. (2013). An overview of the medical school admission process and use of applicant data in decision making: What has changed since the 1980s? Academic Medicine. ↩︎
- Stratton, T., & Elam, C. (2014). A holistic review of the medical school admission process: examining correlates of academic underperformance. Medical Education Online. ↩︎
- Bergemann, A. D., Smith, S. R., & Daboub, J. A. (2024). In holistic admissions, a combination of non-academic explanatory variables has significant predictive value for applicant ranking. medRxiv. ↩︎
- Elam, C., Stratton, T., Wilson, J. F., Scott, K. L., & Lieber, A. (2002). Review, deliberation, and voting: A study of selection decisions in a medical school admission committee. Teaching and Learning in Medicine. ↩︎
- Schofield, W., & Garrard, J. (1975). Longitudinal study of medical students selected for admission to medical school by actuarial and committee methods. British Journal of Medical Education. ↩︎
- Association of American Medical Colleges. (2024). MCAT validity and predictive correlations. AAMC Publications. ↩︎
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