Choosing the Right Medical School

I was reading through “Best 168 Medical Schools“, a manual created by Princeton Review, analyzing the unique aspects of many popular schools my peers and I had applied to. Unlike college where transfers from one place to another are frequent, medical school tends to be more concrete – once you start at one school, you finish at that same school. So how do you know you’re picking the right one?
Personally, Baylor Med was an easy choice for me for the following reasons (not in any particular order):

Proximity to Home

I tend to get home sick rather easily. Not only because I miss my parents, but I’ve lived in Houston my entire (minus six months) life. I love traveling, but won’t live anywhere else. There just isn’t a reason for me to leave Houston when the world’s largest medical center is right around the corner.

Curriculum

Does the school have a curriculum which will help me ace those board exams and land a residency of my choosing? This is probably the most obvious concern for pre-meds; however, it’s probably the most elusive aspect of any school. How will the professors be? Will the students adopt a competitive or collaborative mentality? There are countless questions regarding the curriculum which one will not truly know until he or she attends the school, yet it’s still important to consider the statistics of previous classes.

Residency

Before I wanted to go to Baylor Med for medical school, I knew (more importantly) that I wanted a residency program there. Residency is far more important in terms of “training” a doctor than the didactic, fact-ridden classes of medical school.

What criteria do you base the quality of a school on?

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3 Comments
  1. UTSWStud says

    This probably sums up what to ask: http://www.aamc.org/students/applying/about/31questions.htm

    Things I would say that are pretty important from your list:

    1. Reputation/Ranking – I thought the medical school rankings were quite accurate in hindsight. Is there a real difference btw 19 and 27? Probably not, but is there a real difference between a top 30 and #100? Yes. While the USWNR rankings are based mostly on NIH funding, this is actually very important. PhDs want to go to institutions that receive a lot of NIH funding to do their research. By keeping those PhDs happy, they in turn will be more inclined to be enthusiastic in teaching medical students, who will then ultimately benefit on their board exams. Quality of medical education builds from the bottom up, so you have to have intelligent, competent basic science faculty.

    2. Curriculum (Organ-System based vs. Traditional Subject Based): It’s just 2 different ways of “compartmentalizing” the information. Pick which one you think you would learn better from and choose the school that uses it. One thing about an Organ System based curriculum is that while Pharmacology, Physiology, Pathology fit perfectly, things like Biochemistry and Microbiology (where an infectious disease can affect more than one organ system) do not. Also, very few board review texts (BRS, NMS, Rapid Review, High Yield, etc.) go by organ systems, but instead go by basic science review subject. Also, many schools when they first change from subject-based to organ-system-based, the first year or two tend to be guinea pig years (very disorganized and disjointed), so when choosing a school, ask students how well curriculum “revamping” has worked out: http://services.aamc.org/currdir/section2/courses.cfm. Obviously getting the USMLE Step 1 and 2 CK averages in the past few years is a good idea. A school should be more than happy to give you those numbers. If not, that should put up a red flag for you.

    Adding to it:

    3. Residency Match stuff – Does the school have a residency program in the specialty you’re considering? How helpful are they with their own students? (You could ask to get in contact with one of the students in that specific specialty interest group, to get more info). Some of the med schools don’t have a few of the competitive specialties as residency programs or don’t have research opportunities as either they are not a research hub, don’t have opportunities for students to get involved in, or don’t get enough funding. Seeing several years and looking to see how many people match into a competitive specialty can show you trends of where students feel comfortable going for. A place that does not have a Neurosurgery residency program and in the past 10 years has only had 2-3 people match in Neurosurgery, is not a good sign. Even with a one-month audition elective somewhere else, it’s so little time to get to know you in 4 weeks, not to mention, your attending will have tons of rotators besides you. It’s hard to magically make up a 3 year inability to make faculty contacts/medical writing opportunities/research at your program, with a one-month audition elective somewhere else (unless that place is in a location where most would not want to go to for residency).

    4. With respect to cost – I would say it’s more important to see what you are getting in return for what you are paying out. Luckily for Texas, one good thing is that this state really does fund its medical schools (including Baylor) relatively well in comparison to other states (esp. Southern states).

    For example, from the AAMC website, UT-Houston’s tuition and fees for 2008-2009 is $11,009 (Research Rank #53); UTSW’s was $13,515 (Research Rank #20); Baylor’s was 12,803 (Research Rank #17). There isn’t a big difference between 17 and 20, but there is a big difference between the 17/20 and 53. Notice how UT-Houston’s is the cheapest (of all Texas schools actually), yet it’s research rank (which gives the school it’s reputation) is the lowest, which then explains its low USMLE Step 1 averages that I linked in a previous post. Many of the in-state or out-of-state tuition & fees for public schools EXCEED those of private med schools, and are still crappy.

    1. Rishi says

      Thank you for all this information! Lol, you always seem to have just the right links to tie everything together. 🙂

      1. UTSWStud says

        LOL. What can I say, I’m a HUGE Googler – it’s like an innate reflex at this point. To be complete to see all the categories with all info I’ve listed:
        http://services.aamc.org/currdir/ – see Institutional Characteristics and Curricula Leading to M.D. degree.

        Oh and of course I forgot:

        5. USMLE Step 1 – does the school require you to take/pass the exam before you are allowed to set foot into MS-3 clerkships (i.e. for promotion to MS-3 year), or as long as you take and pass it before you graduate? Obviously the “nicer” schools, usually ones that are private, allow you to take it whenever YOU want to. Some people say that having done clinical rotations beforehand helped for USMLE Step 1 as it let’s you see things in a clinical way thus helping you be more comfortable with clinical vignettes, which are a majority of how the questions are framed. Personally, I didn’t think it was the case and can sometimes confuse you (theory vs. real-life). If you practice with enough question books that are in a clinical vignette format (Case Files series by Eugene Toy or Underground Clinical Vignettes), it’s not really an issue. Also, how long does the school give you after basic science classes are over to study for Step 1 if you have to take it before MS-3 starts? 1 month? 1 1/2 month? 2 months? Obviously the longer the better.

        6. Grading Interval – what are the number of intervals in grading? Is it 2 interval (strict Pass/Fail only), 3 interval (Honors/Pass/Fail), 4 interval (ABCF, H/HP/P/F), or 5 interval (ABCDF, H/HP/P/MP/F, etc.) stratification? Just be careful as the school might still keep some type of internal ranking system, so find out what happens with those class grades (i.e. keeping an internal log of grades even though your transcript will only say Pass/Fail, for purposes of AOA selection or denoting class percentile or rank on a Dean’s letter) – a notable exception is Stanford SOM that has Pass/Fail and also doesn’t maintain internal rank – but it is Stanford after all. lol.

        Also, with PBL (Problem Based Learning), if you find out a school invests a lot of time in it, as opposed to didactic lecture time, stay away. It’s one of those educational innovations that sounds good in theory, but is implemented badly and ends up being a waste of time and soaking up time you could use to read and study on your own for class exams (see threads about it on SDN as well): http://halfmd.wordpress.com/2007/04/10/why-pbl-is-the-suck/