worth paying full price for a top 10 private med school?

[saveninvest]

Hello all,

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship. I am not a medical doctor so was hoping to get the perspective of some informed members. We can afford to pay for the top school but are unsure whether it will lead to significantly better career options that would justify the upfront cost. I suppose getting a brand name MD will matter but not sure how much.

Thank you for sharing your perspective.

[snic]

As the old saw goes: "What do they call the person who graduated at the bottom of their med school class? Doctor."

It probably does make a difference for getting the residency you want. Others will know more, but I think as long as the school is widely recognized as decent, it still shouldn't be that hard to get into a good residency. So I'd go for the scholarship over the prestige.

[Ultane]

Went to a state school down south. Very cheap. I trained at MGH and Stanford. People ask where people train, not where they went to med school.

YMMV.

[Blue456]

Hello all,

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship.

If your son is trying to get into very competitive speciality then what kind of medical school he went to may matter a little. Most important factor will be his USMLE score. After that his personality and after that his medical school. After he is matched for residency then likely nobody (employer wise) will care what medical school he went to ever again.

I suppose getting a brand name MD will matter but not sure how much.

To patient's yes*** but 99% employers won't care. I only been asked whether I have a license and at most where I did my residency. Everything before has been mostly irrelevant. Of course some very academic/prestigious institutions that may care and be more picky. I will tell you one thing that after doing all this training I am mostly looking at work life balance. I love teaching but I would never work for academia due to excessive calls and hours.

*** Where I work most patients are just appreciative that they are seeing a Doctor and not a nurse practitioner or physician assistant. Most places around my area have one doctor and 5 "providers." Getting to see an MD is challenging.

[saveninvest]

Thank you all.

I guess the question is whether getting to train at the elite places itself depends upon where you got the MD or not? My sense is that almost a third or half the graduates do residencies where they got there MD. This might mean you want to start at the best overall school to begin with since you may not be sure what you want to end up doing. Make sense?

[123]

If your son gets his MD and posts his diploma on the wall in his office the only medical school that most patients will have any recognition of will be Harvard. If it's not Harvard most will non-MDs will consider it second-rate and not worth mentioning.

[camden]

You should receive a lot of responses on this one. I’ll start the parade. Congrats on your offspring for gaining admission in the first place, much less having choices where to attend.

My background, so you may assess my response; I’m an MD who practiced his entire career at a large medical center affiliated with a medical school, one that offered a residency in my specialty. I was involved in teaching medical students and residents, and in interviewing candidates for our residency program.

Medical school education is long and very expensive, and as a truism, in medicine it matters less where your degree came from than in any other profession I can think of; certainly a LOT less than in the other profession I am most familiar with, law. Where you do your specialty residency often means more than med school, and after you have been out in practice for a few years neither matters much. Ranking colleges is a very imprecise art bordering on the meaningless; ranking medical schools to get a “top 10”, in my opinion, borders on the absurd and makes college rankings look good by comparison. Whether it might be worth spending a ton more money to get a MD from a more “prestigious” school depends on your financial situation, but most importantly on what path your prospective student wants to pursue. IF they are dead set on a career in medical research going after a Nobel Prize, or an academic career as a subspecialty professor, then going to Harvard or Johns Hopkins may be worth it. But in the vast majority of cases, when the future path is either undecided or relates simply to being a good doctor practicing clinical medicine in whatever specialty, I would advise them to attend whatever school seems the best fit for them personally and, particularly, the least expensive alternative. Save your money for other purposes.

[Sellery1031]

Medical school brand name matters more if you are after 1) an academic job or 2) a highly competitive specialty.

Residency programs pay attention to medical school in their selection process, but it is only one of many applicant variables (test scores, extracurriculars, scholarly activity, personality, etc).

Your residency or fellowship program (as well as acquired skills and network) matter much more for your early employment and professional success than your medical school.

Each phase is just a stepping stone - college, grad school, residency, fellowship, first job, etc.

Is an expensive med school worth it? That is a dollars and cents question. Be very mindful of the direct and opportunity costs of attending medical school and residency/fellowship training afterward - these costs can be huge drivers or sinkers of future net worth.

- 38YO Specialty MD. Midwest and Mountain West public college, med school, residency, fellowship.

[newparent7]

Outside of academics, or a cash only practice like cosmetic surgery, wouldn’t med school be mostly irrelevant. Wouldn’t my health insurance reimburse the doctor at the same rate whether they went to Harvard or Podunk U?

[SteelPenny]

As others have stated, it depends on the goal. If the goal is to come out ahead financially in 20 years, take the state school with minimal debt, perform well, match into high-paying specialty, get a private practice job. The med school will matter little compared to performance. If the goal is to be chair of a department at a prestigious academic hospital, the top-10 med school will be an important factor.

[goodenyou]

No. I definitely would not. Do very well in any public medical school and show a commitment to what you want to do and you will have choices on Match Day.

Most of my private medical school colleagues who had to borrow money to attend medical school regretted it.

30 years in practice in a (highly competitive) surgical sub specialty. Very glad I am close to the end of my career.

[goodenyou]

Outside of academics, or a cash only practice like cosmetic surgery, wouldn’t med school be mostly irrelevant. Wouldn’t my health insurance reimburse the doctor at the same rate whether they went to Harvard or Podunk U?

Paid the same if they are a good doctor or a bad doctor. Reimbursement is not based on quality, unfortunately.

[marielake]

I worked in physician compensation for many years. My experience is that post training, salary is based more on specialty; private vs academic practice; and medical research vs clinical work than where he/she went to medical school. We once set out to do an analysis on the impact of a doc's salary based on where the went to school, but it quickly became too complicated.

[nydoc]

Medical education is becoming irrelevant fast. All no surgical specialists are being replaced by mid levels. Patients don’t know or care about this. Soon they will start encroaching surgical fields too.
Most patients use insurance which doesn’t differentiate between an excellent physician or a bad one. There is no premium for being a better physician.
Go for the elite school if you think candidate is a genius who will become so accomplished that international patients will come to see them for any amount of cash fee they charge. Rest don’t even bother.

[saveninvest]

Thanks everyone. Lots to chew on. My takeaways are that brand name matters more if academic route is a serious possibility and if the speciality he wants is extremely competitive. Still a few med school decisions left... I might circle back with some explicit choices once we have the final set in hand.

[Dregob]

Hello all,

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship. I am not a medical doctor so was hoping to get the perspective of some informed members. We can afford to pay for the top school but are unsure whether it will lead to significantly better career options that would justify the upfront cost. I suppose getting a brand name MD will matter but not sure how much.

Thank you for sharing your perspective.

What do call the med school student who finished last in his class at a mediocre school?
Doctor.

[goodenyou]

Hello all,

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship. I am not a medical doctor so was hoping to get the perspective of some informed members. We can afford to pay for the top school but are unsure whether it will lead to significantly better career options that would justify the upfront cost. I suppose getting a brand name MD will matter but not sure how much.

Thank you for sharing your perspective.

What do call the med school student who finished last in his class at a mediocre school?
Doctor.

Provider or team member.

[Mayacallie]

I’ll be the devil’s advocate here. If you have the disposable income, and not a financial stretch, pay for the elite school. I’m a retired MD specialist, trained after a seven year residency at top 10 residency for my specialty. In the future of physician “extenders,” whether they are NPs, PAs or even DOs, an elite medical education will only serve to separate your son from the average.There is a potential to open more doors and to supply a built in network. I never regretted paying full tuition for my kid to go to Stanford.The job opportunities that he’s had as a result may not be fair, but it’s reality. You won’t regret it.

[21&lewis]

MD here with another vote for training > med school

Full professor at a top 5 med school in a highly competitive surgical subspecialty. Went to a state med school on a modest scholarship with top tier residency and fellowship training. I've interviewed 100s of residents during my time on faculty. The only consistent difference between the top 10 med school students and other med school students seems to be their research opportunities/experiences. Sometimes that moves the needle on their rank position, and sometimes it doesn't...

Two pieces of advice for your son:
1. Develop situational awareness: Learn to add value in any situation. Someone is (almost) always watching.
2. Collect mentors, take what is useful, and leave the rest: Mentorship is often overrated and always biased, but it is important.

[saveninvest]

So many thought-provoking replies! Thanks everyone. I will digest everything and pass it on -- hopefully it will stick with him!

[Doctor Rhythm]

Lots of reasonable opinions on this. My experience from serving on selection committees for residents and faculty for what is usually considered a Top 5 department is that med school reputation definitely matters for residency selection. How much it matters depends on how competitive the residency program is and obviously how strong the rest of the application is, but it can have a substantial impact.

However, this has nothing to do with financial compensation. Going to an elite program doesn't translate well into future earnings. It might even have a negative association, as these programs attract and prepare people for lower paying academic careers.

[delamer]

Outside of academics, or a cash only practice like cosmetic surgery, wouldn’t med school be mostly irrelevant. Wouldn’t my health insurance reimburse the doctor at the same rate whether they went to Harvard or Podunk U?

It’s not about reimbursement once you are practicing. It’s about the cost of medical school.

Say I want to become a neurosurgeon, a very competitive specialty. I am more likely to match into a residency for that specialty if I go to Harvard Medical School vs. Podunk U. Medical School.

In that case, the extra cost of Harvard is worth it.

If I want to go into a less competitive field, like internal medicine, than the extra cost of Harvard is not worth it.

All of this assumes cost is a factor, which is the scenario that the OP laid out.

[snowday2022]

If it enables you to get a highly competitive specialty that is also lucrative, it is a good investment. BTW you also MIGHT have a better time and learn more.

[saveninvest]

Lots of reasonable opinions on this. My experience from serving on selection committees for residents and faculty for what is usually considered a Top 5 department is that med school reputation definitely matters for residency selection. How much it matters depends on how competitive the residency program is and obviously how strong the rest of the application is, but it can have a substantial impact.

However, this has nothing to do with financial compensation. Going to an elite program doesn't translate well into future earnings. It might even have a negative association, as these programs attract and prepare people for lower paying academic careers.

This rings true from my own experience as an academic, although not in medicine. Prestige looms large (maybe too large) in the academy perhaps b/c that is seen as the real measure of success, as opposed to financial metrics. To many in the academy, they are in the business of intellectual influence -- perhaps this is true in academic medicine as well. But in some fields (say business for example), being in the top departments generally means a lot more "real income" -- even if salary is only marginally higher, they can have lower teaching, greater research, and better staff support etc.

[saveninvest]

Outside of academics, or a cash only practice like cosmetic surgery, wouldn’t med school be mostly irrelevant. Wouldn’t my health insurance reimburse the doctor at the same rate whether they went to Harvard or Podunk U?

It’s not about reimbursement once you are practicing. It’s about the cost of medical school.

Say I want to become a neurosurgeon, a very competitive specialty. I am more likely to match into a residency for that specialty if I go to Harvard Medical School vs. Podunk U. Medical School.

In that case, the extra cost of Harvard is worth it.

If I want to go into a less competitive field, like internal medicine, than the extra cost of Harvard is not worth it.

All of this assumes cost is a factor, which is the scenario that the OP laid out.

I think this seems right to me. But since you may not know what exactly you want to do, preserving the option to specialize in a competitive field with a higher chance to match into residency is gotta be worth a lot. Agree that if you are 100% set on internal medicine, cheapest degree might be the way to go. Although someone noted above that lots of non-MD professionals are "encroaching" on this turf, so to make it all worthwhile you sort of have to pick something else if you pay full price at an expensive private school...

[SteelPenny]

It’s not about reimbursement once you are practicing. It’s about the cost of medical school.

Say I want to become a neurosurgeon, a very competitive specialty. I am more likely to match into a residency for that specialty if I go to Harvard Medical School vs. Podunk U. Medical School.

In that case, the extra cost of Harvard is worth it.

If I want to go into a less competitive field, like internal medicine, than the extra cost of Harvard is not worth it.

All of this assumes cost is a factor, which is the scenario that the OP laid out.

I think this seems right to me. But since you may not know what exactly you want to do, preserving the option to specialize in a competitive field with a higher chance to match into residency is gotta be worth a lot. Agree that if you are 100% set on internal medicine, cheapest degree might be the way to go. Although someone noted above that lots of non-MD professionals are "encroaching" on this turf, so to make it all worthwhile you sort of have to pick something else if you pay full price at an expensive private school...

I think this is very slightly true. But consider that top performers at any US allopathic (MD) med school will match into highly competitive specialties if they choose (neurosurgery, derm, radiology, etc.). It is more about the prestige of the residency program that might be more limited than the specialty. For instance, a top performer at an average state school, AOA (honor society), high board scores, is going to match into neurosurgery if they choose. However, a top performer at a top 10 school will have a better chance to match into a top 10 residency program in a competitive specialty, which may be important if trying to enter academics.

Now, if one chooses a lower ranked med school and becomes an average performer, they will likely have difficulty matching in a highly competitive specialty compared to someone who is an average performer at a top-10 school. But why would someone become an average performer if they are one of the most highly competitive applicants in the class to start? So I agree that choosing the top-10 school gives a bit of cushion to become a lower performer in med school and still match a competitive residency. But if the student is a high performer, it makes no difference other than prestige of program (no financial difference).

[boogle_12]

You said the other school is still good, just not the same as top 10. The delta between them might be rather small then depending on the specific schools. Some of those also end up being great choices if the student is determined to match a specific specialty already (ie Jefferson or Miami for ophthalmology).

[stay.the.course]

For background, I am a highly compensated academic surgical sub specialist.

Congratulations to you and to your son.

It is worth it. Send him to the best medical school he gets accepted to, regardless of tuition and support. This will broaden his training horizon and sub speciality options. Pedigree is an important distinguisher, and will open doors to him that would remain otherwise shut, or would require tremendous effort to open. Simplify the road ahead for him.

[Cruise]

Not an MD, but have been associated with several medical schools. One thing I think missing in the analyses so far is that elite schools have access to more institutional support which translates to more advanced equipment and a potentially better learning environment. Your child should visit the competing schools and see which one has the right feel.

[learningtime]

Hello all,

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship. I am not a medical doctor so was hoping to get the perspective of some informed members. We can afford to pay for the top school but are unsure whether it will lead to significantly better career options that would justify the upfront cost. I suppose getting a brand name MD will matter but not sure how much.

Thank you for sharing your perspective.

I am not a doctor but have a child in pre-med. If we are lucky and she puts in the effort, we could be in a similar situation down the road.
Broad brushstroke (so YMMV): If the objective is research, public health or academics, prestige of the med school may be relevant. If the track is private practice, it may not be relevant.

[bolete]

I retired from academic practice a few years ago. During the 10+ years I led a fellows’s training program, I found that students from top medical schools appeared to have a better chance of getting into top residencies. Then those from top residencies were favored for competitive fellowships. When I was choosing residents for interviews I developed a residency program ranking, then tended to over select from the top residencies, as long as residents from those programs tended to come to our program. It is difficult to sort 800 candidates, so I relied on residency strength as a very important factor; participants in top residencies have been vetted from the med school transition, and you also can see how they did during residency (although letters of recommendation are often not representative.) I did use usmle scores as a factor, but there are a few with high scores who don’t work well with others, and ended up in my office frequently, discussing bad behaviors.

If a potential medical student thinks that she will want to pursue an academic career or match in a very competitive residency, then a top school likely makes sense, as that gives her the opportunity of a better residency. If not, then the cheaper option is appealing. Of course many students only develop these interests after they start medical school. And lower ranked med schools can still offer strong learning environments.

[valleyrock]

I'll chime in with the idea of considering the type of student here.
Obviously bright and done well. But if the excellent academic performance is more a result of memorization than of learning the fundamentals, then a top tier medical school might be the way to go. Faculty in research driven programs on the forefronts of their field can be more fundamental in their approach to teaching, and that's a good thing. A memorizer might be less able to get by in that environment, and have to struggle some to learn the fundamentals, and that's a good thing. (But I'm not a physician and know little about how educational approaches vary from school to school. I have read Barry's book on The Great Influenza, which begins with a very interesting and lengthy review of the history of medical education. One conclusion is that current medical education and practice, based on evidence based approaches and science, is majorly good.)

[saveninvest]

Thanks everyone. So grateful for all the feedback. Leaning towards private school for now and will decide once a few remaining decisions have come in. I should add that the kid made the choice to go to a full scholarship at state school over an elite private school as an undergrad. So we saved a few bucks then. At this point, would feel much better letting him go to the best med school he gets into. Too many "what ifs" that I don't want us to have to ponder down the road given the trade-offs....

[chassis]

Hello all,

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship. I am not a medical doctor so was hoping to get the perspective of some informed members. We can afford to pay for the top school but are unsure whether it will lead to significantly better career options that would justify the upfront cost. I suppose getting a brand name MD will matter but not sure how much.

Thank you for sharing your perspective.

Unknowable.

You can afford it.

Pay the price for the brand name.

[JPM]

77 yo retired general internist here. Just my 2cents.

Sounds like OP's son is a star and will probably be a star wherever he goes for medical school. A wise or fortunate choice of a mentor and continued effort will probably result in a good residency slot if coming from a modestly priced state school. Stars do well no matter what med school they attended.

DW's cardiologist is world-famous, meaning when she goes to see him, people testing in his labs or in his waiting room are from all over the world. He is a foreign medical graduate from a non prestigious school. He had residency at a world-famed hospital and made the most of his opportunity there. He treats her like the Queen of England.

In medicine and surgery, more so than any other endeavor outside of sports, talent will out. Who your dad is or where you went to school matters little compared to performance.

On the margins, say you want to be a Stanford-trained orthopedist, it may help to have gone to Yale or Penn compared to an equally accomplished applicant from Mizzou or Loyola. Or not. Interview skill and charm matter.

When hiring for private practice, we wanted a candidate with appropriate experience and training, a reasonably sane cooperative nature, a good work ethic, and no obvious storms in the personal life. We are hiring someone we need to be capable, cooperative, and a positive contributor to the group or clinic. When he or she turned out to be a genius too, that was great. Where he or she went to med school was irrelevant.

[jjones]

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship. I am not a medical doctor so was hoping to get the perspective of some informed members. We can afford to pay for the top school but are unsure whether it will lead to significantly better career options that would justify the upfront cost. I suppose getting a brand name MD will matter but not sure how much.

Thank you for sharing your perspective.

Current medical resident here, graduate of T10 med school at comparable institution for residency for background.

IMO, the key questions really go beyond just prestige versus price. First of all, your son's career goals matter here. As others have pointed out, if he has highly academic career aspirations, there's an ongoing advantage to the name brand. Does he want to work in health policy, or perhaps leadership roles in government in the future? Name brand has an edge. Does he want to do private sector or business work (not private practice, but for example get involved with health tech, startups, healthcare VC, etc)? Name brand has an edge. Does he want to do global health or NGO work? Sadly even for this one, name brand has an edge.

These edges are often subtle, but the snowball starts early to borrow an investing concept. If, for example, he wants to do global health, from his first year in med school he can start working alongside leaders in the field more easily. This bolsters his residency applications first of all, but these relationships can persist through residency. This might mean that by the time he's done, he has a seven year (assuming IM) head start in terms of experience and connections, publications, advocacy, whatever over somebody who went to a school that didn't have those connections. That, plus the name, means he's gonna be in the lead for that NGO job he wants to take versus early career docs who didn't have that edge.

The same thing applies within specialties. He can start early building relationships with influential people in his field of choice. The comments above about "top performers" and such rising to the top are nice, but the reality of selection for highly selective residencies these days is that there are more "top performers" (academically) than there are slots. Anything to give yourself an edge, even if it's small, can help. This includes stuff like personal and professional connections, publications, and yes school brand. I can also personally attest that during my interview cycle, the simple fact that I attended my med school was mentioned favorably by multiple interviewers. It's not the biggest factor in selection of course, but many residency directors do actually care about this. And when they are trying to narrow hundreds of applicants to offer several dozen interviews to rank for a tiny handful of slots, you as an applicant want everything possible to be in your favor. I have to emphasize that the competition graduating docs face these days for "desirable" residency slots is far steeper than what docs who graduated 30 or 40 years ago would have faced, so the game is different. Your son should talk IRL with fourth year med students at his admitted schools, if possible, to get a sense of the lay of the land. Good advice about his personal situation could also be had from junior attendings currently on career tracks that interest him.

Beyond these factors, deciding between schools really needs to consider things like details of the curriculum. For example, my med school was straight pass fail, preclerkship and principal clinical year. That 1) takes enormous pressure off the day to day, allowing you to study in a way that supports deeper learning without grade grubbing for every stupid point, and 2) gives you the freedom and flexibility to pursue professional interests that advance your career earlier on (again, starting that snowball sooner). If you're at a school with letter grades, especially in the new world of p/f step 1, then you damned well better get the best letter grades possible. It's hard to see now for many premeds, but chasing the highest possible grades is not necessarily the most efficient way to build the career he wants, and it's ironically not even necessarily the ideal way to make him the best doctor he can be.

I use p/f as an example, but it illustrates something broader. Comparing schools should really compare other factors as well beyond prestige. Where does he want to live? Are there any unique institutes or opportunities at the school that rankings don't show? These are all important considerations as well.

To finish, given all of the above, and especially since you can apparently afford both options, I strongly suggest NOT over-indexing on low cost in choosing his med school. Sure, it's a factor, but for somebody like it sounds like your son might be, he should really get into the weeds and think about what he wants to do, what opportunities he wants to keep open, and where he'd fit best. If he had to take out a lot of debt and live in penury for a 3 year residency plus a 3 year fellowship or similar, I'd of course increase the weight on cost as a decision factor, but that doesn't sound like the situation here.

[RiskAnalyst]

Most of my private medical school colleagues who had to borrow money to attend medical school regretted it.

I get the sentiment here but I think it deserves clarification. The majority of med school graduates have some student loan debt from it, and while private schools may have higher sticker prices than in-state tuition at public schools on average, they may also have greater funding for need-based aid. For this reason, I was able to attend a prestigious school for the same net price as my state school, but I still had to “borrow money” to go.

To answer OP’s question, in general I wouldn’t pay full price ($300K?) for a prestigious med school over half that for a solid non-prestigious school if I were the student, but I agree it’s worth considering if a competitive residency match is anticipated (e.g. derm, surgical subspecialties) or if family can pay it with little difficulty.

[RiskAnalyst]

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship. I am not a medical doctor so was hoping to get the perspective of some informed members. We can afford to pay for the top school but are unsure whether it will lead to significantly better career options that would justify the upfront cost. I suppose getting a brand name MD will matter but not sure how much.

Thank you for sharing your perspective.

Current medical resident here, graduate of T10 med school at comparable institution for residency for background.

IMO, the key questions really go beyond just prestige versus price. First of all, your son's career goals matter here. As others have pointed out, if he has highly academic career aspirations, there's an ongoing advantage to the name brand. Does he want to work in health policy, or perhaps leadership roles in government in the future? Name brand has an edge. Does he want to do private sector or business work (not private practice, but for example get involved with health tech, startups, healthcare VC, etc)? Name brand has an edge. Does he want to do global health or NGO work? Sadly even for this one, name brand has an edge.

These edges are often subtle, but the snowball starts early to borrow an investing concept. If, for example, he wants to do global health, from his first year in med school he can start working alongside leaders in the field more easily. This bolsters his residency applications first of all, but these relationships can persist through residency. This might mean that by the time he's done, he has a seven year (assuming IM) head start in terms of experience and connections, publications, advocacy, whatever over somebody who went to a school that didn't have those connections. That, plus the name, means he's gonna be in the lead for that NGO job he wants to take versus early career docs who didn't have that edge.

The same thing applies within specialties. He can start early building relationships with influential people in his field of choice. The comments above about "top performers" and such rising to the top are nice, but the reality of selection for highly selective residencies these days is that there are more "top performers" (academically) than there are slots. Anything to give yourself an edge, even if it's small, can help. This includes stuff like personal and professional connections, publications, and yes school brand. I can also personally attest that during my interview cycle, the simple fact that I attended my med school was mentioned favorably by multiple interviewers. It's not the biggest factor in selection of course, but many residency directors do actually care about this. And when they are trying to narrow hundreds of applicants to offer several dozen interviews to rank for a tiny handful of slots, you as an applicant want everything possible to be in your favor. I have to emphasize that the competition graduating docs face these days for "desirable" residency slots is far steeper than what docs who graduated 30 or 40 years ago would have faced, so the game is different. Your son should talk IRL with fourth year med students at his admitted schools, if possible, to get a sense of the lay of the land. Good advice about his personal situation could also be had from junior attendings currently on career tracks that interest him.

Beyond these factors, deciding between schools really needs to consider things like details of the curriculum. For example, my med school was straight pass fail, preclerkship and principal clinical year. That 1) takes enormous pressure off the day to day, allowing you to study in a way that supports deeper learning without grade grubbing for every stupid point, and 2) gives you the freedom and flexibility to pursue professional interests that advance your career earlier on (again, starting that snowball sooner). If you're at a school with letter grades, especially in the new world of p/f step 1, then you damned well better get the best letter grades possible. It's hard to see now for many premeds, but chasing the highest possible grades is not necessarily the most efficient way to build the career he wants, and it's ironically not even necessarily the ideal way to make him the best doctor he can be.

I use p/f as an example, but it illustrates something broader. Comparing schools should really compare other factors as well beyond prestige. Where does he want to live? Are there any unique institutes or opportunities at the school that rankings don't show? These are all important considerations as well.

To finish, given all of the above, and especially since you can apparently afford both options, I strongly suggest NOT over-indexing on low cost in choosing his med school. Sure, it's a factor, but for somebody like it sounds like your son might be, he should really get into the weeds and think about what he wants to do, what opportunities he wants to keep open, and where he'd fit best. If he had to take out a lot of debt and live in penury for a 3 year residency plus a 3 year fellowship or similar, I'd of course increase the weight on cost as a decision factor, but that doesn't sound like the situation here.

Outstanding commentary and agree with all these considerations as someone with a similar background.

[HooCares]

The old joke --

You know what they call the person who graduated last from the lowest ranked med school in the country? Doctor.

[stan1]

This is ALL changing in 2025 and will change even more very quickly, perhaps in unexpected ways. Odds are high AI will disrupt many parts of medicine within 5-10 years by the time he finishes degree and internships. Hopefully the program he enters is looking forward and will help him with that.

He should be flexible and avoid debt as much as possible, and not assume any programs for loan forgiveness would be available to him. If you are able to help him out, great.

[hand]

Assuming this is a financial question, it seems like there is an important difference between:

[Has it been] worth paying full price for a top 10 private med school?
[Will it be] worth paying full price for a top 10 private med school?

I'm not sure how big an upfront investment I'd want to make (especially if funded by debt) given that returns are dependent on the future of medical reimbursements.

[forestcity]

Interesting thread! From my perspective as someone who until fairly recently served as a residency program director, and who currently has a daughter at a "Top 10" med school, the answer is "it depends." From a residency/residency program director standpoint, it definitely DOES matter where an applicant is attending medical school, and for the most competitive specialties (think, e.g., dermatology and ophthalmology) even top students at perceived lower-tier public and private med schools are clearly at a disadvantage. This relates in part to the "name brand" or lack thereof, but also to greater opportunities at elite schools, particularly connected to research.

On the other hand, performing well at a mid-tier or higher med school, public or private, won't close many doors, and particularly if a good public med school in a state with reasonable (a relative term in the current environment) tuition is an option, the ROI may stack up favorably. Bottom line: it's nice to have options; congratulations to your son!

[bltn]

Hello all,

My son has been admitted to a range of medical schools, inlcuding some elite ones (i.e. ranked in the top 10 as per several rankings). He is also under consideration for a scholarship at a good school but not an elite one. The key question is whether it is worth paying full price for a top 10 private school relative to the state school or the good private school with a scholarship. I am not a medical doctor so was hoping to get the perspective of some informed members. We can afford to pay for the top school but are unsure whether it will lead to significantly better career options that would justify the upfront cost. I suppose getting a brand name MD will matter but not sure how much.

Thank you for sharing your perspective.

My daughter attended a top five medical school after attending an elite eastern college and participating in research throughout her secondary schools. She finished with an md/phd degree, and trained at a top residency. She now practices at a top five medical school and a state medical school jointly and runs a research lab. My son attended an elite private undergraduate university, attended a state medical school and is finishing subspecialty training in the second of two highly regarded residency programs.

From my experience with my children, I agree that the private medical school might be better for academic medicine. But if one has a good record at a state school with research and studies (achieving AOA honors), I m not sure the private school will provide much of an advantage in obtaining a top residency. And the cost difference will be significant. And the residency seems to be more important than the medical school for providing job opportunities, in academia or private practice.

From observing the medical school classes that finished with my children, most attended residencies at other institutions. I would guess 90%. The residency name was more important than the medical school name. I feel the medical education was comparable at both schools for my children.

Your son has done well at his undergraduate school to have the opportunities you've mentioned. If he does this well at a state medical school, there will be very little advantage for him to attend a private medical school. From my understanding, the smart kids that graduated with my children from undergraduate school went to medical school at their home state s flagship public school, excelled there , and obtained a high level residency. And saved a lot of money while still having excellent career opportunities.

[Flashes1]

I'm not an MD but my DW is a med school graduate of an ACC school in the top 50.

I've seen several mentions of the old joke of the last student in the most poorly ranked med school is still called "doctor" which might be true but they're not getting a coveted residency. They'll be a family doc at a lowly rated residency program which is still a good job but it won't likely make you a millionaire by your late 30's like you see from many Boglehead physicians earning +$500k/year in their early thirties.

What was the undergrad school? A more highly regarded med school could compensate for a lower rated undergrad.

DW did say that a lot of residency programs have unofficial ties to certain schools...probably because some residency directors like to recruit their old schools and like to get the "inside scoop" on recommendations from professors they know. While MCAT's mean almost everything to get into med schools.....recommendations mean everything to get into residencies.

But it's hard to gauge future recommendations from med school professors when you haven't even started med school so you're going to have to take some risk here no matter where you go.

[happygrayhair]

I graduated from a T10 Ivy league med school, same place for residency, same place as faculty x 5 years. While faculty I chaired resident selection committee, 500 applicants for 5 spots yearly, of whom 20% were interviewed. I left academia (I didn't like trainees doing my surgeries) then private practice orthopedic sub-specialist, and about 15 years community faculty at an orthopedic residency. Now retired.

You've received many thoughtful responses in this thread already. A few thoughts:
Interviewing residency candidates, when all else was equal, we did have some bias towards the "top" medical schools. The question of course, is all else equal?

The out of pocket costs of the private medical school might not be very different from the state school. The private school may have greater support available. Ask if you haven't done so already.

Which public school? There is a wide range of prestige of public university medical schools. UCSF, U Michigan hold much greater weight than some lesser repute state schools.

Lay public will care where you went to medical school. The professionals will care more where you went to fellowship and residency.

I did some expert witness work, mostly malpractice defence. The lawyers cared a lot where I went to medical school. That reflects the great gulf in law school prestige between Yale Law and Fred's Night School of Law.

If research and academia is the hope, then the T10 med school has an advantage. But the student may change his/her mind during medical school. A med school classmate appeared first week with a shirt emblazoned "medicine for the people", planning on primary care. She became a Boston med school faculty orthopedic subspecialist.

[afan]

I find that, is guessing someone's clinical skills, academic docs barely care where someone went to medical school but pay a lot of attention to where they trained when the physician in question is early in their career. After they have been out for a while, the evaluation is based on what the doc actually does in practice, not where they trained and absolutely not where they went to medical school.

On the other hand, when ranking resident applicants, there is an emphasis on getting as many as possible from the "top" medical schools. Even though they people doing the ranking would, in any other context, deny that medical school matters.

My experience is at "top" medicals schools and "top" hospitals, so it reflects the biases at those places.
For general internal medicine and family practice, there are abundant residency slots and, absent serious problems in medical school, everyone who wants to train in those fields can be admitted to a residency. For the highly competitive specialities, there are far more applicants than there are slots and where one attended medical school will matter. How much depends on the competitiveness of the field and the composition of the selection committee. If many of the influenction members of the committee came from non-top med schools, then the attitude may be more rational. But many of the so-called top hospitals are quite inbred with faculty who went to med school and trained at the same small group of top places. They may place more weight on pedigree than others.

I think the prestigious med school is worth something, but how much depends on career aspirations and the specific programs to which one might apply. These can be hard to know as an undergrad.

It is much easier to pay back loans as a spine surgeon than as a family practitioner. Going to the prestigious school, borrowing hundreds of thousands of dollars, and then doing FP would be a bad financial move. Going to that same med school, graduating with the same level of debt and practicing neurosurgery could be just fine.

[Mayacallie]

I have to correct my recommendation based on seeing your post on another forum that listed the schools in question. Vanderbilt isn’t elite in the sense of, or comparison to what most of us refer to as elite programs ie Stanford , Harvard etc.
I would definitely go with the state school. Vanderbilt doesn’t pack any fireworks.

[jjones]

I have to correct my recommendation based on seeing your post on another forum that listed the schools in question. Vanderbilt isn’t elite in the sense of, or comparison to what most of us refer to as elite programs ie Stanford , Harvard etc.
I would definitely go with the state school. Vanderbilt doesn’t pack any fireworks.

Yeah, a lot of the conversation about the value of "eliteness" depends on the specific school in question. It's kinda nauseating to split hairs this way, but I think it's the reality of these kinds of ivory tower institutions and residencies. IMO, there are a few schools that are clearly worth full pay with no reservations if a family can afford them given their powerful boost to overall medical career capital: Harvard, JHU, Penn, UCSF, Stanford. Another bucket is possibly worth full pay, but you might want to scrutinize the side by side a little more closely versus the lower ranked/more affordable school. This basically includes Wash U, Columbia, Duke, Yale, U Michigan. There are a handful of other schools like NYU and (now) Einstein that are tuition-free across the board anyway. When you're getting into the tier below these, you're still dealing with fantastic schools and opportunities of course, but the prestige and opportunity delta starts looking less compelling. This also depends of course on the specific cheaper school you're comparing it with. (eg if it's Vandy versus a relatively new and unknown MD school), then Vandy full pay would be worth every penny. If it's Vandy versus, say, UCSD or UVA? No way would that make any sense.

[rufflesinc]

certainly the tuition difference should be amortized out over a 30-40 year career. Is the difference $100k? $300k?

The difference between UM instate tuition and harvard is $20k a year x 4=$80k. Over 40 years, thats only 2k a year (add interest)

[stan1]

Maybe this is too blunt, but if kid is spending his inheritance for his education let him go where he wants.