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Decide on a Med School: The Four Pillars
 
  Intro

Whether you are pre- or post-MCAT, traditional undergrad or non-traditional post-bac, it’s time to use our tips to decide on a med school.   We will arm you with the right questions to ask and give you suggestions on how to develop a systematic method based on the four pillars, and we’ll talk about how to use the assemblage of MCAT Wizard tools and resources to make your medical school application experience run smoothly.

 

Prior to describing the four pillars, we’d first like to show you two common modes of thinking for pre-med students at this juncture along their medical education journey. You might be thinking, “I just want to get accepted somewhere and it really doesn’t matter where I go.”  Many pre-med students share this same line of thought, initially, because the entire application process seems to be so arduous and time-consuming.  Sure, it’s easier to not overly stress about it and apply to virtually every med school out there that just sounds good to you.  Now, the other vein of thought revolves around applying to only one school – your favorite medical school that you’ve had your eye on for quite some time.  You fully intend to stay the course and will not be deterred in your quest to get accepted at Johns Hopkins School of Medicine, for example.  These thought processes are situated at opposite ends of the decision-making spectrum.  You should have no worries if you feel strongly about either way; however, we submit that it’s wise to be at some intermediate point between both extremes.  

Although there isn’t any set rule or special number of med schools that you must apply to, we know firsthand of the time commitment necessary to honestly evaluate yourself, your credentials, and your fitness for a particular medical program.  You should strive for balance in your approach to med school applications just as with many other situations in life.  It’s perfectly fine and actually recommended to consider a multitude of schools at the outset; still, remember to only apply to schools that you actually would attend if you were accepted.  Keep in mind that each facet of the med school application poses a great opportunity for you to differentiate yourself from the multitude of other candidates vying for a seat in their favorite med school.  My Apps is designed to help you stay organized and efficient as you customize, sort by priority, and develop your application strategy. With My Apps and the other resources and tools we'll be discussing, your application approach will be well-balanced while your perspective should be that of positive thoughts and enthusiasm about this unique opportunity.

You’ve identified your internal mode of thinking and tendencies with respect to med school applications and you know that you must work through med school apps efficiently and with alacrity.  An effective evaluation of medical schools takes place over time and is a natural blend of both internal and external elements.  We’ll now introduce you to the most important external factors, namely the following four pillars (listed in no specific order):

1.  Program

2.  Impact

3.  Location

4.  Affordability

The four pillars will serve as your compass in navigating your way through these unfamiliar waters.  As we alluded to earlier, our aim is help you customize your mechanism for evaluating med schools which is why we do not sort the list by any particular order of importance.  Depending on each individualized situation, a case can actually be made for the significance of any order of the four pillars.  We’ll simply define and discuss the meaning and pertinence of these factors and how they’ll help guide you throughout your decision-making process.

 
  PROGRAM

Let’s home in on just how you will manage to narrow down your choices from this voluminous directory of med schools by starting with the program pillar.   We perceive program to be a broad term that encompasses the overall learning philosophy, curricular innovations, assessment procedures, and peripheral academic matters of a medical school.  In using Med School Search, here are the following sections that fall under the rubric of Program:  Curriculum, Main Degree, Combined Degree Programs, and Other Programs.  When you go to a medical school in Med School Search, first read the med school Description which includes general info.  Then, have a look at the Main Degree offered to see if this is an allopathic (M.D.) or osteopathic (D.O.) school.  You now have your bearings and a basic conception of this particular med school.   Now, go to the Curriculum category and click on the link.  This will take you directly to the curriculum page for a medical school which will display info about the pre-clinical and clinical coursework and requirements that lie ahead of you. 

You might be thinking, “how in the world do I know which curriculum is best for me?”  The truth is that it may be a little challenging to evaluate at first but it gets easier after you know what to do, the relevant info to look for, and who to contact for help.  Speaking of help, you should find out if your prospective medical school has a mentoring or advising system in place.  If so, you should learn if either faculty or med students or both serve in that advising role.  

A traditional medical school curriculum includes two years of basic science (normal and abnormal structure and function) followed by two years of clinical rotations.  The first two years involves hitting the books really hard with relatively little clinical exposure.  However, med school curricula have evolved as a result of the student demand for an integrated learning solution – one in which students construct a well-rounded medical knowledge base with a concomitant development of fundamental clinical skills. Yes, of course, you are still expected and required to read and study at a high intensity level in a non-traditional curriculum.

Irrespective of the current curriculum of your med school, you’ll want to find out if there is any flexibility in the timing and coursework during your pre-clinical and clinical years?  What kinds of options do you have for electives?  Can you finish the pre-clinical component in less than two years or could you lengthen your pre-clinical time frame if you had to take time off for any extenuating circumstances?  The flexibility of a curriculum, or lack thereof, is helpful to know before committing to a med school program.

With respect to a non-traditional curriculum, you might find that schools implementing a Problem-Based Learning (PBL) curriculum are more closely aligned with how you wish to be trained as a physician.  This particular PBL site discusses how this teaching methodology fosters autonomous learning.  If you're interested in PBL for your medical education, start by finding other pre-med students within the MCAT Wizard community who might be interested in a PBL curriculum.  Post a message in the Forum and start up a PBL User Group to engender questions and dialogue about this mode of medical education. 

The latest developments in medical school curricula are complementary to advancements in technology.  You should search for answers to the forthcoming questions to get a glimpse of how classes are conducted and what sort of technology is at your fingertips in your prospective med school.  Are the computer facilities and labs more state-of-the art or are they flat out archaic?  How is new technology, if any, incorporated into the learning environment?  Are lectures available in video or podcast formats so that you can review the content at a later time?  This is important to know because you might ask to see if your med school offers a note-taking service if you cannot go back and watch video or listen to lectures from the beginning.  An important AAMC initiative, called the Medical School Objectives Project (MSOP), published a useful report on the use of technology in medical education.  If you have time, skim that report but here’s a quick article that elucidates some recent teaching innovations in med school classes.   One more tip on curriculum is that you might want to see if a med school has a curriculum committee with student representation.

With an abundance of curricular options out there and an overwhelming amount of details to take into account, you may find it easiest to begin doing your own reading and research on med schools while at the same time contacting current med school students with questions about their school’s curriculum.  Be sure to check out the rankings, comments, and reviews within Med School Search and look for comments about med school curricula and classes.  If someone hasn’t written about it, you should post a question in the Forum to seek answers to your questions and be consistent with reaching out to others, learning, and networking within the MCAT Wizard community.

Ok, so in our discussion of the program pillar we’ve covered Curriculum and Main degree but have yet to talk about Combined Degree Programs and Other Programs.  Again, you’ll go to a particular school within Med School Search and look for these two categories.  Combined Degree Programs will list the types of degree combinations you can get and we directly link you to that page of the med school's web site. 

Let’s say you’ve thoroughly enjoyed undergrad research and you are strongly considering a career as an M.D./Ph.D.  Then, it makes sense to proceed to learn about the M.D./Ph.D. program at your schools of interest.  In contemplating the M.D./Ph.D. track, be aware that it is obviously an even longer journey requiring a huge commitment and an unwavering passion for scholarship.  It’ll be an amazing experience to investigate basic science phenomena within the context of clinically relevant conditions but it’s not the right path for many applicants.  It behooves you to read about the NIH-funded MSTP program which poses a tremendous opportunity for prospective M.D./Ph.D. students.  Here are the participating MSTP medical institutions in addition to the unique opportunity to do intramural research at the NIH as part of the GPP program for M.D./Ph.D. students
But even if you are going with the typical M.D. route, you should see if your medical school has opportunities for students to set up, conduct, publish, and present their own research.  Also, look to get involved in some kind of journal club where you can read papers and discuss research, amongst diverse clinical specialties, within your med school community.

Other interesting Combined Degree Programs include, but are not limited to, M.D./M.P.H., M.D./J.D., and M.D./M.B.A.  Finally, the Other Programs category of the Med School Search provides links to special prep programs offered by a medical school like a baccalaureate/M.D. program, post-baccalaureate program, or summer enrichment program.  

In order to maximize your opportunities here at MCATWizard.com, we recommend that you either join or start your own User Group, especially if you’re interested in particular a combined degree or prep program or some special track.  For instance, if you’re inspired by creating awareness of public health issues and you’re thinking about getting a dual degree M.D./M.P.H., be proactive and lead a user group.  Get others involved and excited about important issues and see what can be accomplished when you put great minds together with good intentions.

Finally, as you proceed through a medical program, your knowledge base and clinical skills will continually be tested.  You must look for a med school’s method on evaluating a student’s academic performance and how clinical skills are assessed.  How do students from this medical school perform on the United States Medical Licensing Exam (USMLE)? Are students required to take USMLE Steps 1 & 2?  Do I need to pass USMLE Steps 1 & 2 in order to graduate?  How does this school assist students who do not pass?

 
  IMPACT

The next pillar of evaluating medical schools is called Impact and it can be viewed from a broad or focused vantage point.  Throughout this section, we’ll show you how to research your med schools and give you guidelines on how to estimate positive and negative impact.  Ultimately, you must weigh and consider both the positives and negatives of a medical school but it’s simple to pare down your list (or at least be aware) of schools by ones with accreditation issues.   

Specifically, find out if your prospective medical school, including any of its clinical departments, has ever been on probation or had its accreditation revoked.  You can do this by sifting through the medical school accreditation info for M.D. schools in the U.S. and Canada on your application list.  Also, by using a tool at the Accreditation Council for Graduate Medical Education (ACGME) site, you can run a quick check on the accreditation history of clinical departments associated with your prospective institutions.  For more info, read this brief AAMC article about accredited medical schools in the works.

 
  Broad Impact

In examining the broad impact of a medical school, you are essentially considering how well the type of school you’re considering sets you up for your medical future, i.e. residency and beyond.  Let’s say you’re thinking about becoming a radiologist or dematologist.  As it turns out, your competition for either of these residency programs is stiffer relative to an internal medicine residency program.  So, you must pay heed to the type of med school you attend and the effect of this decision on your ability to match to a residency program.  In order to delve further into assessing broad impact, we’ll turn to the National Residency Matching Program (NRMP) for our data source.


The National Resident Matching Program (NRMP) is a private, non-profit corporation that reliably and consistently matches the residency preferences provided by the medical student with that of residency program directors.  The reason we introduce you to NRMP now is because evidence and numbers do not lie and definitely carry significance.  For example, you’re trying to decide between attending a U.S. allopathic med school or an internationational med school.  In Table 6 (pg. 13) of the 2008 NRMP Main Residency Match Report, compare the match rates between the two columns of U.S. Seniors and U.S. IMGs.  There’s a very clear difference in the percentage of matches that 4th year med students from accredited U.S. Allopathic schools have (94.2% in 2008) as opposed to U.S. citizen students of international med schools (51.9% in 2008). 

If you’re vacillating and unsure about whether to go to an allopathic (M.D.) or osteopathic (D.O.) school, look at the data in Table 2 (pg. 5) of this same NRMP match publicationDo not base your final decision on these data alone but do consider the information and place it within a balanced approach to evaluating medical schools by weighing the positive and negative points.  For more info about osteopathic medicine read about AACOM and have a glance at the National Board of Osteopathic Medical Examiners (NBOME) to get your feet wet. 

Another component of broad impact entails a med school’s strengths in certain specialty areas.  Firstly, think about what kind of medicine you’d like to practice down the line.  Is this school widely renowned for primary or specialized care, academic medicine or private practice?  Try to get in contact with current students of that med school who are on track for the specialties you’re considering and fire some questions at them.  It helps to toss around some ideas and glean whatever info you can now so that your path will be more focused as you advance in your medical education.

 
  Focused Impact

While broad impact helps you research the type of med school and its strong suits, focused impact leads you to other useful info and commentary about a specific med school.  Again, use the resources and links available to you within Med School Search.  Open up a med school page and scroll down to the Impact category and check out the link(s) which will give you info about graduates of that particular program.  Then, check out the rankings and comments on a med school posted by users.  You may very well be reading comments posted by med school students who currently attend your favorite medical school or reviews by alumni.  Before proceeding, read this quick section on Top Medical Schools and medical school rankings if you haven’t already done so.

Let’s now illustrate the significance of checking MCATWizard.com rankings and comments by considering a very common scenario.  You are on your way to your first med school interview and you arrive there bright-eyed and ready to soak up everything that's coming at you for the day.  You're concerned about putting your best foot forward and this might, for some of you, take away from your ability to analyze and assess the dynamics of the interview process.  Here it is plain and simple - when you are touring the med school and meeting fellow applicants, current med school students, and faculty, be sure to direct your questions to the med school students.  They will give you the skinny on their med school...telling you their likes and dislikes.  In your encounters with med school faculty and the like, realize that it's their job to always represent their institution with pride and respect; hence, it's not as likely that you'll get full disclosure from them, so you MUST pick the brains of current med school students and ask them about their experiences inside and outside of the classrom, in the labs, and on clinical rotations.

This scenario demonstrates that you are, in effect, tapping into the minds of med school students and seeing what everyone else in the community thinks by researching with Med School Search and checking out the Top Medical Schools.  Now that we're clear about the value of candor and where to get your info, you now have another element to balance out your perspective and strategy when evaluating which med schools are right for you.

 
  LOCATION
 

The location of a medical school is one of the simplest and fastest ways to trim down your massive list and thus, we deem it to be one of more important pillars in evaluating med schools.  There are personal, social, and medically-related considerations that come along with the location you ultimately settle on.   On a personal level, surely you must reflect on whether or not you’d be happy at this med school, living in this particular city and environment, for the next four years of your life.  What will your commute to school be like?  Is having a car absolutely essential and, if so, is parking typically an issue?  Is your med school situated in a bustling metropolis or a small town?

Many students ultimately go with their state school because of a significant tuition break, the higher probability of admission, and the bonus of having family and friends nearby.  Some students may need to be near their family in order to help them while others may prefer to have family in proximity for their own comfort and support throughout the grueling, intense studying and clinical experiences of medical school.  With respect to support, you should also take into account the various counseling services at your disposal.  What sort of personal or financial counseling is accessible for students and are these services also offered to spouses and dependents?  Another factor to consider is if your spouse or significant other is locked into a job in a particular city.  You’ll then be faced with an important decision to make together about your course of action.  Depending upon how simple or complicated your personal situation is, you’ll want to work through these questions and jot down more ideas and questions as you go along and do not forget to check out how the AMA Alliance exists for the welfare of medical doctors and their families.

When it comes to facilities on campus, check out the library and study lounges in addition to recreational facilities.  Do not forget to assess on-campus housing options.  Is there even housing available on campus?  If so, how much is the rent per month?  Where’s housing close to campus and does the neighborhood seem friendly and safe?

Let’s now turn to some important social factors that may help you better assess med schools.  How culturally diverse is the area and what’s the ethnic blend of the student body?  What kinds of special groups and organizations exist for students?  You might want to get involved in student government.  If so, take a look at the web site and activity of the student council and see what they’ve done recently.  How easy is it to create and lead new clubs and interest groups?  These social experiences can be very enriching throughout your time in med school, so definitely do your homework and see what’s out there!

Now, the medically-related part of your school location is also important. What are the kinds of clinical sites available or required for your rotations?  Does your med school permit its students to do clinical rotations at other institutions within the country and/or abroad?  If you can envisage living in a specific area for quite a while, for whatever reasons, then also check if there are quality residency programs close to or within the medical center where your school is located.  It seems like a ridiculous amount of things to consider now but this type of forethought will pay dividends for you in the future.

 
  AFFORDABILITY

The affordability of a med school is the last of the four pillars and an important one as it could greatly affect your lifestyle after residency and fellowship years.  The average debt for medical school grads is roughly $140,000, as reported by the American Medical Association in 2008.  This debt load doesn’t even factor in credit cards and other short-term debt that students commonly accumulate.  While it’s tempting to completely rule out all super-expensive med schools, do not let affordability be the litmus test for med schools that stay on your application list.

In assessing a med school's affordability, first go to the Med School Search and take note of the Resident tuition and Non-resident tuition expenses for that given medical school.  Next, click on the link to Financial Aid info for that medical school and read about your options.  Here are some ideas for questions that you may ask and want to keep track of.  Is there an unchanging, consistent level of financial aid available to med students?  Are there medical school endowments and scholarships in addition to federal aid?  Examine the current tuition and fees and compare schools on your list.  See if you can find out the rate at which these expenses are expected to increase annually.  What if students have unmet financial needs?  How do these students pull together the additional funds?  Is financial counseling readily available to med students?  Are spouses and dependents covered in a student’s budget? 

To allay your anxieties about financing medical school, you should definitely sift through the useful info provided by AAMC in their Monetary Decisions for Medical Doctors Program in addition to their First Facts data and tips on money and debt management for future physicians.

 
  Final Thoughts

We hope that our questions and advice revolving around the four pillars will help you be far more efficient and less stressed as you complete your med school applications and as you make your impending huge decision on where to go.  Remember that you are definitely not in this alone as MCATWizard.com provides the community and the interactive platform for you to share knowledge, insights, and experiences about pre-med and medical school.  We’d love for you to get involved at MCATWizard.com in any capacity.  You can register a free account in seconds and immediately take advantage of this opportunity to add to your foundation for a successful medical career.

 
 
 

 

 

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