Given the competitive landscape of medical school admissions, most premeds are happy to get into any medical school. But is there value in putting in extra effort to get into a top-ranked program? How much does medical school ranking matter? Let’s find out.
When discussing the importance of medical school ranking, it’s common to look at it through the lens of residency matching, as that’s the next step in training. Getting into residency has become increasingly competitive in recent years. This is especially true for highly competitive specialties such as plastic surgery, ENT, or dermatology.
When it comes to medical school ranking, there are often two sides to the argument. On the one hand, some believe that it doesn’t matter where you go and that matching into a competitive residency is all about individual metrics such as Step scores, research, and letters of recommendation. On the other hand, some believe that medical school ranking is incredibly important and there are better opportunities at top institutions that help with your scores, research, letters, and other factors. But who’s right?
Let’s explore both sides of the argument and answer the question once and for all: how important is medical school ranking?
Medical School Experience
One of the most common arguments in favor of attending a top-ranked institution is that you will get a better education and have opportunities that aren’t available at lower-ranked programs.
The average Step 1 score for students from a top 20 medical school is 238 while the average Step 1 score for all schools is 232. This lends support to the idea that top medical schools offer a better education thus increasing your chances of matching into a competitive residency.
The counterargument, however, is that it is typically more difficult to gain admission to a top medical school so students who attend these institutions tend to be stronger students at baseline.
The average MCAT for matriculants at the top 20 medical schools is 520 whereas the average MCAT for all matriculants is 512. For reference, a 520 on the MCAT is a 97th percentile score whereas a 512 is an 84th percentile score. In addition, the average GPA for all medical school matriculants is 3.75 whereas the average GPA at the top 10 programs is 3.88.
As such, the differences we see in Step scores may have to do less with curriculums or instructors and more to do with individual differences between students. This lends support to the argument that medical school prestige doesn’t matter as top students are likely to perform well regardless of the medical school they attend.
That said, it is impossible to determine whether this is a chicken or an egg phenomenon. Will going to a top-ranked program make you a better doctor? Possibly. On the one hand, national standards are rigid and implemented in every school. On the other hand, some schools teach these better than others.
Ultimately the work you put in is the most important factor in whether you become a great doctor, but the medical school you attend can shift that up or down in terms of both effort and outcome.
Another important factor to consider is access to clinical rotations in your specialties of interest. Larger, top-ranked academic institutions are much more likely to have programs in your desired specialties or subspecialties than lower-ranked schools. Since over 50% of medical students change their intended specialty, there is further utility in attending a program with wide specialty exposure. While this isn’t a hard and fast rule, as some lower-ranked institutions have access to large academic hospitals with a wide breadth of specialties, the trend holds true.
Having access to your desired specialty is important. This will allow you to network with doctors in the field and gain much more experience, research, and strong letters of recommendation with less effort and friction than attending a medical school without that specific specialty. Can you match into ENT without having an ENT program at your medical school? Absolutely, but it will be more challenging.
That being said, there are numerous other factors that you need to consider when choosing a medical school outside of prestige, curriculum, and access to specialties. This includes location, cost of living, family, and much more.
Residency Program Directors & Medical School Ranking
Now that we’ve explored how medical school prestige affects students, how much do residency program directors care about medical school rankings?
According to the 2021 NRMP Program Director Survey, a large proportion of residency program directors consider medical school reputation when deciding which students to interview. In terms of the more competitive specialties, approximately 46% of plastic surgery PDs and 36% of ENT PDs consider medical school reputation when deciding who to interview. For lower-tier specialties, the numbers are similar with 40% of internal medicine PDs and 30% of family medicine PDs considering medical school reputation.
Another way to interpret these numbers, however, is that between 50-70% of program directors do not consider medical school reputation in residency matching. As such, you are likely to find a great deal of variation between individual programs. Program directors at top residencies are more likely to consider a student’s “pedigree”, meaning the quality of their medical school and even undergraduate institution, more so than program directors at less iconic programs.
Put simply, while medical school ranking is important, not every program director considers it.
It is important to note, however, that as of January 2022, USMLE Step 1 has become a pass-fail. Given that this exam was one of the most important metrics in determining one’s competitiveness for residency and it will no longer be used to stratify students, other metrics such as Step 2 score, number of publications, AOA status, and medical school prestige may be weighted more heavily moving forward. Although much of the weight from Step 1 going pass-fail will likely be passed onto Step 2CK, we may see medical school prestige become a more important factor in residency admissions.
So how important is medical school ranking? In short, it matters but there are still other factors you need to consider. At the end of the day, going to a top medical school doesn’t guarantee you a good match, nor does going to a newer or lower-ranked school doom you. It is important to consider your personal and professional goals and choose the medical school that aligns most with your priorities.
Should you turn down a full-ride scholarship to your state school to attend a top-20 medical school? That’s a question only you can decide. You need to think about your desires, priorities, and what you’re hoping to get out of a career in medicine. If your dream is to get into a hypercompetitive specialty, become academic faculty at a top research institution, or get into a high-ranking position at a hospital, then medical school prestige may be more important for you. On the other hand, if you know you want to practice family medicine or pediatrics in your home state, medical school prestige may matter less.
One thing to consider, however, is that the majority of medical students change their minds about what specialty they want to pursue during medical school. For this reason, attending a higher-ranked medical school with greater access to a variety of specialties may allow you to keep more of your options open.
You should also keep in mind the law of diminishing returns. The benefits of attending a top 5 institution versus a top 20 institution are going to be less than the benefits of attending a top 20 school instead of an average or lower-tier medical school. For instance, when I was accepted to UC San Diego, which was ranked number 14 at the time, I was still considering other top 5 schools. But after looking at the pros and cons of attending each program, I determined that UCSD better fit my desires and preferences over other top 5 programs with more name recognition.
Although attending a top-tier medical school may give you an advantage over other medical students when it comes to matching into your desired residency program, it is far from the most important piece of the puzzle. Factors such as your Step 2CK, clinical grades, research experience, and letters of recommendation are much more important in determining your acceptance into a program. What primarily separates those who are successful from those who are not isn’t the school that they attended, but rather their willingness to adapt and push forward.
If you find yourself getting discouraged because your dream specialty is highly competitive or your medical school isn’t highly ranked, stop right there. Your ability to match into your desired specialty is less a function of prestige and more a function of proper preparation, constantly improving, and putting in the work.
If you’re applying to medical school, do everything you can to get into the best program possible. But once you’re in medical school, don’t worry about prestige and focus on the other factors within your control.
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