How to Decide Which Medical Schools to Apply to: 10 Critical Factors

Building your medical school list is one of the most consequential decisions in your premed journey, and most students don’t give it nearly enough time. A poorly constructed list can undermine an otherwise strong application. You can have a competitive GPA, a strong MCAT, and compelling extracurriculars, and still end up with no acceptances because you applied to the wrong schools.

Start this process earlier than you think you need to. Researching programs, understanding matriculant data, and figuring out how many medical schools to apply to takes time, and rushing it is one of the most common and costly mistakes premeds make.

Here are 10 factors that will help you build a medical school list strategy that matches your profile and maximizes your chances of acceptance.

1 | Your Competitiveness as an Applicant

Each school has different cutoffs and expectations for your GPA and MCAT score, but remember that these hard metrics are only one factor in your overall competitiveness. You also need to look at your soft components, such as your personal statement, interview skills, and letters of recommendation. All medical schools use holistic applicant review processes that go beyond your scores.

While many schools use cutoffs for GPA and MCAT, having a high score doesn’t mean you’ll necessarily be interviewed or accepted. This is why, every year, you’ll see official data reported by the AAMC of students with near-perfect GPA and MCAT scores who fail to secure even a single acceptance.

If you haven’t yet taken your MCAT or completed your college coursework, do everything you can to improve your hard metrics. Better numbers will only ever help you. Ignore the misguided forum advice that having too high numbers is harmful. That’s only the case if securing strong metrics comes at the cost of neglecting other components of your application.

If your MCAT and GPA are already set, you can still do much to improve your competitiveness by focusing on the soft components. This is how we’ve helped students with 3.3 GPAs and 505 on the MCAT get into Ivy League and other highly prestigious medical schools. They have a compelling narrative woven throughout their application.

Research the statistics of recent matriculants for each of the schools you are considering applying to.

The free Medical School Chance Predictor helps you determine the best medical schools to apply to based on your GPA, MCAT, location, and matriculant metrics, including out-of-state versus in-state acceptance rates. You can see how many students from a given school matched into a specific specialty, and generate a stratified list of schools ranked by your likelihood of acceptance.

Keep in mind that the stronger your application, including both hard and soft components, the greater your optionality. In other words, by becoming the most competitive applicant you can be, you can put yourself in the position of choosing from multiple acceptances. Don’t shoot for the average. Aim higher.

2 | In-State vs Out-of-State Medical School: Why Location Matters

The location of the school is a huge determining factor since each city and state has its own culture and benefits. The vibe in California is much different than Nebraska. Do you enjoy the hustle and bustle of a busy city, or is a laid-back, rural environment more your style?

Medical school will be a stressful and taxing four years, so you don’t want to add any more stress with your environment. What are your personal pros and cons of each city you’re considering, and how can the city provide convenience, enjoyment, and comfort in your minimal downtime?

Plus, the school’s location could skyrocket your tuition costs. Out-of-state students often pay much more in tuition and fees, and some schools accept very few out-of-state applicants. 

For example, Texas residents have a far higher chance of being accepted to schools in Texas than non-residents do. Public universities in Texas are legally required to cap out-of-state enrollment at 10% of their matriculating class, making Texas one of the most difficult states for non-residents to break into, regardless of their stats.

So, if you are a resident of Texas, it’s a good idea to take a thorough look at the schools in your home state. On the other hand, if you are not a resident of Texas, you can still apply to schools in that state, but your chances of being accepted are slim. Plus, you’ll need to apply through a separate application service called the Texas Medical and Dental School Application Service, or TMDSAS for short. That said, it still makes sense for certain out-of-state applicants to apply to Texas medical schools.

Give extra consideration to schools in your home state, especially if cost is a top factor for you, and remember that every city is different. Going to medical school in the Midwest will be completely different from attending school in a large city, such as New York.

The school you choose will be your home for at least four years, so do your research on where you will live.

What’s the city like? How far away is the city from where you currently live? What’s the cost of living? What type of food is popular? What do people do for fun?

If you can manage it, take time to visit some of the campuses and cities of your top schools to get a better sense of the campus as well as the surrounding area.

Watching videos and doing research online is a great way to start, but setting foot on the ground is the best way to determine whether or not it’s a place you can imagine yourself living for the next 4 years.

3 | How You Prefer to Learn

Everyone learns differently, which means the teaching styles of certain schools may be a better fit for you. Consider whether you prefer large or small classes, as well as the type of learning environment you want.

Most schools have a mix of problem-based learning, team-based learning, and regular lectures. But there are unique circumstances scattered across the various schools that could change your medical school experience.

For example, the University of Colorado School of Medicine has its students begin clinical rotations in second year instead of third year, which has multiple implications on patient exposure, testing timelines, and student experience, with both pros and cons.

Learning about different teaching methods will take more research than simply looking at a database of averages. Research individual programs to find out more about how you will learn. Dig into online networks to ask about school programs, and if you are deeply considering a specific school, take the time to reach out to someone who is attending or has attended to learn more about what it’s like to study there.

4 | Your Special Interests in Medicine

If you already know what specialization you want to pursue, this may help you narrow down your best med school options. Most strong medical schools offer a balanced and diverse range of opportunities for students, but there are some schools more well-known for certain specialties.

If you have a specific interest you want to explore, look for a medical school that has the most to offer in that area.

If you want to go into neurosurgery, for example, and you don’t have a neurosurgery program at your medical school, it’s not impossible, but it will be much harder to get proper exposure, gain research experience, and find a mentor. You can do it, but you’ll have to go outside the university.

Some school rankings will list schools based on what they have to offer in specific fields of study, and top-tier schools will be able to provide all the resources you need, no matter what specialty you land on.

This is why we often advise students to aim for top-tier schools if possible, since over 70% of first-year medical students change their specialty by the time they apply for residency.

5 | Personal Opportunities

And beyond specialties, what extra opportunities are available at the schools you’re considering? Think about anything you might want to pursue inside or outside of your studies.

There’s much more to a school than just its curriculum. Does the school have clubs that align with your interests outside of medicine? What electives are you able to take? Does the school offer internships, med tech incubators, work-study programs, or exchanges? Do they offer additional or dual degrees, such as an MBA? How can the school assist you in reaching your personal and professional goals?

6 | School Prestige

Of course, there’s a certain prestige to attending a big-name school like Duke, Stanford, or Harvard, and some of those big names can have more weight when it comes time to apply to residency.

Many prestigious residency programs care about your “pedigree”, meaning what institutions you previously trained at. For many, this is off-putting. But for those who are set on being academic physicians at an Ivy League institution, it’s worth considering.

However, that doesn’t mean those big names will be the right fit for you. School fit, including location, teaching style, culture, and other factors, is far more important.

If a school’s reputation is important to you, make sure those big-name schools still align with your values, student needs, and career goals.

7 | DO vs MD Medical School: What the Decision Really Means

This choice will completely change which schools you apply to. You may share the convictions and principles of osteopathic medicine, you may have a mentor with DO after their name, or you may not have the hard metrics to be considered at MD schools. 

Depending on the specialty you’re interested in, choosing the DO path could limit your ability to match into more competitive specialties, and you also can’t practice outside of the US as a DO. These are very real factors to consider. But, again, keep in mind you may start medical school set on something where the DO degree won’t be an issue, like pediatrics, and change your mind to something like plastic surgery, where it will be an uphill battle.

It’s also true that the statistics for acceptance to osteopathic programs are lower than allopathic (MD) schools. Osteopathic schools tend to accept applicants with a lower GPA and MCAT score.

But don’t pursue osteopathic medicine simply because you believe it will be easier. While the admissions process may be more forgiving of lower stats, DO students go through the same training process as MDs, completing four years of medical school followed by residency. If you don’t have an interest in osteopathic medicine or are concerned that it will limit your specialty options, work at improving your GPA, MCAT score, and overall application instead.

Applying to osteopathic programs requires you to use the American Association of Colleges of Osteopathic Medicine Application Service, otherwise known as AACOMAS, as opposed to AMCAS. The services are similar, but there are a few small differences, and applying through two services is not without minor drawbacks.

8 | Tuition & Financial Aid Opportunities

Determine the tuition cost and the financial aid opportunities that are available at the schools you’re interested in.

Tuition costs vary considerably across medical schools for in-state vs. out-of-state applicants. Many schools charge much more, sometimes double, for out-of-state applicants, and there’s a cost difference for public versus private schools. The average student debt for graduating medical students is over $260,000, which should not be taken lightly.

Financial aid varies from school to school, both in the amount available and how and when you are eligible to receive it. If you’re depending on financial aid in order to pay for medical school, carefully research what is available, as well as the details surrounding the aid, for each school. Many schools offer more aid and scholarships to those applying in-state.

You won’t know what your financial aid package looks like until you get accepted, so this will become more of a consideration after you begin to receive acceptances.

And cost will matter more to some applicants than others. For example, if you’re used to the cost of attending college in New York or California, your cost of living won’t change as drastically as it might if you moved from a small town to New York City.

9 | Cost of Living

Tuition is only one piece of the puzzle when it comes to calculating your med school expenses.

Renting a two-bedroom apartment in Mississippi will run you roughly $1,200 to $1,300 per month, whereas the same apartment in California will cost closer to $2,800 to $3,400, depending on where you are in the state. 

A thousand dollars more per month for rent alone is a high cost to consider over four years. Additionally, factor in the cost of groceries, transportation, and lifestyle expenses, all of which vary considerably depending on the city you’re living in.

10 | Personal Preference and Gut Feeling

Choosing what medical schools you want to apply to also comes down to your own personal preference. You might fall in love with particular schools or certain cities, or you may already know that you don’t want to leave your home state.

Get to know a variety of schools, and do your research well in advance so that you can choose schools that feel like a good fit. If it doesn’t feel right, it probably isn’t. You’re going to invest at least four years of your life (and tens of thousands of dollars) into the school you choose, so it’s important that it feels right to you.

Back when I was making my decision, I created my own meticulous spreadsheet to track the various strengths, weaknesses, costs, and other factors to help me decide which medical school to attend. But once it was time to make my decision, I realized relying on my gut was far more important than quantifying such a critical decision.

At a certain point, schools can start to seem the same from one to the next, and all that matters is how you feel about each one. What’s the energy like on campus? Do you get along with faculty and students? Do you feel comfortable in the city and inspired by your surroundings?

My second look at my top schools was invaluable. I learned so much more from immersing myself in the campus, city, and the people who lived there than what any spreadsheet could tell me.

In the end, I realized that out of the 3 schools I was considering, two were in the running simply because they were big-name, top-5-ranked schools; however, one was in the Midwest and the other on the East Coast. The third school was a top-15-ranked school that still offered amazing training and opportunities, even if it wasn’t as prestigious in the traditional sense. Ultimately, that third school had an energy I loved, students and faculty I clicked with, and a city that inspired me. I’m so grateful I ultimately committed to UC San Diego.

Trust your gut.

What’s Next?

Get started on the process of choosing schools as soon as possible. Take as much time as you feel necessary to research programs thoroughly so that you can land at the school that helps you thrive and supports you in achieving your goals.

Going to medical school often means relocating to a new city or state. Give yourself all the time you can to explore these cities to ensure you will be comfortable learning and, ultimately, living there.

The free Medical School Chance Predictor takes the guesswork out of building your school list. Enter your GPA, MCAT, and location, and it generates a stratified list of schools ranked by your likelihood of acceptance, including out-of-state versus in-state acceptance rates and specialty match data. It’s free, and it’s a smarter starting point than a spreadsheet.

Medical School List FAQs

How Many Medical Schools Should I Apply to?

We recommend applying to 25 to 30 schools. Applying to too few programs puts you at risk of not receiving enough interviews, and with rolling admissions, that’s a hole that’s difficult to dig out of. Base the final number on the strength of your application. If your GPA, MCAT, or experiences have gaps, err toward the higher end to give yourself more options.

How Do I Build a Medical School List?

A solid medical school list strategy starts with your stats. Use the free Medical School Chance Predictor to generate a stratified list of schools based on your GPA, MCAT, and location. From there, layer in factors like tuition, cost of living, teaching style, specialty resources, and personal fit. Your list should include a mix of reach, target, and safe schools, and it should be longer than you think.

When Should I Research Which Medical Schools to Apply to?

As early as possible. There are a lot of variables to account for, from location and tuition to curriculum structure and specialty resources, and rushing the process leads to a weaker list. If you’re relocating to a new city or state, give yourself enough time to actually visit campuses and explore the surrounding area before committing.

Does Location Affect My Odds of Acceptance?

Yes, significantly. In-state vs out-of-state medical school status can make or break your chances at certain programs. Public universities in Texas, for example, are legally required to cap out-of-state enrollment at 10% of their matriculating class. If you’re applying to most Texas schools, you’ll also need to submit through TMDSAS instead of AMCAS. Research each program’s residency preferences before finalizing your list.

Should I Apply to Both MD and DO Schools?

It depends on your stats and your specialty goals, but go in with a clear understanding of what the DO path means before you decide. 

DO programs have lower average GPA and MCAT thresholds, but the degree can significantly limit your ability to match into competitive specialties. If you have both MD and DO acceptances, take the MD every time. If you only have DO acceptances and your goals align with fields like family medicine, emergency medicine, or psychiatry, going DO and becoming a doctor is the right call. If your stats fall below the MD threshold, applying to both keeps your options open.

For a full breakdown of the data behind this decision, see our MD vs DO guide.

How Do I Know If a Medical School Is a Good Fit?

Fit goes beyond rankings and reputation. School mission fit is one of the most overlooked factors in building a medical school list, and admissions committees notice when applicants haven’t done their homework. Research each school’s mission, values, and curriculum structure, and if you can, visit the campus. At a certain point, the data only gets you so far. Trust your gut.

What’s the Difference Between AMCAS, AACOMAS, and TMDSAS?

These are the three primary application services for medical school. AMCAS is used by most MD programs, AACOMAS is used by DO programs, and TMDSAS is used by most medical schools in Texas. Depending on which schools you apply to, you may need to submit through more than one. See our full breakdown: AMCAS vs AACOMAS vs TMDSAS.