Choosing to go to medical school is probably the most important (and most expensive) decision you will make in your life. So it is in your best interest to choose wisely. With the American Medical Association (AMA) having declared a national physician shortage, there has been a surge in the establishment of new American MD and osteopathic schools. Not to mention, Caribbean MD schools have also responded to the call to help ameliorate this nation's shortage by increasing class size and acceptance rates. Although it would appear that more spots equate to more opportunity for aspiring medical students, the recent additions are far from a blessing in disguise. Instead, they make your choice of medical school that much more important. Let me explain. Although there are more medical student positions being created, the American College of Graduate Medical Education (ACGME), which is responsible for overseeing residency training, has NOT increased the number of total residency spots. Therefore, it’s only a matter of time before we’re graduating more medical students than residency positions, leaving many students jobless.
The medical school you go to will of course determine the quality of your education, but even more important is it will profoundly influence your chances of landing a residency, and that too in a specialty of your choice. We all want to become doctors, but ideally, we want to deal with specific disease processes and patient subgroups. Remember, you'll be doing this the rest of your life so it’s important to pursue your specific interests rather than just settle for any residency position.
It cannot be emphasized enough that established US medical schools remain the Mercedes Benz of medical schools. Altogether, there are approximately 120 of them. Securing admission to one of these schools almost guarantees you'll match into a residency after you graduate. School ranking (top 20, top 50, etc) becomes more important for those who hope to pursue more competitive specialties, such as orthopedics, urology, ENT, neurosurgery, plastic surgery - essentially the surgical subspecialties. Attending a top 20 or even top 50 medical school gives you the edge when it comes time to match into a surgical subspecialty. As a student at a mid-tier or low tier medical school, you’ll still have a shot, but you become more regionally restricted; your best chance will be getting into your home institution’s residency program or at comparable low-to-mid tier institution where you actually do an elective rotation (more on that in another blog). Bottom line is, you should be aiming to get into an established US medical school. Anything else is Plan B.
So what about the newer US medical schools? There’s a BUNCH of them popping up. Are they worth a shot? Should you instead opt for a more established osteopathic school OR even a well-known Caribbean Medical school? I would have to say that newer US medical schools, essentially ones that have yet to graduate its first class (or have graduated only a few classes) should be your next go to after more established US MD schools. Although they have not established a strong track record with respect to graduating medical students who become competent residents and clinicians, in the end, they are still American medical schools and therefore held to a higher standard of education. The concern a prospective student should have is whether the faculty of the school is in tune with how to teach a cohort of medical students, particularly for the standardized medical licensing exams (USMLE), considering they have not done so previously. The USMLE is probably the most important test you will take in your medical career because it determines in large part what residency you can pursue. Fortunately, from what I've gathered in interacting with students from several newly established US medical schools, their performance on the USMLEs is fairly strong and students remain competitive applicants. Nevertheless, many established residency programs are not familiar with new medical schools, often limiting options for graduates of early classes. It is common practice for hospitals affiliated with new medical schools to preferentially select their own student graduates for residency. This is generally done so the school can bolster its own “match rate” and thus gain credibility among more established centers. With this said, there are some perks to going to a newly established US medical school. Tuition is generally cheaper or partially subsidized. Additionally, the hospital and the medical school faculty are a bit more invested in the students because they want to see the medical school grow into a successful entity. As a result, the medical students are catered to a bit more.
In the next blog, I continue my discussion of selecting a medical school by sharing my take on osteopathic schools and Caribbean MD schools.
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