Med school admissions biased?

[esob]

At the end of the day it doesn't matter anyway; a GP who graduated in the top 10% from Harvard gets the same reimbursement rate for an office visit as one who graduated in the bottom of their class from any D.O. school (or the Caribbean if they managed to get a residency) and when someone comes in for bronchitis they don't really care where you went to school. I imagine there is some benefit if you wanted to get into some super competitive med spa derm residency but for most, the more important factor in choosing a school is 1) will they accept you and 2) is the school a good fit for you (learning style, location, cost, etc).

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[BombsAway]

OP, I would refer you to Serenity Prayer, minus the god stuff.

A way I figured out how to deal with this process was by re-ranking the "top" med schools. My list starts with: #1 "Whoever Accepts me School of Medicine".

 

[PB&Jam]

N=1 I got into a top 10 school (and had an interview at another, ultimately waitlisted) coming from a state school. Actually, a couple other students the from my class are going to prestigious schools as well, so n=more like 3 or 4. What other people have said here is true, it is a tougher road coming from an undergrad that doesn't carry a brand name. But if you have an outstanding resume and accomplishments, odds are that a higher tier medical school will take notice.

 

[TheTeacher]

So doesn't it basically just trickle down all the way? Undergrad is a factor for med school. High school is a factor for undergrad. What high school you go is determined by where you live ( most of the time). The good high schools are in the wealthier areas. I would love to see a research study that proves ( or disproves) that med school self selects for wealthier members of society.

 

[sullen-burger]

So doesn't it basically just trickle down all the way? Undergrad is a factor for med school. High school is a factor for undergrad. What high school you go is determined by where you live ( most of the time). The good high schools are in the wealthier areas. I would love to see a research study that proves ( or disproves) that med school self selects for wealthier members of society.

I got you fam

https://www.aamc.org/download/165418/data/aibvol9_no11.pdf.pdf

 

[TheTeacher]

I got you fam

https://www.aamc.org/download/165418/data/aibvol9_no11.pdf.pdf

oooo thanks homie

 

[Lucca]

So doesn't it basically just trickle down all the way? Undergrad is a factor for med school. High school is a factor for undergrad. What high school you go is determined by where you live ( most of the time). The good high schools are in the wealthier areas. I would love to see a research study that proves ( or disproves) that med school self selects for wealthier members of society.

It does. To what extent depends on a lot of different factors. Let's just look at some numbers though for a typical, prestigious goal in medicine: matching at a Harvard residency as a physician scientist. What path gives you the best chance at this? Likely, the one that puts you in the "Harvard" pipeline as early as possible.

17/19 (~90%) MD/PhD grads in the HMS class of '17 matched at a Harvard residency.
~30% of HMS MD/PhDs come from Harvard undergrad

~32% of Harvard undergrad's class comes from 11% of the high schools represented at Harvard. About 6% come from just 10 high schools. (Source: The Crimson 2013)
"In total, one out of every 20 Harvard freshmen attended one of the seven high schools most represented in the class of 2017—Boston Latin, Phillips Academy in Andover, Stuyvesant High School, Noble and Greenough School, Phillips Exeter Academy, Trinity School in New York City, and Lexington High School."

Make no mistake, these are extremely competitive charter, private, and boarding schools. Household names to kids (such as myself) whose classmates self-medicated with adderall more often than marijuana and cigarettes. Some of them have tuitions upwards of 40-60k a year and the boarding schools in particular have entry starting as early as Kindergarten.

 

[Cyberdyne 101]

It does. To what extent depends on a lot of different factors. Let's just look at some numbers though for a typical, prestigious goal in medicine: matching at a Harvard residency as a physician scientist. What path gives you the best chance at this? Likely, the one that puts you in the "Harvard" pipeline as early as possible.

17/19 (~90%) MD/PhD grads in the HMS class of '17 matched at a Harvard residency.
~30% of HMS MD/PhDs come from Harvard undergrad

~32% of Harvard undergrad's class comes from 11% of the high schools represented at Harvard. About 6% come from just 10 high schools. (Source: The Crimson 2013)
"In total, one out of every 20 Harvard freshmen attended one of the seven high schools most represented in the class of 2017—Boston Latin, Phillips Academy in Andover, Stuyvesant High School, Noble and Greenough School, Phillips Exeter Academy, Trinity School in New York City, and Lexington High School."

Make no mistake, these are extremely competitive charter, private, and boarding schools. Household names to kids (such as myself) whose classmates self-medicated with adderall more often than marijuana and cigarettes. Some of them have tuitions upwards of 40-60k a year and the boarding schools in particular have entry starting as early as Kindergarten.

Just one thing: Stuy is a public high school in Manhattan aka it's free.

 

[gyngyn]

An adcom once showed me some list that I believe all med schools have access to categorizing undergrad schools into tiers of competitiveness, and they get a certain amount of points according to their undergrad's tier. Maybe people who get into top med schools all have 4.0s and 40+'s (or whatever the heck that is equal to now), so where they went for undergrad makes the difference at that level of competition.

Where can this document be found?

 

[Cyberdyne 101]

Where can this document be found?

I think they were referring to the University of Miami and how they assign points to specific aspects of people's apps.

 

[gyngyn]

I think they were referring to the University of Miami and how they assign points to specific aspects of people's apps.

I see. For a moment, I thought it was a game the other schools were playing and I was not invited!

 

[enchantediris]

Just one thing: Stuy is a public high school in Manhattan aka it's free.

Same with Lexington High School in MA! The New York Times actually wrote a recent article about how competitive and stressed students are there...

 

[Cyberdyne 101]

Same with Lexington High School in MA! The New York Times actually wrote a recent article about how competitive and stressed students are there...

I went to one of those uber-competitive public high schools and the stress levels were insane. It was like living in a totalitarian state.

 

[Goro]

It's 2017, yet some of you still seem surprised that wealth buys privileges.

I have to reiterate that it's not about what you want, but about what the school wants.

I remember someone posting that there's more inbreeding at Brown than in an Alabama trailer park.

EDIT: This is not our problem. It's the applicant's problem. BTW, with my boy in high school, and my daughter not too far from that, I am fully aware of what it takes to get into our state school, and other colleges as well. We'll probably send them to the local CC, and them to State U for their UG degrees... or, where ever they want to shoot for, within reason.

AND, FYI, most of my Adcom colleagues have kids in high school.

Most of the people in the adcom probably have no idea how hard it is to get into a name brand undergrad these days.

 

[mwsapphire]

Where you go to HS does not have as much of a pull on where you go to UGrad, or at least not as much as where you go to UGrad influencing where you go to Med school. ( I went to a posh HS and applied to a few colleges where my gpa was a bit below the median- rejected).
Going to a top med school from a no-name undergrad is more dependent on you than you than your undergrad's name.

 

[NeuResurgens]

Of course there are biases. Admissions committee members have all sorts of biases for things outside an applicant's control, I figure those would also include things more in an applicant's control like which undergrad they went to. We're all only human, and there's lots of bias in the human mind.

 

[AnatomyGrey12]

a GP who graduated in the top 10% from Harvard gets the same reimbursement rate for an office visit as one who graduated in the bottom of their class from any D.O. school (or the Caribbean if they managed to get a residency) and when someone comes in for bronchitis they don't really care where you went to school

Don't tell Jalby that...

 

[P0ke]

At the end of the day it doesn't matter anyway; a GP who graduated in the top 10% from Harvard gets the same reimbursement rate for an office visit as one who graduated in the bottom of their class from any D.O. school (or the Caribbean if they managed to get a residency) and when someone comes in for bronchitis they don't really care where you went to school. I imagine there is some benefit if you wanted to get into some super competitive med spa derm residency but for most, the more important factor in choosing a school is 1) will they accept you and 2) is the school a good fit for you (learning style, location, cost, etc).

I shadowed an ER doc once and a patient actually asked where the doc went to med school. Of course they did seem to be the pompous type and talked about their pedigree and schooling during the interview... definitely not the norm, but it does happen.

 

[gyngyn]

I shadowed an ER doc once and a patient actually asked where the doc went to med school. Of course they did seem to be the pompous type and talked about their pedigree and schooling during the interview... definitely not the norm, but it does happen.

I once had a patient call my school and ask for my grades!

 

[cactusman]

I remember someone posting that there's more inbreeding at Brown than in an Alabama trailer park.

I believe @AnatomyGrey12 gets credit for that one. I think it was specifically referring to residencies.

 

[Goro]

I once had a patient call my school and ask for my grades!

 

[mwsapphire]

I once had a patient call my school and ask for my grades!

WTF
That is so creepy! But don't plenty of med school lean towards P/F? Or maybe they dont hold on to transcripts?
Edit: I know you can't give random ppl info on grades, but in general I feel like they dont even have it is my point.

 

[P0ke]

WTF
That is so creepy! But don't plenty of med school lean towards P/F? Or maybe they dont hold on to transcripts?

Pretty sure you can't just give out a former student's grades to a random person calling the school.

 

[Goro]

Pretty sure you can't just give out a former student's grades to a random person calling the school.

There are Federal Laws against it (FERPA).

 

[aformerstudent]

Most patient's won't ask where you went to school or do anything extreme unless you weren't charming to begin with.

 

[gyngyn]

Most patient's won't ask where you went to school or do anything extreme unless you weren't charming to begin with.

She became a friend for life after her hysterectomy!
I still get cards from her.

 

[aformerstudent]

She became a friend for life after her hysterectomy!
I still get cards from her.

This is the same person who called your school about your grades? I would be VERY cautious of this "friendship" then.

 

[gyngyn]

This is the same person who called your school about your grades? I would be VERY cautious of this "friendship" then.

I'm pretty sure an annual holiday card is perfectly safe.

 

[Miami Thrice]

I see. For a moment, I thought it was a game the other schools were playing and I was not invited!

I believe it's Barron's Profiles of American Colleges.

 

[gyngyn]

I believe it's Barron's Profiles of American Colleges.

How do I use it to score points?

 

[efle]

I believe it's Barron's Profiles of American Colleges.

I'd be surprised if they used that system. Barron puts U of Miami's own undergrad is Tier 1 and gets scored the same as HYP, but then UC-Berkeley is Tier 2 with Grove City College ? Wouldn't make much sense

 

[WedgeDawg]

I'd be surprised if they used that system. Barron puts U of Miami's own undergrad is Tier 1 and gets scored the same as HYP, but then UC-Berkeley is Tier 2 with Grove City College ? Wouldn't make much sense

It would if you attribute its rank to inbreeding

(Not totally serious)

 

[libertyyne]

At the end of the day it doesn't matter anyway; a GP who graduated in the top 10% from Harvard gets the same reimbursement rate for an office visit as one who graduated in the bottom of their class from any D.O. school (or the Caribbean if they managed to get a residency) and when someone comes in for bronchitis they don't really care where you went to school. I imagine there is some benefit if you wanted to get into some super competitive med spa derm residency but for most, the more important factor in choosing a school is 1) will they accept you and 2) is the school a good fit for you (learning style, location, cost, etc).

That's the thing though, the argument is if you go to a top school your chances of one of the competitive specialties is higher. Ergo income bump that comes with that. If you looked at life time earnings of Harvard grads vs touro grads there would be a stark difference considering a majority of students at touro are primary care vs a majority of Harvard grads are higher paying specialists.

 

[Sardinia]

She became a friend for life after her hysterectomy! I still get cards from her.

This is the same person who called your school about your grades? I would be VERY cautious of this "friendship" then.

He surgically removed her hysteria. She is now normalized.

 

[Goro]

That's the thing though, the argument is if you go to a top school your chances of one of the competitive specialties is higher. Ergo income bump that comes with that. If you looked at life time earnings of Harvard grads vs touro grads there would be a stark difference considering a majority of students at touro are primary care vs a majority of Harvard grads are higher paying specialists.

But this will be true of any MD grad! Up to 80% of them go into specialties.

 

[mwsapphire]

The only way I can think pf this as bias is if you're thinking of people going to a state school for a lower tuition even though they made it into a top school. That may be counted as money based discrimination, a few example I know irl come to mind.
Otherwise, there should be a "bias" towards top schools.

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[libertyyne]

But this will be true of any MD grad! Up to 80% of them go into specialties.

I have yet to see the numbers but my gut says that top medical schools send a higher proportion of their grads into the more competitive specialties compared to their other MD counterparts. The examples just a counter point to the school doesn't matter post .

 

[Sardinia]

I have yet to see the numbers but my gut says that top medicinal schools send a higher proportion of their grads into the more competitive specialties compared to their other MD counterparts. The examples just a counter point to the school doesn't matter post .

I think the biggest factor is not the school, but actually self-selection bias. Students use their top priority match picks to prioritize the safest return on their investment. Four years and six figure debt are sufficient conditions to necessitate accurate selections.

 

[Goro]

MSAR can tell you this, at least to a degree

I have yet to see the numbers but my gut says that top medical schools send a higher proportion of their grads into the more competitive specialties compared to their other MD counterparts. The examples just a counter point to the school doesn't matter post .

 

[TSteezy]

OP,

You have the opportunity to succeed no matter where you attend undergrad. Yes, those who attend prestigious undergrads have an initial advantage. Can it be discouraging? You bet. Regardless, you can prove your worth to any medical school from any undergraduate institution.

I'll bring up three (n=3) case studies:
1. Myself - I attended a no-name (and I mean no-name) state school. Worked my butt off, did all the right "things," and ended up receiving multiple interviews and acceptances from USNWR "top 20" schools and will be matriculating at a "top 10" university this August.
2. A classmate had similar success. We'll be matriculating at the same "top 10" university
3. A classmate who graduated a year before me matriculated at Harvard this fall.

Moral of the story: If you build it, they will come.

 

[jcorpsmanMD]

Most but not all. There's plenty of idiots running rampant in places of power with Ivy League pedigrees...

There's also many of those aforementioned people running around at state schools... your point?

 

[AnatomyGrey12]

That's the thing though, the argument is if you go to a top school your chances of one of the competitive specialties is higher. Ergo income bump that comes with that. If you looked at life time earnings of Harvard grads vs touro grads there would be a stark difference considering a majority of students at touro are primary care vs a majority of Harvard grads are higher paying specialists.

Yes but that is a specialty bump, not a bump in pay because of the school. The point is that an ENT from Touro and an ENT from Harvard get paid the same for a tonsillectomy. Not that a harvard grad has a better chance at ENT, that's a separate discussion. If you want to really compare you need to compare the lifetime earnings of ENTs from Touro and ENTs from Harvard.

This is one instance where looking at match lists overview a number of years is useful. The top schools actually don't place their grads into the competitive fields at a higher rate than most other MD schools. Compare Harvard match lists with a school in the 40s and 50s. The percentages going into competitive specialties are really similar.

This is also completely discounting the fact a higher percentage of top school grads go into academia, which tends to pay less than PP.

 

[esob]

I have yet to see the numbers but my gut says that top medical schools send a higher proportion of their grads into the more competitive specialties compared to their other MD counterparts. The examples just a counter point to the school doesn't matter post .

Well, I specifically stated the caveat about specialties, but also directly noted the example was for primary care. However, the should hold true if you are comparing apples to apples regardless. A Harvard derm doesn't get reimbursed any more than a Tour derm. It may give you an edge in being competitive for a specialty but you could make the counter argument about actually going to lower end school so that you could outgun all your peers and get AOA, honor all classes, etc.

 

[Shirafune]

I'm not going to pretend to speak for anyone else but here is why the pedigree chasing by schools, to the extent that it happens in med admissions, bothers me:

Most of the people in the adcom probably have no idea how hard it is to get into a name brand undergrad these days. Honestly, it's practically rigged. The kids that do make it through are either astounding, wound up so tight they'll explode if you touch them, or come from wealth such that their success was guaranteed by attending the right schools and knowing the right people every step of the way.

it doesn't help that of the people I know IrL who have been admitted to "top" medical schools, most are not even interested in ever practicing medicine and are looking for the first opportunity to bail for the comfiest, most lucrative option whether it be in clinical medicine or not. Obviously, I don't think everyone is actually like this, but it's discouraging to say the least to watch what are essentially highly trained, highly capable hoop jumpers rise to the top at every step while genuine, caring but less bright individuals are discouraged from continuing entirely.

Thank you so much for posting this. I see this all the time and it bugs the hell out of me.

 

[efle]

Thank you so much for posting this. I see this all the time and it bugs the hell out of me.

@Lucca too, why tho? If someone is the dermie at my local hospital because he was smart, put the work in and wanted a cushy lifestyle, why should I care? Can he not be great as his job because of that? Is the world better off with that person in finance or business or law instead?

 

[Lucca]

@Lucca too, why tho? If someone is the dermie at my local hospital because he was smart, put the work in and wanted a cushy lifestyle, why should I care? Can he not be great as his job because of that? Is the world better off with that person in finance or business or law instead?

It is not so much that this dermie should succeed, it is more that the system is set up so that so many more will not succeed to reach the top echelons who have every ability and willingness to do so.

 

[WedgeDawg]

It is not so much that this dermie should succeed, it is more that the system is set up so that so many more will not succeed to reach the top echelons who have every ability and willingness to do so.

I don't think most people think derm is the top echelon, at least in terms of things that they want to do. Not that many people (relatively) are actually interested in being a dermatologist.

 

[mwsapphire]

I don't think most people think derm is the top echelon, at least in terms of things that they want to do. Not that many people (relatively) are actually interested in being a dermatologist.

He means success in general is easier for in genuine, smarter people to obtain, rather than less intelligent, more genuine people.
Replace "dermie" with "CT surgeon" and it's a better example.

 

[WedgeDawg]

He means success in general is easier for in genuine, smarter people to obtain, rather than less intelligent, more genuine people.
Replace "dermie" with "CT surgeon" and it's a better example.

Again, not necessarily. Being any kind of doctor can make you successful. Contrary to what sdn says, being a CT surgeon or a dermatologist or a neurosurgeon appeals to a minority of medical students. A lot of people want to do things like IM and peds and psych, and things of that nature.

More to Lucca's point, while it's true that some high achieving people within medicine jump ship at first opportunity, by and large, most do not.

Sorry - I have to run and can't flesh this out immediately but I can come back later and do so if anyone cares.

 

[mwsapphire]

Again, not necessarily. Being any kind of doctor can make you successful. Contrary to what sdn says, being a CT surgeon or a dermatologist or a neurosurgeon appeals to a minority of medical students. A lot of people want to do things like IM and peds and psych, and things of that nature.

More to Lucca's point, while it's true that some high achieving people within medicine jump ship at first opportunity, by and large, most do not.

Sorry - I have to run and can't flesh this out immediately but I can come back later and do so if anyone cares.

*waits patiently*