choice of medical school

<p>i was just wondering why it is important to go to a top medical school (at least in terms of rankings)
seems like all the doctors, at least in one particular field, get paid the same despite the GREAT difference in medical school prestige. anything more worthwhile besides having a better brand name on a resume and more top-notch connections/friends?</p>

<p>You're pretty much exactly right. See thread here:
<a href="http://talk.collegeconfidential.com/showthread.php?t=213924%5B/url%5D"&gt;http://talk.collegeconfidential.com/showthread.php?t=213924&lt;/a&gt;&lt;/p>

<p>thread searches help ;)</p>

<p><a href="http://talk.collegeconfidential.com/showthread.php?t=213924%5B/url%5D"&gt;http://talk.collegeconfidential.com/showthread.php?t=213924&lt;/a&gt;&lt;/p>

<p>BDM beat me to it!</p>

<p>There is great difference in prestige but not in the quality of education. Luckily for us, hospital administrators know this and are smarter than your average high schooler.</p>

<p>Hospital administrators play almost no role in deciding whether or not a particular physician receives hospital privileges, as most hospitals have an open staff policy. Physician selection for private practice occurs at the group recruitment level; depending on location and the balance of supply and demand, prestige will matter a little, a lot, or not at all.</p>

<p>Medical education is so regulated that there cannot be much difference in quality of education, and it is not at all clear that the most prestigious schools provide education that is any better.</p>

<p>However, attending a famous school does help quite a bit when residency application time comes around. I think this extends beyond ROAD to many surgical programs that are in demand. For example, a Harvard or Hopkins student will find many more options in neurosurgery than will an equally well prepared student at an average medical school. Same would apply to any field in which there are more applicants than slots. For those applying in fields where any US grad will match (internal medicine for example), WHERE they match will depend in large part on where they went to medical school. Way easier to get in Hopkins medicine program from Hopkins or other top medical school.</p>

<p>The effect repeats itself for those who do fellowships. Coming out of a "top" residency enhances one's options for fellowship. </p>

<p>For non academic medicine, for those who are not doing fellowships or who are doing fellowships that are not competitive, then it does not matter where they go to medical school.</p>

<p>True that excelling at any medical school makes up for a large gap in prestige. But this is easier said than done. Since admission to medical school anywhere is so competitive, all medical students are very accomplished at academics. It is way harder to be first in the class at No-Name State medical school than middle of the pack at Harvard.</p>

<p>Right, but the question is: does a "top" residency matter?</p>

<p>Again, for private practice, my answer is no.</p>

<p>BDM, how 'bout if u wanna work w/ government/private hospitals? Does it matter?</p>

<p>You'll have to clarify what you mean. You do realize that the vast majority of physicians in a hospital are in private practice, right?</p>

<p>
[quote]
Right, but the question is: does a "top" residency matter?</p>

<p>Again, for private practice, my answer is no.

[/quote]
</p>

<p>Coming from a top residency will help, but not as much as coming from a bad residency will hurt.</p>

<p>When a private practice group sorts potential candidates, residency and medical school do matter. Some programs are assumed to be very good because of their name and some are known to be bad because of personal research. Board certification, or especially lack thereof, and letters of recommendation, particularly those from a personally known source, carry substantial weight in hiring.</p>

<p>
[quote]
You'll have to clarify what you mean. You do realize that the vast majority of physicians in a hospital are in private practice, right?

[/quote]
</p>

<p>Suppose you are living in a city like NYC. And you are an orthopedist working with government hospitals.....(most likely not more than 2 or 3). And you hardly have time to set up private practices......that was my question.</p>

<p>Government hospitals -- you mean the VA?</p>

<p>Top residency could matter if you want a fellowship. Your choice will be greater coming out of a prestigious residency. Depending on the field, this may mean being limited to less desirable fellowships, or not getting one at all.</p>

<p>If you don't want to do a fellowship, and you want to go into private practice, the best thing is to do your residency in the community where you want to practice. If people know you and like you, that is far better than a stranger coming from a big name place.</p>

<p>I'm neither fully endorsing nor fully disagreeing with your point, afan.</p>

<p>The best approach is probably to reason our way backwards through it.</p>

<p>What's the ultimate goal? The job.</p>

<p>What are the requirements for the job?
1.) You need to be certified in the right field
2.) A group needs to want you (easier) OR you need to be able to attract patients on your own (harder).</p>

<p>For goal #1, you need a fellowship or residency in the right field -- anything, really. Doesn't matter if you do it at Mayo or at Nowhere Memorial, you just need to do a residency.</p>

<p>There are some fields where ANY residency or fellowship is very difficult. Radiology, anesthesiology, etc. are tough residencies. Cardiology is a pretty tough fellowship, to name just one. In this scenario, sometimes you can improve your chances through picking a certain school, but even then the USN rankings do not do a particularly good job (nor should they be expected to) of capturing the variability implicit in such a decision.</p>

<p>For example, Vanderbilt's rad/onc program is (so I'm told) particularly prestigious, and it is usually easier to stay within a hospital system -- so Vanderbilt Med, for somebody interested in rad/onc, might be better than a slightly higher ranked program like, for example, Pritzker. (Of course, then you start to worry about an inbred resume, but that's really a very small concern.)</p>

<p>Then there's the second question: getting hired. This is a particularly difficult situation to assess, partly because I'm so far away from it and partly because there's a lot of variability for it anyway. Afan correctly points out the importance of geography; Double Penny has in the past pointed out that sometimes coming from too-big-name a place can backfire. (He was talking about undergrad, but the point remains true.)</p>

<p>On the other hand, of course, the market for physicians is always very, very strong. You might not get offers from every group you would have wanted, but it's not as if the alternative is unemployment, or even practicing out of your specialty. You'll get a job offer -- probably lots of them. (I believe I read in an economics class that the average number was seven?)</p>

<p>Again, to emphasize: if you're a premed and you've got the time and money to burn, usually there's no harm going to a more famous school. But it's hardly necessary for a career unless you're talking about one of the ultra-tough specialties.</p>

<p>
[quote]
Again, to emphasize: if you're a premed and you've got the time and money to burn, usually there's no harm going to a more famous school.

[/quote]
</p>

<p>Again, there's no real benefit to attend top med school if u just wanna set up private practice right? </p>

<p>By Government Hospital I meant government regulated hospital or the ones which are funded by federal fund (not owned by private organizations). Say like the First Health of the Carolinas. </p>

<p>Are most hospitals owned by private organizations and universities?</p>

<p>The vast majority (I want to say 70%) are non-profit owned, which would include universities. Of the remaining 30%, the vast majority of those are for-profit. Of the remaining 10%, I suspect a huge proportion of those are under DOD (Dept. of Defense) oversight in some way or another.</p>

<p>I don't know anything about the remaining kinds of hospitals -- I know a lot of hospitals are referred to as "county" hospitals, but I'm not sure whether that's their source of financing or just a description of their geographic spread.</p>

<p>okay, so my question was most likely regarding the 70% of the hospitals......do they care whether u go to a name college?</p>

<p>Remember, they're not your employer. They don't pay your salary. At a fundamental level, essentially what is happening is that the patient is hiring you to take care of them and you're renting space from the hospital to do so.*</p>

<p>All they care about, really, is that you're not so grossly incompetent that you're going to get everybody sued. They're not hiring you; if anything, you're hiring them.</p>

<p>*The actual financial arrangements are very complicated and I do not know them very well.</p>

<p>
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*The actual financial arrangements are very complicated and I do not know them very well.

[/quote]
</p>

<p>Physician reimbursement is a complicated subject. A book that comes highly recommended if you really want to know more about it is <a href="http://www.amazon.com/Understanding-Health-Policy-Thomas-Bodenheimer/dp/0071423117/ref=pd_bbs_sr_1/002-7275514-0472829?ie=UTF8&s=books&qid=1181257454&sr=8-1%5B/url%5D"&gt;http://www.amazon.com/Understanding-Health-Policy-Thomas-Bodenheimer/dp/0071423117/ref=pd_bbs_sr_1/002-7275514-0472829?ie=UTF8&s=books&qid=1181257454&sr=8-1&lt;/a&gt;&lt;/p>