<p>Does it matter where a doctor gets his MD when it comes to salary?</p>
<p>No. Salary is determined almost entirely by a combination of specialty, geographic location, and individual choices made in regards to work/life balance (some of these options are limited by the other two factors I mentioned).</p>
<p>Specialty - in general surgeons make more than non-surgeons (ie urologists make more than pediatricians). Sub-specialists make more than generalists (ie neurootologists make more than regular ENT surgeons, reproductive endocrinologists make more than general OB/GYN practioners, or cardiologists make more than general internists). And those practicing adult medicine make more money than their pediatric counterparts. There is of course considerable overlap in the ranges of salaries made and those are affected by the other two factors.</p>
<p>Geography - if a place has high cost of living, generally the physicians will be paid more. You’ll get a higher salary in NYC than you will in Des Moines. On the flip side, when it comes to residency positions and everyone makes about the same, cost of living can really stretch your salary. It’s a lot cheaper to live in Kansas City than in Chicago, so if you’re making $47,000 in both places…well it’s simple.</p>
<p>Personal choices: limiting your practice to certain types of patients, scheduling patients from 8AM to 6PM instead of 10AM to 4:30PM, taking fewer vacations, taking more call, moonlighting at other hospitals, covering call for other physician groups, having your patients in the hospital managed by the hospitalists, renting a timeshare instead of owing your own ski cabin, cramming 8 clinic visits in an hour instead of 4, hiring PA’s or NP’s as physician extenders, using LPN’s instead of RN’s, and a thousand other options can affect just how much money a particular physician makes and how much money they have to spend. </p>
<p>But in terms of a degree from Harvard Medical School being valuable in and of itself than one from the University of Missouri, no, it doesn’t matter…</p>
<p>No, with some caveats. </p>
<p>As BRM noted, compensation is largely a function of specialty and subspeciatly training. For most specialties, American medical graduates with similar board scores and experience have similar success applying to residency programs. Highly competitive residency programs, such as Plastics or Ophthalmology, may factor in prestige to distinguish otherwise identical candidates. Foreign medical graduates have a much more difficult time securing “desirable” residencies and jobs.</p>
<p>In general I agree, but foreign graduates are not homogeneous. If you come from a prestigious medical school in Western Europe, and did well there, you will be welcomed even into the most competitive programs. In England, where doctors train endlessly, many people come to the US to finish their training, and stay here, after one or more residencies in the UK.</p>
<p>For the high demand specialties it can make a big difference to come from a prestigious medical school just to get into the residency. NOTE that the high demand specialities may change a lot after health care reform. Right now there are some specialties that pay much more than others. If they flatten this out, and make physicians income similar across fields, then the competition to get into these fields may decline, and the importance of medical school would decline as well.</p>
<p>Define “big”.</p>
<p>To get into particular residency programs name of school can matter (and this is of true of programs in every specialty from pediatrics to neurosurgery), but to get into the field…not so much, and certainly the disadvantage for a particular program can be overcome. Who you know, who makes calls on your behalf, doing away rotations, having a great interview, where you grew up and so on, all can level the playing field.</p>
<p>The issue is that with the match, you really have no idea what matters and if a program highly values a “name” school does that move you up 5 places on their rank list or 20? And what’s significant? Certainly for things like pediatrics or internal medicine where program sizes are into the 20’s and 30’s (for peds, CHOP and Texas Children’s, widely considered the top two programs in the country take 40 and 42 interns each year respectively), moving up 5 spots is less significant than moving up 5 spots for derm programs that only take 2 residents each year.</p>
<p>If you look at the match reports you find that the highest demand specialties-like plastic surgery, neurosurgery, etc, have a higher proportion of residents who went to medical school at the places with highest NIH funding-one good definition of prestigious. None of them take their residents exclusively from these schools, so going to a less prestigious medical school does not mean that such careers are out of the question. However, you will find many more graduates of, say, Hopkins than some bottom 20th percentile medical school in the most competitive specialties. </p>
<p>Who writes letters and makes calls on your behalf? This counts for much more if the people doing the calling are leaders in the field. This is much more likely if they are at Harvard or Stanford, than if they are at the bottom 20th percentile school. This is self-perpetuating. Many of the faculty at the top residencies went to medical school at the top schools. Many trained at these places. Everyone tends to listen more to recommendations from people they know. At the most competitive residencies, and in the most competitive fields, particularly the smaller ones, the faculty has lots of connections at the top schools, and far fewer at those lower down in the rankings. So the graduates of the top schools get a better hearing.</p>
<p>And it has nothing to do with the fact that someone who got into hopkins might be a little more on the ball than someone who went to a less competitive school ;)</p>
<p>That may be part of the effect. Or at least what the residency selection committees assume. Of course, the admissions rates to the top medical schools are so low that they are in some ways more like lotteries. No one would claim that Harvard accepts the “best” applicants it gets each year. It accepts a small subset of the outstanding applicants, and recognizes that it could replace the admitted class multiple times over and end up with equal academic ability</p>
<p>Are the average Step I and Step II scores of different medical schools published? If so, what are the standard deviations? </p>
<p>If we could get these data, that would explain how many students that went to JHU or HMS had a substandard/poor Step I and II scores and be able to compare with optimal scores of students from state funded med schools.</p>
<p>Personally, I have seen some Premed students who get into JHU and equivalent schools scrape through with C’s in Science requirements. Similar trends may exist for those who matriculate in these med schools too, right?</p>
<p>I have not seen published data on USMLE scores by med school. However there is data that the MCAT predicts USMLE scores depressingly well. That would imply high USMLE scores from schools with high MCATS-which is to say the top schools. There seems to be a common factor in SAT, MCAT, and USMLE, with scores at each level predicting the score later on.</p>
<p>Thanks afan. That’s good to know. If excellent MCAT scores project excellent Step I and Step II scores, ultimately, one’s performance in these tests matter way more than prestige/name of school one attends.</p>
<p>I was just checking a state school’s residency list for 2009 and I am impressed with their residency placement (95% applicants got their 1st choice residency). From CC threads it appears that Step I and II scores matter much more than prestige when it comes to getting the desired residency. So, it may be better to go to a state funded med school and shoot for a top residency than the other way around.</p>
<p>It’s really, really tough to draw any sort of valid conclusions by looking at match lists. There’s simply far too much personal preference that goes into the decision making process.</p>
<p>First, most people are pretty reasonable about their chances once they’ve got their Step 1 scores. You can make occasional headway with a big improvement on Step 2 but Step 1 is really what keeps doors open.</p>
<p>Second, just because someone gets a 275 on Step 1 doesn’t mean they’re automatically going to start looking at Derm, or Neurosurg or ENT or Plastics or anything else where the average Step 1 score is really high…these specialties are not for everyone and regardless of you board score, if you’re heart is set on internal medicine, that’s where you’re going to go.</p>
<p>Third match lists only reflect the end results of the interview season. From personal experience, last year at this time I was really hoping to hear from peds programs at Oregon Health Sciences U and University of Virginia. Those two programs were the ones I really wanted interviews from…and I didn’t get invited to interview at all. However, when it came to match day, I was still one of that 87% nationally who got one of my top three choices on my Match list. So do you count my experience as a success or a failure? Without knowing the “rest of the story” you’d have to say success, but knowing the full details you could easily say failure. (On a side note, after having been through the process and realizing what I really was looking for in a program, both OHSU and UVA would have been poor fits for me, just on program size alone, so it actually worked out as best it could). </p>
<p>Fourth, what people are looking for in terms of programs is highly variable. And you have to remember that most people going through the match are between 26 and 32 years old…they have significant others, aging parents and quite often kids. While there are certainly some people who are still pursuing that “I have to go to the prestigious place possible” mindset, it’s certainly a distinct minority as life has gotten in the way for most everyone else. The woman at my school who was named the top student in both the internal medicine and pediatrics 3rd year clerkships could have gone anywhere she wanted (she had great board scores and was AOA), yet she stayed at our medical school because of her husband’s job.</p>
<p>Fifth, the general public, and even other medical professionals outside a particular field have no idea how good/prestigious a particular residency program is. How many people on this board would be impressed initially with a Pediatrician who trained at the University of Cincinnati? My guess is not many, but UofC is certainly a top 10 peds program, and probably top 5. But if I hadn’t told you that, most of you would have had no idea…</p>
<p>There are more issues I could cover, but I think you get the idea…</p>
<p>Thanks for the info, BRM.
IMHO, getting into one of top 3 choices, is a resounding success no matter how you cut it! You should be very proud!</p>
<p>By the way, how does one qualify for AOA?</p>
<p>Talking about residency matches, here’s the 2009 match report for UMDNJ NJMS program.
Four grads got into Neurosurgery, 12 in Anaesthesiology, 2 in derm, 16 in general surgery from this State funded med school.</p>
<p>[NJMS</a> – Education – Prospective](<a href=“http://njms.umdnj.edu/education/prospective/view_admissions.cfm]NJMS”>http://njms.umdnj.edu/education/prospective/view_admissions.cfm)</p>
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<p>Med-school brand name can affect salary if you’re in a highly consumer-oriented and discretionary specialty such as cosmetic surgery or laser eye surgery that nobody really ‘needs’ and that insurance almost never covers and hence a key component of the business consists of marketing oneself to potential customers. Regular people don’t know where the best medical training is to be found - heck, they may never have even heard of the concept of a medical residency. All they’re going to recognize is a prominent school brand name.</p>
<p>For example, consider refractive surgeon Scott Hyver who isn’t exactly shy about advertising his Harvard MD. </p>
<p>[San</a> Francisco LASIK Surgeon, San Jose LASIK Surgery and Wavefront Laser Vision Correction](<a href=“http://www.scotthyver.com/]San”>http://www.scotthyver.com/)</p>
<p>Or consider eye surgeon Dan Kline, who prominently displays his Harvard and Yale training. </p>
<p>[OC</a> Eye Associates - About Dr. Kline - Dr. Daniel C Kline, MD](<a href=“http://www.oceyeassociates.com/about.php]OC”>http://www.oceyeassociates.com/about.php)</p>
<p>However, certainly I agree that most doctors won’t even such highly consumer-oriented and marketing-driven specialties.</p>
<p>Agree with everything BRM said, and to elaborate a bit further. These people are graduating medical school, they are older and more experienced, and for the most part, they have real goals, related to their personal situation and preferences, that substitute for “go the best you can” thinking that may have been their guide in high school. If you want to practice pediatrics in a particular area, then it makes sense to do your peds training there. You get to know the local docs, and when they look to expand their groups, they think of people they know. You get to know the area, the hospitals and clinics, you can settle down and pick a place to live. There are lots of reasons that this should dominate most people’s choice of residency location. If you do not have any geographic limitations, or preferences, which is unusual, then you can decide to ignore those considerations in selecting where to train.</p>
<p>You can decide to train in Boston at a Harvard hospital, but realize that the area is hopelessly over supplied with doctors, so there may not be many job choices once you finish. </p>
<p>Also second BRM on the desirability of the most competitive specialties. Many top students are completely uninterested. If you are fascinated by pathology, then the fact that you could match in neurosurgery would be of no interest to you. Further, the people who do want the most competitive specialties have to do the things required to get in. They have to obsess about their board scores and recommendations. For someone who wants to train in, say, internal medicine, at the hospital where they did their med student rotations, who has decent preclinical grades, and did well during the rotation, the drama may be over. If they like you, they will take you.</p>
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<p>It says Dr. Hyver graduated as valedictorian of UCSD. I didn’t even know there could be valedictorians in college.</p>
<p>The second link has the cheesiest music ever.</p>