"Bottom-ranked" medical schools in the USA

Well, the time finally comes around for you to apply to medical school. How do you choose a medical school to apply to? What factors should be considered? What about those US News & World Report rankings? What about pass rates for USMLE Step I? What about Match Lists?

You may want to consider location as your first priority. Medical school can be a very expensive undertaking but add in the cost of a few cross-country airline flights each year (you do want to come home for Christmas don't you?) and you can add significantly to your costs of attending. You may also want to look at the cost of living in some of the cities that have medical schools. Cities like Washington, DC, New York and San Francisco can be quite expensive to live in while other cities like Cleveland may have substantially cheaper housing.

Your first step in choosing a medical school is to look at your competitiveness as an applicant. The 2005 (last year that we have numbers) averge GPA and MCAT for medical school matriculants was 3.65 and 29. You can simply look at your numbers and figure if you are above average, average or below average in terms of matriculants across the country. You can also consult the MSAR (Medical School Application Requirements) and look at the averages for individual schools. Again, are you above their average, at their average or below their average.

The next thing to look at is curriculum types. Most schools have some variation of an integrated (systems-based) or classical curriculum. Some schools also have problem-based learning (PBL) integrated with a systems-based curriculum or classical curriculum. The classical curriculum requires a fair amount of self-integration of the material for USMLE (all steps intergrated). The intergrated and system-based curriculi require less self-integration but may pose problems if you are a slow starter and find that you missed key portions of an important system.

Depending on your learning style, you may find that PBL is not going to be a good "fit" for you. PBL demands strong individual initiative and proactivity in terms of getting the information that you need. If you are not a natural leader or work poorly in group situations, PBL is going to prove problematic. PBL is also fairly dependent on good faculty who thoroughly understand its concepts and implementation of those concepts. In short, some people become lost in the PBL process and find recovery difficult.

How about "ranking" of your medical schools? It is not so much the rank of your school but how well you perform there. The high performers at any medical school are going to go further than the low performers at a high ranked school. If you are uncomfortable or stressed (money, housing, study space) in the environment of your "high ranked" school, you are not going to perform well and thus, the ranking of your medical school is not going to help you very much in terms of your performance.

Your medical school environment should provide adequate access to study rooms and materials, adequate lectures and access to the faculty that presented those lectures, adequate access to the information that you need for doing well in your coursework and a safe environment for you to come, go and stay late for study. If your faculty are not available during office hours or there are no study rooms available either in the library or in the school itself, you are going to have a difficult time mastering the material that you need to become a good physician. Again, this has little to do with the "prestige" of your medical school and more to do with the quality and ethics of your faculty. Strong medical schools may not be highly ranked by US News & World Report and the best medical school for you as an individual may not be ranked #1 by the rest of the country. In the end, your individual performance will determine how well you do on licensure boards, in your coursework and how much control you have over your choice of residency.