Decision Making Time

In applying to med school, medical school on April 23, 2010 at 8:57 pm

Well, if you’re fortunate enough, all your hard work has paid off and you are coming down to the final steps on the road to med school. Whether the final decision is between 2 schools or a list of 10, I’d say usually that last real choice boils down to an expensive school that you love or a cheaper school you’re not crazy about. I’d argue that this is the case for a majority of applicants, with the exception being the school that you love being the cheaper school either because of actual cost of attendance (COA) (i.e. usually your state school) or due to scholarship. But, I feel that the percentage of applicants in this scenario is tiny compared to the rest of us. (Another very small percent has the funds to go where ever their little hearts desire, but I’m not talking about them.) So what do we do? Where do we go? Arguments can be made for both sides…

On the side of the cheaper school is the fact that it is cheaper, which means I’ll in debt for a shorter period of time. Also, when cheaper equals state school (as it does for me), it means closer to friends and family, which can help in unwinding.

Against the state school we have that it usually isn’t as technologically advanced as private schools. For instance, at my state school (which quite honestly resembles a 70’s designed prison), when I asked about a simulation and clinical skills training center, my tour guide looked confused, as if he never had heard the terms before, while both private schools I was looking at either had both or were actively building them. In this economy, we know that while all schools are taking hits, I feel that public schools are getting hit a little harder, mainly because they are state-funded and states are making severe budget cuts (ex: after just paying off a multi-million dollar lawsuit, they just lost $20 million in funding…yikes). Also against my state school is that its COA for in state last year was $56K. They’ve yet to release the updated 2010-11 suggested budget, but I’m sure it’s going up as they stated they have no money. Personally, I don’t find a $10K – $15K/year difference that significant when we’re talking about hundreds of thousands in debt.

On the side of the school you “click with” (i.e. the private out-of-state school) you have the fact that you are happy with your potential student body for the next four years and you feel comfortable there. If you’re anything like me, this is of the utmost importance. I want to know that the place I am spending the next 4 years of my life will feel like a home to me. I don’t want to spend this time feeling out of place or wishing I was elsewhere or annoyed with my surroundings. I know my state school has a very young student body (many 7yr BA/MD students from the ugrad state schools…annoyingly young too) whose immaturity and lack of real world experience irritated me while the private school has an older student body with people with truly diverse backgrounds. Get in where you fit in! Next up is that it is far from home. Now, don’t get me wrong, I love my family and friends, but let’s be real, they can be a distraction. They tend to not understand the demands of preparing for a career in medicine. Furthermore, time in med school will be severely limited, so it’s not like I’ll have ample time to hang out with them. Plus, I feel that if I did, it would detract from my bonding with my classmates. This way, since I’ll be far away, I can minimize the guilt associated with not being able to spend time with them – there’s always fb, twitter, gchat, ichat, BBmsger, etc. Cold, I know, but I only speak the truth.

Against the school you “click with” is, simply put, usually that it costs more and is farther away. Nine times out of ten, these are really the only two cons that can be found, and for me, they really don’t play into my happiness. Really, anywhere I go, I’m about to be in a lot of debt. Also, anywhere I go is really only a plan ride away – a plane ride usually factored into COA.

There are other factors I’ve left out for different reasons. First is which school is higher ranked? Personally, I really don’t believe in the US New & World report rankings and think that to a certain extent they’re silly and there as a large, ongoing marketing scheme for certain schools. But, for some this is very important. Clearly, it’s not a cue I utilized in my decision making process. Related to this is the notion of prestige, that certain appeal of being associated with a certain name. While I maintain that “fit” is the most important factor for me, I will say that “fit” aside, I think prestige is pretty high up there. I also think that it may operate at a more subconscious level than anything else, but have no doubt, it plays a large role. Another factor is location, which personally was high on my list of importance. My state school is, for all intents and purposes, in the hood, which students argue makes for excellent clinical training. True, BUT the private school far away is in a city that has its large pockets of poverty and high uninsured rates, coupled with a lack of doctors to serve the area, this too affords excellent, hands-on clinical experience and opportunities to deal with “the really bad stuff.” Plus, I actually like this city and feel at home there. Also not included are research opportunities. I’d argue you could find research anywhere you go, it’s just easier to obtain at certain schools, making it a smaller factor in my deciding. In addition, some people know where they want to be geographically for residency. Personally, I do not (but I do have some vague areas I’m interested in), however I want to know I have options, so I looked at match lists and all schools placed all over the country in various specialties, so it wasn’t that big of a deal for me. For some, the opportunity and ease of completing another degree while in med school is important to some. It was for me, and the school I decided on is very strong in the area I’m interested in. I’m sure there are more factors, but those listed suffice.

Funny thing is I know that I’d be fine where ever I went. I know I’d adapt, find my own crowd, and have a great, memorable 4 years – that’s just me. I refuse to let less than ideal surroundings influence my happiness. But then, why wouldn’t I just save a few bucks (i.e. ~$40K-$60K + interest) and chose my state school. To be honest, I feel that this is where the importance of first impressions comes into play. Personally, I was impressed with the pre-interview correspondence and sold on interview day with the professionalism of expensive private school. On the same note, I was equally unimpressed with correspondence and interview day of my state school. I am of the personal opinion that these first impressions carry significant weight and subconsciously influenced the interpretation of subsequent acts of the schools.

When I plugged all my weighted cues into my cognitive Lens Model for decision making, I came to the conclusion that I needed to be at the school I felt most comfortable and supported at and where I’d soar, and for that reason, I chose the more expensive, far away private school, and I’m not looking back.

May 15th is quickly approaching – get on it and good luck!

  1. Hey, I am in a similar situation I think between a state school and private. Could I PM you by any chance?

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