A system for developing your school list to help you get into medical school the first time and avoid having to reapply
(Note: This article can also be found in our free, 66-page comprehensive guide to medical school applications, Get Into Medical School: 6 Practical Lessons to Stand Out and Earn Your White Coat.)
Part 1: Introduction
As a medical school applicant, you're probably extremely stressed out.
After surviving a grueling pre-med curriculum, slaying the MCAT monster, conducting research, shadowing physicians, and participating in other extracurricular activities, you’d think that you deserve to get in somewhere.
Unfortunately, only about 40% of applicants matriculate into medical school in any given year!
The Association of American Medical Colleges (AAMC) provides great information about the basics of applying to medical school. Still, you likely have several burning questions about your application process that fall into two categories: 1) things you can’t change and 2) things you can affect.
Things You Can’t Change
Example questions that fall into this category include:
Do I have enough clinical hours? (Our article on extracurricular activities answers this question)
I don’t have any research experience. Am I doomed? (Again, our article above answers this question)
Am I too young/old to apply? (You might be interested in our guide for non traditional applicants)
Does being part of a non-minority group make me a less competitive candidate? (Learn about medical school acceptance rates by race)
Things You Can Affect
Where should I apply?
How do I make my personal statement not sound cliché?
Since our goal is to help improve your odds of getting in and reducing your stress, we want to focus only on things you can affect.
Therefore, we decided to write a multi-part guide (click here to get it) on how to approach the medical school admissions process and craft standout applications to help you move on from this tense period of your life and get a step closer to becoming a doctor.
This article highlights three major considerations to help you decide where to apply.
We want to stress that the question of where to apply to medical school is perhaps the single most underrated part of the admissions process. Many students who end up not getting in anywhere simply applied to too many schools where they were not very competitive.
Part 2: Location
From a financial, personal, and admission odds perspective, you should seriously think about where you’re going to spend the next four years of your life.
Financially, there can be a HUGE difference between attending a public school as an in-state resident (less expensive) vs. a public school as an out-of-state resident or private school (much more expensive).
To demonstrate this point, let’s compare the annual and total tuition costs from the 2017-2018 academic year (of course, costs are expected to rise every year) of two great Los Angeles medical schools—UCLA (Geffen) and USC (Keck):
UCLA (in-state): $39,494 x 4 years = $157,976
UCLA (out-of-state): $51,739 x 4 years = $206,956
USC (in- or out-of-state): $53,448 x 4 years = $213,792
Thus, if you’re a California resident, attending UCLA instead of USC will save you a whopping $55,816 (that’s a 26% savings)!
This example doesn’t even factor in cost-of-living expenses (e.g., food, rent) or interest on your loans that will increase your final repayment amount by tens of thousands of dollars. Ouch!
So yes, med school is only four years, but it could be the most expensive four years of your life.
Personally, consider where you want to spend four years of your 20s (and/or early 30s).
Yes, you’ll be working hard and won’t be living a lavish lifestyle, but your quality of life matters greatly in getting you through med school. Some questions we ask our students when developing a school list include:
Do you want to live out in the country or in a big city?
Are you open to living in a place with cold winters or do you want to have warm weather all year?
How near to your family do you want to be?
While perhaps the most important factors in deciding where to apply are your stats (i.e., GPA and MCAT score; more on that below in Part 4), you should definitely consider where you think you'll feel most happy.
Where you apply geographically also influences your chances of admission.
Medical schools in popular areas, like California or New York City, tend to receive more applications. Restricting your applications only to these competitive locales may hinder your chances of getting in anywhere.
On the other hand, applying to in-state or regional schools often increases your admissions odds because schools prefer to admit students who will be more likely to serve their state’s or region’s health care needs.
Conversely, you'll have very low odds of getting into certain out-of-state or out-of-region medical schools that prefer to admit local students. For instance, whereas University of Washington admits ~20% of in-region applicants (i.e., those from Washington, Wyoming, Alaska, Montana, and Idaho), they admit <1% of out-of-region applicants! Given the fee and amount of work you'll be putting into each secondary application, it's important to choose the schools on your list carefully.
Part 3: Number of Schools
Technically, applying to a greater number of schools increases your admission odds.
In reality, applying to too many schools often leads to less attention and effort given to each individual secondary application (most schools automatically send these), compromising the quality of your essays. Moreover, submitting too many applications can exhaust you—physically and financially—when it comes time to travel around the country for interviews.
Applying to too few schools, on the other hand, reduces your odds of finding and getting admitted to schools that are the right fit for you. Furthermore, you likely won't be able to strike the right balance of "reach," "target," and "undershoot" (a.k.a., "safety") schools.
Therefore, we recommend that you initially apply to 15-25 carefully-selected schools and devote your full effort to those applications. Then, depending on your availability, energy level, and finances, you can recycle your essays and apply to an additional 5-15 med schools.
(Note: As a general rule, the higher your grades and MCAT scores, the lower number of schools you need to apply to. Conversely, the lower your grades and MCAT scores, the higher number of schools you should apply to.)
Part 4: Your Stats vs. Their Averages
You can probably recite your cumulative and science GPA and MCAT score without thinking.
This will make it easier for you to compare your scores with various medical schools’ entering classes’ admissions statistics, found on most schools’ websites (see Tufts University School of Medicine's Class Profile as an example) or—to make the process easier—by checking out our list of the average GPA and MCAT score of matriculants at every US medical school.
However, it's much more difficult to figure out how to classify medical schools as "reach", "target," and "undershoot". Therefore, we will offer two approaches that you can independently or collectively use to develop your perfect school list: Medical School Chance Predictor and a general rule of thumb.
We recommend that you use the Chance Predictor to make your first pass at developing a school list, and supplementing it with our rule of thumb as needed (more on that in a moment).
(Note: We want to reemphasize that applying mostly to “reach" schools—that is, schools whose average GPA and MCAT scores are higher than yours—is one of the primary reasons students end up not matriculating, so it's important to develop your school list heavily based on stats.)
Step 1: Medical School Chance Predictor
ProspectiveDoctor's wonderful Medical School Chance Predictor can help you determine your competitiveness at every medical school based on your stats and state of residence.
Step 2: A Rule of Thumb
Students report the following three issues with the Chance Predictor: 1) it does not list every osteopathic medical school, 2) some of the listed averages are different than what is found in Medical School Admissions Requirements (MSAR), and 3) state residency status is not well accounted for. The latter issue necessitates you having to do your own research on out-of-state public schools. To classify unlisted DO schools and schools whose averages differ from MSAR, we developed another way to decide whether a given medical school is a "reach", "target", or "undershoot" for you by comparing your stats to their averages. The rule goes as follows:
GPA: If your GPA is .2 or more points higher than the average student of a medical school's entering class, consider that school an "undershoot" in the GPA category. Conversely, if your GPA is .2 or more points lower than their average matriculant's, classify that school as a "reach" in the GPA category. If your GPA is neither .2 or more points above or below the school's entering class average, consider that school a "target" in the GPA category. (You can compare either your cumulative or science GPA, but using your science GPA will typically offer a more conservative estimate since most students have a lower science GPA than their overall GPA.)
MCAT: If your MCAT score is 3 or more points higher than the average student of a medical school's entering class, consider that school an "undershoot" in the MCAT category. Conversely, if your MCAT score is 3 or more points lower than their average student's, classify that school as a "reach" in the MCAT category. If your MCAT score is neither 3 or more points above or below the school's entering class average, consider that school a "target" in the MCAT category.
Overall: Based on the GPA and MCAT categories, you should classify schools as follows:
"Reach" GPA and "Reach" MCAT: "Reach" Overall
"Undershoot" GPA and "Undershoot" MCAT: "Undershoot" Overall
"Reach" GPA and "Undershoot" MCAT: "Target" Overall
"Undershoot" GPA and "Reach" MCAT: "Target" Overall
"Reach" GPA and "Target" MCAT: "Target" Overall
"Target" GPA and "Reach" MCAT: "Target" Overall
"Undershoot" GPA and "Target" MCAT: "Undershoot" Overall
"Target" GPA and "Undershoot" MCAT: "Undershoot" Overall
"Target" GPA and "Target" MCAT: "Target" Overall
(Note: The one exception to the Overall rule is when your GPA or MCAT score is significantly lower than the school's entering class average. Specifically, if your GPA is .4 or more points lower or your MCAT score is 6 or more points lower than the average student's at a given school, you should classify that school as a "reach", regardless of how high your score is in the other category.)
Although applying our general rule of thumb can give you a strong sense of where you stand academically in a given school's eyes, your GPA and MCAT scores shouldn’t completely discourage you from applying to a school because averages are simply averages. For instance, a school whose entering class boasts a 3.7 GPA most probably admitted students with a 3.9 and 3.5.
The same applies to MCAT scores. Even if your scores are below a certain school’s averages, you could still get in if you demonstrate excellent "fit" by discussing particular skills of interest in your personal statement, AMCAS Work and Activities section, and secondary essays, such as:
Speaking Spanish: for medical schools located in areas with a large number of monolingual Spanish speakers
Having a strong medical research record, including multiple publications: for schools with a heavy research emphasis and MD-PhD programs
Having a significant service background: for schools emphasizing community involvement
Nevertheless, you should send around three quarters of your applications to schools whose averages you meet or exceed. Here's my suggested breakdown:
3-5 "reach" schools
7-10 "target" schools
5-7 "undershoot" schools
Bonus: 3-5 "far undershoot" (i.e., "very safe") schools
And please, apply to all of your in-state and regional schools if your GPA and MCAT scores hover around their averages.
(Note: If you find yourself in the position where you can't identify enough "undershoot" and "far undershoot" U.S. MD schools to fill out these categories, feel free to supplement as needed with DO and Caribbean medical schools. Regardless, you'll want to prioritize applying to schools with strong residency match rates.)
(Note: Once you develop your school list, find out whether any of them require the CASPer Test. If so, make sure to sign up for the exam right away.)
Choosing the right medical schools you apply to can mean the difference between getting in and having to reapply.
Moreover, where you apply can have a significant financial and personal impact on your next four years and beyond.
Therefore, rather than practicing wishful thinking, taking a data-driven approach to developing your school list can help you achieve major admissions success—and avoid heartbreak.