What impact do medical school rankings have on residency chances? Learn the truth.
Assuming all things were equal (e.g., location, tuition & fees), you probably want to attend the highest-ranked medical school you can get into.
A lot of students and schools talk about “the right fit,” but my years of experience helping students get into top med schools has shown me that students prefer to attend “the best available.”
I don’t blame you. You’ve worked incredibly hard to prepare a competitive medical school application, and you’d like to reap the rewards of your hard work.
Still, it’s worth asking: Are medical school rankings important? If so, how important are they?
How are medical school rankings produced?
We Americans love ranking things. We rank things like the best burgers in America and the best cities for dating, so of course we rank our country’s medical schools.
The most popular med school ranking system is the one provided by US News, with separate lists for research and primary care.
When asked about the best medical schools in the US, most people look to the research rankings, which, according to the 2019 US News list, is where we see Harvard, Johns Hopkins, NYU, Stanford, and UCSF as the top five.
However, few people consider how medical school rankings are compiled. A closer look under the hood provides the following methodology for the 2019 research list:
Quality assessment: 30%
Peer assessment score: 15%
Residency director assessment score: 15%
Research activity: 40%
Total NIH research activity: 15%
Average NIH research activity per faculty member: 15%
Total non-NIH federal research activity: 2.5%
Average non-NIH federal research activity per faculty member: 2.5%
Total nonfederal research activity: 2.5%
Average nonfederal research activity per faculty member: 2.5%
Student selectivity: 20%
Median MCAT total score: 13%
Median undergraduate GPA: 6%
Acceptance rate: 1%
Faculty resources: 10%
How much do medical school rankings matter for you?
While reviewing the previous section, you may have asked some of the following questions:
What does research activity have to do with my education or career?
What do faculty resources have to do with me?
I see that student selectivity matters for med school rankings, but how will that affect my chances of getting into a competitive residency?
If you’re like most people, you probably care less about what US News—and other ranking systems—thinks is important for med schools to demonstrate, and more about how school perceptions will impact your education, residency options, and career.
Most medical schools provide a strong education, and nearly all medical school graduates will be accepted as a resident somewhere.
Therefore, what concerns most physicians—unlike, say, many law school or business school grads—is not whether they’ll get a job, but rather which job (i.e., which residency, which specialty, which hospital, what salary) and where (i.e., which city) they’ll land.
These are fair concerns because the quality of your residency training will indeed impact your medical knowledge, care quality, and earning potential as a future attending or independent physician.
Since residency is so critical, it’s worth understanding which factors most influence residency interview decisions. Fortunately, the National Resident Matching Program surveyed program directors to determine which factors they found to be most important.
Below are the top 10 factors that program directors consider when selecting applicants to interview (listed as a percentage of programs that cited each):
USMLE/COMLEX Step 1 score: 82%
Letters of recommendation in the specialty: 81%
Personal statement: 77%
Grades in required clerkships: 71%
USMLE/COMLEX Step 2 score: 70%
Grades in clerkship in desired specialty: 69%
Graduate of U.S. allopathic medical school: 69%
Medical student performance evaluation (MSPE/Dean’s letter): 68%
Class ranking/quartile: 67%
Gaps in medical education: 63%
While attending an allopathic medical school (i.e., MD program) is listed as the seventh most commonly cited factor, the specific school attended falls outside the top 10. In fact, “Graduate of highly regarded U.S. medical school” (i.e., school prestige) ranks 23rd, with 53% of programs citing it as a factor for determining interview invitations.
Nevertheless, the following two questions come to mind:
Isn’t 53% still a lot? That means over half of all residencies will consider which school I went to!
Yes, 53% is nothing to scoff at. However, the list suggests that how well you do at a given school matters more than which school you attend.
For instance, a student in the top 10% of their class at the #40 school who does well on the Step 1 exam would be quite competitive for many residencies.
Can we believe that just because program directors less commonly state that the specific school matters that it truly matters less?
This question is trickier to answer. While fewer program directors cite school attended as a factor when making interview decisions, this list says nothing about how much each residency program weights the importance of school attended.
We also don’t learn whether competitive residency programs are more or less likely to consider a school’s ranking when evaluating applicants.
In addition, it’s impossible to know whether a residency application reviewer can be truly “school blind.”
For instance, if an evaluator notices that a student attends Duke School of Medicine, will they really not factor in its strong reputation, even subconsciously?
My conclusion about the importance of medical school rankings
Coupled with my research, my conversations with medical school faculty and residency program directors has led me to believe that medical school rankings do matter when it comes to the residency match, but that they’re not everything.
Therefore, rankings should be one factor of several—location, cost, likelihood of acceptance, USMLE Step 1 pass rates, program offerings, etc.—when choosing which medical schools to apply to.
Most applicants don’t matriculate into medical school in any given year, let alone have the luxury of choosing between schools.
Therefore, it’s important to develop a balanced school list that matches your GPA and MCAT score, as well as your medical education priorities, and consider rank when the dust has settled.