Advice for the lowly med school applicant

Realize that there's a very good chance, no matter how unlikely it seems to you now, that you will end up not going into ortho. I'm not saying that in a negative way, I'm just saying that during 1st year, there were lots of guys in my class that said they wanted to do ortho, and by third year a lot realized that they would be happier in other fields that they just didn't know about before starting medical school. Go into this with an open mind! There are lots of awesome fields in medicine, not just one. Go to the school where you will be happy. Spend the first 3 years working to become the best doctor you can be...it's what separates orthopedic surgeons from podiatrists and chiropractors. After that, if you still want to do ortho, you will be in better shape to match than if you spent 3 years being the stereotypical "ortho gunner".

ps - a month is plenty of time to study for the boards. In my class, there was definitely an inverse correlation between the length of time people took to study and how well they did.

Best of luck!

I've gotta agree with gamma, I have a similar story and definitely feel like I made the right choice. Out of college I was looking at a couple of the "top" programs, or a school on the tier just below that was 1/2 the price. I had some of the same questions as you, so I asked the head of the ortho program at the place where I did undergrad (it's a top residency program frequently mentioned here) Turns out he went to a "no-name school" and basically said, it doesn't matter as much where you go, if you have the tools to do well, so go where you want and don't stress too much about small differences in prestige. Right now every time I pay my tuition for the semester I think about that decision
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The other huge factor is where will you be happy? If you're not happy, it doesn't matter how good or prestigious the school is, if you end up not doing as well because you're bummed out all the time. That was another big factor in my decision, I figured that I'd be more motivated to work hard if I was where I felt the most comfortable. I'm not saying you can't throw yourself into your work and kick butt even if you're somewhere that doesn't fit your personality as well, but it's tougher to do. One caveat though, is that you WILL have to work a little harder for grades, connections, etc if you go to a school with less prestige, so that you stand out 4 years from now.

And finally-keep in mind that if you're really thinking hard about ortho, even if UT-Memphis overall doesn't have as prestigious a program as Wake (I can't make any judgements, I didn't look into it at all), the ortho program at campbell is top notch, which will be key in the long run.

Hope that helps, and good luck!

First of all, the crimson douche line may be my favorite quote from this forum and I think soudes should get some props for it. Second, I agree that money does matter. I don't think it should be the No. 1 factor, but if you have two quality schools that you are interested in than money can make the swing. There is a big difference between 100k and 200k of loans! As an orthopod, can you pay off your debt? yes, but you will be at least 30 before you start making any real money and by that time you will want a nice house/car/etc.
To me the most important thing you said is that your gut is telling you to go to UT. Then go to UT. I turned down what were (at the time) 3 of the top 5 US news "best med schools" for my state school, and last week I matched where I wanted to go for ortho. I made that decision because my gut told me to go there, and I liked the curriculum/students better than the ones at the "big names". I have no regrets.

After a long season of interviews, my choice has come down to UT-Memphis and Wake Forest.

I feel like Wake is the 'better' or more prestigious school, and I really liked alot about WFU (the curriculum looked pretty innovative, longer time protected for step 1, the hospital was impressive, and it has a smaller class).

I also really liked UT; to me, its biggest strengths are its clinical opportunities (very hands-on, get to do more as a 3rd and 4th year). And it is affiliated with two ortho residency programs, one of them being the campbell clinic. I'm indifferent about the town, but you gotta love the price.

Right now, I'm leaning more towards UT, simply based on my gut instinct alone... and the thought of paying a much smaller loan repayment in a decade or so. UT also matched 9 (out of 10) in ortho this year.

While I realize that the next three *may* change my mind, I really think I want to do ortho at this point, and was wondering if I would be giving up any advantage by going to the less prestigious school.

As always, any advice would be greatly appreciated.

money does matter.

plain and simple.

if you are an all-star, you will do well no matter where you go. likewise, if you're a douche, it won't matter that you went to Harvard. YOu'll just be a crimson douche.

while applying for med school, i found out that i was elligible for a full-ride to med school at my state school. once i got into my state school, and subsquently found out that i got the scholarship, I pulled my applications from everywhere else, including from what many would call "top-tier" places.

It didn't matter to me that I would "only" be getting my MD from a state school. I did help that I didn't graduate with $200,000 in loans from med school, because now I own my own apartment in NYC, something that I wouldn't have been able to do otherwise.

if you think it matters to you it probably does. don't let people try to talk you out of something that you feel. you have to live with all of your choices. we are just people with nothing better to do at 6 AM on a Sunday before going on call.

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First off I have to say that this is really a great site.

Ok now to add my 2 cents. I agree that money shouldnt be a big big factor in your decision on a school. I also feel that the school's name can be misleading to those who think that they may not have to work as hard as someone from a "lesser" name school...(if you will). I do not attend a school that has a high reputation for churning out Orthopods, but I have seen those who work hard at what they desire to become (orthopods included) match at some reputable programs. I have also seen individuals from Ivy league schools not match in Ortho and had to scramble. It was told to me personally from a chairman of Orthopaedics at a very reputable program recently, that they look at BOARDS..No. 1, grades etc. He emphasized on Boards...you have to produce or have Divine intervention otherwise.

I am taking Step 1 this June (atleast that is the plan) I can only hope that 1 month is enough time....because that is all the time I am given. But knowing there are students in the class ahead of me who had the same time I will..and they were able to kick ass on the boards then I have to imagine since they are human like me I have a chance to either do the same or better.....I pray to GOD not worst.

So I guess it is safe to say where ever you go you have to work hard period!

Oh yeah I liked the comment about being a big fish in a small pond I think they just might eat better and enjoy it in the process.

I think that it is always easier to give advice to people when you have all the information. What schools are you talking about? I'm sure that you will get more accurate opinions if people know something specifically about the schools.

Med school is a hard time in life, so go where you are happy. Money is an important consideration, but it is not worth graduating with less debt if you had a horrible time during school. You need to be happy in order to do well in school. There are ways to get around the money, but someone mentioned earlier that you are not guaranteed to love ortho in 4 years. You may go into a much less lucrative specialty at which point the money becomes more of an issue.

You don't need a home ortho department, but it is helpful. You will have people you can talk to (face to face) and really plan out your career plans. They can serve as great mentors. As for having a hard time with research, you can do research in sport medicine or look for radiology research that is applicable to ortho.

Overall, go into school with an open mind. Don't limit yourself to ortho, but if it is a possibility you should work hard from the beginning. It makes application time much easier!

I've said enough.

I think four weeks is enough for the vast majority of people. I personally took about 5-6 weeks and kept a relatively leisurely pace (i.e. worked out, saw movies, read books--had a real life). Without the hindrances of classes, I felt like I still had a great deal of time to study. I think I easily could have condensed it into four weeks. Actually, around week four I was starting to get a little burnt out (keep in mind that you will have recently finished studying for finals as well) and am not sure that my score was much better at week 6 then it would have been at week 4. Plus, your review for step 1 should hopefully be just that--a review--not an introduction to the material. Antedoctally, I believe the top three or four scorers in my class all took Step 1 after two or three weeks (disclaimer: they were also some of the best test takers in the class). The main disadvantage of only having a month off probably does not relate to your ability to study enough for the test to do well, but is instead the difficulty you may have recharging your batteries with some vacation time and much needed R&R between your 2nd and 3rd years. All that being said, if you like the medical school and think the curriculum is strong, my opinion would be to not let the four week issue hold you up too much.

i am going to have to agree with orthoprogdir. i came from a regional campus of a large state medical school with no ortho dept at our site. i did not have superstar boards, but did well on my third year rotations and on my aways. being at a more "community" based medical program really allowed me to learn how to function at the level of an intern while in medical school. we had direct attending to student interations and didn't have any of the heirarchy issues or amazing amounts of scut work. worked well for me. i am now in my fourth year of ortho, have gotten my number one choice for fellowship, and have every opportunity open. going to a state school did not close any doors for me. also, be very weary about what you call a "small pond". i also had some of that attitude going into med school and realized quickly that there are a hell of a lot of really bright people that will show up to occupy that "pond" on day one!!

no matter what you choose, it is not university of (insert state) or harvard that shows up for rounds on your first ortho away rotation, it is you. if you are good, it doesn't matter where you are from...and if you suck, no pedigree or school will make you not suck.

p.s. if you really base your decision on what we all say, you are an idiot.

two points:
1. Go to the best school. The Ortho people at your schools are the ones who can get to know and like you over the 3 years and write a whole lot better letters than you can EVER get doing an away rotation where you are one of 20 applicants at that school. Besides, you can't do research at a school without an ortho department. And who you know gets you into the better residency program which will allow you to work in whatever city you want to work at.

2. The amount of time studying for the boards does matter a ton. My school went from a traditional curriculum of one month board studying to one that gave roughly 10 weeks. The avg board scores went from 219 to 225, and trust me, the extra time helped EVERYBODY. The people who wanted a vacation and took it early got a longer vacation. Without exception, the people who took most of the time scored amazingly.

Some of you are remarkably in tune with the system and some are remarkably arrogant and ignorant (a dangerous combination)

Go where you will be happy.

Someone who expresses this much interest this early in their career is probably better off at a place without an ortho program(a potential distracton). Why? Because of the order of what is important to program directors (like me)


You have to kick butt in the first 2 years of med school. Start by Honoring Anatomy (typically easy for most people interested in ortho).

You should get over 220 or 230 on the boards

You need to do well in most of your clinical rotations-including psych, ob, peds etc.

Then you need to get good ortho letters-typically acquired during away rotations. Without a home program you would have to do at least 2.

Meet the above criteria and you will match at a good program.
Want to get to a top tier program? (whatever that means) demonstration of a real commitment to ortho and research helps, but most research endeavors of applicants are just fillers, a real effort on something simple (even a case report) with a local orthopaedist/physiatrist or even radiologist rounds out the application.

All program directors know what is real and what is BS, we also know that many med schools (especially 'top' ones) flagrantly inflate grades, put 3/4 of the student body in senior AOA and make everyone president of the orthopaedic club.

I do not know what this local state school is, but the other positive for any med school rests on the amount of work and involvement afforded to 3rd and 4th year students. I have to admit that students who cut their teeth in inner city hospitals or other sites where they have to function at the level of an intern are much more appealing. Anyone can look good in an ivory tower if they kiss enough butt.

Lastly, the money thing IS a big deal: I went to med school at a state funded site, my loans are 125K. I know plenty of other MDs with loans over 200-250K from private institutions. Staffords are like at 7 or 9% now right? You will not make a dent in them until your in your 2nd or 3rd year of practice (11yrs from now).

Hope this was helpful

1 month is definitely enough. youll already be on your way since you spent your last few weeks of second year studying for your finals and shelf exams. i agree with the post above, if you take more than that much time your very likely to burn out. It happened to a bunch of friends of mine and while i was partying after having finished the test, they were still complaining about studying and how much they just wanted to get the test over with. Some even attributed their below expected scores to too much time to study.

No matter how long you take, just study really hard and do as many questions as you can and youll be fine

I think 1 month is enough time to study for the boards. I had the opportunity to study longer, but took the test after 1 month. It does take 1 month of SOLID studying, but I feel like I would have been burnt out with more time. I think most schools only give about a month off in between 2nd and 3rd years.

I have a quick question... I have been accepted to a school that I love for a ton of reasons (curriculum, strength of clinical rotations, affiliated with ortho res. programs, location, cost, etc). But one thing about the school has been bothering me; the school only allows one month off to study for Step 1. Admittedly, I know next-to-nothing about step 1, but alot of the other schools that I have interviewed at allotted more time than this... Is this generally enough time to prepare? Is this something to be concerned about, or will this be more than enough time for a slightly-above average test taker to study for (and do well on) step 1?


Thanks in advance!

-sde

Listen to Grizzle.
He knows what he's talking about.

I will agree wholeheartedly with this statement:

"The bottom line, however, is that picking a medical school based on future potential earnings is a bad idea. Go with where you will fit, and feel like you will get the best education. Like anything else, you will get out of med school what you put into it. I can guarantee you that if you sit for four years at Harvard with you thumb up your butt and perform poorly, you will be extremely unlikely to get into any ortho program simply on name alone."

But I will take exception to this one:

"He is still in med school and so has no real idea how the real world of medicine works."

Grizzle is actually a guy with a job at a little program in the Midwest. And since he has worked closely with people who are hospital administrators and those who buy and overhaul health systems for a living, he knows that hard work is important, and necessary, but sadly rewards are not directly proportional to effort expended.

I don't think name brand should be anyone's number one determining factor (I have turned down bigger name schools and programs than my own), but I also don't think the desire to save some cash or the misguided thought that med school will be easier at a state school should be the determinant.

-Grizzle-

I would take one LARGE exception to what Grizzle claims....

He is still in med school and so has no real idea how the real world of medicine works. He is still blinded by the world of ivory tower academic medicine, but in reality, I would contend that where you go to med school has little or NO bearing on future salary. This holds true for orthopedics and all other specialties of medicine.

One gets paid the same for a total hip, breast reduction, colonoscopy, etc REGARDLESS of what their med school diploma or residency certificate reads. What you make in private practice depends on your volume, region, payor mix, overhead, etc. etc. In fact, if someone were to actually do a study (would be worthless, but interesting nonetheless), I wouldn't be surprised to see graduates of more prestigious schools actually making LESS money because of the simple fact that those graduates may be more inclined to remain in academic medicine. If you think academic medicine (in all fields) pays more on average than private medicine, you may want to seriously look at numbers.

The bottom line, however, is that picking a medical school based on future potential earnings is a bad idea. Go with where you will fit, and feel like you will get the best education. Like anything else, you will get out of med school what you put into it. I can guarantee you that if you sit for four years at Harvard with you thumb up your butt and perform poorly, you will be extremely unlikely to get into any ortho program simply on name alone.

Go to the better school. Why? Bigger name schools increase your options. Period. You will have more connections and better resources. Your faculty most likely trained with the gatekeepers at academic programs--no matter the specialty. Sure you can match Neurosurg at Mayo coming from BuFu State, but if you don't think it would be easier coming from Harvard or Hopkins, you're sleeping.

Also, the credential has value both in matching and in future salary. Is it a largely unnecessary bell + whistle? Sure. But compare it to buying a Mercedes.

What's the difference between a CL 500 and a CL 66?
$90 grand. get in the car.

If there was absolutely no value to having bigger bragging rights, these schools would not be able to fill their classes each year. Whether or not the value is equal to the extra $150k in tuition is a good question. I would say yes (though when I'm weeping over my loan checks, I sometimes question it). You will never have to feel as if you're playing 2nd fiddle to anyone. And unlike the ride, it never depreciates.

-Grizzle-

Thanks guys for all your responses... I really appreciate the sincere advice of your experience. Its still relatively early in the app cycle, so I'm not sure what other opportunities will come my way, but when it comes time to make a final decision, I will definitely ask for more specific advice.

I talked with an orthopod (ivy leage grad, academic doc) that I shadowed about this and his reccomendation closely mirrored much of what I've heard on here so far... he basically told me to ask for his (and your) advice to evaluate ortho programs at schools I get accepted to... I am by no means a stellar applicant (although I feel extremely fortunate so far) so my choice will no doubt be an interesting one...

Thanks again!