Is a degree from a prestigious medical school advantageous for doctors?

Some of us are overachievers. Some of us are overachieving doctors. What if you’re in-between? Let’s say that you’re an overachiever, and you want to become a doctor.

Should you go all the way up top and get that medical degree from a top private institution? Does it even matter? With tuition costs skyrocketing, you can easily spend $60,000 annually on tuition alone for each year in medical school. Add another $10-$15k in room and board, and you will be about a quarter million in the hole by the time you get out. In contrast, medical school tuition in 2016 for UT Houston for in-state resident is only about $20,000 annually. That’s a big difference.

These are considerations that are rarely taught or even discussed. If you are planning to go to medical school, it does pay to consider the consequences thoroughly before you proceed.

 

 

Does a prestigious degree help get you a better job?

It depends. It depends on where you plan to work. In clinical medicine, you can either work at an academic institution or in the private sector. Many job situations in the academic world require teaching, research, or involvement in administration. If I were a departmental chair looking to bring on a clinician-researcher, I’d want someone who not only can practice medicine well, but also has strong writing skills, coherent presentation abilities, and innovative characteristics. If two candidates had similar track records with similar recommendations and charisma, I might lean towards going for the gal with the Ivy-league degree, especially if I am running an Ivy-League department.

If I needed a doctor in the private sector, the institution that granted the degree is unlikely going to matter much at all. Yale? Great. Wayne State? That’s okay with me. You just need to be ethical, hard-working, and reasonable to deal with. For all other qualities, the verification process in each state and governing medical board can do the rest.

Do doctors from prestigious institutions make more money?

It depends again. To understand this question, you should understand how doctors make money to see whether an Ivy-League degree will translate to higher dollars. This is also contingent upon how you are using your medical degree, whether you are practicing medicine, performing administrative work, or consulting. Remember, you don’t have to be a doctor to get rich. Or you shouldn’t become a doctor if your main goal is to become rich.

If we are considering doctor worth from revenue alone obtained through clinical practice, insurance companies make no distinction between where you obtained your degree. U.S. grad, international grad, it doesn’t matter. As long as you pass your boards (sometimes you don’t even have to do that!), you’re golden. From clinical practice alone, you’re not going to make more money having gone to a top college or medical school. Period.

Now having that special degree CAN get you more business, depending on which part of the country you practice medicine. This is particularly true (and sometimes annoyingly so) in the New England area. Patients in New Caanan Connecticut do (in general) care where you obtained your degree. They may or may not even be highly educated, but the high concentration of Ivies in that region predisposes this behavior. Unless you have significant street cred and have been working in the area for a long time, your patient may doctor shop your degree.

 

Okay, I sank $200,000+ into an Ivy-league medical degree, what am I going to get in return?

Many of us, under the guidance of family, friends, or schooling, end up enrolling in well-known [read: expensive] private universities and medical schools.

DESPITE the equivocal conclusion by Smart Money MD.

Don’t fret. You’re not totally screwed. If you have a good inheritance coming your way or an alternative means to fund the process, you’re actually in great shape.

If the above doesn’t apply to you, don’t fret either!

Step 1. Pat yourself on the back.

Congratulations. It is not easy getting in. It is SIGNIFICANTLY more difficult to get in medical school than law school, business school, or college. Kudos to you.

This is a fact. By numbers alone. There are simply fewer number of available positions in medical school. The Class of 2018 Stanford Graduate School of Business has 417 new students. Last I checked, the Stanford medical school had fewer than 90 students per class. I think the acceptance rate in the medical school was about 2-3%, while the business school acceptance rate was 6%. If you compare these numbers to that of an average public medical school and public business school, you’ll see that the class sizes will be larger and the acceptance rate will also be higher.

Step 2. You’ve got a lifetime of prestige attributed to your name.

Yup, your mother can brag about her daughter at every holiday party. Your distant relatives will direct their children to you for advice. Your alma mater will also hit you up for donations every single year. You can volunteer with your local alumni group and have “exclusive parties”.

You have a lifetime of memories and connections to potentially successful friends and colleagues.

This is not a bad situation to be in.

Step 3. Clear your mind and get to work.

Get yourself back into the real world. Don’t let anything else cloud your judgment. You’re probably not even that smart. Your coworker at the hospital who came from Portugal probably is one the smartest gals in her country. She memorized Harrison’s twice to pass her country’s exams. Oh yea, she also repeated residency in the U.S. and passed all of her U.S. board exams…in English.

That’s right, her native tongue is Portuguese, and she learned Spanish as her secondary language. English was her third language.

Get yourself out of debt if you funded your education through loan sharks. If I dug myself out of debt, so can you. Save up your money. Figure out how much you are worth.

Figure out what makes you happy. Then work to get there. Easy peasy.

Would you spend extra to get a degree from a top medical school?

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  • Average Joe

    Taken from financial samurai:

    A Good Doctor’s Financial Path

    I feel kind of sorry for doctors. When they first entered medical school 15 years ago they were promised a much higher salary than they are receiving now. For example, my friend who has a post fellowship from Cornell Medical will be making roughly $200,000 as a cardiologist at 36 years old. When he entered medical school in 2001, he was expecting to make $300,000 – $400,000 to start!

    For three years he made $40,000 – $50,000 a year as a resident after four years of medical school, and $60,000 – $75,000 a year as a fellow for the next three years after that. Luckily for him, his parents paid for all his medical school tuition. The median education debt was $170,000 in 2012, and surely higher today according to data from the Association of American Medical Colleges.

    Age
    23 – $0
    27 – $50K
    30 – $65K
    33 – $200K
    36 – $275K
    38 – $325K
    40 – $400K
    43 – $450K
    45 – $500K
    49 – $700K
    52- $1M

    I’m being very gregarious with my total compensation assumptions for doctors. Doctor’s salaries have done nothing but go down thanks to big government and difficult insurance companies. I doubt most doctors will ever make $1 million a year anymore, let alone $700,000. But I’ve thrown the figures in my chart anyway since this is one very special cardiologist.

    • Smart Money MD

      Hi Average Joe,

      Where does your friend work now? There are many instances where doctors may still earn significantly below reported numbers until they build up a significant patient base and referral network. This can take years.

      http://smartmoneymd.com/how-doctors-make-money/

      What profession are you in?

      • Average Joe

        It’s Sam’s friend at FS. I was only including it in the conversation because I’m still trying to figure out if the med school path is worth it in general, versus earning 80-100K by 24 with a MA and having no school debt. Of course, 125K could be the max earning potential with the MA so there is obviously way less earning potential over a lifetime, but also probably way less stress. I would only be choosing medicine for the earning potential as I can’t really say I have a passion for the field at my age. Intrigued by the excelerated BS/MD programs though. Eliminating one or two years of debt accumulation and potentially earning money a couple years earlier is intriguing.

        • Smart Money MD

          I’d say that if your only reason for choosing medicine is for the money, you’d be better off not going into it. Yes, it’s a relatively stable career path, but I probably wouldn’t want my doctor to be someone who only shows up to work to get the paycheck. Doctors like these are more likely to let issues fall through the cracks. Eventually this attitude will catch up to you.

          If you look at the earning potential over the course of a career, saving a year or two isn’t going to make a huge difference. Many of my colleagues took time off during medical school, residency, and fellowship to conduct research. Does that directly translate into higher earning potential? Most definitely not. But it sure made them much more competent doctors.

          • Average Joe

            I hear you. That said, I doubt many of us would work without a paycheck so we are all working for a paycheck to be honest. Most of us reading blogs like this are interested in ROI. I’m sure it’s the primary motivator for most highly paid professionals (banking, law, technology, etc.). I’m sure the banker doesn’t enjoy working 60+ hours a week. The motivator is the earning potential. Why would choosing medicine as a career path be all that different? Being able to help people stay healthy would seem to be a nice benefit just like helping with a clients financial well being as a banker. In the end, I think most are still driven by the earning potential and ROI.

          • Smart Money MD

            It’s interesting to see what reasons people have for picking a particular career. And certainly there is no single correct answer for how people make career choices. Most of my friends in finance simply love money–they love working with numbers, earning big numbers, and spending big numbers. Was that the reason why they went into finance? Perhaps, but I’ve never asked them directly.

            In contrast I’m sure that the majority of my physician colleagues also like the money that comes from being a doctor, but I’d bet that money was certainly not the primary reason that they went into medicine. Some of them actually went into the banking industry AFTER finishing medical school (talk about bad ROI). The goal of my website is actually to help professionals realize that they SHOULD look into ROI and make better financial decisions. I’ve met one too many doctors who don’t take the time to learn to understand the financial working of the world, yet they are darn good surgeons.

            Before I went into medicine, I used to write software. The only reasons I couldn’t sleep at night because of work was that either I couldn’t figure out how to implement a process or the routine seemed a little too inefficient. Eventually the problems sorted themselves out, and all was good. For high impact projects, we had a team of people for redundancy. If the team really couldn’t figure things out, perhaps the company loses a serious chunk of change, and people got fired. All of those people who lost their jobs actually found new jobs (sometimes even better ones) quickly.

            In medicine, if certain problems don’t get fixed in time, people die. Is this risk worth the extra $50-80k a year that a doctor could make compared to a banker? For some doctors, it might be simply because they’d make horrible bankers!

  • I work at a large HMO as a Family Medicine doctor and no matter where you went to medical school, the pay is based on a very strict scale of how much experience you have and what your specialty is (of course).
    I went to UCLA for med school, my other buddy went to Scottland for his, and the other dude went to Ross in the Caribbeans. I would say all 3 of us are decent docs, do good work, are honest and try to do right by the patient. And more important we all get paid the same.

    Now, when it comes to hiring, I have heard on more than one occasion “Oh wow, you went to UCLA for med school”… I think it might open a few extra doors but the reality is, as medicine is becoming more and more hospital based and larger groups are potentially taking over, there probably will be a system of pay in place similar to other professions.

    That’s my take at least.

    • Smart Money MD

      Hi Dr. Mo,

      Thanks for stopping by! I agree with you completely. If you are working for a hospital, no one cares where you got your degree as long as you are licensed. If you do good work, you’ll get your contract renewed. Now, perhaps you decided to work at UCLA’s faculty practice. Would they choose you over the guy at Ross if both of your experience levels were the same? What if you decided to join a clinician-educator track? Would your degree be considered more highly?

      • I think you’re right, in that sense it would certainly make a difference. In the bigger perspective I think getting a job might be easier, that’s a valid point. And working for a place that might expect more prestige… well, the better med school might be the only thing setting someone apart, all else equal.
        It’s a great topic, thanks for writing about it.

        • Smart Money MD

          I guess some jobs would look at where you’ve done residency and how much research you have done as well. In this case, where you did medical school may matter less except for yourself.

  • As time goes on, I don’t think docs will find that $200,000 in education is that much at all. In your 20s and early 30s, you may. But once you’re in your late 30s, you guys won’t blink an eye about $200,000 in debt b/c you’ll be thinking about much more when it comes to a mortgage!

    From a patient’s standpoint, I never asked until I did one day where my doctor went. But since he’s been my doctor for 15+ years now, I ain’t changing, no matter where he went! 🙂

    Sam

    • Smart Money MD

      Absolutely. High income professionals with six-figure debt start running into trouble when they drag their feet to repay their 6.8% educational debt, stretch their budgets on homes 5x of their annual pretax income, and start investing inappropriately in high-risk vehicles and lose their money. There should be no reason why some people with $200,000 in student loans on a $200,000 annual salary still have that loan active after 10-years. But it happens. People do strange things.

      Prestige is a strong motivator, albeit for impractical reasons in some cases. Just as you have written about CEOs taking a financial hit joining a startup for a lower compensation package with high risk of worthwhile shares. Why do they do that? And the entrepreneur John you met whose company is still in the premarket stage, yet he is courting new employees at expensive trade shows? The key is to consistently remind ourselves whether what we’re doing is right for us.

  • Nancy Henning Weres

    I am a graduate of the University of California San Francisco, a prestigious medical school. We were taught that 90% of the correct diagnosis lies in the history, not the physical or lab studies. We were also taught to question every lie of the drug companies. I have not idea what UCSF teaches now, but they do support government medicine, which today is in bed with Big Pharma, Big Heathcare Unions, and Big Insurance vendors, including AARP. Government/corporate medicine also requires the serf/whore physician to spend as little time speaking to the patient as possible, which will not lead to a correct diagnosis (see above). To be a good earner, one must throw Hippocratic Medicine in the garbage. So to answer the question of SmartMoneyMD, I would get the cheapest medical degree possible if the goal is to be a whore for the system of government medicine.

    • Smart Money MD

      Thanks for stopping by! Yes, spending less time with patients is one of the more unfortunate changes that we’ve witnessed in medicine. Do you work in academics or private practice? That is also a strong consideration for many of my colleagues since there is often a bit of a salary discrepancy in where we choose to work.

      Hey, you’ve got your prestigious diploma out of it and quality education! Last I checked, tuition at UCSF was up to $40k a year, which not bad for a top notch medical school. I think that HMS is up to $50-$58k annually!

  • jeffrey wacksman, M.D.

    This article needed to be written by a Physician. A prestigious medical school is nice but not worth the investment unless the costs are similar. Yes Harvard or Yale or Stanford are great but a good state school is fine . The most important factor is to do well at Medical school and finish in the the top 5-10% of your class because the the post grad education is THE MOST IMPORTANT factor which will determine how well you can compete to get the top jobs. This was never mentioned. Of course I graduated in 1970 and went to a very average medical school but since I graduated at the top of my class the post Graduate training positions that were available to be HUGE. I ended up doing 3 years at Harvard in Surg followed by 3 more years at one of the top Urology Residencies at the time , Duke University. After I finished I was literally recruited to go anywhere except back to Boston Children’s because they didn’t have much of a Dept. in Urology. I went in to Ped Urology which was just starting as a Specialty and finally after spending 3 years at the Cleveland clinic was able to go Back to Cincinnati and was instrumental in starting the first Pediatric Urology Dept. at Cincinnati Children’s Hospital. Our Dept. of Urology is currently #3 in the country. None of this would have been possible without a great Post Grad Education which would not have been possible without finishing high in my Medical school class.

    • Smart Money MD

      Thanks for stopping by!

      I agree that a strong postgraduate residency/fellowship is instrumental in opening doors, especially for academic institutions. When you are considering faculty for your department, do you consider where they went to medical school? I’d looking for recommendations, publications, and most recent clinical activities.

      What is peculiar is that it seems that Mass General and Brigham’s IM program tends to have a higher percentage of HMS grads, and grads from the surrounding medical schools. Coincidence? Is the faculty in the region more familiar with each other? Likewise, the numbers in HHS’s orthopedics program is more apparent. I think that you’d have a better shot getting in if you were in the top 5% of your Ivy League class.

      The private practice world is a bit different. People seem to care a little bit less about your lineage, especially if you are in the more rural parts of the country.

      • jeffrey wacksman, M.D.

        Faculty positions are usually determined by where you did your post MD training and your research, clinical as well as basic science, much more than where you went to Medical School.Yes MGH and the Brigham tend to be in bread but many other good academic institutions are much more open.
        So my advice to young college Grads is to go to a good Medical School but work hard so you get as high a rank as possible. Most good Post Grad programs won’t even interview you unless you are in the top 5-10% of your class. Private practice is slightly different but they want their colleagues to be well trained before they hire them which means they need to go to a program. So the key is to work and study hard in Med school as it will open many doors. Also having a good personality doesn’t hurt.

        • Smart Money MD

          Great suggestions. My impression for private practice is to focus on the A’s: affability, accessibility, and ability. Doesn’t hurt to be smart. 😉

    • fasteddie

      Agreed. Even an average or below-average State school may be fine over a prestigious expensive school. I went to an average to below-average med school. Most students were in-state but very smart, hard-working and crushed the boards. The top students would usually still match in the competitive specialties, mostly mid-tier programs but with some at the upper tier programs. Those that went into less competitive specialties would match into top-20 programs, but maybe not cracking the top-5 programs. Likely a more prestigious med school may have helped these same students crack the top-tier residency programs, but at a greater financial cost. In the end, everyone from my med school were still able to have great fellowship/career opportunities and have less debt to show for it. Where and how they did in residency was a bigger factor than their med school and I’d be hard pressed to recommend a more prestigious and expensive school over a cheaper one.

      • Smart Money MD

        After all of the training is finished, I do agreed that even where one completed residency or fellowship may not matter as long as you are competent.

        What specialty are you in, and did you find that your pedigree made any difference in your obtaining a job?

        • fasteddie

          I’m in GI, but nearing the end of training. My med school pedigree doesn’t seem to have mattered much once I got into residency. Looking forward at potential jobs, what I have done and can do, either clinically or academically (I’m interested in clinical work), seems to matter more. The prestige of my fellowship may help for jobs, the prestige of my IM program would likely matter less and my med school would likely not matter much at all.

          • Smart Money MD

            What I also noticed is that the longer we train and the more specialized we become, the fewer other people we actually have to compete against too for either more fellowship or jobs. at a GI, you’ve already filtered through the IM masses. You’ll do great.

            Let me know if I can be of any help!

            Also, are you looking to be on the coasts? More competitive markets on both ends of the country, but still plenty of great jobs to be had.