Location
Most applicants assume that they will only apply to the closest/in-State schools because of residency issues. There is the option of moving to a more desirable location to establish residency before applying. Each State varies as to residency requirements and should be researched. Differing locations may have benefits that affect a particular individuals needs. Climate, proximity of family and therefore support, cost of living and a host of other factors may make one locale more desirable than another.
Look at Texas, for example, which has about 12 Medical/Osteopathic schools at which one might get favorable residency status for tuition. The cost of living is very favorable. Eventually one might appreciate the absence of state income taxes. The climate may vary across the very large state but, in general, is temperate. (Other than having been born, raised and schooled there, I have no affiliation with the State of Texas and receive no kick back if you decide to enroll there.)
Another consideration that location may have is population. Certain areas of the country have differing populations and if one is interested in a particular disease, training in an area that has a density of a population that has a propensity for that disease makes sense. For instance, if you’re interested in Tay-Sachs disease, you might move to a community with a concentration of Eastern and Central European Jewish immigrants.
Expense
Tuition and living expenses are a significant factor. If you haven’t read my post on this, please look here. Living expenses should be considered in concert with location. For instance, if funds are severely limited, consider the location in the light of where you will live, travel and train. Will you be able to afford to live close enough to the school and be in a safe area? Will you be able to afford transportation to and from school at all hours of day and night, safely?
Reputation
The reputation of the school is probably the least important criteria. Remember that the person graduating last in their class is called Doctor. The same is true of the school from which they graduate. For 99.9% of graduates, the reputation of the school will have negligible, if any, effect on their following career. After graduating from Medical School, choosing a residency is a completely different situation, but by that time, one will have had time and experience to have researched where they need/want to go for more training. Just as in undergraduate school where a student’s major may change weekly, in Medical School, one’s choice of career specialty may change several times. Therefore, I opine that the Medical School’s reputation is the least relevant factor.
Having said that, there may be an individual or 2 that knows early exactly what they are going to do and chasing the Ivory Tower is the only path they will consider. There may be an argument for training at a particular institution, in these cases.
Volume
The top factor in choosing a Medical School, residency and fellowship is the size. Here, size matters. The number of clinical sites, patient encounters, referrals, faculty, resources, other students and other staff are all very important. If one is to study and practice Medicine, then as a foundation the most experience one can get is the most beneficial factor to that foundation. For instance, the best opportunity to encounter a rare disease, illness or injury is at a facility that has the most volume. Since a smaller facility will usually refer an unusual case to a larger facility because of lack of experience treating the unusual, larger facilities will provide a better opportunity for that encounter.
Not to harp on Texas too much, but consider the following. The Texas Medical Center , in Houston, is the largest medical complex in the world.
10,000,000 patient encounters
180,000 surgeries
750,000 ER visits
9,200 patient beds
The world’s largest children’s Hospital
The world’s largest Cancer Hospital
So, if there is a rare case, one would be more likely to stumble across it and would be more able to find faculty experienced in treating it in the larger volume environment than at a smaller facility.
St. Elsewhere
If one is interested in an international practice, I suggest that training be in the US to start. Foreign medical graduates that immigrate to the US are required to complete a residency in the US before they are allowed to practice. Even if they have completed a residency in another country and been in practice elsewhere. It’s my opinion that having the training in the US first will provide a better opportunity to expand to other countries later, if desired. Others may have a different opinion.
Your Uncle Dave
- https://igfiddles.com/wearywretch/the-cost/
- http://www.tmc.edu/about-tmc/facts-and-figures/