What Makes a Medical School Great?

The medical school interview season has just concluded. Each year, approximately 45,000 students vie for approximately 20,000 first-year positions at U.S. M.D.-granting medical schools. Most of these students will not have gained admission, and if they wish to become physicians they will need to seek medical education outside the U.S., pursue an alternate degree such as a D.O. (doctor of osteopathy), or improve their grade point averages and test scores and apply again next year. At the other end of the spectrum, many fortunate students face the task of choosing between multiple schools.

With only 20,000 new M.D.'s emerging each year to help care for a nation of over 310 million people, these are momentous choices. Every graduate counts, and where students go to school can powerfully shape the kinds of physicians they become. What factors should count the most in choosing a medical school?

A second way to biopsy a school's culture is to ask students to describe their best teachers and role models and ask faculty members to describe their best students. If students have difficult identifying a best teacher, or if they for example laud instructors who do not require them to attend class, this is a bad sign. Likewise, if instructors define their best students in terms of their grades or test scores, it suggests a lack of real human engagement. In a thriving medical school culture, the countenances of both students and teachers should brighten as they describe their favorites.

Another quick indicator of culture is to ask faculty and administrators to describe what they are proudest of about their school. Do they immediately repair to indicators such as clinical revenues, research dollars, or publications? Or do they refer to particular programs and people that are making a difference in the lives of students, faculty, and patients? In a thriving culture, people should be ready and enthusiastic to relate their contributions to the work of their school, and the contributions their school is making in the lives of those it serves.

There is no need to beat around the bush. Just ask them straight away. "What difference are you making in the lives of your students? What different are you making in the lives of your patients? In what distinctive ways would this school help me to become a better physician, enabling me to make a bigger difference in the lives of my patients? What is the school doing to nurture the human side of medicine?" Merely posing such questions is important. For one thing, it helps students to glimpse more clearly their true priorities in becoming physicians. Equally importantly, it sends a powerful message to medical schools about what really matters most to our future physicians.

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