Journeys with Joshua: Joshua Wienczkowski walks us through med school at East Tennessee’s College of Medicine with his monthly blog updates. Get an inside look into med school down South and life as a student adcom member through the eyes of a former professional songwriter with a whole lot of clinical experience — thanks Joshua for sharing this journey with us! 

We’ve all seen the US News report that comes out every year with a list of the top medical schools, and think man, it’d be pretty freaking awesome to be at the top medical school in the country. Who doesn’t want to be the best, right? What I’ll walk through next is how to understand what those rankings actually mean, how to interpret them, and begin to further narrow down your top choices for medical education. Before we move on, check out the US News report of this year’s top medical schools.

So, what goes into actually ranking a medical school? What makes Harvard numero uno almost every year, followed by Hopkins, U Penn, Wash U, etc.? Well, according to the Huffington Post, “Schools [are] ranked according to student selectivity, faculty-to-student ratio, research activity and the proportion of graduates entering specific primary-care programs. Quality [is] measured in terms of peer assessment and the opinion of residency directors.” Let’s break this down:

 • Student selectivity – admissions rate, which means the lower, the better. Big name schools have no shortage of applications, because let’s face it, we both read the headlines and said hell yeah I should go to the number one medical school! That increase in applications results in a need for higher MCAT, GPA, etc for admissions.

 • Faculty-to-student ratio – the bigger the name, the more post-docs, faculty, fellows, etc. there are. This false sense of inflation should be ignored, because what are the odds the post-doc working on the prime temperature to feed one footed purple raptors is actually going to be involved in your education? Having that many faculty available, however, could also mean more opportunities for you if you’re interested in research. The only time you should be concerned is if this ratio is really low.

 • Research activity – this simply looks at “how much research money from the NIH and NSF institution X has.” This will likely have no impact on your education, but if you’re considering MD/PhD or are interested in becoming a physician scientist, this factor may play into your decision tree. As a first year medical student (almost second year!) and co-investigator in clinical research on sepsis at a small school, I’ll be the first to tell you there will be more opportunities than you know what to do with, wherever you go. Truth be told, I’d rather be the “big fish in a little pond” than vice-versa, but to each their own.

 • Graduates entering primary care – if you’re really interested in primary care, I would look carefully at these studies, because they don’t include who’s continuing onto fellowship. Most specialties require you to enter a primary care residency (family, internal med, peds, OB) first, so I don’t think these numbers are necessarily valid in evaluating a school. You’ll know what a school’s mission is simply by reading their mission statement and looking at the match list of graduating classes by specialty (available on all medical school websites).

 • Peer assessment and opinion of residency directors – this, honestly, would be my absolute number one to look to as far as evaluating a medical school as an applicant. What do current students have to say about the school? What do residency directors (your future employers) have to say? Hearing straight from the horse’s mouth what someone has to say about their own community and how they are viewed by their superiors says a lot about the integrity and strength of a program.

Truth be told, unless you have some killer credentials, I wouldn’t get too wrapped up in going to the best medical school in the country, because as one of the admissions counselors at my school, and a close friend says, “Joshua, you go to the absolute best medical school in the entire country – for some people.” Sometimes, the best doesn’t mean all of the research money in the world, exorbitant entrance requirements, and one footed purple raptor feeders. Sometimes, it means having a community you call family that will support and help you achieve your greatest potential through the incredible gift that medical education can be. I may be biased, but Harvard ain’t got nothin’ on the smaller medical school I call home, and I’m willing to bet my patients would tell you the same.

Best of luck!

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