Primary Care vs. Research: Which Med School Is Right for You?

US News & World Report
By Ilana Kowarski
June 14, 2018

Experts say research-based med schools are often harder to get into than primary care programs.

If you’re unsure whether a research- or primary care-focused med school best fits your needs, experts suggest evaluating the areas of medicine you’re most interested in and targeting the institutions that provide high-quality training in those disciplines.

For instance, someone who is fascinated by a highly technical medical specialty such as surgery or oncology should look for schools with teaching hospitals that provide state-of-the-art care within that specialty, experts say. Meanwhile, a med school hopeful who is intrigued by the idea of becoming a primary care physician or family doctor should favor med schools that provide significant training in preventive medicine and public health.

However, medical school professors caution that the admissions process is extraordinarily competitive, and premeds may not necessarily get accepted at their first-choice program. On the upside, nearly any quality med school can provide a pathway to a career in either primary care, subspecialty medicine or medical research.

“What’s wonderful is that research-based medical schools send a number of graduates into primary care, and primary care-focused medical schools send a number of graduates into subspecialty fields,” wrote Dr. McGreggor Crowley, an admissions counselor at the IvyWise consulting firm, in an email. “If you can manage to get admitted to a medical school, I think it’s freeing to know that your pathway should be supported by your colleagues, educators, and administrators.”

Dr. Daniel West, a professor of pediatrics at the University of California—San Francisco School of Medicine, says the reality is that for most premeds, the primary concern isn’t which med school to attend, but rather where they are most likely to get in.

West, vice chair for education in the UCSF department of pediatrics, says that students deciding which types of medical schools to apply for should assess the competitiveness of their academic profile. They should also consider the fact that research-based med schools typically require higher MCAT scores and GPAs than primary care programs, he says.

For most premeds, it makes sense to apply to a mix of med schools, including some that prioritize research and others that prioritize primary care, West says. Premeds who are concerned about whether they will be able to get into the most appropriate type of med school should remember that med school is only the beginning of medical training, he adds. When med school grads choose residency programs, they have the opportunity to choose programs that supplement what they learned in med school and fill gaps in their med school education, West says.

“The most important thing is to get into a medical school that will prepare you well for the next stage of your career,” West says. Premeds who are anxious about getting into the right medical school should know that the vast majority of U.S. medical schools provide a a solid foundation for a medical career, he explains.

How to Find the Ideal Med School
Dr. Clarence Braddock, vice dean for education with the David Geffen School of Medicine at the University of California—Los Angeles, says the best situation for an aspiring doctor is to attend a med school that excels in both medical research and primary care medicine.

When assessing research-based and primary care-focused medical school rankings, applicants should determine which of these two rankings is most relevant to their personal situation, Braddock says. “If a student is entering medical school primarily to seek a research career, then it would be essential to apply to schools strong on the research ranking,” Braddock wrote in an email.

However, research-focused premeds should favor schools that perform well in both the research ranking and the primary care ranking over schools that only perform well in the research ranking, Braddock says. Premeds who intend to focus on clinical medicine rather than medical research should carefully consider the primary care med school ranking, Braddock adds.

Angela Mihalic, the dean of medical students and associate dean of student affairs with the medical school at the University of Texas Southwestern Medical Center, says the best medical schools provide students with compelling research and clinical opportunities.

“Academic medical centers have three core missions related to education, research and clinical care,” Mihalic wrote in an email. “The finest medical schools and the ones in which students receive the best training are the ones who are equally strong in all three.”

Mihalic urges med school hopefuls to remember that though they might feel certain about what type of doctor they want to become, they could change their mind about their professional goals during medical school.

“We often find that students have preconceived notions of specialties and areas in medicine they are considering upon matriculation, and that those plans change as they experience the wonders of scientific discovery in the lab or the various fields of medicine in the hospitals and clinics,” she wrote.

How to Assess Career Opportunities
Dr. Alison Loren, an associate professor of medicine and vice chair of faculty development at the University of Pennsylvania’s Perelman School of Medicine, says it’s best to attend a school where fourth-year students are typically satisfied with their residency matches. It’s a good sign when an institution sends a significant proportion of students into their first-choice, second-choice or third-choice residency program, she says.

Loren says that med school applicants who visit med school campuses should directly ask current students about whether they are happy with their career prospects and if they are confident in their ability to pursue their desired specialty.

Dr. Michael Ghalchi, a cardiologist based in New York City, says that research-based medical schools tend to offer students more opportunity to explore a variety of medical specialties than primary care programs. But he notes that primary care programs can be a great fit for aspiring doctors who are enticed by the idea of forging strong, long-term relationships with their patients.

“For those students that go into medicine for the human connection part of the profession, the healing part of the profession, I think those students will take away more from a primary care focused institution,” says Ghalchi, the founder of Manhattan Cardiovascular Associates, a cardiology practice.

Ghalchi adds that students at a primary care medical school are likely to get an abundance of lessons in motivational interviewing, patient advocacy and other skills that are directly relevant to the job of a primary care physician.

Experts say that premeds who are fortunate enough to be admitted to multiple medical schools and who are considering both research-based and primary-care-focused programs, should visit med school campuses to see which one would be a good fit.

“No one should overlook which medical school just feels right to them,” says Glen Fogerty, the associate dean of admissions and recruitment at the University of Arizona College of Medicine—Phoenix. “This will be the next four years of someone’s life and, in the end, feeling good and being excited about this decision should be in the equation.”

Primary-care-focused premeds sometimes feel isolated at research-based med schools where there isn’t a strong emphasis on primary care, Crowley explains. Premeds with an interest in surgery would probably prefer to study at a school that frequently sends students to surgery residency, he adds.

Josh Nosanchuk, senior associate dean for medical education at Albert Einstein College of Medicine in New York City, and a professor of medicine, microbiology and immunology, says medical school hopefuls should ask their college premed advisers for guidance.

“Very early on, even if you’re not sure whether you want to apply to medical school, you need to reach out to that individual or group,” Nosanchuk says. A premed who is interested in conducting influential medical research or who wants to learn about cutting-edge medical technology should focus on applying to research-based med schools, he says. And regardless of what a premed’s career goals are, he or she should apply to their dream medical school, Nosanchuk says.

“I always think that you should apply to where you absolutely would love to go, because if you don’t, then you can’t get in,” he says. “It’s like baseball. If you don’t swing, then you can’t hit a home run.”