Here’s something that sounds contradictory and isn’t. A medical school can accurately report a high USMLE pass rate and a high residency match rate in a year when a large share of the students who started never finished.
Both numbers can be completely true at once. The explanation is arithmetic, and specifically it’s the denominator.
This is a skill worth learning early, because you’ll be reading statistics about your future for the next several years, and almost nobody teaches you how.
What a denominator does to a percentage
Every percentage is a fraction, and the bottom half decides what the top half means.
“Ninety-seven percent match rate” tells you very little on its own. Ninety-seven percent of whom? Everyone who matriculated in that cohort? Or the students who made it far enough to sit their exams, finish clinicals, and certify a rank order list?
Those are wildly different claims. The second is counted only over the people who got that far, which means anyone who left along the way has come out of the bottom of the fraction. Attrition doesn’t drag that kind of match rate down. It pushes it up.
The same logic applies to a USMLE pass rate. Denominate it on first-time test takers and you’ve excluded everyone who left before reaching the exam.
None of this requires anyone to be acting in bad faith. Schools report the figures that are standard to report, and survivor-denominated rates are standard almost everywhere in education. The arithmetic works the way it works regardless of intent, which is exactly why you need to be able to see it.
The check that takes a minute
Find the percentage. Then look for the sentence that says what it’s counted over. A school reporting in full writes something like “of the N students who matriculated in this year, N graduated.”
If a percentage appears without a denominator, treat it as not disclosed. Not as bad news. Not as good news either. As missing information, which is a genuinely different thing from either, and it’s how you should read any statistic on any school’s website.
One more pattern worth knowing. If a school’s Step 2 CK pass rate is noticeably higher than its Step 1 rate, it’s fair to ask why. There are several ordinary explanations, and one of them is simply that the two exams have different denominators, because students who struggled at Step 1 may not be in the Step 2 CK group.
Now apply it to me
You should run this on my numbers too, and I’d rather tell you how than have you find out later.
When I say I’ve coached more than 500 students, that’s a count, not a rate. It tells you something real about volume and nothing at all about outcomes. Those are separate claims and they deserve separate scrutiny.
If I ever quote you a percentage, about anything, ask me the same question you’d ask a school. What is it counted over, and where did it come from. Every figure I put in front of you carries a source link and a date showing when it was last checked. That’s deliberate, because a number you can’t trace is a number you shouldn’t lean on.
Asking for the number directly
Per-school attrition isn’t a standard public disclosure anywhere. National aggregates get published, and they’re worth knowing, but the figure that decides anything for you is the one for your school and your entering year. Plenty of institutions have simply never been asked for it. You’re still entitled to ask.
Email admissions and ask for the four-year attrition rate by entering cohort. Ask specifically by cohort, because an aggregate across many years smooths out the recent trend, which is the part you actually care about.
Keep whatever comes back. It’s the only version of this information that’s specific to the year you’d be starting, and it’s far more useful to you than a figure from a prospectus printed three years ago.
Two things you can verify yourself
Both come from primary sources rather than a prospectus, and neither takes long.
Accreditation status, from the accreditor rather than from the school’s own page about its accreditation. Which accreditor depends on where you’re training. The LCME publishes the MD programs it accredits in the United States. The Commission on Osteopathic College Accreditation publishes the colleges of osteopathic medicine. If your school sits outside the United States, the Department of Education publishes whether that country’s accrediting authority has been through a comparability review, and that determination is one of the inputs governing what options are open to you later. In every case a status can carry conditions or sit under review, and that detail lives with the accreditor, not in a prospectus.
Who actually verified the number you’re reading. This sounds pedantic until you go and look. AACOM’s own directory of osteopathic colleges says, in writing, that the information “is submitted by each College of Osteopathic Medicine and has not been verified by AACOM.” That’s an honest disclosure and a useful one, and it tells you exactly how much weight an entry can carry. Most directories don’t say it that plainly, which doesn’t mean they checked.
I don’t rank schools here and I won’t do it in public. What I’ll say is that the questions above are answerable, they’re specific, and they give you something more solid to decide on than a campus visit.
Why attrition is the number that matters most
Attrition is the outcome that makes every other consideration moot, because a student who doesn’t finish never sits Step 2 CK, never enters the Match, and never becomes a physician, while still carrying whatever they borrowed.
That’s why it belongs at the front of your due diligence. It’s usually at the back, and not because anyone is being careless. Attrition is an uncomfortable thing to ask about when you’re excited, and the information is genuinely harder to find than the numbers a school leads with.
Where to take this next
The full evaluation framework, covering what to verify, where each primary source lives, and what a weak answer looks like, is in the Playbook. Free, and a good deal more thorough than I can be here.
If you’re choosing between two or three schools right now, or you’re already enrolled and want an honest read of where that leaves you, Application and Career Strategy starts with exactly this kind of groundwork. Book a free consultation and bring the schools you’re weighing up.
Read next: what match rates mean by applicant type, which is the same denominator question applied to national data instead of a single school’s page.
- Match data
- Due diligence
- Attrition
Sources
- LCME, school directory (accreditation status for MD programs in the United States)
- Commission on Osteopathic College Accreditation, American Osteopathic Association (accreditation of colleges of osteopathic medicine)
- AACOM, Choose D.O. Explorer (directory of colleges of osteopathic medicine, stating that entries are submitted by the colleges and not verified by AACOM)
- US Department of Education, National Committee on Foreign Medical Education and Accreditation (NCFMEA) comparability decisions
Figures verified against these sources on . Exam rules, match data and costs change. Check the primary source before acting on a number.
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