Growing up in a middle-class family, I never seriously considered attending an Ivy League school—and to be honest, I’m not even sure I would’ve been admitted if I had tried. Today, as a physician and a father of four kids ranging from ages 3-13, my wife and I are just beginning to think about college. I tend to encourage our kids to follow in our footsteps by attending our public university—or, depending on their interests and strengths, to consider a trade.
But practicing medicine and being surrounded by other high-income professionals, I’ve already felt the cultural pull to push my kids to excel. In many of these circles, the pinnacle of achievement is having your child get into an Ivy League college and eventually land a prestigious, high-paying job. That cultural pressure, combined with my own internal drive to see my kids succeed, has made me pause and reflect. In an effort to be intentional and thoughtful about the path we choose, I decided to dig into the data and share what I found.
The Allure of the Ivy League Schools (and Why Parents Chase It)
It’s easy to understand the appeal of sending your child to an Ivy League or similarly elite college. The Ivies carry prestige, history, and a certain mystique. As physicians, many of us have Type A tendencies and want the “best” for our kids. Around the hospital and on the sidelines of kids' sports games, I hear proud parents swapping stories: “My daughter is taking five AP courses, playing three sports, and volunteering at the homeless shelter—all for her Yale application.”
There’s a sense that an Ivy League education is a golden ticket to success. Indeed, studies show that Ivy League graduates are disproportionately represented in high-income and leadership positions—for example, they’re more likely to end up in the top 1% of earners, attend elite graduate schools, or lead prestigious firms. This data fuels the perception that elite colleges open doors that public universities may not.
But I remind myself: correlation is not causation. Elite schools admit highly talented students—often from very privileged backgrounds—so it’s no surprise that many graduates do well. The better question is: would my child do just as well—or even better—at a less elite school?
Interestingly, research shows that for students from highly educated, high-income families (like many physicians), the long-term earnings difference between attending an Ivy and a top public university is minimal. In fact, the prestige of an Ivy seems to benefit low-income and first-generation students more, offering networks and credibility they can't otherwise access.
Still, the cultural cachet of the Ivy League is hard to shake. Let’s be honest: it feels good to say, “My kid got into Princeton.” I’d be proud, too. But at what cost—financially, academically, and emotionally—does that experience come?
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The Cost: Ivy League Price Tag vs. State School Savings
Ivy League schools have truly shocking price tags. Tuition, fees, room, and board at many Ivies now exceed $90,000 per year—putting a four-year total around $360,000. By contrast, our in-state public university costs a fraction of that—around $11,000 for tuition and about $30,000 per year with living expenses included (my children would receive an additional 40% off tuition since I am a university employee). Even with scholarships, the gap could be over $200,000.
As a high-income physician family, we likely wouldn’t qualify for need-based aid, so we’d be footing most of the Ivy bill ourselves.
What could we do with that $200,000+ in savings? Fund medical school tuition. Help with a down payment on a house. Or simply keep our kids out of debt. Opportunity cost is real. Money not spent on undergrad could be invested, saved, or used in ways that offer greater long-term value. Dr. Jim Dahle put it best: “College costs what you’re willing to pay.” That extra money only makes sense if the value gained is worth the premium.
To be fair, some elite schools offer generous financial aid to middle-income families. But for families like ours, the math tilts toward state schools—especially when you consider we’re saving for four children. With one child, the decision may be easier to justify. With four? The case for a state school gets stronger.
Big Fish in a Small Pond: GPA, Psychology, and the Hidden Costs of Being ‘Average'
Beyond tuition and prestige, one of my biggest concerns about sending a child to an ultra-competitive school is the psychological toll of being surrounded by high-achieving peers. There’s a well-known concept in education: “big fish in a small pond vs. small fish in a big pond.” And it’s not just a catchy phrase. It carries real psychological weight.
In high school, my child might be at the top of their class. But at an Ivy League school, where every student was top of their class, that same kid could feel like they’re falling behind. That shift can do more than just bruise the ego. It can reshape self-confidence, academic performance, and even career aspirations.
Malcolm Gladwell illustrates this in Outliers, showing how success often results from “a thousand tiny, invisible advantages” that compound over time. In one striking example, he notes that an unusually high number of Canadian professional hockey players are born in January or February. Because the youth league cutoff is January 1, these kids are the oldest in their age group—bigger, stronger, and more mature. That slight advantage leads to better coaching; more ice time; and, eventually, professional success.
The same principle applies in academics. Gladwell writes, “We all know that successful people come from hardy seeds. But do we know enough about the sunlight?” That sunlight—mentorship, confidence, consistent wins—often shines brightest on those seen as the best in the room. When a student feels like a small fish, they might get fewer leadership roles, less faculty attention, and often a lower GPA.
For a pre-med student, GPA matters. A lot. Medical schools are GPA-sensitive, and many use cutoffs when screening applicants. A brilliant student with a 3.4 from Harvard may be passed over in favor of a 3.9 from State U. The name on the diploma rarely makes up for lower academic performance.
So when I think about college choices, I ask these questions. Where will my child be supported? Where will they have opportunities to lead and thrive? That might be an Ivy, but it might just as well be our local state university or a small liberal arts college.
Gladwell’s message is clear: success isn’t just about talent—it’s about context. And in college, context can be everything.
The Pre-Med ‘Weeding Out' Reality
The path to med school is brutal, no matter where you go. Only about 16.5% of college freshmen who start pre-med actually complete all the required courses. That’s an 83% attrition rate.
The reasons vary—grueling coursework, better-fitting interests, or getting discouraged by weed-out classes like organic chemistry. At Stanford, a significant portion of students intending to go pre-med drop out, often citing chemistry as the reason. One student described it as “an incredibly demoralizing environment.” To be fair, elite schools offer excellent resources (top professors, research labs, and strong advising). But the key predictors of medical school acceptance are still GPA, MCAT, and relevant experience—not where you went to undergrad.
That’s why many of my colleagues are steering their kids toward state schools, knowing they’ll have an easier time excelling academically. Some of those kids get into top med schools. Meanwhile, I’ve seen Ivy grads with brilliant minds struggle to gain admission to med school due to average GPAs.
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Peer Pressure: The Parenting Arms Race
One of the hardest parts of this deliberation is the peer pressure from other parents. In many social circles, there’s a quiet arms race: more AP classes, more extracurriculars, more leadership roles—all aimed at building the perfect college résumé.
It starts early. I’ve heard of colleagues vying for spots in elite kindergartens. By high school, their kids’ schedules are packed: varsity sports, robotics, internships, SAT prep. Every minute seems accounted for.
Sometimes I wonder. Am I doing a disservice by not pushing harder? Should I be loading up my kids' calendars?
College admissions counselors say today’s teens are taking twice as many AP courses as we did. And not surprisingly, teen mental health is suffering. One counselor described it as “a competition they can’t win . . . a race to the bottom.” Even Yale’s Laurie Santos, who teaches a popular course on happiness, has said anxiety is rampant among her Ivy League students.
As a doctor and a dad, that worries me more than any acceptance letter. I’d rather have a happy, grounded kid at a state school than a burned-out Ivy student. I don’t want to chase prestige so hard that I squeeze all the joy out of their childhood. If one of my kids finds their own drive and lands a spot at an Ivy, I’ll be thrilled. But it has to be their dream—not mine.
Career Outcomes: Does Ivy League Matter for Doctors?
If my child wants to become a doctor, their undergrad is mostly a stepping stone. No patient has ever asked where I went to college. They care whether I’m competent and kind. In medicine, everyone takes the same board exams and goes through the same match process. Your success depends more on your medical school performance than your college pedigree.
However, in certain non-medical careers—like finance, law, or politics—Ivy degrees open doors. Ivy grads are more likely to land in the top 1% of earners, get recruited into top firms, or attend elite grad schools. Yes, if my kid wants to be a Supreme Court justice or Wall Street executive, an Ivy might help. But for medicine? A high GPA from a solid state university—paired with a good MCAT—will open the same doors, often with far less debt.
Other Options
When I started writing this column, I intended to contrast Ivy League schools with state schools. But in wrestling with this topic, I realized something else: my kids might not need college at all.
Both my wife and I went the four-year college route, so it’s our default. But our children are different from each other—and from us. Some of them may thrive more in trade school, the military, or a skilled profession that doesn’t require a college degree. I’ve met welders, electricians, and plumbers—many of them my patients—who love what they do and make an excellent living. That might be a better fit for some kids. I think that’s probably a great topic for another column.
Reflecting on My Parenting Goals
After digging into all the data and doing some honest reflection, I keep circling back to one question:
What kind of adult do I want my child to become?
Is it more important that they graduate from a prestigious school—or that they grow into someone who is honest, resilient, and kind? I say I value character. But do my actions reflect that? What do I praise? What do I fund? What gets the strongest emotional reaction from me?
Lately, one of my children has made it clear they’re on a very different academic path than I was. At first, I felt a wave of disappointment, fear, and even shame—as if their trajectory somehow reflected poorly on me. I didn’t want to talk about it with anyone. It felt too personal, too exposing. Around the same time, I found myself getting unusually frustrated at one of my 13-year-old’s basketball games. After a missed shot or a rough play, I felt like I was the one failing. Here I am—a grown man, a successful physician—and yet I was living vicariously through my middle schooler’s sports performance.
Those moments were a wake-up call. I realized I was projecting some of my own insecurities and need for validation onto my children. And that’s not fair. They already carry enough. They don’t need to carry me, too.
What they need from me isn’t pressure—it’s presence. Not ambition disguised as encouragement but unconditional support. I want to be the kind of father who is confident and secure enough to celebrate them fully, regardless of what path they choose or what outcomes they achieve.
I’ve started asking myself harder questions:
- When I reach the end of my life, what will I be most grateful for in how I raised my children?
- What will I regret giving too much weight to—or too little?
It’s easy to confuse our children’s résumés with our own worth. But maybe success in parenting has little to do with diplomas or job titles. Maybe the real measure is whether I loved them well, supported them consistently, and helped them grow into capable adults whose lives are shaped by integrity and compassion.
As Julie Lythcott-Haims writes in How to Raise an Adult:
“The point of parenting isn’t to have a child who gets into a great college. The point is to raise a child who is prepared for life.”
That quote is a needed reminder. Every time I return to it, I’m grounded again in the truth that the real goal of parenting isn’t control or prestige. It’s preparation. And it’s love.
More information here:
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The Bottom Line
This column isn’t meant to convince you that your kid should go to a state school. It’s meant to challenge the assumption that “most prestigious = best outcome.” Especially in medicine, that assumption may not hold true.
Where your child goes to college is a deeply personal decision. But I hope this encourages you to reflect not just on where they’ll go but on why. In the end, I want my kids to become loving, joyful, capable adults. I want to support them, not push them into a prestige race that doesn’t serve them. If that path leads to an Ivy, great. If it leads to a local university or trade school, also great.
Diplomas collect dust. Character endures.
What do you think? Are the price and sacrifice needed to succeed at an Ivy League school worth it? Did you go to an Ivy League school? How did that influence the rest of your life? Or did you go to a “less prestigious” college? How did it work out?