The most unrealistic part of this movie...
I don't think the director has any idea what medical school is like. Like most medical schools don't even have dorms and there isn't a partying or frat-type culture because it's so damn stressful. Just studying 24/7 and very little sleep. I've seen former party animals from high school and college have their hair turn gray once they hit medical school. If there's any drinking it's probably a coping mechanism. A lot of students live off campus because they're married or have families by the time they enter medical school. Becoming a practicing pediatrician or anesthesiologist like Ryan and Al by age 30 is pretty unlikely.
When Madison mentions "you know what it was like" and starts talking about all the parties and blacking out, there's no way anyone could get through med school doing that. Pretty sure they just applied what sticks to Playboy's Top Party Schools list for undergrad at schools like Arizona State and Cal State Chico and just applied a "one-size fits all" approach to post-secondary education.
Allowed myself suspense of disbelief because it was a great film otherwise.