In view of the increasing importance of medical imaging in healthcare and the large amount of image data to be transmitted/stored, the need for development of an efficient medical image compression method, which would preserve the critical diagnostic information at higher compression, is growing. Discrete cosine transform (DCT) is a popular transform used in many practical image/video compression systems because of its high compression performance and good computational efficiency. As the computational burden of full frame DCT would be heavy, the image is usually divided into non-overlapping sub-images, or blocks, for processing. This paper aims to identify the optimum size of the block, in reference to compression of CT, ultrasound and X-ray images. Three conflicting requirements are considered, namely processing time, compression ratio and the quality of the reconstructed image. The quantitative comparison of various block sizes has been carried out on the basis of benefit-to-cost ratio (BCR) and reconstruction quality score (RQS). Experimental results are presented that verify the optimality of the 16 x 16 block size.