Presidents: Throw in USNWR’s “Best Medical School” Survey

Yale and Harvard Law Schools recently announced they would no longer participate in the flawed US News & World Report (USNWR) ranking system, with more schools to follow. The nation’s medical departments need to follow them.

Why? The USNWR ranking system is in direct conflict with the goal of medical schools to educate a well-trained, diverse, and culturally competent medical profession.

For more than 15 years, as dean of medical education and associate dean for medical school administration at the University of Chicago Pritzker School of Medicine, we had the unique and unparalleled experience of contributing to the USNWR’s Best Medical School ranking process for the school. .

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For too long, medical school leaders have done a disservice to medical school applicants and medical school itself by emphasizing and valuing an elitist focus on school reputation and wealth, which have little or nothing to do with supporting the future medical workforce. to achieve the highest level of clinical skill and scientific acumen.

While several medical schools have chosen not to participate in this annual disgrace, the nation’s best-known and most prominent medical schools have not taken the same courageous stand. Leaders of American academic medical centers should stop engaging in misleading the American public, especially students who dream of the opportunity to become doctors.

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It is hardly a secret among deans that USNWR rankings are based on data not directly related to educational process, quality, and outcomes. Nor can they rely on the veracity of the data provided, given the recent scandals reported in other colleges and universities that manipulate the formula to their advantage.

But more importantly, the rankings fail to describe or measure any important outcome related to the quality of education provided by medical schools. In fact, USNWR rankings do little more than confirm a school’s prestige and financial prosperity, fostering a cycle in which the wealthiest schools pursue the most privileged and wealthy students and vice versa, widening disparities and creating competition that does nothing to advance public health or education of future doctors.

It’s no secret that the Emperor has no clothes. Comprehensive analyzes of the USNWR rankings have long demonstrated that the methodology is ill-conceived, that the response rates of those who complete the questionnaires that feed into the ranking formula would not meet the standards of a peer-reviewed publication, and that the most important aspects of educational quality are largely ignored.

It is not simply that the methodology used by the USNWR lacks utility and value. It does a serious disservice to medical school applicants and reinforces biases, even racism, that should be antithetical to the values ​​and professional standards of academic medicine. The only benefit of these ranks? That would be the USNWR itself, which reaps significant financial rewards — medical schools and hospitals pay money to license the USNWR “Best Of” label — for luring medical schools into participating in a flawed system that ultimately misleads students who aspire to become doctors.

What does the USNWR recommend when evaluating the “best” medical schools in the country? It is based on these data points:

federal research dollars, as it disproportionately favors larger schools over smaller ones, but at no point does it consider the benefits to medical students or how this flow of research money into an institution supports their experience or education or even their participation in this research enterprise.

reputation, which is assessed by a survey (with a derived response rate) among deans, deans and program directors who could not possibly have the necessary knowledge to make an informed judgment about the quality of education provided at every medical school in the country. country, thus maintaining a focus on “brand name recognition.”

The ratio of full-time teachers to studentsindependent faculty involvement in student education, which values ​​larger institutions over smaller ones.

Median student scores on the medical school entrance exam and their average undergraduate grades, quantitative measures that are strongly influenced by economic and social factors such as family wealth and educational opportunities, as well as bias and discrimination in the educational environment itself.

The acceptance rate — the ratio of students offered admission to the number who apply — which encourages schools to encourage applications (and application fees) from those they have no intention of seriously considering for admission.

What is not part of this ranking? There is no assessment of the quality of the education provided to the students or of the quality and ability of those who graduate from these schools and become the nation’s doctors. The educational value of medical schools should not be boiled down to a number for comparison, favoring some schools and disadvantaging others without any real reference to the quality of the medical education provided.

We know it won’t be easy for medical schools to move away from the magic of the USNWR list because we personally experienced the pressure to participate from those for whom this ranking has significance and meaning, such as board members, alumni, faculty, and educators. admissions officers. There is peer pressure to stay within the system and compete for the top prize because it’s good to see your school at the top, no matter how flawed the bar is.

Rejecting this position means risking backlash, but it’s the right thing to do—and every medical school leader knows it. They owe it to their students (and their families) to be honest and upfront and do everything they can to assist them as they go through the process of finding the right school to help them become the doctors they want to be. These are the future doctors who will care for all Americans.

We applaud Yale and Harvard Law Schools, and every other school in every discipline, for choosing not to participate in a ranking system that is flawed at best and misleading at worst.

Medical schools: your survey form is about to arrive from US News and World Report for the 2024 Best Medical Schools edition. Throw it on behalf of the country’s students and their future patients.

Holly J. Humphrey, a pulmonologist and emergency physician, is president of the Josiah Macy Jr. Foundation, which is dedicated to improving the education of healthcare professionals. Dana Levinson is Josiah Macy Jr.’s chief programming officer. Base.


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