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Deans give med school rankings a failing grade

Reputation metrics skew overall quality ratings, they say

Topics: Quality, Performance Improvement, Candidate Pool Development, Recruitment and Retention, Workforce

October 31, 2011

A panel of top medical school deans says popular magazine rankings are a poor gauge of quality, noting that the lists lean on reputation metrics instead of program innovation.

U.S. News & World Report and Mount Sinai School of Medicine last week convened a first-ever panel to discuss the methodological limitations of the magazine's prestigious rankings. Each year, U.S. News assesses schools' performance in research and primary care based on several factors, including student selectivity, faculty-to-student ratio, research activity, and the proportion of graduates entering primary care after graduation. In addition, medical school officials complete reputational surveys, which comprise 40% of a school's overall score.

Challenge of ranking 'reputation'
According to the panelists, the reputational component generally fails to account for program improvements. Meanwhile, many medical school officials admit they know little about the quality of educational programs offered at other schools.

For example, Yale School of Medicine Dean Robert Alpern said he often ranks schools "based on what I remember their reputations were 30 years ago." He notes that it is "frustrating when you make improvements (to your school) but it has no effect on your reputation score."

In addition, Allen Spiegel, the dean of the Albert Einstein College of Medicine, suggests that the reputational scores may be skewed by response rates. Only about 20% of residency program directors completed the latest survey, compared with almost 50% of medical school deans, MedPage Today reports.

Panelists also noted that the rankings fail to consider diversity. Mount Sinai Dean Dennis Charney notes that emphasizing GPA and MCAT scores in the rankings penalizes schools that admit "students who come from tough backgrounds and are inspirational in what they've achieved" but do not have outstanding test scores.

New methodologies?
U.S. News editor Brian Kelly says the magazine's rankings are "one tool" for assessing medical schools and notes that the publication encourages applicants to conduct their own medical school research. "Maybe we need something like what's on the back of a pack of cigarettes, something like 'Use at Your Own Peril,'" he says.

To better represent medical school quality, the panelists recommended that U.S. News collaborate with the Association of American Medical Colleges to develop improved methodologies. In addition, they suggested presenting rankings in quartiles or quintiles instead of a list, and fielding more student input about the medical school qualities they value most, such as financial aid opportunities and global health initiatives (Mogul, "Shots," NPR/WNYC/Kaiser Health News, 10/28; Fiore, MedPage Today, 10/28).

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