People love to rank things: college basketball teams, vacation spots, cars, vacuum cleaners ... even medical schools. But a growing number of those schools say that the most well-known rankings do a disservice to them and to prospective students, and are refusing to participate in the process.
More than a dozen medical schools have recently announced that they will no longer provide data to U.S. News & World Report for its annual rankings because of the way those rankings are calculated. Notably, several schools that routinely place near the top, such as Harvard University, Stanford University, and the University of Chicago, have recently dropped out of the rankings. While most medical schools still participate, more are reconsidering their positions, and the diminished participation puts a spotlight on what other information is available to help students decide where to apply.
“My hope, for the health of our future physician workforce, is that their perspective shifts a bit toward looking at what the school stands for,” says Keme Carter, MD, associate dean for admissions at University of Chicago Pritzker School of Medicine. “What are the opportunities they offer? Who could I become if I go to this school?”
The recent withdrawals come after decades of complaints about the value of the rankings.
Critics say the rankings rely too much on the grades and test scores of accepted students, and the reputation of schools among academicians, all of which reward the privileges of certain applicants.
“It kind of becomes like who's in the ‘in crowd’ in high school,” says Suzanne Allen, MD, MPH, vice dean for academic, rural, and regional affairs at the University of Washington (UW) School of Medicine in Seattle, which also withdrew from the rankings.
At the same time, the rankings don’t fully reflect the efforts of schools to diversify their student populations and support students with certain needs, including language proficiency or day care.
“The lists don’t value anything about education – only about competitiveness for applications based on metrics that have underlying inequities,” says Eva Aagaard, MD, vice chancellor for medical education at Washington University School of Medicine in St Louis (WUSM), which stopped participating with U.S. News.
Leila Amiri, PhD, associate dean for admissions at the Robert Larner, M.D., College of Medicine at the University of Vermont, which is rethinking its participation in the rankings, says students will benefit if medical school rankings carry less influence. “It makes them [students] work that much harder to really find the place that deserves them.”
What to focus on
Forget school prestige: Students often apply “to the top [ranked] schools assuming that they’re going to get the best education there,” Amiri says. But a high overall ranking “doesn’t necessarily coincide with what they would experience” as students or with their educational objectives.
For example, schools that are especially selective – as reflected by the high grades and test scores of the applicants they accept – tend to rank higher. But while students might be rightfully proud to get into such a school, Amiri says they should assess whether it will provide the type of supports that might be best for them, as “this is not a school that’s in the business of holding your hand as you’re going through medical school.”
Some schools do well in rankings because they get a lot of funding to conduct scientific research, Aagaard notes. “If you don’t want to do research, why would you care about going to a top ten research-intensive institution?” she says.
Pinpoint your interests: One of the first things to figure out is what you want to do with a medical degree, Amiri says. “Most of them [medical students] want to be clinicians, but they might also want to teach or conduct research,” she notes. For either of the latter ambitions, students should look for schools that provide clear paths to gain experiences that coincide with teaching or conducting research, such as earning a masters or a PhD with their medical degree.
Even within those decisions, students can get more specific about their interests. When she advises pre-med students in St. Louis, Aagaard says, “I spend a lot of time asking, ‘What is really important to you?’
“Are you passionate about doing advocacy work for the unhoused? There are schools that are aligned with that” through the courses they offer and the populations that their hospitals serve. At WUSM, for example, “our patient population is very underresourced,” as it comes largely from low-income areas of the city, Aagaard says. That is well-suited for students who want to work with and advocate for underserved populations.
Find the school’s interests: The populations that students work with are often influenced by the location of the school. Many urban schools serve a high percentage of people from underserved racial and ethnic populations. The UW School of Medicine draws students from throughout the northwestern United States, and a lot of its courses and clinical opportunities are geared toward the populations there. “The Northwest has a lot of rural and frontier communities,” Allen says. “Close to a quarter of our graduates say they’re going to work in a rural or small community.”
In addition, schools focus on different areas of medicine, such as primary care or various types of surgery. Aagaard says that a lot of students come to WUSM because “they know that we put a large number of [graduates] into research and academic medicine careers, including in surgical subspecialities.”
Where to look
Prospective students “should look at what the school does well, and how it aligns with what they want to learn,” Aagaard says. “That can be a hard thing for students to figure out.”
Here are some tools that might help:
Mission statements: While college mission statements tend to sound alike, some medical schools are creating statements that specify their priorities within medical education.
“The mission statement should be specific and tie into the core values of the institution,” Carter says. “It should give students an idea of what the school feels is its purpose.”
For example, the Boston University Chobanian & Avedisian School of Medicine incudes social justice among its core values and stresses the provision of “frontline medicine.” The UW School of Medicine’s mission statement cites as its first goal, “Meeting the healthcare needs of our region, especially by recognizing the importance of primary care and providing service to underserved populations.” The Carle Illinois College of Medicine says its mission is to “educate exceptional physician-innovators” to provide “transformative solutions developed at the intersection of engineering, science, and medicine.”
The AAMC has convened the Mission In Action Pilot Working Group to help schools develop mission statements that provide enough specifics to reflect their educational priorities. “Our hope now is that applicants will get a better understanding of what to expect” if they attend that school, says Amiri, who is part of the working group.
Curriculum and experiences: The curriculum can show prospective students the opportunities they have to pursue their specific medical interests, and should back up the mission statement, admissions officers say.
“These things you say that you do – what does that look like in your curriculum?” Amiri says. If the mission includes advancing global health, does the school provide ample opportunities for students to study and work abroad? If the school prioritizes community health, does it offer courses and hands-on opportunities?
For example, at the Larner College of Medicine, where the stated mission includes “to engage with our communities to benefit Vermont and the world,” first-year students must complete a local public health project. “It puts them in the communities that need help,” Amiri says.
Residencies: Seeing where a school’s graduates get placed through the National Resident Matching Program (NRMP) can give applicants an idea of where they are likely to match for their residencies, Amiri says. Some schools provide statistics each year showing the hospitals and specialties their graduates matched into. Amiri urges applicants to look at several years of that data to see consistencies over time.
Other students: Finding current and former students to give straightforward assessments of their experiences at a school can be especially helpful. Finding those students usually requires personal connections or building a network through social media sites at each school. Some people get advice through groups on Reddit and other online forums.
Putting in the time
All of this requires a lot of time and effort.
“It’s worth it,” Amiri says. In term of money, she says that medical school tuition “is a mortgage.” In terms of the time it takes to become a doctor, “It’s four years of your life, at minimum [in medical school], then residency.”
And the choice is virtually irreversible. While it’s common for undergraduates to change their minds about a school and transfer to another, “it’s really hard to transfer to another medical school,” Allen says. A major reason, she says, is that the schools’ curricula are so integrated that it is difficult for medical students to transfer the credits to another school.
College administrators suggest resources that can help. One is the AAMC’s Medical School Admission Requirements (MSAR) database, which provides an array of information about U.S. and Canadian medical schools that users can search and sort according to their preferences. The database provides such information as average test scores for accepted applicants, class sizes, research opportunities, combined degree programs, and the percentages of students in each specialty. (Some functions of the database are free and some require a subscription.)
Admissions officers also urge applicants to talk to pre-med advisers at their undergraduate colleges. “Your pre-med adviser is going to have a good idea of where you’re going to be competitive to get into medical school,” and what schools might seem like the best fit depending on the student’s academic interests and style of learning, Aagaard says.
And yes, school rankings can provide some valuable information to consider, regardless of a school’s place on a list. “I think students will continue to look at the rankings as long as they exist, but I hope their perspective shifts” to examine other factors more specific to their educational goals, Carter says.
“The most important thing,” Amiri says, “is that it has to be a place that matches your personality, what you need as a learner, and the type of environment you can thrive in.”
