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AAMC Reporter: May 2007
A Word from the President:
Medical School Rankings: Is There Really a Number One?
Every year at this time, prospective medical school applicants
begin to ask the all-important question, "How do
I find the best medical school for me?" Often, one of the
first places they look for answers is the U.S. News and
World Report annual rankings, especially given the widespread
press they typically generate.
As a former dean who actively interviewed applicants, I
learned that the right fit for aspiring medical students is
not about a ranking or number. It is all about the individual
fit between a specific student and school.
Just what is wrong with the rankings? The fundamental
problem is that they are based on a set of metrics that fail
to directly measure the quality of education. In the U.S.
News rankings, "reputation" is the most heavily weighted
metric. While a variety of factors help determine a
school's reputation (such as the number of alumni and
the size and location of its home city), many are in no
way measures of educational quality.
Other metrics used in the rankings, such as the amount
of National Institutes of Health (NIH) research grants
awarded and faculty-to-student ratios, seem impressive
at first glance, but can be misleading to an applicant.
For example, while high levels of NIH funding may signal
an institution's commitment to building strong
research programs (and may also reflect research opportunities
available to students), a strong research orientation
could have the unintended consequence of limiting
faculty time in the classroom. As for faculty-to-student
ratios, there is no guarantee that more faculty appointments
directly correlate to the amount of time faculty
members actually spend teaching.
Another metric, "student selectivity," is based primarily
on MCAT® scores, which measure cognitive abilities.
However, attributes such as humanism, compassion,
and empathy are also critical to selecting students who
will make good doctors, as well as good colleagues.
Lastly, the U.S. News rankings list only 50 of the
125 accredited U.S. medical schools. Does this mean
unranked schools do not provide a high-quality education?
To the contrary; it has been my experience that
a superb medical education can be found in some of
the less well-known, yet very student-focused schools
that might not even appear on the U.S. News list.
Given these limitations, it is my sincere hope that medical
schools take great care in their promotion of the
rankings. While I certainly understand the pride that
comes with a high ranking, I am concerned that the
rankings as a whole present an important audience—our applicants—with a very limited picture of U.S.
medical schools.
So what should medical school applicants do to
determine which school is right for them?
As a first and critically important step, prospective medical
school applicants should understand that accreditation
of U.S. and Canadian medical schools granting the
M.D. degree is conducted by the Liaison Committee on
Medical Education (LCME). LCME accreditation is a
rigorous evaluation process that ensures high quality
across medical schools. Unlike the rankings, LCME
accreditation is a quality assurance process that determines
whether a medical school educational program
meets established high standards for function, structure,
and performance.
At the heart of the process are ad hoc teams of experienced,
voluntary peer evaluators.Made up of basic science
and clinical educators and practitioners, these evaluators
conduct an on-site medical school survey and
assess factors ranging from a school's curriculum to the
support and educational resources directly provided to
students. In addition to conducting on-site surveys of
each medical school approximately every eight years,
(the standard term of accreditation), the LCME annually
reviews data and written reports from all accredited U.S.
and Canadian medical schools. It is interesting to
note that a school could rank highly in each and every
metric measured by U.S. News, but still fail to receive
LCME accreditation.
Second, applicants should rely upon the more comprehensive
and objective information found in the Medical
School Admission Requirements (MSAR™) to assess a
school's potential fit more thoroughly. Published each
spring by the AAMC, the MSAR is filled with data that
provide a broader understanding of a school's mission,
entrance requirements, selection factors, and curriculum.
It also contains a wealth of other important information
for applicants' consideration, ranging from the percentage
of accepted applicants who have community service
or medically related work experience to accepted applicants'
self-reported data on race and ethnicity.
Third, I highly recommend that applicants take a look
for themselves. In my experience, campus visits are far
and away the best method for students to assess their fit
with a particular school. By visiting a medical school
and speaking with current students, faculty, and staff,
prospective applicants can see if their personal preferences
match the unique features of a school. Campus
visits also help stimulate questions that applicants may
not have previously considered, such as whether the
presence or absence of a large research program or
strong community-based clinical learning sites would
enhance their particular educational experience. And
perhaps most importantly, campus visits are the only
way to tell whether a school's current medical students
seem happy and engaged.
In the end, to determine which medical school is
"number one" for them, applicants should understand
the significant limitations of the rankings, seek objective
information, visit schools in which they are interested,
and ultimately make decisions based on the values and
criteria most important to them.
Darrell G. Kirch, M.D.,
AAMC President
Editor's Note: For a copy of the 2008-2009 MSAR, please
visit www.aamc.org/msar.
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