Rankings of American medical schools published annually by the news magazine U.S. News & World Report are widely used to judge the quality of the schools and their programs. The authors describe and then critique the rankings on methodologic and conceptual grounds, arguing that the annual U.S. News medical school evaluation falls short in both areas. Three categories of program quality indicators different from those used by U.S. News are presented as alternative ways to judge medical schools. The authors conclude that the annual U.S. News & World Report rankings of American medical schools are ill-conceived; are unscientific; are conducted poorly; ignore medical school accreditation; judge medical school quality from a narrow, elitist perspective; and do not consider social and professional outcomes in program quality calculations. The medical school rankings have no practical value and fail to meet standards of journalistic ethics.
All Americans have a stake in the quality of U.S. medical schools. Prospective medical students and the schools themselves have a particular, practical interest. Everyone wants assurance that the doctors produced by U.S. medical schools are effective and safe.
The news magazine U.S. News & World Report has addressed such concerns by publishing an annual national ranking of graduate education programs in a variety of fields, including medicine. The U.S. News medical school rankings have become a de facto measure of program quality by assessing American medical schools' reputations, research activity, student selectivity, and faculty resources. These rankings are accepted and cited by the medical profession, colleges and universities, the national and local popular press, broadcast journalists, and the public. The U.S. News rankings are so highly valued and relied upon because uncritical consumers believe these data provide the only available objective, unbiased way to assess and compare U.S. medical schools. In this article, we examine problems and weaknesses in the U.S. News rankings and raise doubts about their utility for judging the quality of medical education programs. We point to other, potentially more meaningful, kinds of assessment that could be used instead.
People want sound, objective data about the quality of medical schools and their programs for several reasons. Policymakers want evidence that the U.S. medical education system is efficient and works. Prospective students need information to help them decide where to apply so they can assess how well they fit an educational environment. Others may want to know how productive different schools are for their enrolled students: What is the graduation rate? What is the value added for students by graduation from a particular academic medical institution, and are some kinds of contributions more valuable than others? Does it matter, for example, if an American physician graduates from the University of California, Irvine College of Medicine, or from Johns Hopkins University School of Medicine, the University of Missouri-Columbia School of Medicine, or the Ponce School of Medicine in Puerto Rico? If there is a difference, what is it?
In this article, we address such questions, after considering the U.S. News & World Report ranking system.