The most recent new attempt at ranking residencies (US News/Doximity)

[675015]

I'm a college sports fan, and I follow recruiting. High school basketball and football players are ruthlessly evaluated and compared, and players from disparate parts of the country get ratings that are intended to delineate between the 11th best defensive lineman (who might be from Florida) and the 12th (who might be from California). They do this despite the reality that no scout can really watch these different guys. It can seem silly to differentiate 11 and 12, but you can be sure that the Alabamas and Oklahomas have rosters packed with guys rated highly, while the smaller football schools have few such recruits. Nevertheless, in the NFL draft, there are inevitably stars who come from these smaller schools.

In comparing psych programs, I don't see the real problem. This list of the 10 most elite places can be argued, but does anyone really think that this group of 10 is interchangeable with the residencies rated 40-49? The elite programs have deeper faculties, far more research money, better writing opportunities, and get many more of their top picks among resident applicants.

As with the transition from high schools to colleges and colleges to med school schools, there is a lot of movement, of course, and any of us can go up and down. Further, some of the best faculty and residents in the world thrive in programs that are viewed as mediocre, while all of the best places have their share of intellectual/personal duds, but if you're a betting person, I'd put my money on the places more highly ranked....

A. It's a horrible analogy if you look at the metrics for ranking athletes and the metric (an email poll to 300 people or so) or ranking residency programs.

B. Even your own metrics are silly. "Deeper facilities" (whatever that means... I assume you were somehow trying to stick with the sports analogies) and more research money and writing opportunities? Those latter two have nothing to do with how good a residency training program is unless you want to be an academic, which isn't the majority of doctors. The problem when rankings is when peoe use it as a surrogate to say "I know there are exceptions but doctors from program 6 are better trained than doctors from program 18"." Why? Because they had more basic science research? And FWIW, which is literally nothing's, I go to a "top ranked" place.

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[Monkey House]

Recently, Yelp moved into the hospital rating sphere** Can't wait till they also begin ranking residency programs! How many stars will your program be getting?

** http://www.modernhealthcare.com/article/20150805/NEWS/150809943 .

 

[675015]

Recently, Yelp moved into the hospital rating sphere** Can't wait till they also begin ranking residency programs! How many stars will your program be getting?

** http://www.modernhealthcare.com/article/20150805/NEWS/150809943 .

I can't wait until they start offering "Free Dose of Narcotics with Check-in"

 

[Doctor Bagel]

I'm a college sports fan, and I follow recruiting. High school basketball and football players are ruthlessly evaluated and compared, and players from disparate parts of the country get ratings that are intended to delineate between the 11th best defensive lineman (who might be from Florida) and the 12th (who might be from California). They do this despite the reality that no scout can really watch these different guys. It can seem silly to differentiate 11 and 12, but you can be sure that the Alabamas and Oklahomas have rosters packed with guys rated highly, while the smaller football schools have few such recruits. Nevertheless, in the NFL draft, there are inevitably stars who come from these smaller schools.

In comparing psych programs, I don't see the real problem. This list of the 10 most elite places can be argued, but does anyone really think that this group of 10 is interchangeable with the residencies rated 40-49? The elite programs have deeper faculties, far more research money, better writing opportunities, and get many more of their top picks among resident applicants.

As with the transition from high schools to colleges and colleges to med school schools, there is a lot of movement, of course, and any of us can go up and down. Further, some of the best faculty and residents in the world thrive in programs that are viewed as mediocre, while all of the best places have their share of intellectual/personal duds, but if you're a betting person, I'd put my money on the places more highly ranked....

So yeah, certainly there are programs that are better than other programs, and there's some link between resources and quality of education. It doesn't mean you can't be a great psychiatrist from a lower resource place and a lousy psychiatrist from a higher resource place, but yeah, true, there are differences. I'm not sure how this current ranking system actually captures quality, though -- I can't really comment on the top 10, but when you look lower, the rankings just seem odd. My program was ranked over a program that I think applicants generally find more desirable, and then there were programs ranked above my program that I would not conceive of as better or more desirable. We all know of psychiatry programs that are associated with big hospital systems that really aren't considered to be that great of programs. So anyway, yes, we're not equal, but still, these rankings are odd.

 

[Therapist4Chnge]

USN&WR had bad metrics and methods and so does Doximity….shocker . Admittedly my training programs and current employer are both highly ranked, that doesn't make the metrics any better.

 

[cleareyedguy]

A. It's a horrible analogy if you look at the metrics for ranking athletes and the metric (an email poll to 300 people or so) or ranking residency programs.

B. Even your own metrics are silly. "Deeper facilities" (whatever that means... I assume you were somehow trying to stick with the sports analogies) and more research money and writing opportunities? Those latter two have nothing to do with how good a residency training program is unless you want to be an academic, which isn't the majority of doctors. The problem when rankings is when peoe use it as a surrogate to say "I know there are exceptions but doctors from program 6 are better trained than doctors from program 18"." Why? Because they had more basic science research? And FWIW, which is literally nothing's, I go to a "top ranked" place.

Dear Mr. Bub,
1. I think the mailing was last year. This year, they let lots of psychiatrists vote, so I'm assuming they got more votes. Obviously, this is a problem. Hey, it's not my system. Better ideas, aside from just not doing such a ranking?
2. These aren't my metrics, but it does seem that these top programs have obviously deeper faculties (not "facilities"), etc. I'd assumed that an academic ranking of programs would focus on academics, but I did try to make clear that there is obviously going to be movement every time there is a new round of applications. further, this list has nothing to do with which places are nicer or better or build character or make do with limited resources or do God's work.
3. I write in because I wonder why psychiatry bridles so strongly against rankings. I think it's related to something beyond the imperfection of the metrics.

 

[MiddleRoad]

Which gets bashed more here, rankings or the DSM?

They're both far from perfect but each is not completely without merit.

For an applicant deciding on programs, the rankings give a sense of what places are esteemed among psychiatrists in terms of reputation, prestige and competitiveness (with a good deal of interchangeability among the top 25). This is only one factor, which will likely have very little bearing on whether that applicant is a good fit for a program. Still, these factors do tend to aggregate together and, with a few exceptions, these rankings don't seem terribly off base to me.

 

[Monkey House]

It is too bad the NRMP does not release data on the number of applicants ranking each program #1...now that is data that already exists....and would be very interesting! No more subjective bias.

 

[OldPsychDoc]

It is too match the NRMP does not release data on the number of applicants ranking each program #1...now that is data that already exists....and would be very interesting! No more subjective bias.

It would depend on the # of interviews that program offered though--a small, desirable program might interview <30 applicants to fill 4 slots, while a large "brand name" program might interview 100 for 10, yet both might theoretically have 100% #1 rankings.

 

[Therapist4Chnge]

I would like to think that medical students applying to residency are wise enough to not base life decisions on a list.

Not sure if serious....unfortunately many do this to a fault.