US News & World Report Rankings

Big whoop...

Like your average suicidal-with-a-plan person on the street is going to consult this before they decide where to enroll themselves for three-hots-and-a-cot after their girlfriend kicks them out this weekend....

Why anyone would listen to a third rate news source as an authority on anything, let alone base their choice in education on it, is beyond me. As my friend noted, he feels stuppider anytime he reads one of the paragraph long articles in the publication.

Doc Samson said:

This years edition of the questionable rankings of uncertain significance (from the perspective of both patients and trainees) for psychiatry are:

1 Massachusetts General Hospital, Boston 43.6
2 Johns Hopkins Hospital, Baltimore 26.4
3 New York-Presbyterian Univ. Hosp. of Columbia and Cornell 22.3
4 McLean Hospital, Belmont, Mass. 19.2
5 UCLA's Neuropsychiatric Hospital, Los Angeles 18.8
6 Menninger Clinic, Houston 15.1
7 Yale-New Haven Hospital, New Haven, Conn. 14.5
8 Stanford Hospital and Clinics, Stanford, Calif. 12.4
9 Sheppard and Enoch Pratt Hospital, Baltimore 12.4
10 Duke University Medical Center, Durham, N.C. 12.3
11 Mayo Clinic, Rochester, Minn. 11.3
12 University of Pittsburgh Medical Center 10.9
13 Hospital of the University of Pennsylvania, Philadelphia 7.0
14 Barnes-Jewish Hospital/Washington University, St. Louis 6.2
15 Emory University Hospital, Atlanta 6.0
16 University of California, San Francisco Medical Center 5.8
17 Methodist Hospital, Houston 5.3
18 NYU Medical Center, New York 5.1
19 Austen Riggs Center, Stockbridge, Mass. 4.9
20 Cleveland Clinic 4.6
21 University Hospital, Cincinnati 3.5
22 University of North Carolina Hospitals, Chapel Hill 3.4
23 Georgetown University Hospital, Washington, D.C. 3.2
24 University Hospitals of Cleveland 3.1
25 Bellevue Hospital Center, New York 3.0
26 University of Michigan Hospitals and Health System, Ann Arbor 3.0

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For the sake of discussion, with the understanding that this list means nothing from a practical standpoint other than some vague sentiment of prestige, it is interesting to note that the "competitiveness of the residency programs" does not really correlate with this list.

For example, last year, Pittsburgh did not fill all their spots and had to fill with a scramble of left over applicants. (of course, i'm not commenting on the quality of education there, I have no idea what its like as I didn't interview there, and for the record it is tremendously well funded for research).

In addition, location seems to trump many other factors as I know for a fact that UCSF, Columbia, NYU, and UCLA are exceptionally competitive to get into and in my opinion significantly more so that Johns Hopkins, yet this list and a bunch of premeds probably worship Hopkins as the Mecca of psychiatry.

In addition, depending on style of psychiatry you are interested in, you may be competing with a different pool of candidates such that biological psychiatrists are probably drooling at the mouth to work at Wash U in St. Louis while psychoanalytic enthusiasts likely are chomping at the bit to get into Cornell and work with the likes of Otto Kernberg and the upper east side/west chester analysts involved in that program.

Making one all encompassing list is just plain silly and is just to sell magazines, but to the benefit of US news, I do consider the 15 or so most influential academic programs to be included on that list, which at least lends itself to some superficial indication of "reputation".

double post

I remember reading US News & World Report among several other sources ranking schools & such and found it had little correlation with my satisfaction at the particular place.

I found Princeton Review's review of college campuses more useful. E.g. they would tell what the people at the school thought of it, got polls done etc. E.g. you think I want to go to a 5 star school in the Barrons guide when all the students hate it there? I'd rather go to a 4 star school where all the kids are happy with the school.

I remember one particular website was ranking programs, and their criterion was by how much money it received in research and other factors that had little to do with how well the residents performed and their satisfaction with the program. How much money in research? That makes little difference unless you want to do research for real--not just the token paper for the CV.

Anyways, its nice to see lists like this and I thank the poster for putting it up, but you also have to consider the criterion for the ranking.

Doc Samson said:

As the preamble to my initial post hopefully indicated, I don't put too much faith in lists like this, but just to clarify, this is not a rank list of quality of training or of patient care. It is a survey of nebulously defined "reputation" among our senior colleagues. Whatever the list is worth, I am sort of pleased to see a nice smattering of psychotherapy-dominant facilities (Austen Riggs, Menninger) side-by-side with the bio-giants... although maybe they were only voted for by the crusty old grey-beards.

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BTW, what does the number next to the ranking signify?

I am sorely tempted to suggest that it is an anatomical measurement, perhaps in cm?

Doc Samson said:

"Percentage of responding board-certified physicians surveyed by U.S. News in 2004, 2005, and 2006 citing a hospital as among the best in their specialty for patients with difficult conditions."

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So 56.4% of board-certified psychiatrists surveyed wouldn't cite Mass Gen as "among the best"?

Maybe we should talk more about why we have this urge to rank things against each other...

OldPsychDoc said:

So 56.4% of board-certified psychiatrists surveyed wouldn't cite Mass Gen as "among the best"?

Maybe we should talk more about why we have this urge to rank things against each other...

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I actually know a number of very academic psychiatrists involved in training medical students who feel that Mass General is "resting on its laurels" and its reputation and isn't such an impressive place as the people who work at Mass General think it is (in psychiatry). I ranked it highly, but ranked others higher in part because of these opinions and my feeling that there was some of that unwarranted arrogance in place there. Maybe thats what lead to the discrepancy...and if you can only put down a few choices when ranking hospitals, maybe you just won't choose that one because of these factors.

doc samson, can you be kind enough to elaborate upon which programs are emphasizing psychotherapy vs biology vs psychopharm and/or how we can find that out for ourselves??

thanks so much...........

Doc Samson said:

As a broad generalization, programs in the midwest tend toward the biological end of the spectrum, while programs on the coasts tend towards the psychotherapeutic. It's almost impossible to find a program that emphasizes psychotherapy to the exclusion of biological approaches - Cambridge used to have that rep, but no so much anymore - but the inverse is all too easy to find. So when I refer to a "psychotherapy oriented program" that would mean one that manages to emphasize therapy at least as well as it emphasizes meds.
From what I've heard, the high-ranking programs that place a lot of focus on biology include Pitt, WUSTL, Duke, and Hopkins. The programs that place equal emphasis on psychotherapy (of one shade or another) include Columbia, Cornell, Brown, MGH/McLean, Harvard Longwood, Cambridge, UCLA, UCSF, Penn, and NYU. Again, I'm sure there are others out there with far greater familiarity with all of these programs, but like I said, it's all word of mouth.

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From my impressions from the interview trail last year, what D.S says seems fair and accurate. The only point I disagree with is counting Duke among the "mostly biological" programs. Duke seemed like it had the most serious psychotherapy training of any program I visited. They start you with a therapy case in the PGY1 year and have a mandatory family therapy program for third year residents. They make heave use of one way mirrors and videotape and there seems to be a significant amount of integration between the Psychology Phd faculty and interns, and the psychiatry faculty and residents.