As many have said before, "best" and "worst" are not absolute terms when it comes to medical schools - each person should consider what they are looking for in a medical school (location, cost, curriculum style, research and clinical opportunities, faculty/student friendliness, residency stats, etc.) and construct their own "Top 10" list rather than relying on ranking systems that use criteria which don't always have an effect on medical education. Of course, that isn't to say ranking systems are totally useless - residencies take into account the "reputation" of a school which ranking systems show fairly well.
For me, I didn't look at the rankings slot by slot - i.e. I would not go to a school ranked #9 over a school ranked #10 just because #9 is one higher than #10. Ratings fluctuate (sometimes dramatically), year after year - some say U.S. News purposely skews the results so they don't have a static ranking year after year, which would hurt sales. Honestly though, medical schools are pretty stable institutions, and there is no good reason why a school should jump or fall something like 5 spots in the space of a year (unless they get something like a $200 million donation to build new facilities or something dramatic of that nature). I think a good rule of thumb is to group the schools in rankings if you are concerned about them. For example, if you were concerned with overall ranking, you might group the top 5 schools in the same grouping, then the next 10 schools as being equal in a second grouping and if you get into two schools of the same category, you choose between them through your own criteria. If you do look at the rankings, I would focus on two categories - academic and residency reputation, especially the latter. One of the (many) reasons I chose to attend Michigan is because its residency ranking is 4th, much higher than its overall rank if 12, which really says something about Michigan graduates. Incidentally, many current Michigan students I spoke to initally thought that the ranking was bu11$hit until they went on residency interviews and directors immediately lit up when they discovered that the students were Michigan grads. (/End plug for UMich here
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To answer the flipside of your question, I would say that no medical school can be considered "worst". All medical schools will provide you with decent training and in the end, success in medicine far more depends on the individual rather than the school. Just for comparison, U.S. News only ranks the top 50 medical schools, leaving over 70 unranked schools. So would you say that the 70 unranked schools are "worst"? Hardly. Again, it all goes back to focusing more on what YOU want and think is good, not what some magazine says. It's natural to want to attend as highly ranked a school as you can get into, but keep in mind that may not be where you will learn the best or be happy the most.
Incidentally, the URL for the U.S. News rankings is at
http://www.usnews.com/usnews/edu/beyond/gradrank/med/gdmedt1.htm
Good luck.
[This message has been edited by WingZero (edited 08-02-2000).]