the self-perpetuating problem with all med school rankings

No Egrets

Bachelorette of Science
7+ Year Member
15+ Year Member
May 16, 2003
Houston, TX
So in any type of ranking of medical schools (US News), one factor in the rankings is how the school's graduates are viewed by the residency programs. Another popular way of ranking schools as evidenced by the insane number of threads on match results is the number of students going to the top residency programs in the country.

These stats are useful for people applying to medical school, because it gives you a good idea of the likely outcome depending on what med school you attend. However, these data still beg the question, "*what* is it about these schools that makes them so good that a significant number of them go on to the best residencies?" I don't think anyone would say that a graduate of Johns Hopkins knows more about medicine than a graduate of, say, USC for example. Both are "good" med schools, but clearly Hopkins wins in terms of residency placement.

What residency placement is to med school rankings, employment rates are to law school rankings. Is it a BAD law school if only 30% of its grads are employed after graduation (answer: yes)? Well clearly the employers don't want to hire grads from that school, but *why*? Do they learn less?

I think the answer in both of these cases is that the "best" schools end up with the "best" students, that reputation invites selectivity which results in the most eligible candidates sorting out to the most highly ranked schools. What residency directors are acting on, then, is the understanding that med schools have already done the basic screening in accepting the best candidates they could who would attend their schools...

In the rankings of undergraduate colleges, the "quality" of graduate programs attended by a school's graduates isn't taken into account, nor is their average income after graduation. I think this reflects the idea that the undergraduate programs vary so much by so many factors (core requirements/departmental strengths/extracurricular involvements/residential systems/etc) that these grad school/salary comparisons wouldn't have much meaning. By the same token, then, one could argue that the fact that people do rank grad schools based on these future outcomes (residency/employment) reflects the general similarity of the programs themselves.

Just some things on my mind! Any thoughts?


10+ Year Member
15+ Year Member
Jan 3, 2003
  1. MD/PhD Student
Hmm. Sounds good. The fact that half of a school's score comes from their selectivity numbers sort of backs your idea up.

I read an article a little while ago (a research article in a journal--just can't remember which one) that analyzed the US News Rankings and concluded that they are worthless for two major reasons:

1. The survey response rate for program directors, etc. hovers around %50 every year. According to statisticians, this is an abominably low rate, making the entire ranking system highly suspect.

2. Factors such as selectivity don't really tell you much about the school's ability to train physicians, just what kind of students they're willing to accept. The suggested remedy would obviously be to use board scores and med school GPA in the rankings rather than MCAT scores and undergraduate GPA.

If they could both of these problems, the rankings would be much less dubious, and then you wouldn't have the self-perpetuating problem any more (at least it wouldn't be recognizeable as the same problem).
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Senior Member
7+ Year Member
15+ Year Member
Sep 28, 2003
Sorry, I didn't explain much.

I just meant to point out that the same reasoning No Egrets mentioned some residency directors have exists in the minds of some medical school admissions officers. Therefore, some believe you can use undergrad school as an indicator of a premed's relative strength.

Personally, I agree that the only outcomes that matter are the ones that matter to you. That's why most of us care about matches and residency director ratings. That these two factors, along with selectivity, avg GPA/MCAT of entering students, research funding, etc, all tend to correlate with each other does not say much about causality. Are our matches good because our entering students had high numbers or do students with high numbers enter our school because of our good matches? It all feeds off itself.
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