US News Medicine Residency rankings

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WaryWildcat

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US News came out with its first ranking of medicine residencies today, apparently based on a poll (on Doximity, which is apparently a weird sort-of Facebook for docs) of other physicians as well as program directors. Just since people on this forum tend to obsess over how others view programs (yeah yeah me included), I figured I'd start a discussion. Link is here:

http://health.usnews.com/health-new.../doctors-name-americas-top-residency-programs

IMHO this is a fairly silly list... CCF at #15? Yeah right. Just goes to show that, as data driven people, we shouldn't rely so heavily on others' by and large subjective views of the prestige of various programs when we decide where to train. Even when n is much greater than 1, they count for little.

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Silliest thing ever. The public is just obsessed with making a top list for everything. It doesn't work that way when it comes to academic programs.

The most genuine evaluation of residency programs should come from current residents and recent graduates (within 3 years or so), and not from PDs or ,even worse, general internists. I think that every sane person here agrees that claiming CCF IM has a better reputation than stanford, cornell, U of Chicago, Yale, Vanderbilt or MSSM takes away the last drop of credibility this list might have.
 
I'm not sure I agree with the premise upon which you are discussing. What are we discussing here? The quality of training? As far as I know, there is no objective way to gauge how a typical "MGH" resident will stack up against a typical "BU" resident without including their pre-determined biases. For example, a medical student who reads a lot on their own will generally get better grades and thus a better shot at a prestigious residency. At this prestigious residency, the resident will excel. Was this because the training at MGH is that much better, or is it because MGH trains more knowledgeable/motivated residents?

At the end of the day, we rely on reputations--on this website, we rely on mostly residents' and medical students' perceptions of reputations. If you're looking for a job after your PGY-3, don't you think (based on this survey that includes the typical limitations of surveys), you're more marketable to come from CCF than from MSSM?

This survey tells us what we already knew--the big 4 are the big4. The nominations drop so precipitously after the top 4 that it's hard to glean any information from it.
 
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This survey tells us what we already knew--the big 4 are the big4. The nominations drop so precipitously after the top 4 that it's hard to glean any information from it.
Of course. But don't think that doesn't mean you grandma (and all your patients) aren't going to use it as a (stupid) barometer of how good of a doctor you are.
 
At the end of the day, we rely on reputations--on this website, we rely on mostly residents' and medical students' perceptions of reputations. If you're looking for a job after your PGY-3, don't you think (based on this survey that includes the typical limitations of surveys), you're more marketable to come from CCF than from MSSM?

And that's why they should stop making these stupid lists! so they don't drive the public to draw false conclusions. You and I both know that a graduate from Duke IM for example is not by definition a better physician than a graduate from Vanderbilt IM, but when patients look at these lists and rankings again and again they believe that one program trains you to become a great doctor while the other ... not so much. And that's Vanderbilt, so how about graduates from programs not even on this lists? OMG are they even doctors?

people don't seem to understand that sometimes a doctor trained in a community hospital can actually be a better physician than an MGH graduate.
 
US News came out with its first ranking of medicine residencies today, apparently based on a poll (on Doximity, which is apparently a weird sort-of Facebook for docs) of other physicians as well as program directors. Just since people on this forum tend to obsess over how others view programs (yeah yeah me included), I figured I'd start a discussion. Link is here:

http://health.usnews.com/health-new.../doctors-name-americas-top-residency-programs

IMHO this is a fairly silly list... CCF at #15? Yeah right. Just goes to show that, as data driven people, we shouldn't rely so heavily on others' by and large subjective views of the prestige of various programs when we decide where to train. Even when n is much greater than 1, they count for little.

I think CCF does not belong on this list, period. It's probably the most overrated IM programs in the country. Other than that, the list does not look terrible to me although the order of the programs as listed is very much open to debate. Being said that I think the difference between the "top" programs is so miniscule that debating the order would be one of the biggest waste of time I can imagine.
 
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It is just another tool, no more and no less. Surely it is no less legit than the various Megathreads we all read. I find the PD rankings interesting. Only one vote for BID and 8 for Yale, yet they are 22 & 23 respectively overall. I suspect the list is biased towards IM programs with larger classes. More alums to vote for their alma maters...
 
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I needed a good laugh today.
This list delivered, AND THEN SOME.

thx.
 
go utsw!! if only our non-conference schedule were stronger our ranking might have been top 10 this year.
 
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Mayo at number 5?? I guess with so much emphasis on education they belong in the top 15.i didnt realize that their internal medicine residency was so popular. I shd have ranked their residency and fellowship higher!
Notable omissions: UAB, Iowa.


I guess Mayo and CCF have finally arrived ;)
 
I love nw, but I think that's a bit high
 
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mine too
 
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why does cleveland clinic have such a bad rep when it's just a great hospital with a top ranked medical school program?

WTF are those publications per graduate accurate... Mass gen has a average of 20 publications per graduate?????????????
 
why does cleveland clinic have such a bad rep when it's just a great hospital with a top ranked medical school program?

WTF are those publications per graduate accurate... Mass gen has a average of 20 publications per graduate?????????????
Great hospital- Yes
Great Fellowship programs- Yes
Great medical school- Maybe
Great IM residency program- hell NO
 
Great hospital- Yes
Great Fellowship programs- Yes
Great medical school- Maybe
Great IM residency program- hell NO

well the medical school is in the top 25 and extremely competitive so id say its a pretty amazing medical school esp w/ their tuition scholarship and a class of 40.. but how the hell do residents training at a top hospital suck. how do they even mess this up lol wow
 
why does cleveland clinic have such a bad rep when it's just a great hospital with a top ranked medical school program?

WTF are those publications per graduate accurate... Mass gen has a average of 20 publications per graduate?????????????

I presume that includes publications prior to residency, so PhDs, people who took time off to do research during med school, and people with substantial undergraduate research experience would drive up the average. I also wonder how far out post-graduation they tracked people. I can't think of a good reason for a resident to be on an NIH grant, for example. If a place like BWH is averaging 0.8 NIH grants per resident, they're probably including grants either before or after residency.

The publication numbers probably also include abstracts and posters, which can inflate the totals very quickly depending on how deep you want to dig to fill up your CV.
 
well the medical school is in the top 25 and extremely competitive so id say its a pretty amazing medical school esp w/ their tuition scholarship and a class of 40.. but how the hell do residents training at a top hospital suck. how do they even mess this up lol wow
Cedars Sinai. Top hospital. Meh IM program. Easy enough. Also, I may be alone on this, but I personally don't see a small class size as an advantage or something that should mean the school is better. Harvard has a class size of 170....I think they do ok with that. Also, they probably offer tuition scholarships because you'd have to seriously pay someone to move to Cleveland...
 
Cedars Sinai. Top hospital. Meh IM program. Easy enough. Also, I may be alone on this, but I personally don't see a small class size as an advantage or something that should mean the school is better. Harvard has a class size of 170....I think they do ok with that. Also, they probably offer tuition scholarships because you'd have to seriously pay someone to move to Cleveland...

Agree - class size is irrelevant. I'm not sure where the top 25 comment came from either. It's no research powerhouse, at least by volume, and with a tiny class and a short history, it's not impacting primary care much either. I could cherry pick metrics to call my med school top 10, but people would roll their eyes, laugh, and be right to do it.
 
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I am oddly pleased the state school I want to go to (for location purposes) isn't on that list

More competition for me is bad >_> Everyone else pls try to go to MGH thx bye
 
I am oddly pleased the state school I want to go to (for location purposes) isn't on that list

More competition for me is bad >_> Everyone else pls try to go to MGH thx bye

and let that post be the end of this thread
 
Agree - class size is irrelevant. I'm not sure where the top 25 comment came from either. It's no research powerhouse, at least by volume, and with a tiny class and a short history, it's not impacting primary care much either. I could cherry pick metrics to call my med school top 10, but people would roll their eyes, laugh, and be right to do it.

cleveland clinic is research heavy. even case western is ranked #25 based on research and cleveland clinic is more research focused. and when i said top 25 i was referring when you judge based on mcat score/gpa. lerner college of medicine has the 4th highest mcat avg in their applicants in 2011.

but i guess thats not the focus of this discussion. still surprising the IM sucks
 
cleveland clinic is research heavy. even case western is ranked #25 based on research and cleveland clinic is more research focused. and when i said top 25 i was referring when you judge based on mcat score/gpa. lerner college of medicine has the 4th highest mcat avg in their applicants in 2011.

but i guess thats not the focus of this discussion. still surprising the IM sucks

You seem to be totally missing the point. What makes a medical school/residency great is not the MCAT/USMLE scores but rather what the school/program has to offer. The IM program at Cleveland Clinic has very little to offer in terms of quality of training and this is why the program has a lot of difficulty recruiting quality US MD students. They do recruit some great IMGs who are probably fooled by the name recognition and do not recognize the mediocre IM training offered at the clinic until it's too late. The average USMLE score of cleveland clinic residents is in par with most of the top IM programs in the country. But this alone does not make the program one of the best in the country. I stand by the fact that Cleveland clinic IM program is one of the most overrated program in the country.
 
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You seem to be totally missing the point. What makes a medical school/residency great is not the MCAT/USMLE scores but rather what the school/program has to offer. The IM program at Cleveland Clinic has very little to offer in terms of quality of training and this is why the program has a lot of difficulty recruiting quality US MD students. They do recruit some great IMGs who are probably fooled by the name recognition and do not recognize the mediocre IM training offered at the clinic until it's too late. The average USMLE score of cleveland clinic residents is in par with most of the top IM programs in the country. But this alone does not make the program one of the best in the country. I stand by the fact that Cleveland clinic IM program is one of the most overrated program in the country.

I agree with you about IM residency. but thats not the case for medical school. many ppl chose medical schools based on scores/locations/cost/rep, rather than what the school 'has to offer' (which is pretty subjective anyway, one person may prefer the school offering loads of free time, while another prefer full of lectures). But for residency, the goal is pretty much the same.. to be a great doctor. So yes i agree with what you are saying about IM program at clinic. I'm just saying im surprised that a top notch hospital has so little to offer. thats all
 
A bunch of notable programs were left off.
 
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cleveland clinic is research heavy. even case western is ranked #25 based on research and cleveland clinic is more research focused. and when i said top 25 i was referring when you judge based on mcat score/gpa. lerner college of medicine has the 4th highest mcat avg in their applicants in 2011.

but i guess thats not the focus of this discussion. still surprising the IM sucks

Cleveland Clinic had around $82 million in NIH funding in 2012. Case had more than double that. If you put the two together on the assumption that the rest of Case will be easily accessible to you in Lerner, you have a low-top 25 institution by NIH funding, but Cleveland Clinic by itself is fairly small (UTMB, VCU or Dartmouth-sized).
 
jdh and gutonc are right, my career is over.
 
How come Pitt is not on that list?

I agree UPMC is not even close to the big 4, but I'm pretty sure their IM program is not inferior in terms of reputation, quality of training and research opportunities to highly regarded places in that list like Mayo, Emory, Yale and obviously CCF. The same thought apply, in my opinion, to UVA, UAB and UNC.
 
How come Pitt is not on that list?

I agree UPMC is not even close to the big 4, but I'm pretty sure their IM program is not inferior in terms of reputation, quality of training and research opportunities to highly regarded places in that list like Mayo, Emory, Yale and obviously CCF. The same thought apply, in my opinion, to UVA, UAB and UNC.

Are you beginning to understand why this list is so stupid?
 
Are you beginning to understand why this list is so stupid?

Well, evidently many IM docs (I will just take a guess that many of the survey's respondents are FMGs, not belittling but just making a point that people not "in the know" can be easily swayed by big names) think that a resident that "helped treat" (a.k.a. did what their famous attending told them to do) the duchess of Bahrain or the royal archprince of Kiribati or whatever apparently is better trained than a workaholic resident from Columbia, Duke, Penn or the like who actually did all the work (typically as an intern) and didn't have the luxury of a handpicked patient population who could pay for their care out of pocket and order every possible test for them "just because".

This list is a massive slap in the face to some exceptional programs that made the cut but somehow barely made it on.
 
Well, evidently many IM docs (I will just take a guess that many of the survey's respondents are FMGs, not belittling but just making a point that people not "in the know" can be easily swayed by big names) think that a resident that "helped treat" (a.k.a. did what their famous attending told them to do) the duchess of Bahrain or the royal archprince of Kiribati or whatever apparently is better trained than a workaholic resident from Columbia, Duke, Penn or the like who actually did all the work (typically as an intern) and didn't have the luxury of a handpicked patient population who could pay for their care out of pocket and order every possible test for them "just because".

This list is a massive slap in the face to some exceptional programs that made the cut but somehow barely made it on.

seriously? you really think its the FMG internist that is the only one not "in the know"? PLEASE…the average everyday community physician is not going to be anymore "in the know" about the quality o of residency programs throughout the country (heck! i would imagine most of those FMGs that DID train at CCF are not going to be ranking the IM program there high on the list, since they know 1st hand what the program is like)…

and sorry…the "workaholic intern" is not necessarily coming out of those big name places…they all have fairly large classes and the work is spread out amongst them….the ones that really do do all the work are those that come mid to small programs and they have little choice at the busy city hospitals (Columbia would probably be the exception of that list you mentioned) where they don't get the luxury of cherry picking their census and sending everything else to the hospitalist service (and sorry Penn, Duke and Columbia are not the charity hospitals of their respective cities-most of their pts have insurance and its not medicaid).
 
Can we correlate this list with how PRIVATE practice employers view programs? ultimately the goal is to get a good job, so why not go to the program that your future employer thinks is really top notch?
 
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How come Pitt is not on that list?

I agree UPMC is not even close to the big 4, but I'm pretty sure their IM program is not inferior in terms of reputation, quality of training and research opportunities to highly regarded places in that list like Mayo, Emory, Yale and obviously CCF. The same thought apply, in my opinion, to UVA, UAB and UNC.
Are you beginning to understand why this list is so stupid?

I do find it bizarre how Pitt seems to be frequently missed on all sorts of lists (not just IM, but surgery, pediatrics as well). Perhaps location plays a role?
 
US news rankings are rarely accurate
 
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seriously? you really think its the FMG internist that is the only one not "in the know"? PLEASE…the average everyday community physician is not going to be anymore "in the know" about the quality o of residency programs throughout the country (heck! i would imagine most of those FMGs that DID train at CCF are not going to be ranking the IM program there high on the list, since they know 1st hand what the program is like)…

and sorry…the "workaholic intern" is not necessarily coming out of those big name places…they all have fairly large classes and the work is spread out amongst them….the ones that really do do all the work are those that come mid to small programs and they have little choice at the busy city hospitals (Columbia would probably be the exception of that list you mentioned) where they don't get the luxury of cherry picking their census and sending everything else to the hospitalist service (and sorry Penn, Duke and Columbia are not the charity hospitals of their respective cities-most of their pts have insurance and its not medicaid).

You may missed my point. But I was probably too subtle, so my fault really.
 
Hey guys,

I am one of the PGY-2, from CCF. Not here to defend my program ( I believe everyone is entitled to their opinion ) but just wanted to clarify on 2 pieces of information.


1. Less research due to low NIH funding : I am not sure who sponsors rest of the program, but I do research in cardiology, and all expenses are paid probably by Heart and Vascular Institute , particularly the intervention group ( my mentor is an intervention cardiologist ) . I can easily get data extracted from EPIC, have statisticians readily available,though now I am trying to do that myself and mentors who are the biggest names in their fields.

2. We see Kings of Middle east and stuff : I wish! We have a floor dedicated to all VIPs ( J8-3). I have had patients there only 2-3 times in the last 1.5 years. In one patient, I didn't even feel a difference as compared to a regular patient, the other one, was I would say, not so pleasant , as they would dictate care, asking me to call consults on things I could manage on my own.
But that was 1 patient in probably 100s to 1000s I have seen since internship. I would not let that change anyone's perception about the program.

No program is perfect, but trust me, CCF is nowhere as bad as you guys make it sound!
 
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Hey guys,

I am one of the PGY-2, from CCF. Not here to defend my program ( I believe everyone is entitled to their opinion ) but just wanted to clarify on 2 pieces of information.


1. Less research due to low NIH funding : I am not sure who sponsors rest of the program, but I do research in cardiology, and all expenses are paid probably by Heart and Vascular Institute , particularly the intervention group ( my mentor is an intervention cardiologist ) . I can easily get data extracted from EPIC, have statisticians readily available,though now I am trying to do that myself and mentors who are the biggest names in their fields.

2. We see Kings of Middle east and stuff : I wish! We have a floor dedicated to all VIPs ( J8-3). I have had patients there only 2-3 times in the last 1.5 years. In one patient, I didn't even feel a difference as compared to a regular patient, the other one, was I would say, not so pleasant , as they would dictate care, asking me to call consults on things I could manage on my own.
But that was 1 patient in probably 100s to 1000s I have seen since internship. I would not let that change anyone's perception about the program.

No program is perfect, but trust me, CCF is nowhere as bad as you guys make it sound!

No one is saying its an awful program, but to put it ahead of Vandy, UCLA, Stanford, etc...is just a total fallacy. I bet half the residents at CCF did not even get interviews at a lot of those programs.
 
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No one is saying its an awful program, but to put it ahead of Vandy, UCLA, Stanford, etc...is just a total fallacy. I bet half the residents at CCF did not even get interviews at a lot of those programs.
Half is being too generous. I am willing to bet >95% did not get interviews from any of the places you mentioned.
 
The percentage of IMGs in CCF exceeds that of any mid-tier program. Now I'm sure that most of those are stellar IMGs but there's a reason why good AMGs don't compete to go there. Even nearby programs (not even on that magic list) like Case, OSU and IU have fewer to even zero IMGs in some of their classes. I know that's a lousy marker, but a top program doesn't fill with IMGs unless there's something wrong going on.
 
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Half is being too generous. I am willing to bet >95% did not get interviews from any of the places you mentioned.

Probably true.

Gotta give CCF credit though, if you keep touting your own horn, eventually people will start to believe it. You know future med students will use this list, and CCF will be getting stronger applicants.
 
Probably true.

Gotta give CCF credit though, if you keep touting your own horn, eventually people will start to believe it. You know future med students will use this list, and CCF will be getting stronger applicants.
I hope future applicants are smarter than that. It's a shame that such a great hospital with strong fellowship programs has a totally mediocre IM program. The potential for CCF to be a great IM residency is there but definitely not being utilized IMHO.
 
I hope future applicants are smarter than that. It's a shame that such a great hospital with strong fellowship programs has a totally mediocre IM program. The potential for CCF to be a great IM residency is there but definitely not being utilized IMHO.

just going to add my 2 cents..I wouldn't say that it's a mediocre program (and I've rotated at some terrible programs, which are being praised on this forum solely based on the "name" of the university/med school). One of the major reasons why CCF IM is filled with IMGs is because CCF is classified as a "community program" while a similar program like Mayo is not. Even though CCF itself is very academic, very research heavy for a "community program" and has a medical school, CCF is not classified as a university program based on a technicality--they do not actually have their own degree-granting medical school like Mayo does (CCF's medical school program belongs to Case, we get MD degrees from Case--they did this to avoid having to go through the accreditation process of starting a new medical school) and UH is Case's primary teaching hospital so UH gets the university designation while CCF gets the community program designation. Yes there are quite a few IMGs at CCF IM program, but I've been pretty impressed with CCF IM program including the calibre of the IM residents, seemed like a very well-organized program based on my clinical rotation and AI, and they're some really smart people and many of those IMGs have >260 Step 1 scores. I'm sure the "community program" classification and the fact that it's located in Cleveland affects it's ability to attract some top US candidates, but no way would I call it a "mediocre" program, I would actually say it's one of the top community programs. It ends up getting compared with the top university programs like in this thread which is not exactly a fair comparison in my opinion, especially when people are looking at the number of IMGs to assess their opinions of a program (community programs will always be filled with more IMGs), although the fact that a community program is being even compared to top academic programs should tell you the clout of the CCF brand.

Plus, the CCF cardiovascular staff (who you will obviously interact with as an IM resident) are pretty well known in the field (Dr. Steve Nissen was named Time's Magazine Top 100 Most Influential People several years ago, http://www.medscape.com/viewarticle/789270).

as for the medical school, pardon my bias but since many may not actually be be familiar with it, let me introduce you to the program (especially you amine2086): majority of the students and I chose the Cleveland Clinic program over the Ivys and other top programs (Duke, UCLA, Michigan, UCSD, WashU, Emory, Mayo, etc), it's traditionally been a top 20-25 program by US News, as a student you're both a CCF and Case medical student so get access to all the resources of both institutions, get to rotate at CCF (ranked #4 nationally by US News), University Hospital (ranked #18 nationally by US News), Metro (county hospital/level 1 trauma), VA, and/or affiliated regional programs including CCF abu dhabi or CCF Florida, the school was being recruited by Columbia and UPenn to join their medical school when CCF was thinking about breaking off from Case, 6th highest MCAT score in the nation for admitting classes, high average USMLE score (>240s), only 32 people admitted out of nearly 2,000 making it one of the most competitive programs in the nation, free tuition for all students (which yes helps draw people to live in Cleveland), often has the highest number of Howard Hughes recipients per year (Duke is the only other school that is even close), free Master's degree (MPH, MS in Clinical research, etc), because of the curriculum's emphasis on research the students have a ridiculous amount of publications by the time they graduate (one 3rd year student already has 20 publications), a lot of other free immenities (free laptops, free parking, free NBME exams, reimbursements if you present research at national conference, etc), awesome new medical school building being built with Case on Cleveland Clinic campus, IBM selected our school and its students to help "teach" IBM Watson medicine, classes only last until noon during 1st 2 years, thursdays completely off, no exams/grades/no class rank at any point during medical school career (it's not even P/F, shelf exams during clinical rotations are optional, its awesome)...has everything a medical student could ask for and more, it's an awesome program and definitely one of the most unique curriculums out there
 
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Cleveland Clinic had around $82 million in NIH funding in 2012. Case had more than double that. If you put the two together on the assumption that the rest of Case will be easily accessible to you in Lerner, you have a low-top 25 institution by NIH funding, but Cleveland Clinic by itself is fairly small (UTMB, VCU or Dartmouth-sized).

It's no small feat that Cleveland Clinic alone can rival entire medical schools (who include their biomedical departments at the university AND typically their hospital-affliations into the total amount)..with a revenue of $6 billion dollar a year revenue that rivals the total endowment of most top universities, Cleveland Clinic is a powerhouse (clinically and research)
 
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More of a question than an assessment, but isn't one of CC's IM program's weaknesssesss the fact that it's over specialized? when I was there the idea I got was that pts will get diverted into different services if they have left toe ache or a right toe ache... obviously exaggerated, but I did think that over-specialization detracted from a general service like IM. Essentially Fellowship programs are really good, but at the expense of primary ones as IM.

Again, I'm no expert, but that's the impression I got from CCF's IM program. Mistaken?
 
It's no small feat that Cleveland Clinic alone can rival entire medical schools (who include their biomedical departments at the university AND typically their hospital-affliations into the total amount)..with a revenue of $6 billion dollar a year revenue that rivals the total endowment of most top universities, Cleveland Clinic is a powerhouse (clinically and research)

CC is #67 in NIH funding, nestled between Medical College of Wisconsin and Dartmouth. I prefer this as a metric because every grant represented has to go through a ridiculous peer review process that is the closest thing we have to a check on quality and value. NIH typically provides around half of a given institution's overall funding, so for the most part, there aren't huge swings according to how much internal money goes into overall expenditures. If you take CC's total research expenditures, roughly one quarter of which are internal revenues, and plug that into NSF's R&D survey, it would rank in the low 80s, right around UConn, UMass, Carnegie Mellon and Nebraska.

Biomedical departments count. Any science counts, as far as I'm concerned. You can't disregard the basic science that makes patient-centered research possible. What would GI and cardiology be without physics? Where do you think study drugs come from? CC should be judged by its overall product, and on that count, it is a respectable institution. If it were a basketball team, though, it would be in the NIT.
 
It's no small feat that Cleveland Clinic alone can rival entire medical schools (who include their biomedical departments at the university AND typically their hospital-affliations into the total amount)..with a revenue of $6 billion dollar a year revenue that rivals the total endowment of most top universities, Cleveland Clinic is a powerhouse (clinically and research)

Thats not true, Some universities such as UCSF, and UTSW are only a medical school so all of the funding in their departments are incorporated. Also some places like Uchicago, their medical school is within their department of biological sciences and so again in these cases they are also combined. Most other traditional schools that have separate departments between the medical school and their undergrad are considered separate. NIH does not lump them all together (NSF ranking do but they are evaluating UNIVERSITIES, not medical school).
 
Changing the topic a little. Interesting to see how high Mayo was ranked. I had interviewed there in 2005 . PD was Joe Kolars who is well known for educational innovations and enigmatic.i almost went there because of him- the program seemed to be quite rigorous and academic at that time.
I ended up ranking them lower because of the location and the big brother/big corporation feeling I got there.
It's surprising that Mayo was ranked ahead several of the powerhouses. I guess PD's rankings were only a part of the metholodology.
 
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