US News: Research vs. Primary Care

[luke77]

Hey guys,
I have a question about the US News rankings. They have the "Research" rankings that most people pay the most attention to, but then they also have "Primary Care" rankings that put U of Wash at 1, UNC at 2, etc. Does anyone know the methodology used for the primary care rankings? Do they just look at the percentage of graduates going into primary care, or do they actually try to quantify which schools will be best for preparing a doctor to practice in primary care?

And on a related note, if one plans on going into primary care should you pay attention to the primary care rankings and ignore the research rankings? And what exactly is meant by primary care? I assume internal medicine, pediatrics, emergency medicine...anything else?

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[willow18]

Just look at the column headers.

http://www.usnews.com/usnews/edu/grad/rankings/med/brief/mdprank_brief.php

 

[Zoom-Zoom]

And on a related note, if one plans on going into primary care should you pay attention to the primary care rankings and ignore the research rankings? And what exactly is meant by primary care? I assume internal medicine, pediatrics, emergency medicine...anything else?

Yeah ignore the research ones. And ignore the primary care ones too. We could all be a lot happier without those stupid things. That's why I'm going to bomb the USNews database* fight-club style ...this way we can all go to top 10 schools.


*see avatar

 

[Wahina]

If you go to the USNews ranking site and look around you will see a link for the methodologies of each graduate school ranking, including the Medicine Primary Care rankings. I'm being lazy, but if you can't find it let me know and I'll link it. The percentage of grads going into primary care fields is weighted as 0.3, fyi.

 

[usnavdoc]

Hey guys,
I have a question about the US News rankings. They have the "Research" rankings that most people pay the most attention to, but then they also have "Primary Care" rankings that put U of Wash at 1, UNC at 2, etc. Does anyone know the methodology used for the primary care rankings? Do they just look at the percentage of graduates going into primary care, or do they actually try to quantify which schools will be best for preparing a doctor to practice in primary care?

And on a related note, if one plans on going into primary care should you pay attention to the primary care rankings and ignore the research rankings? And what exactly is meant by primary care? I assume internal medicine, pediatrics, emergency medicine...anything else?

EM isnt considered primary care. FP, IM, Peds, Ob/Gyn

 

[UNC-or-BUST]

I hear UNC moved into the top 20 research, #2 primary care

 

[nicholasblonde]

I know that the primary care rankings factor in the percentage of graduates entering primary care residencies. Not sure what statistical weight this percentage gets in figuring the final rankings, but I personally think it is a bs variable to use...How does the number of graduates from a certain school entering primary care residencies have anything to do with the quality of that school's educational program? It might be important if you feel the need to be around students with similar interests, but I doubt it reflects on the quality of curriculum, etc. No offense to anyone trying to go ER, FP, or IM, but ER,FP, and IM are certainly not the most competitive residencies to apply for. Choosing to go primary care vs. specializing is really a personal choice that has more to do with someone's lifestyle choices and interests...lots of people choose to go ER or FP for the shorter residency, closer patient interaction, and increased time/flexibility for family life. It really doesn't say anything about the prestige of the school or the quality of curriculum and faculty.

So just because 56% of graduates at school X chose to go into primary care doesn't necessarily mean the school is excellent at educating primary care phsyicians. All it really indicates is that the school seems to attract/accept more people who are good candidates to go into primary care.

On the other hand, those "residency director" scores might be a valid variable. Looking at those ratings--and those ratings alone--might actually be relevant to choosing a school.

 

[deleted77919]

I know that the primary care rankings factor in the percentage of graduates entering primary care residencies. Not sure what statistical weight this percentage gets in figuring the final rankings . . .

It is weighted 30% of the total score.

 

[medhacker]

EM isnt considered primary care. FP, IM, Peds, Ob/Gyn

Source please,

It may vary but it has always been presented as primary care to me.

 

[MNsocsci]

I didn't think Ob/Gyn was usually included in primary care, so I checked:

http://www.usnews.com/usnews/edu/grad/rankings/about/06med_meth_brief.php


Primary-Care Rate (.30 in the primary-care medical school model only) the percentage of M.D. or D.O. school graduates entering primary-care residencies in the fields of family practice, pediatrics, and internal medicine was averaged over 2002, 2003, and 2004.

 

[luke77]

Yeah, these rankings do seem kind of bogus...the percentage of your students entering primary care doesn't really measure how well prepared the students are in a primary care setting.

 

[Zoom-Zoom]

I didn't think Ob/Gyn was usually included in primary care, so I checked:

http://www.usnews.com/usnews/edu/grad/rankings/about/06med_meth_brief.php


Primary-Care Rate (.30 in the primary-care medical school model only) the percentage of M.D. or D.O. school graduates entering primary-care residencies in the fields of family practice, pediatrics, and internal medicine was averaged over 2002, 2003, and 2004.

that's because obgyn counts as "surgery"

 

[deleted77919]

that's because obgyn counts as "surgery"

I think the confusion stems from the primary care classification by the National Health Service Corp. Qualifying residencies are:

Family medicine
General pediatrics
General internal medicine
Obstetrics/gynecology
Psychiatry

Source: http://nhsc.bhpr.hrsa.gov/join_us/scholarships.cfm

 

[Rafa]

Regardless of what 'counts' and what doesn't as PC, I think the question we'd all like an answer to is 'are the US rankings accurate'?

I don't know. The ranking methodology doesn't seem to qualify exactly *what* is used to rank schools for their primary care capabilities.

 

[Iwy Em Hotep]

So just because 56% of graduates at school X chose to go into primary care doesn't necessarily mean the school is excellent at educating primary care phsyicians. All it really indicates is that the school seems to attract/accept more people who are good candidates to go into primary care.

Maybe true. But it certainly says something when a school (I go to UW) attracts so many students interested in primary care and maintains their interest during the clinical years, when many students start looking towards fields that pay more/have better hours.

 

[DarkFark]

Not that I think highly about the research rankings, but what is the point of ranking primary care medical schools, given that most primary care residencies (especially IM and FP) are less competitive to get into, no matter where you went to medical school.

Just so we're clear, I'm in no way bashing primary care, I just can't fathom why, if you don't have to ace your boards to get into it, then where you go to med schoool matters at all.

 

[Centinel]

Not that I think highly about the research rankings, but what is the point of ranking primary care medical schools, given that most primary care residencies (especially IM and FP) are less competitive to get into, no matter where you went to medical school.

Just so we're clear, I'm in no way bashing primary care, I just can't fathom why, if you don't have to ace your boards to get into it, then where you go to med schoool matters at all.

The logical answer would be that some schools better prepare you to be a primary care clinician. Of course, that is immaterial to this discussion because the US News Primary Care rankings only rank based on quantity of students going into primary care, not based on quality. So your question still stands, and I doubt anyone will be able to give a good answer.

 

[DarkFark]

The logical answer would be that some schools better prepare you to be a primary care clinician. Of course, that is immaterial to this discussion because the US News Primary Care rankings only rank based on quantity of students going into primary care, not based on quality. So your question still stands, and I doubt anyone will be able to give a good answer.

I agree completely- some schools will prepare you better. Of course, this has to do with curriculum and faculty, not the ham-fisted statistics that generate rankings.

If I were going into PC, I would base my school selection purely off of 1) Location 2) Cost and 3) Gut feeling/Interview impression.

 

[MNsocsci]

The logical answer would be that some schools better prepare you to be a primary care clinician. Of course, that is immaterial to this discussion because the US News Primary Care rankings only rank based on quantity of students going into primary care, not based on quality. So your question still stands, and I doubt anyone will be able to give a good answer.

I am usually the first to criticize the rankings as unscientific, but I just have to respond to this post for the sake of clarity. The U.S. News Primary Care rankings are NOT only based on the quantity of students going into primary care. If that were true, wouldn't the DO schools be ranked higher? Look at the link I put in a previous post that gives the methodology of the rankings. Percentage of students entering PC only accounts for 30% of the ranking. Other considerations are selectivity, reputation, etc.

I think that people should ignore rankings for the most part and pick a school that is the best fit for them, but the rankings aren't as baseless as some people are making them out to be.

 

[deleted77919]

The ranking methodology doesn't seem to qualify exactly *what* is used to rank schools for their primary care capabilities.

They do quantify exactly wehat is used to rank the schools. See the link MNsocsci posted. They break down every catagory and what percentage of the total score that catagory encompasses.

I think the residency directors scores are important . . . but as far as the other catagories (specifically that the largest catagory point wise is how many enter primary care, 30% of the total score) the rankings are not set up in the manner I would choose.

 

[CytochromeP450]

USNews = Lets sell the SAME information over and over again and make money doing it!

 

[NehsNairb]

The methodology for primary care definitely seems flawed. A significant fraction of people who enter primary care residencies will eventually decide to subspecialize within their field of practice. IM and pediatric residents can become cardiologists, oncologists, etc which are not primary care physicians. A better indicator would be to check the percentage of alumni who remained in primary care 5 or 10 years after residency.

 

[OSUdoc08]

Source please,

It may vary but it has always been presented as primary care to me.

Yes, EM is considered primary care.

 

[Rafa]

They do quantify exactly wehat is used to rank the schools. See the link MNsocsci posted. They break down every catagory and what percentage of the total score that catagory encompasses.

I've read that page. They simply give the percentage of graduates entering primary care - and we can't even agree on what p.c. is. What they did is the equivalent of asking someone what the best cities are to live in in the US, and having the person give you a list of the top ten cities with the lowest suicide rates - it doesn't tell you anything.

 

[OSUdoc08]

I've read that page. They simply give the percentage of graduates entering primary care - and we can't even agree on what p.c. is. What they did is the equivalent of asking someone what the best cities are to live in in the US, and having the person give you a list of the top ten cities with the lowest suicide rates - it doesn't tell you anything.

The rankings aren't simply based upon those entering primary care. This is only a small percentage of the calculation.

 

[Rafa]

The rankings aren't simply based upon those entering primary care. This is only a small percentage of the calculation.

See below:

Quality Assessment (weighted by .40)

* Peer Assessment Score (.20 for the research medical school model, .25 for the primary-care medical school model)
In the fall of 2004, medical and osteopathic school deans, deans of academic affairs, and heads of internal medicine or the directors of admissions were asked to rate programs on a scale from "marginal" (1) to "outstanding" (5). Survey populations were asked to rate program quality for both research and primary-care programs separately on a single survey instrument. Those individuals who did not know enough about a school to evaluate it fairly were asked to mark "don't know." A school's score is the average of all the respondents who rated it. Responses of "don't know" counted neither for nor against a school. About 53 percent of those surveyed responded.


* Assessment Score by Residency Directors (.20 for the research medical school model, .15 for the primary-care medical school model)
In the fall of 2004, residency program directors were asked to rate programs on two separate survey instruments. One survey dealt with research and was sent to a sample of residency program directors in fields outside primary care, including surgery, psychiatry, and radiology. The other survey involved primary care and was sent to residency directors in the fields of family practice, pediatrics, and internal medicine. Survey recipients were asked to rate programs on a scale from "marginal" (1) to "outstanding" (5). Those individuals who did not know enough about a program to evaluate it fairly were asked to mark "don't know." A school's score is the average of all the respondents who rated it. Responses of "don't know" counted neither for nor against a school. About 29 percent of those surveyed for research medical schools responded. Twenty-eight percent responded for primary-care.

Primary-Care Rate (.30 in the primary-care medical school model only) the percentage of M.D. or D.O. school graduates entering primary-care residencies in the fields of family practice, pediatrics, and internal medicine was averaged over 2002, 2003, and 2004.

Student Selectivity (.20 in the research medical school model, .15 in the primary-care medical school model)

* Mean MCAT Score (.13 in the research medical school model, .0975 in the primary-care medical school model) the mean composite Medical College Admission Test score of the 2004 entering class.


* Mean Undergraduate GPA (.06 in the research medical school model, .045 in the primary-care medical school model) the mean undergraduate grade-point average of the 2004 entering class.

* Acceptance Rate (.01 in the research medical school model, .0075 in the primary-care medical school model) the proportion of applicants to the 2004 entering class who were offered admission.

Faculty Resources (.10 in the research medical school model, .15 in the primary-care medical school model) resources were measured as the ratio of full-time science and clinical faculty to full-time M.D. or D.O. students in 2004.

Overall Rank: Indicators were standardized about their means, and standardized scores were weighted, totaled, and rescaled so that the top school received 100; other schools received their percentage of the top score.

These are basically popularity contests - almost every single measure is a poll amounting to "which is your favorite school?" It may be quantified in the sense that numbers are aggregated, but all it tells you is which med schools different groups of people liked the most. It's slightly more complex than generating a poll in the pre-allo, allo, and residency forums asking students to rank their opinions of the top ten medical schools in the country.

 

[OSUdoc08]

See below:



These are basically popularity contests - almost every single measure is a poll amounting to "which is your favorite school?" It may be quantified in the sense that numbers are aggregated, but all it tells you is which med schools different groups of people liked the most. It's slightly more complex than generating a poll in the pre-allo, allo, and residency forums asking students to rank their opinions of the top ten medical schools in the country.

This is true. However, you must also put the "research" rankings in that category, since many of the methodologies are the same. Many people worship the research rankings and dismiss the primary care rankings entirely. However if you consider them, they must be considered together, since the foundation of the rankings are the same for both.

Yes, one includes research, and one includes primary care. However, it is more of a popularity contest for both.