what top ten med schools produce the best-trained physicians?

[Law2Doc]

Again- I'm prefacing this by reminding you this is just my unqualified opinion.

Although Hopkins clearly has some of the best hospitals in the world and sees some of the most unique and exciting cases in existence, the school has a big focus on research that detracts a little from the clinical education. You just can't do everything, and a large portion of Hopkins students are preparing for acadmic medicine careers and need to focus on research.

Penn seems to focus slightly less on research and slightly more on clinical training than Hopkins. I also think the 1.5 yr science curriculum at Penn facilitates a better clinical experience because students get into the clinics earlier and have more time to space our their clinical requirements and electives. For these reasons, I'd rank Penn above Hopkins. The difference is not huge though- that's why I put them one after the other.

I actually know someone from the prior cycle who, after careful analysis and discussions with many people, chose Hopkins over Penn because Penn was the one too focused on research. I'm not so sure you are right on this -- Penn is certainly a research juggernaut in its own right.

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[Art]

This thread really is asking a group of people their opinion about the best clinical training for medical students. Unfortunately, the people who are responding are not in a great position to judge that clinical training because of limited experience and limited exposure.

This is one area where the US News ranking can make some sense if you look at the assessment score by residency directors. The residency directors recruit the medical students into their programs and then have direct responsibility to train them. They are in an ideal position to decide how well the student was trained. Another advantage of the US News residency directors ranking is that they ask the opinion of several hundred residency directors. A larger sample size should have greater power to be accurate.

With that preamble, here are the current scores:

4.8, Harvard, Hopkins
4.6, Duke,
4.5, U Mich, Stanford, UCSF
4.4, Columbia, Penn, Wash U

 

[huknows00]

Just like all things subjective and involving no clear and definite metric, which top ranked school produces "better" physicians is a moot discussion that probably has been debated year after year by SDNer's to death. Ideally, how "good" a physician is can only be judged by each individual patient that the particular physician works with, and that cannot possibly be measured for everyone who ever graduated from an institution and for every patient that they've ever seen. So practically, from the point of training, residency director's survey is probably the closest we can get to get any useful idea of how well trained a physician is from each particular school.

I think the above list is probably as good as your're get, but the actualy order of the schools is really not that concrete.

 

[gujuDoc]

I think you might want to go to the allopathic board and ask individual posters from the various schools how they feel about their clinical curricula. Also, maybe the residency forum might be able to help you out.

You are most likely to get more informative answers from then, then other people who are also applying and whom have not yet started med school.

The opinion of current med students and residents might hold more weight and be more objective.

 

[footcramp]

I just know that at UMich, you get WORKED your third year. They will take you DOWN, deprive you of all dignity, but you'll emerge a butterfly. I'm still mentalling perparing myself for the beatdown. Does Harvard do this?

I feel like premeds are incredibly misled by what they hear during interviews and on SDN. This kind of myth spreads so easily.

Michigan's third year is not as rigorous as people make it seem. In terms of hours I would guess that it's much more benign than other programs. The most frequent call I've taken this year was about q5, and that was in pediatrics. In medicine I was q6, q8, and no call for one month. In surgery I had "call" until 10pm every week or so. In neurology I had "call" until midnight maybe q14 days. In family medicine I had no call. In psychiatry I was about q12 or so, and those "calls" were 6 hour blocks. I don't know if premeds realize what this means, but it basically translates to an incredibly benign third year.

Michigan does not "take you DOWN, deprive you of all dignity." 3rd year students here are treated as people who are just starting out their clinical training and are new to how the hospital works. We make mistakes, we do things the wrong way. People will correct us for this. To some that is demeaning, but who cares about those primadonna crybabies. I've only heard rare stories of outright demeaning behavior, and I personally have not witnessed a single incident. Most of these rumors are started by people who take a little criticism the wrong way.

As far as "emerging as a butterfly", no one who gets beatdown and demeaned emerges as a butterfly. Instead those people will become bitter and angry. Fortunately I think the vast majority of our experiences as third years are far from demeaning.

One thing I will say about the Michigan clinical experience is that they expect you to perform more than "just a third year student." They expect you to keep track of details, to leave no stone unturned. I think there is an attitude here that you are supposed to check all the facts yourself and never take what's written in the prior notes at face value. It's about being accountable yourself for everything, and that makes good clinicians. Is that "rigorous" or "hard core"? I don't think so, I think that's a basic work ethic that all physicians should have. Michigan does a good job of instilling that mentality.

 

[Orthodoc40]

guys, stop hating on Harvard! You know you would be there in a split-second if you had the chance. I know I would. 😉

Not true. There are at least 2 schools I would go to over Harvard (if I ever had the choice!)

 

[gujuDoc]

Not true. There are at least 2 schools I would go to over Harvard (if I ever had the choice!)

True. I know people who would go other places over HMS given the choice based on the program, curricula, and financial help that may be offered by other institutions.

 

[ChocolateKiss]

This thread really is asking a group of people their opinion about the best clinical training for medical students. Unfortunately, the people who are responding are not in a great position to judge that clinical training because of limited experience and limited exposure.

This is one area where the US News ranking can make some sense if you look at the assessment score by residency directors. The residency directors recruit the medical students into their programs and then have direct responsibility to train them. They are in an ideal position to decide how well the student was trained. Another advantage of the US News residency directors ranking is that they ask the opinion of several hundred residency directors. A larger sample size should have greater power to be accurate.

With that preamble, here are the current scores:

4.8, Harvard, Hopkins
4.6, Duke,
4.5, U Mich, Stanford, UCSF
4.4, Columbia, Penn, Wash U

Sorry, these scores don't say anything about who is a good doc. They don't ask residency directors which schools turn out the best residents. Rather, they ask them to rank the schools. A residency director might think Harvard is the top, most prestigious school without believing that the residents he's seen from Harvard are good clinicians. These scores are extremely important because your school's rep influences your ability to get a good residency. However, the scores don't neccessarily correlate to good clinical training.

 

[wetlightning]

amen, chocolate kiss!

 

[wetlightning]

Sorry, these scores don't say anything about who is a good doc. They don't ask residency directors which schools turn out the best residents. Rather, they ask them to rank the schools. A residency director might think Harvard is the top, most prestigious school without believing that the residents he's seen from Harvard are good clinicians. These scores are extremely important because your school's rep influences your ability to get a good residency. However, the scores don't neccessarily correlate to good clinical training.

yes, my point in asking which top ten schools provided best training was not to ask for a regurgitation of rankings. i'm asking --within the top 10-- which schools are known to provide the strongest clinical foundation. of course harvard and hopkins are ranked the highest by residency directors...this is the same self-perpetuating crap that consistently gets hms the number one spot. (i exclude hopkins b/c i think that it is a school that has genuinely earned its stature). the usnews rankings are suspect, b/c they base so much on an intangible like general reputation or on something like NIH dollars earned...which has little to no correlation with the quality of medical education provided.

 

[jebus]

So, are you essentially asking what the best primary care schools are? Because I imagine those probably train physicians to be good listeners, empathetic, to be humane and caring, and all of the other non-cognitive attributes one associates with gifted physicians.

 

[wetlightning]

no. my question was sparked b/c i heard --from several students and physicians--that there were a few top ten schools (namely hms and stanford) whose educational quality did not live up to their general reputation. so i'm trying to gauge which top 10 research schools have strong curricula and training as well as excellent grant support and faculty research.

 

[happydays]

I feel like premeds are incredibly misled by what they hear during interviews and on SDN. This kind of myth spreads so easily.

Michigan's third year is not as rigorous as people make it seem. In terms of hours I would guess that it's much more benign than other programs. The most frequent call I've taken this year was about q5, and that was in pediatrics. In medicine I was q6, q8, and no call for one month. In surgery I had "call" until 10pm every week or so. In neurology I had "call" until midnight maybe q14 days. In family medicine I had no call. In psychiatry I was about q12 or so, and those "calls" were 6 hour blocks. I don't know if premeds realize what this means, but it basically translates to an incredibly benign third year.

Michigan does not "take you DOWN, deprive you of all dignity." 3rd year students here are treated as people who are just starting out their clinical training and are new to how the hospital works. We make mistakes, we do things the wrong way. People will correct us for this. To some that is demeaning, but who cares about those primadonna crybabies. I've only heard rare stories of outright demeaning behavior, and I personally have not witnessed a single incident. Most of these rumors are started by people who take a little criticism the wrong way.

As far as "emerging as a butterfly", no one who gets beatdown and demeaned emerges as a butterfly. Instead those people will become bitter and angry. Fortunately I think the vast majority of our experiences as third years are far from demeaning.

One thing I will say about the Michigan clinical experience is that they expect you to perform more than "just a third year student." They expect you to keep track of details, to leave no stone unturned. I think there is an attitude here that you are supposed to check all the facts yourself and never take what's written in the prior notes at face value. It's about being accountable yourself for everything, and that makes good clinicians. Is that "rigorous" or "hard core"? I don't think so, I think that's a basic work ethic that all physicians should have. Michigan does a good job of instilling that mentality.

But isn't it true that in the pass, high pass, honors system, very few can obtain high pass and honors? What do we have to do to "honor" or get a "high pass" in our clinicals?

 

[MNsocsci]

Has anyone else read the critique of the U.S. News ranking system that came out a few years ago in the Journal of Academic Medicine? Regarding the ratings from residency directors, it says,

"U.S. News survey response rates from deans and senior faculty and residency program directors about the academic reputations of American medical schools are insufficient to reach valid conclusions."

The response rates from residency program directors were about 40-45%, which is, of course, considered not reliable. Anyway, it's an interesting article that reminds us once again not to base our decisions on rankings.


"America's Best Medical Schools: A Critique of the U.S. News & World Report Rankings"
http://www.academicmedicine.org.floyd.lib.umn.edu/cgi/content/full/76/10/985

 

[happydays]

Has anyone else read the critique of the U.S. News ranking system that came out a few years ago in the Journal of Academic Medicine? Regarding the ratings from residency directors, it says,

"U.S. News survey response rates from deans and senior faculty and residency program directors about the academic reputations of American medical schools are insufficient to reach valid conclusions."

The response rates from residency program directors were about 40-45%, which is, of course, considered not reliable. Anyway, it's an interesting article that reminds us once again not to base our decisions on rankings.


"America's Best Medical Schools: A Critique of the U.S. News & World Report Rankings"
http://www.academicmedicine.org.floyd.lib.umn.edu/cgi/content/full/76/10/985

Could you please post the text? I can't see it since I don't have a login.

 

[MNsocsci]

Could you please post the text? I can't see it since I don't have a login.

Err... It's 8 pages long. I was hoping that people could access it if they went through their school's library system--that's how I did it.

Here are some other interesting parts from the article:

"There are at least five reasons to criticize the U.S. News & World Report rankings on methodologic grounds: (1) narrow focus, (2) inadequacy of response rates, (3) measurement error, (4) unchanging stability of results, and (5) confounding."

"Second, the annual U.S. News & World Report ranking of American medical schools is simply a demonstration of ‘‘Matthew effects’’ in medical education.17 This is drawn from the New Testament book of Matthew (25: 29), which states, ‘‘For to every one who has will more be given, and he will have abundance; but from him who has not, even what he has will be taken away.’’ Columbia University social scientist Robert Merton, who coined the term for a 1968 article in the journal Science, described its practical consequences. Merton states, ‘‘One institutional version of the Matthew effect . . . is expressed in the principle of cumulative advantage that operates in many systems of social stratification to produce the same result: the rich get richer at a rate that makes the poor become relatively poorer.’’17, p. 62 [Emphasis added.] Thus it is no surprise that a small minority of American medical schools are consistently named ‘‘top’’ schools in annual U.S. News rankings while the majority of accredited medical schools receive no mention."

 

[Mr.Neuron]

So, Brown University never comes into the mix? I've always heard good things about Brown. Any views on that? Oh, and wasn't Harvard said to have had a low percentage of satisfied students because the teachers were inaccessible? So, in theory, if you can't access the people with the information, how are you to learn what will be required of you in the future? Though I suppose the Brown PLME program can be a bit too liberal, thus excluding itself from the assembled list.

 

[wetlightning]

brown isn't ranked in the top 10 (according to the usnews rankings)

 

[NotAnMD]

chuck norris trained dr. kevorkian.
-mota

HE - LARIOUS....well done my man, well done

 

[ChocolateKiss]

brown isn't ranked in the top 10 (according to the usnews rankings)

hehe, poor wetlightning...no one seems to understand your question. it was clear to me if that makes you feel better

 

[gujuDoc]

hehe, poor wetlightning...no one seems to understand your question. it was clear to me if that makes you feel better

I think the problem is that the majority of the posters on this part of SDN are premeds. Premeds don't really have much knowledge about a program they are not part of. So the wiser thing would be to go scroll to the medical student forums and residency forums. I think they might be able to be of better assistance. BTW, Wetlightning, congratulations and good luck on wherever you decide.

 

[wetlightning]

hehe, poor wetlightning...no one seems to understand your question. it was clear to me if that makes you feel better

hahaha, thanks chocolatekiss 🙂

and thanks guju!

 

[wetlightning]

mods, could you move this to allo? mucho thanks