Which medical schools make the best doctors?

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I don't think research rankings really parallel the degree to which a school makes good doctors
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3 of the best doctors I've worked with went to Carribean (SGU). 1 went to Howard. Also worked with many excellent doctors from Western COMP. I work as a medical scribe in the ED btw, probably worked with over 40+ physicians across several hospitals.

Where you go for residency matters more than where you went for medical school.
 
MareNostrummm said:
3 of the best doctors I've worked with went to Carribean (SGU). 1 went to Howard. Also worked with many excellent doctors from Western COMP. I work as a medical scribe in the ED btw, probably worked with over 40+ physicians across several hospitals.

Where you go for residency matters more than where you went for medical school.
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Preach.
 
The worst doctor I ever worked with was a MD/PhD from one of the schools that frequently vies for the top position in the country. He literally couldn't diagnose a tension pneumothorax and was trying to order albuterol for a patient that was dying. One day I hope to go to his practice and present him with a golden medal for the worst physician I've ever had the displeasure of working with.
 
MareNostrummm said:
3 of the best doctors I've worked with went to Carribean (SGU). 1 went to Howard. Also worked with many excellent doctors from Western COMP. I work as a medical scribe in the ED btw, probably worked with over 40+ physicians across several hospitals.

Where you go for residency matters more than where you went for medical school.
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Aside from doing well on Step 1 and in clinical rotations, what do you think are the most important things that contribute to getting into a good residency?
 
Mad Jack said:
The worst doctor I ever worked with was a MD/PhD from one of the schools that frequently vies for the top position in the country. He literally couldn't diagnose a tension pneumothorax and was trying to order albuterol for a patient that was dying. One day I hope to go to his practice and present him with a golden medal for the worst physician I've ever had the displeasure of working with.
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Some mud phuds just want to be left alone in the lab lol
 
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MareNostrummm said:
3 of the best doctors I've worked with went to Carribean (SGU). 1 went to Howard. Also worked with many excellent doctors from Western COMP. I work as a medical scribe in the ED btw, probably worked with over 40+ physicians across several hospitals.

Where you go for residency matters more than where you went for medical school.
Click to expand...
How does being a scribe allow one to evaluate who is and is not a good doctor? I’m genuinely curious
 
jcorpsmanMD said:
How does being a scribe allow one to evaluate who is and is not a good doctor? I’m genuinely curious
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Let's see... having eyes and ears and using those to observe what other people think about said doctor (including fellow doctors perhaps), outcomes for patients, how they talk to patients? This view that you have to be a medical student, resident or attending to evaluate another doctor is naive, if they have poor communication skills or show incompetence/deer in the headlights when put in critical roles it's easy to tell, you don't need an MD to see that.
 
jcorpsmanMD said:
How does being a scribe allow one to evaluate who is and is not a good doctor? I’m genuinely curious
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During shift change when the "good doctors" come on everyone cheers for joy (not exaggerating)... When the "bad doctors" come on everyone sighs and shakes their head knowing it's going to be a bad night. Most doctors are in the middle.

1. Does the staff respect and trust them? (Word gets around fast, you will know who the competent doctors are very quickly by talking to the nurses, techs, and other doctors).
2. Can they handle the pace of the ED? Are they stressed out and screaming at people over minor things?
3. Orders (Are they ordering unnecessary tests that clog the ED and increase patient length of stay?) Do other doctors constantly question their orders? Does the next doctor rewrite all the previous orders after sign out?
4. Bedside manner (rude, egotistical, genuinely empathetic)?
 
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PhiGamDoc said:
Let's see... having eyes and ears and using those to observe what other people think about said doctor (including fellow doctors perhaps), outcomes for patients, how they talk to patients? This view that you have to be a medical student, resident or attending to evaluate another doctor is naive, if they have poor communication skills or show incompetence/deer in the headlights when put in critical roles it's easy to tell, you don't need an MD to see that.
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Right. According to that view, as a patient I shouldn't be able to tell if my doctor is competent or not.
 
AnatomyGrey12 said:
Most patients can't tell if their "doctor" is either a doctor or a nurse, let alone how competent they actually are. It's baffling really. I definitely agree that ancillary staff who spend lots of time in a hospital and around physicians can definitely know who is good and who isn't.
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I guess my experiences have been different then. I'm referring to doctors who openly treat you as if you're inferior, making "jokes" and not picking up on when they've gone too far. Pretty much a lack of communication skills. (P.S. not directly to me but when I've had to take older family members to the clinic)
 
MareNostrummm said:
3 of the best doctors I've worked with went to Carribean (SGU). 1 went to Howard. Also worked with many excellent doctors from Western COMP. I work as a medical scribe in the ED btw, probably worked with over 40+ physicians across several hospitals.

Where you go for residency matters more than where you went for medical school.
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gonnif said:
Much, Much more
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But to land a solid residency depends partly on where you went to medical school. Unless you're claiming there is zero correlation, which is not true.

MGH is an awesome place to be an internal medicine resident but matching there would depend on board scores, letters, clinical grades, research... and medical school graduated. There's a real and significant reason for the disadvantage faced by US DOs and IMGs for matching placements, and there are also intra-US MD variations that are taken into account even if they may be significantly minor in comparison.

Basically, where you go for residency depends in part on where you go for medical school which in turn depends in part on where you go for undergrad.
 
Lawper said:
But to land a solid residency depends partly on where you went to medical school. Unless you're claiming there is zero correlation, which is not true.

MGH is an awesome place to be an internal medicine resident but matching there would depend on board scores, letters, clinical grades, research... and medical school graduated. There's a real and significant reason for the disadvantage faced by US DOs and IMGs for matching placements, and there are also intra-US MD variations that are taken into account even if they may be significantly minor in comparison.

Basically, where you go for residency depends in part on where you go for medical school which in turn depends in part on where you go for undergrad.
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The relationship isn't dependent. It helps to go to a high ranked medical school. But it doesn't "depend" on it.
 
Lawper said:
Basically, where you go for residency depends in part on where you go for medical school which in turn depends in part on where you go for undergrad.
Click to expand...


With top stats in hand, it helps land a top residency if you went to a MD school that has a MSTP program because imho the residency program directors are more impressed and familiar with those schools. However, getting into one of those 40 med schools does not require coming from a notable undergrad. Many of those med schools are state schools which routinely provide preferred enrollment to their state's students who are coming from a variety of schools...ranging from nationally ranked to unknown outside their region.
 
The problem with this question is that too many factors go into people becoming "good doctors."

For example, a recent study out of Princeton University found that physicians who graduated from top ranked medical schools tended to sparingly prescribe opioid medications when compared to those who graduated from lower-ranked medical schools. Paper: http://www.nber.org/papers/w23645.pdf

That doesn't make the graduates of lower-ranked schools incompetent physicians; they could very well excel in other areas. I read a lot of articles relating to this study after it was released and people often extrapolated that this study shows we have a lacking medical educational system in the U.S. (I tend to disagree).

They talk about DO-prescribing habits in the article as well (quoted below):
"Comparing the prescribing habits of DOs to MDs, we see that DOs in general practice prescribe similarly to GPs trained at the lowest ranked US schools. However, at an average of over 400 opioid prescriptions annually per physician, DOs across all specialties write more opioid prescriptions per prescriber than MDs trained either domestically or abroad."

Also they go into foreign-trained doctors practicing in the U.S. I know this paper is slightly off-topic but I found it fascinating and would be interested in hearing SDN's thoughts on it.
 
And there we go from an actual discussion of good vs bad doctors to med school rank. Listen, the God honest truth is that everything matters to some degree. Where you go to school matters, what your board scores are matters, the amount of research you do matters, you basic science grades matter, where your family lives and SO can find jobs matters. EVERYTHING is at least factored into the decision of whether or not you apply and even match into a particular residency. I've been on that side and have also been part of the selection committees and know for a fact we look at all these. Do some things matter more than others? Of course but that's likely going to depend on which program and who the PD is. But ultimately, it really boils down to "fit". Does the residency vibe/nature "fit" your personality and does your personality mesh with the people in that residency. Right now everyone thinks prestige and name programs but by the time you get to that point you may have gotten married, found the love of your life and/or some other life event happens that you realize those things don't matter and the only thing important is your happiness and the happiness of the people you care about.

And to put things in perspective. We've had residents from Harvard and UCLA SOM who couldn't cut it and were asked to leave and residents from U of Hawaii who swept the resident awards at graduation. So instead of thinking the place you go to (SOM, residency) makes a good doctor, instead you should focus on taking every advantage of learning and working as hard as possible wherever you may be so you can be the best doctor out there. No residency training can prepare you for all the problems you'll encounter but self motivated learning and willingness to stay late and see every case you can will.
 
Each medical school produces both incompetent and competent physicians. I'll see where I fall in the spectrum.
 
Lawper said:
But to land a solid residency depends partly on where you went to medical school. Unless you're claiming there is zero correlation, which is not true.

MGH is an awesome place to be an internal medicine resident but matching there would depend on board scores, letters, clinical grades, research... and medical school graduated. There's a real and significant reason for the disadvantage faced by US DOs and IMGs for matching placements, and there are also intra-US MD variations that are taken into account even if they may be significantly minor in comparison.

Basically, where you go for residency depends in part on where you go for medical school which in turn depends in part on where you go for undergrad.
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But the issue is that residency requirements are so strict that every residency will train you to be a competent, good physician and that a more prestigious residency does NOT = better doctor. I will use general surgery as an example and one I've seen multiple surgeons use on this site before: the Mayo Clinic is a prestigious place to train and will land you very good academic jobs or fellowships if you want them, yet it is known that the residents there do not operate as much and lack operating skills due to the big name surgeons doing a lot of the cases. However, some smaller, less prestigious community programs produce grads that are extremely proficient surgeons that are excellent at what they do.

Becoming a great doctor is largely separate of the school or residency you go to and is a product of individual time and effort. Every school or residency will give you the tools to do so.
 
PreMedMissteps said:
With top stats in hand, it helps land a top residency if you went to a MD school that has a MSTP program because imho the residency program directors are more impressed and familiar with those schools. However, getting into one of those 40 med schools does not require coming from a notable undergrad. Many of those med schools are state schools which routinely provide preferred enrollment to their state's students who are coming from a variety of schools...ranging from nationally ranked to unknown outside their region.
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There is still a varying degree of bias by admissions to those coming from elite undergrads. The way I used “depend” in that sentence doesn’t mean “required” but a factor that is still considered by admissions regardless. To what extent, who knows, but it isn’t zero.

AnatomyGrey12 said:
But the issue is that residency requirements are so strict that every residency will train you to be a competent, good physician and that a more prestigious residency does NOT = better doctor. I will use general surgery as an example and one I've seen multiple surgeons use on this site before: the Mayo Clinic is a prestigious place to train and will land you very good academic jobs or fellowships if you want them, yet it is known that the residents there do not operate as much and lack operating skills due to the big name surgeons doing a lot of the cases. However, some smaller, less prestigious community programs produce grads that are extremely proficient surgeons that are excellent at what they do.

Becoming a great doctor is largely separate of the school or residency you go to and is a product of individual time and effort. Every school or residency will give you the tools to do so.
Click to expand...

I was largely disagreeing with the notion that where you go for residency matters more than where you go for medical school since that doesn’t make sense and it’s misleading. An important factor to match into a good residency is the medical school attended.

While I generally agree with your underlying message, the idea on what makes a good doctor is based on subjective and arbitrary criteria though that it’s hard to reliably compare. Clinical skills improve with research, and academic medical centers do groundbreaking research to make new discoveries and improve on prior principles. Some may argue that surgery has improved significantly because of research to minimize the operating risk (this is why minimally invasive procedures are largely popular today despite few decades ago, open surgery was the norm).

If research does advance and shape clinical skills, then where you went to residency and fellowship can matter significantly, and it’s better to do training in major academic medical centers.

gonnif said:
That is a far too simplistic view of how the interplay of factors works here and to the question asked, which medical school makes the best doctors

1) Do not confuse getting into a specialty with getting into a program. The more highly ranked medical schools may send more graduates to competitive specialties (derm, ortho, plastics, etc). However, that does not say anything about the ranking of the specific program/hospital in the specialty. It is the program/hospital in your chosen specialty that is much, much more important. This is what doctors want to know about other docs. And a program in one field at hospital X may be viewed much different than other specialty at the same hospital (ie Derm is good but Ortho sucks at Hospital X). So if your connection to a good medical school is good enough to get you into a bottom-third Orthod residency make you a better physician than a grad from a mid-tier medical school who gets into a highly rated IM residency? That is apples to oranges aint it?
2) About 50% of residency directors overall cite "graduate of a highly-regarded US medical school" as a factor of consideration, below some 20+ other factors
3) Additionally, it ranks medical school the same or below about 20 factors in importance for those directors who do cite it
4) The level of these factors will change dramatically across each specialty
5) Personally, I see that networking via the dean's letter or connections across faculty much, much more important than the school ranking. That is a clinical professor you have for your rotation may know, went to school, was in residency, professionally connection may know the PD or a doc in the specialty/program you want. Those letters carry great weight. The influence of small-group dynamics within residency selection is enormous
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1. I’m pretty sure MGH is known for its solid internal medicine program, hence that specific example. I’m controlling the specialty to consider how the most selective and elite programs would behave. I’m aware that residency program quality varies by specialty but in any case, the most selective programs in any specialty can probably choose to consider less important factors when making the final decision.

2-4. I thought it said 56% with a mean importance rating of 3.8. In any case, that isn’t close to 0%, even when looking at program directors for each specialty. And that’s a pretty significant importance rating (unless you’re viewing anything above 4.5 to be critical, 4 to be important etc.). Someone at some program apparently cares that their potential interns are from graduates from top schools.

5. Except top schools inherently offer better resources and better networking opportunities, which could explain a bias from some program directors for graduates from top schools. The other factors you mentioned are important but the key thing is program directors don’t simply ignore medical school name/type altogether when making decisions. They have their own cognitive biases.
 
Mad Jack said:
The worst doctor I ever worked with was a MD/PhD from one of the schools that frequently vies for the top position in the country. He literally couldn't diagnose a tension pneumothorax and was trying to order albuterol for a patient that was dying. One day I hope to go to his practice and present him with a golden medal for the worst physician I've ever had the displeasure of working with.
Click to expand...
Yeah but what was his MCAT? What was his Orgo grade? Did he have over 200 shadowing hours?
 
Lawper said:
Clinical skills improve with research, and academic medical centers do groundbreaking research to make new discoveries and improve on prior principles
Click to expand...

Lawper said:
If research does advance and shape clinical skills,
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I would completely disagree with the idea that clinical skills improve with research, unless you mean clinical skills in the context of the medical profession as a whole. You have to define what "better" means. Better at what? If you are uniquely talking about a physician that deals solely on one rare disorder or specializes in one certain surgical procedure then yeah the big, quaternary academic center program guy is "better." If you mean (again with the surgery analogy) the guy who has an incredibly low infection rate in the community who does a million appys a year then he would be considered "better." It's a moving target
 
AnatomyGrey12 said:
I would completely disagree with the idea that clinical skills improve with research, unless you mean clinical skills in the context of the medical profession as a whole. You have to define what "better" means. Better at what? If you are uniquely talking about a physician that deals solely on one rare disorder or specializes in one certain surgical procedure then yeah the big, quaternary academic center program guy is "better." If you mean (again with the surgery analogy) the guy who has an incredibly low infection rate in the community who does a million appys a year then he would be considered "better." It's a moving target
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That’s really the underlying problem of this thread. It’s impossible to objectively determine what “better” means and what “good doctor” means. There are subjective and arbitrary criteria involved.

And yeah by research, i’m referring to the overall medical profession.
 
gonnif said:
Oh, on this note lets clarify something. The "school rank" that premeds use, especially that god-awful hospital marketing material from Useless Snooze and Wuss Report, or whatever its called, has nothing to do with the rank that PDs use. PD directors are much more likely to be concerned with the reputation of the specialty field or department of the medical school you come from or the general reputation of how hospital ready their graduates are, that research budget and the rest...
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I've seen this thrown around a lot, the PD ranking, but have never asked about it. Is there a link for that or no?
 
Also note that deeper in the document you can find the breakdown for each specialty. So for example for Ortho surg, AOA being important jumps up to 90%
 
AnatomyGrey12 said:
Most patients can't tell if their "doctor" is either a doctor or a nurse, let alone how competent they actually are. It's baffling really. I definitely agree that ancillary staff who spend lots of time in a hospital and around physicians can definitely know who is good and who isn't.
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Not always. I worked with a surgeon who was a complete dingus who would get really angry and upset if things didn't go just right. Most of the staff wouldn't let him operate on their dog, but he was actually a fairly good surgeon. He just had a bad temper and handled stress by yelling.

I wouldn't work with him because he was a dick, and there were plenty of better surgeons who weren't dicks.
 
gonnif said:
Oh, on this note lets clarify something. The "school rank" that premeds use, especially that god-awful hospital marketing material from Useless Snooze and Wuss Report, or whatever its called, has nothing to do with the rank that PDs use. PD directors are much more likely to be concerned with the reputation of the specialty field or department of the medical school you come from or the general reputation of how hospital ready their graduates are, that research budget and the rest. Yes, there is a slight name/prestige advantage for residency selection but as I noted in a previous post, only about 1/2 of residency directors use this as a factor in selection and of those, it ranks at or below some 20 other factors. Lastly, let me also again emphasis that readers must understand the difference in the concept of choosing a specialty field versus getting into a specific program for that field.
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This is using the same source that you loathe, but PD rankings of schools in USNWR correlate pretty well with USNWR research ranking.
 
gonnif said:
The paper here is seriously, very seriously flawed for a number of reasons

1) The paper that you cite is a working paper and has not been peer-reviewed or accepted for publication.

NBER working papers are circulated for discussion and comment purposes. They have not been
peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies
official NBER publications

2) The paper is counting absolute numbers of doctors and prescriptions without taking into any account the ratio of various doctor type to populations interaction. That is, most patient interaction occurs with their "GP" (term which the authors use) and therefore get most prescriptions from GP and therefore GP write most perscriptions. They did not to standardize this measure with a rate of either per 100,000 population or as prescription written per rate of visits across doctor type.

3) Authors do not have any discussions on why "lower-tier" medical schools are more likely to have graduates go into FP/ IM than higher ranked schools, particularly DO which produce under 25% off all physicians in the nation, but now produce fully 50% of all new PCPs

4) The authors are economists with no background, understanding in how residency selection for item #3 works

Frankly, if I received this paper in a Public Health Policy class, I would have given it a C at best. It shows no indepth understanding of how/why/which type of physicians patients will see the most or the understanding of residency selection, particularly for DO, of while lower tiered schools tend to produce more PCP. Their use of the very out of date term "GP" is a good indicator of their lack of knowledge.
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Not to mention the implicit assumption that more opioid prescriptions makes a bad doctor.
 
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Lost in Translation said:
Interesting, it seems AOA doesn't matter as much for ranking but does matter in deciding who to give interviews to.
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Just an idea...but at the time for ranking, most of the interviewees are AOA members (and those that aren't may have otherwise strong points within their application) so it becomes a moot point?

Of course it varies per specialty, but would it make sense to say that AOA opens the door, but (not limited to) a quality interview gets you through it?
 
Mad Jack said:
The worst doctor I ever worked with was a MD/PhD from one of the schools that frequently vies for the top position in the country. He literally couldn't diagnose a tension pneumothorax and was trying to order albuterol for a patient that was dying. One day I hope to go to his practice and present him with a golden medal for the worst physician I've ever had the displeasure of working with.
Click to expand...

My point exactly.
 
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