Academia trains us to focus on rankings from a very young age. From worrying about the top handball players on our schoolyard to identifying valedictorians/salutatorians from a sea of high school seniors, we spend much of our early education worrying about how we compare with others around us.
This fixation on rankings extends to how we view our academic institutions, which are constantly compared to one another via a host of publications. I’m sure most, if not all, of you spent hours scouring U.S. News and World Report, Niche.com, or Princeton Review when deciding where to apply to college. Most assume that higher ranking schools provided the best education and best fit. Is this really the case though?
Like undergraduate colleges/universities, medical schools are also ranked against one another through these same publications. For many medical school applicants, it is easy to get tunnel vision and be fixated on these rankings when choosing which medicals schools to apply to. Yet it is important to consider some critical questions when it comes to these rankings and their impact:
Let’s consider some of these questions and create a better framework for understanding how medical schools compare to one another.
How are Medical School Rankings Created?
Each publication creates a different algorithm for producing their rankings. With that said, this article will focus on the U.S. News and World Report, the best-known education ranking publication.
U.S News and World Report publishes two separate medical school rankings: Research and Primary Care. For the sake of time, this article will focus most of its attention on the Research rankings, since these generally get more attention from prospective applicants and guide the general public opinion of medical school rankings. However, the two rankings use very similar algorithms, so much of what is discussed about the Research rankings also pertains to the Primary Care rankings.
Per U.S. News and World Report, the ranking algorithm incorporates several high yield data points, including the following:
1 | Student Selectivity (Median MCAT, Median Undergraduate GPA, Acceptance Rate, and Faculty Resources)
2 | Research Activity (i.e. NIH, non-NIH federal, and non-federal research activity)
3 | Peer/Residency Director Assessment Scores
Each component is weighed based on the publications interpretation of how important that component is to determining the quality of a medical school (for example 40% Research Activity and 20% Admissions Selectivity). The publication then ranks the top 75% of schools based on their overall score and leaves the bottom 25% as “rank not published.”
How Rankings Can Help Medical School Applicants
While you probably should not base your entire application list on the U.S. News and World Report Rankings, there are some benefits of using the rankings when determining where to apply.
1 | Where Do You Stand as an Applicant?
First, it is important to know where you stand as a candidate when applying to schools. Because U.S. News and World Report’s algorithm uses selectivity as a major factor in creating their rankings, individuals can use a university’s rank to help determine how competitive an applicant they may be at a specific school.
For example, an applicant with a 3.5 college GPA and 510 MCAT score will likely be more competitive at a top 50 school than those in the top 10. However, this is only a general principle as medicals schools consider many factors (extracurricular activities, personal statements, letters of recommendation, post-college professional/educational experiences, graduate degrees, professional interests) when making decisions on admissions.
2 | Research vs. Clinical Interests
Because the two sets of U.S. News and World Report rankings focus on research and primary care, they may be most helpful to prospective candidates interested in these specific fields. Someone interested in being a physician scientist may benefit from being at a higher ranked research institution where there likely are more active research projects and grants for him/her to get involved.
Similarly, candidates interested in clinical work may benefit more from looking at the primary care rankings, which are weighted towards programs that send more graduates to primary care specialties, though this number likely changes year to year with each graduating class.
3 | How are Medical Schools Viewed by Residency Programs?
While the ranking algorithm does not incorporate any data about the proportion of a school’s graduates entering highly competitive specialties or well-ranked residencies, it does include assessments from national residency directors (15% of overall school rating via US News and World Report). Therefore, higher ranked universities likely got more favorable ratings from a sample of residency directors across various specialties than lower ranked schools.
While this data suggests that graduates from higher ranked schools may be viewed more favorably on residency applications, it is hard to make this prediction given how many factors residency programs take into consideration when selecting applicants, much like medical schools themselves (research experience, extracurricular projects, additional graduate degrees/experience, USMLE scores, medical school evaluations, letters of recommendation).
There are certainly many students of less highly ranked medical schools who excel at their school and on the boards and match into the most competitive specialties at the top schools. Rankings matter, but what is most important is how you perform and achieve once you enter medical school.
What To Look For Outside of Rankings
Ranking algorithms, while trying to take as much data into consideration as possible, often fail to incorporate many important factors that determine a student’s fit at a given school. Geographical location plays just as large a role in determining a student’s performance as the school’s curriculum or residency match statistics. Individuals spend four years, if not more, in that city. It is important to be somewhere you can enjoy when not sitting in class.
Students who feel that they are not a good fit for a program and city may perform worse in the long run than those who do, regardless of their medical school’s ranking. Similarly, if you want to practice rural or underserved medicine, it may make more sense to choose your school based on such training opportunities rather than its overall national ranking.
Medical school rankings provide a broad, general interpretation of a school’s overall quality. However, at a more micro level there are many factors that can dramatically influence individuals’ performance that are not included in any ranking system.
Factors such as pre-clinical course load, early opportunities for clinical experience, shadowing opportunities, career mentorship, research opportunities, required vs. elective third-year rotations, and available training sites can all significantly affect the quality of the experience at a school, regardless of its ranking. Therefore it is just as important to explore school websites, speak with current students/faculty, and attend interview/second look days to learn the nuances of an individual school’s culture and curriculum.
“Factors such as pre-clinical course load, early opportunities for clinical experience, shadowing opportunities, career mentorship, research opportunities, required vs. elective third-year rotations, and available training sites can all significantly affect the quality of the experience at a school, regardless of its ranking.”
Looking into rankings is a good way to get additional information about the schools you are applying to, but always remember that there are many other factors that determine whether a school will be a good fit for you. If you would like further advice on navigating the complicated medical school admissions world, our Med School Insiders team of advisers is a great resource for providing you with additional advice and support throughout the process. You will ultimately find the school that is right for you.
If you are interested in learning more about Dr. Kass’s career as a psychiatrist at UCSF or his thoughts about wellness and mental health, follow him on Instagram @ DrKassMD