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Most Elite Medical Schools Rank Low On ‘Social Mission’

This story also appeared on NPR’s health blog, Shots.

A new study is turning the traditional medical school ranking list on its head. When it comes to “social mission” – graduating doctors who are minorities, practice primary care and/or work in underserved areas, private schools (especially those in the Northeast) are at the bottom of the barrel, according to the survey published today in the Annals of Internal Medicine.

Of the 141 schools surveyed, Columbia, Johns Hopkins, Northwestern, Duke, University of Pennsylvania and Stanford all rank in the bottom twenty. The schools with the highest “social mission” scores, on the other hand, include all three historically black colleges surveyed – Morehouse College, Meharry Medical College and Howard University– along with a slew of public universities, such as the University of Kansas, Michigan State University, and the University of Mississippi.

With 32 million newly-insured patients on the horizon due to the health overhaul, the shortage of primary care physicians is becoming more urgent. Dr. Candice Chen, one of the authors and an investigator at the George Washington University School of Public Health and Health Services, says medical schools have a lot of say in what the primary care workforce will look like in the future. 

Medical schools, Chen explains, often claim whether students choose primary care has a lot more to do with financial worries – including paying off student loans – than with how the schools operate. “But the variation shows that some medical schools are obviously doing it better than others,” she says. “It allows us to give credit to medical schools that are doing the hard work, the good work, the social mission work. Medical schools have traditionally not gotten a lot of credit for this work.”

But John Prescott, Chief Academic Officer of the Association of American Medical Colleges, says that social mission ought to be looked at more broadly. The survey, says Prescott, “produces an inaccurate and limited picture. Medical schools meet society’s needs in many ways through their integrated missions in medical education, research and patient care.” He points to the Uniformed Services University of the Health Sciences, which educates the military physicians who treat service men and women but ranks in the bottom twenty.

But it doesn’t have to be all or nothing. Some major research institutions like the University of Washington, ranked 6th in the U.S. News & World Report survey but still managed to rank in the top 20 for producing primary care doctors. “We need our private schools to reevaluate their policies on recruitment and enrollment, curriculum choices, the culture they’ve established,” says Chen. “The University of Washington shows you can do both.”

This story was corrected to reflect the fact that the study was published in The Annals of Internal Medicine, not the Archives of Internal Medicine.

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