Updated on April 12, 1:00 p.m.
A preview of U.S. News & World Report's annual list of the nation's best medical research schools has landed with several of its high-profile detractors claiming the top spots.
The pending rankings have Johns Hopkins University, University of Pennsylvania's Perelman School of Medicine and Harvard University listed as the top three performers.
Leadership of all three announced in recent months that their institutions would no longer be submitting performance data to the publication due to "unintended consequences" and "perverse incentives" they said the list perpetuates (see the stories below).
Other recent objectors included on the top 15 are Washington University in St. Louis (tied for fourth place), Columbia University (sixth place), Stanford University (tied for seventh place), Duke University (tied for ninth place) and University of Michigan-Ann Arbor (tied for ninth place).
The previewed rankings are not considered final until the full listing of 2023-2024 Best Graduate School Rankings are published on April 18, U.S. News said.
"We know how difficult it is to be a student searching for comparable information, and we will continue to incorporate data that medical schools reported directly to U.S. News over the past two years on the U.S. News’ rankings and school profile pages, including indicators not used in the ordinal rankings and other critical information," the publication said.
"More data on schools benefits everyone. U.S. News remains committed to collecting more data on the metrics that matter most to students in future iterations of our rankings. By doing so, we hope to empower students with the knowledge they need to make informed decisions about their educational pursuits and set themselves up for success."
Updated on March 17.
Physicians have put out the call for adult and children's hospitals to follow the wave of law schools and med schools pulling out of U.S. News & World Report's annual rankings.
In an op-ed published Friday in Health Affairs, Seattle Children's pediatricians Madeline Wozniak, M.D., and Chinenyenwa Mpamaugo, M.D., dug into the outlet's published methodology to outline how the current rankings undervalue specialty care delivered to minority patient communities and, subsequently, perpetuate underinvestment in certain conditions.
They illustrated the point by comparing the scoring for cystic fibrosis, which affects about 35,000 primarily white people in the U.S., and sickle cell disease, which affects one in 365 Black newborns but extremely few white newborns.
The former inherited disease is mentioned more often throughout U.S. News' rankings and makes up nearly half of the points a children's hospital can earn within the pulmonology subspecialty ranking. There is no section for hematoloty or a dedicated subsection for sickle cell disease, they wrote, though a hospital can earn a single point for having a formal sickle cell program in place.
"Dramatically overvaluing [cystic fibrosis] over [sickle cell disease] in rankings illustrates just how much U.S. News has failed to critically analyze structural racism in medicine, a failure that only perpetuates health inequities rather than addresses them," the authors wrote.
Wozniak and Mpamaugo acknowledged recent editions' inclusion of a dedicated equity, diversity and inclusion section, which represented 2% of total awarded points in the most recent rankings. Though "certainly a step forward," they considered the methodology's limited attention to conditions like sickle cell disease and no measures of a hospital's quality of care for minority patients as "two steps back."
The real-world impact of such exclusions are incentives for hospitals and other healthcare entities to prioritize conditions or policies that yield higher scores and leave underserved patient populations out in the cold, the pediatricians wrote.
"If U.S. News more prominently featured [sickle cell disease] into its scoring mechanisms, hospitals might be more inclined to invest their finite resources in building staffing dedicated to excellence in [sickle cell disease] care or cultivating researchers who can compete for government research grants to advance novel therapies that will advance care for years to come," they wrote.
"If, like universities, hospitals divorce themselves from ratings, we can refocus on the mission of treating our patients and communities equitably, and not being unduly influenced by flawed US News incentives."
Updated on Jan. 31.
Several more medical schools have now joined Harvard Medical School and other early movers in publicly boycotting U.S. News & World Report's rankings (see below the break for more).
The list of schools with published statements currently includes:
Icahn School of Medicine (Mount Sinai)
Perelman School of Medicine (University of Pennsylvania)
Pritzker School of Medicine (University of Chicago)
Vagelos College of Physicians and Surgeons (Columbia University)
Five of the nation’s top-ranking medical schools have publicly announced they will no longer be participating in U.S. News & World Report’s “Best Medical Schools” survey over concerns of the “perverse incentives” and “harmful impact" the annual rankings may have on higher learning priorities.
On Jan. 17, Harvard Medical School Dean George Daley wrote in a blog post that his institution would no longer be submitting admissions numbers and other relevant data to the outlet, a decision Daley said he’s contemplated “since becoming dean six years ago.”
Although he touched on criticisms of the specific methodology U.S. News uses to build its rankings, Daley said that it was his and others’ “more philosophical” concerns that drove the decision to pull out.
“As unintended consequences, rankings create perverse incentives for institutions to report misleading or inaccurate data, set policies to boost rankings rather than nobler objectives or divert financial aid from students with financial need to high-scoring students with means in order to maximize ranking criteria,” he wrote in the post. “Ultimately, the suitability of any particular medical school for any given student is too complex, nuanced, and individualized to be served by a rigid ranked list, no matter the methodology.”
Daley said Harvard Medical School would continue to share “key information” publicly on its website and would continue submitting other raw data to the Association of American Medical Colleges (AAMC)’s Medical School Admission Requirements Reports for Applicants and Advisors.
The following day, U.S. News Executive Chairman and CEO Eric Gertler released a statement saying that students “deserve” access to as much information as possible when weighing one of the most important decisions of their life.
“We know that comparing diverse academic institutions across a common data set is challenging, and that is why we have consistently stated that the rankings should be one component in a prospective student’s decision-making process,” Gertler said. “The fact is, millions of prospective students annually visit U.S. News medical school rankings because we provide students with valuable data and solutions to help with that process."
Still, Daley and Harvard Medical School’s decision appears to have uncorked the simmering frustrations of other medical schools.
This past week four additional well-performing medical schools—Columbia University’s Vagelos College of Physicians and Surgeons, Stanford University School of Medicine, The University of Pennsylvania’s Perelman School of Medicine and Mount Sinai’s Icahn School of Medicine—announced they would also be withdrawing from the survey in the coming year due to similar concerns of inaccuracies, overrepresentation of federal funding, limited characterization of applicant diversity and a “narrow focus on achievement that is linked to reputation,” among other critiques.
“We believe that our decision, along with those of a growing number of peer institutions, is necessary to lead a long-overdue examination of how medical education quality is evaluated and presented to aspiring students,” Stanford School of Medicine Dean Lloyd Minor, M.D., said in his announcement.
The medical schools’ decision comes a few months after a similar revolt among leading law schools, which was cited by some of the medical schools’ deans as a factor in their decision.
U.S. News also surveys and releases annual rankings for the nation’s top hospitals. Statements from UPenn and Stanford stressed that their decisions do not impact the participation of their institutions’ health systems in the hospital rankings, with the latter noting that “medical school and hospital rankings are separate and independent and use different methodologies.”
Mount Sinai’s deans noted that the institution's withdrawal currently only applies to its medical school ranking participation but noted that the institution “will re-evaluate our participation in other U.S. News rankings over time.”
In an email statement following the announcement from Harvard Medical School, AAMC Chief Academic Officer Alison Whelan, M.D., said that the industry organization “encourages medical schools to regularly collect internal data and assess themselves against their own institution’s missions. The more medical school leaders concentrate on their institutions’ missions, the better the academic medicine community is positioned to provide for the healthcare needs of its communities and the nation.”
Concerns and criticisms of consumer-facing school ranking systems like U.S. News’ are nothing new among academic medical centers.
Alongside Whelan’s comment, an AAMC representative pointed to a 2013 journal commentary penned by former President and CEO Darrell Kirch, M.D., and former Chief Academic Officer John Prescott, M.D.
In it, the former AAMC executives referenced a “growing consensus” that had been budding among higher education leaders since the 1980s that publications’ rankings for medical schools, undergraduate and graduate programs alike “fail to acknowledge and appreciate the varied and complex missions of educational institutions.” Rather, they pointed to benchmarks—such as their own Medical School Admissions Requirements and Missions Management Tool—as a more objective means to achieve their missions.
“Some institutions allow the convenience of popular rankings to serve as a proxy for achievement, sometimes linking them to everything from public relations, to fundraising campaigns, to executive compensation incentives,” they wrote nearly a decade ago. “Given the challenges faced in the areas of national healthcare, health professions workforce development, and support for medical research, the times demand that we abandon the pursuit of arbitrary measures such as popular rankings.”