Here’s how U.S. News ranks the best medical schools

U. S. News’ rankings of America’s best colleges and universities for undergraduates are an influential and much-anticipated annual publication. One indication of their undeniable impact and staying power is that last year marked the 37th year for the rankings, making them the grandfather of all such ranking systems.

Nonetheless, these rankings have come in for severe criticism over the years, and many higher education experts have urged students, families, and other consumers to pay little or no attention to them.

A frequent criticism is that the rankings of undergraduate schools place too much of a premium on inputs – the resources a school has – rather than outputs, the success in educating and graduating students with strong comparative economic performance. U.S News has attempted to respond to those critiques by periodically introducing changes in their methodology, making small, but meaningful shifts toward evaluating educational outputs, as opposed to the emphasis that’s historically been placed on incoming student credentials and institutional resources.

However, substantial concerns remain.

• It’s still too easy for schools to game the rankings, in part because of the weight that’s given to the oft-maligned reputational or peer survey.
• Because schools submit much of the data themselves, there are insufficient checks on the accuracy of what they claim.
• The various proxies for institutional wealth (e.g., faculty salaries and per-student spending) over-reward colleges that have abundant resources, resulting in the perennial dominance of private colleges in the rankings.
• The continued use of ACT and SAT scores is becoming increasingly harder to justify, as institutions abandon their use in droves.

So how does the methodology used to evaluate medical schools stack up against these criticisms? In general, although some of the same objections leveled against the undergraduate ratings can be made about the medical school rankings, the overall medical school methodology does not seem unreasonable.

• The rankings still use reputational surveys filled out by peers, but the number of schools that raters are asked to judge is smaller, and they are likely to have a greater familiarity with the quality of a single entity like a medical school than they are the overall academic program – involving dozens of majors and departments – of an entire institution.
• In a hands-on curriculum like that required in medical school, giving weight to a faculty–student ratio seems legitimate even though it might tend to favor richer schools.
• The largest weight – 40% – is given to outcome measures: research productivity in the case of research medical schools and primary care practice outcomes for the primary care rankings.

College rankings never seem to lose their appeal despite the many criticisms aimed at them. At the undergraduate level, they’ve turned into something of a rat race, mattering far more than they should to both students and the institutions themselves.

The medical school rankings share some of the liabilities of their undergraduate ranking counterparts, but for students dedicated to going into medicine, they also provide useful analysis and interesting comparisons. While they don’t define the quality of a medical school and should not be the only basis for making a decision about what school to attend, they can help students learn more about their options. That’s why they still hold some value.

Analysis of U.S. News medical school rankings

U.S. News has published its 2023 rankings of the best medical schools in the United States. Separate rankings are provided for 2 overall categories of schools: the best schools for primary care education and the best schools for medical research.

The primary care rankings should be of most interest to students who want to obtain a medical degree and then practice as physicians, offering basic and preventive medical care to their patients. The research rankings are for students who are interested in careers where they pursue and make discoveries in basic science and clinical applications.

While some of the same criticisms that have been lodged against U.S. News’ rankings of America’s best undergraduate colleges and universities (and even high schools) can be made about its rankings of medical schools (see below), the factors and methodology used to score medical schools appear to be better overall, resulting in some useful data and information for students considering the study of medicine.

The University of Washington topped the list of best primary care medical schools. Rounding out the top 20 in this category were:

2. University of California, San Francisco

3. University of Minnesota

4. Oregon Health and Sciences University

5. University of North Carolina – Chapel Hill

6. University of Colorado

7. University of Nebraska Medical Center

8. University of California, Davis

9. Harvard University

10. (tie) University of Kansas Medical School, University of Massachusetts Chan Medical School and University of Pittsburgh

13. University of California, Los Angeles

14. Brown University

15. University of Maryland

16. (tie) Baylor College of Medicine, University of Iowa, University of New Mexico, University of Texas Southwestern Medical Center

20. (tie) University of Michigan, University of Pennsylvania, University of Wisconsin

Harvard University claimed the top spot for medical research, followed by:

2. New York University

3. (tie) Columbia University, Johns Hopkins University, University of California – San Francisco

6. (tie) Duke University, University of Pennsylvania

8. Stanford University

9. University of Washington

10. Yale University

11. (tie) Icahn School of Medicine at Mount Sinai, Washington University in St. Louis

13. Vanderbilt University

14. (tie) Cornell University, Mayo Clinic School of Medicine, University of Pittsburgh

17. (tie) Northwestern University, University of Michigan

19. University of California, Los Angeles

20. (tie) University of California, San Diego, University Chicago

Methodology

How did U.S. News determine its rankings? First, it surveyed 192 medical and osteopathic schools that were accredited in 2021 by either the Liaison Committee on Medical Education or the American Osteopathic Association. Of the 192 schools surveyed, 130 schools provided enough data for a rank to be calculated . A total of 124 of these medical and osteopathic schools were ranked in both the research and primary care rankings.

Both the primary care and research rankings are calculated from weighted averages on several indicators, summarized below.

Quality assessment: 2 indicators, worth 30% of the total ranking.

• Peer assessment (15% for both the research medical school and primary care medical school rankings). Medical and osteopathic school deans, deans of academic affairs, and heads of internal medicine or directors of admissions separately rated the quality of research and primary care programs on a scale from 1 (marginal) to 5 (outstanding). Respondents who did not know enough about a school to evaluate it marked ‘don’t know’.
• Residency directors’ assessment (15% for both the research medical school and the primary care medical school rankings). Residency program directors rated the quality of either research or primary care programs on a 1-5 scale of marginal to outstanding. Respondents who did not know enough about a program to evaluate it marked ‘don’t know’.

Student selectivity: 3 indicators totaling 20% of the total ranking for research medical schools and 15% for primary care medical schools.

• Median Medical College Admission Test, or MCAT, score for the entering 2021 class (13% for research medical schools; 9.75% for primary care medical schools.
• Median undergraduate GPA for the 2021 entering class (6% for research medical school model; 4.5% for primary care medical schools).
• Acceptance rate (1% for research medical schools; 0.75% for primary care medical schools). This is the proportion of applicants for the 2021 entering class who were offered admission.

Faculty Resources: A single factor accounting for 10% of the research medical school ranking and 15% of the primary care medical school rankings. This factor was the ratio of full-time faculty to full-time M.D. or D.O. students in 2021.

Research Activity: 2 indicators used only for ranking research medical schools, comprising 40% of their overall score.

• Total federal research activity (30%). The total dollar amount of federal grants and contracts (direct costs plus facilities and administrative costs) recorded at each medical school and its affiliates, averaged between 2019 and 2020.
• Average federal research activity per faculty member (10%). The total federal research activity described above divided by total full-time faculty members; calculated as an average of 2019 and 2020 quotients.

Primary Care Production: 2 indicators used only for ranking primary care medical schools, comprising 40% of their overall score.

• Medical school graduates practicing in primary care specialties (30%). The proportion of a medical school’s 2013-2015 graduates who are practicing in a primary care specialty as of 2021.
• Medical school graduates entering primary care residencies (10%). The percentages of a school’s graduates entering primary care residencies in the fields of family practice, pediatrics and internal medicine, averaged over 2019, 2020, and 2021.

U.S. News also published ratings for several medical specialties, including anesthesiology, family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, radiology, and surgery. However, these rankings are based solely on ratings by medical school deans and senior faculty from the schools surveyed. This means the rankings lack the objective indicators that comprise a significant percentage of the medical school practice and research rankings.