<p>Most people usually go by USNews but I was just on it and realized something that interested me. The Mayo which is usually considered the top or among the top med schools such as Harvard med (correct me if I'm wrong) is just ranked #26 for research and #28 for primary care. I don't understand how a school that is widely considered one of the most, if not the most prestigious and selective is not even in the top 20 med school list for either category. Are the rankings inaccurate or is my perception of the school inaccurate? Or is the Mayo known for residencies and not its med school? Someone please clarify this for me. Thank you.</p>
<p>I can’t speak to the research ranking, but I’m not surprised by the primary care ranking. Mayo is based in a large town in rural Minnesota. People come to Mayo because of its specialty prowess, not for primary care. Although Mayo has acquired clinics and hospitals in other rural Minnesota towns, historically primary care has not been its focus. It also competes with other local providers for primary care, including Olmsted Medical Center and its related Clinic (Rochester is in Olmsted County). While its medical school is great, its residencies are really great.</p>
<p>The fact of the matter is that the rankings from USNWR are bogus. Look at the methodology. The research rankings are based primarily on the overall value of NIH grants awarded to the school, while the Primary Care rankings focus on the % of students going into primary care residencies (Family, internal med, pediatrics, med/peds combined and OB/GYN).</p>
<p>The research rankings are bogus because the research $ is a poor marker for actual impact on medical students. I can think of a number of different data sets that would actually give you info on the type/quality/penetration of research as a primary goal for medical students and none of them are based on the amount of money some PhD post-doc has managed to garner for a technology that will never reach the bedside, ever. But getting that data would require a lot more work from USNews to dig up and so they don’t do it.</p>
<p>As for the Primary Care rankings, again, it’s cherry picking the easily available data and ignoring the more nuanced reality that is medical specialization. Yes, Family Medicine, IM and Peds are the cornerstones of primary care, but IM and Peds are the gateways to all the medical specialties - adult and pediatric versions of cardiology, critical care, GI, pulm, nephro, endocrine, rheum, hematology, oncology, infectious disease, as well as things like developmental pediatrics, neonatology, and peds emergency medicine. Meanwhile other specialties out of those fields ARE primary care - geriatrics and adolescent medicine definitely fit that bill. As someone who went into a pediatrics residency knowing with 100% certainty that there was no way I was going to be a general pediatrician, I still got counted as a “primary care placement” by the data USN uses despite the fact that pediatric intensivists (which is what I want to do) are the antithesis of primary care.</p>
<p>Bottom line, don’t be swayed by the rankings unless you happen to agree with the methodology they employ. </p>
<p>As for quality of residency programs, those do not correlate with USN rankings in the slightest and they are different for every field. For example in pediatrics, the Universities of Utah and Cincinnati are easily some of the best residencies in the country but their names aren’t exactly the type that make the general public swoon.</p>
<p>USNews’ criteria tends to favor large, major research Unis, which can more easily attract federal grants. Thus, high quality, smaller programs don’t fare as well. The latter maybe just as good – if not better – at training future physicians, but the former is probably better for a future researcher.</p>
<p>I’d bet the sum of my med school loans debt that any premed worth his salt (and who has done his research about medical schools) would jump at the opportunity to go to MMS. </p>
<p>Then again, I’ve been absolutely jaded by Mayo Clinic since interviewing there. For what it’s worth, it was the only school that positively exceeded my expectations in every regard. Somehow it’s even better than it’s cracked up to be. Go figure.</p>
<p>I think the research rankings would be valuable for somebody who had no intention of practicing medicine – or very little – e.g. the MD/PhD track. Otherwise what I’d do is recalculate the USN formulas while omitting the NIH research budget. I know USN publishes their data (for a fee) and their methodology, so the reweighting would take a little while on Excel but should be pretty easy to do. I’d be curious to see the results if anybody who had access was willing to do this.</p>
<p>Given the problems with the Primary care rankings, any suggestions on how to choose which schools to apply to if the intent is to go into one of the primary care fields? </p>
<p>Admissions criteria (eg. how many OOS applicants accepted)? </p>
<p>Program features (eg. no grading first year)? </p>
<p>Other…</p>
<p>When it comes to ranking medical schools, I am convinced that the best medical school in the country is the one that accepts you. That was how I felt when I was applying and finally got a letter from a medical school that started out “Congratulations…”</p>
<p>In general, I think that if you know you want to go into primary care, there’s no school that is going to stop you. The way I would actually interpret the USN PC rankings is not “what school produces the best primary care residents” but more along the lines of “this school does a better job of convincing students to go into primary care”. If you know with absolute 100% certainty that primary care is where you want to go (and I’d challenge that assertion of any pre-med just like I do if they say they want to into derm or rads or neurosurgery), then I’d be looking for schools that are going to support that mission. </p>
<p>Overall, now that I’m a resident, I firmly believe that residency is infinitely more important than medical school in terms of the quality of the resultant new physician ready to practice on their own. And more important than residency is just that person’s overall demeanor/personality. I mean, some of the best residents in my program come from the least prestigious schools and some of the worst residents (ones I’d never let take care of my own future children) came from the most highly regarded schools. </p>
<p>As far as things I’d look for if I knew I wanted to go into primary care - again focusing on what med schools can do to support students wanting to go in that direction.
[ul]
[li]What sort of exposure to they give students to family medicine. There are the big 5 third year clerkships that every school does - Internal Med, Surgery, Peds, Psych and OB/Gyn - but after those, there’s a fair amount of variability. Some schools require Neuro, others ER, and many Family. But not every school does a family medicine block. That’d be a big red flag. The other thing I’d look towards is where does this family medicine block take place. I know of several med schools in more rural states where students are sent to small towns for 4-8 weeks to precept with family medicine physicians. Some do it as part of the 3rd year clerkships, others make it a requirement during M4 year. I spent 8 weeks in a town of 2300 people working with 5 family physicians while a 3rd year. It was definitely a rewarding experience and something that I enjoyed a fair bit. Getting away from residents and other students meant that I got to do far more than what was typical when back at the University. I delivered my first baby, put in more stitches and did my first intubation while in that town.</p>[/li]
<p>[li]In addition to the third year clerkship in family med, I’d look for other unique aspects that relate directly to family medicine. Again, my medical school places a high priority on primary care, consistently landing high on the USN rankings. During the summer between 1st and 2nd years we were required to a primary care block of 3 weeks, again out in rural parts of the state. It was a great experience and certainly looking back, I think a major part of the indoctrination of primary care my med school was trying to achieve, you know, get to the impressionable 1st years and give them a great experience early before they get exposed to the heirarchy and formality of the university hospital.</p>[/li]
<p>[li]As a general rule, expect state schools to be more primary care focused than privates. Those schools have missions and directives given to them by state legislators to serve the needs of the state, students have less debt burden usually, and are less likely to have prestige be one of their top priorities. </p>[/li]
<p>[/ul]</p>
<p>Beyond those things…I don’t think there’s much else I can point to as a consistent factor.</p>
<p>Thanks BRM, that helps a lot. I realize that getting in is the first priority, but it helps to have other factors to look at in order to sort through the multitude of schools in order to figure out which ones to apply to. </p>
<p>Neither myself or D1 are very savvy on how programs differ between schools, so your information is enlightening. Does each med school website give this kind of information on what is done each year in their program? Is that the best place to get an understanding of their programs or is there a book or website that would be helpful?</p>
<p>Primary care is not 100% certain, although it’s been the general direction since volunteering in HS in a local clinic, through SMDEP, college activities and now an AmeriCorps position in the fall. I guess part of the problem is the Research/Primary care split which is artificial and doesn’t really separate two distinct entities. Probably more certain that primary care is that she isn’t interested in research.</p>
<p>D1’s school is ranked highly in primary care and like BRM’s school, they assigned her a 4+ week internship with a rural family practice doc. She has delivered babies, assisted in C-sections, assisted in sterilizations, appendectomies, been on call, done the M-F clinic work every day in his office. The program is extremely hands on, when I say she delivered babies, I mean by the end of her time there she was acting as lead and her preceptor was assisting her. It was very nitty gritty, very exciting, rewarding, and taught her a great deal, plus there was all the politics of the practice & the small town to see.</p>
<p>Her school has that offered as one option during MS1 summer, one could also choose research, etc. Hands on is the best.</p>
<p>D1’s school is well ranked in primary care. Like BRM’s and somedaughter’s school, it requires a 4-6 week summer internship in a rural healthcare setting at the end MS1. MS0s also get an introduction to clinical practice during orientation when they spend 2 weeks learning to take patient histories, put in IV lines, draw blood, assist with procedures, etc.</p>
<p>(D1 already helped delivered a baby during her EMT-I training. Kinda convinced her that a) she didn’t want to be a OB/GYN, and b) she was NEVER going to have kids…)</p>
<p>^Ha!</p>
<p>10 char</p>
<p>
Well, a good way to start would be to take my kid’s app list …and then scratch all those schools off. ;)</p>
<p>Is that really true, that any strong research med school is going to be poor for someone not interested in research? What about the ones that are often considered good in both, say like UWashington (disregarding their IS/WWAMI policy)?</p>
<p>Well, DD as at UW and they have strong offerings for exploring primary care, but the other MS1 summer option was all research related, so, yes, some do try to cover both bases.</p>
<p>Yes, so in formulating a list of schools, strong research and strong primary care are not mutually exclusive. So curm’s Ds and my Ds lists may very well have some overlap.</p>
<p>Well, entomom. I think my kid’s school with a required research thesis and being completely un-ranked in primary care might not be the best choice. 
CCLCM (Cleveland Clinic) would be completely out. That’s two off the top of my head. Some of her other favorites, like UTSW and Baylor, do well at both. So yeah. Some overlap for sure.</p>
<p>People do not go to the highest ranked school out of the ones that accept them. They go to the ones that they like. My D. did not go to the highest ranked one, she went on Second Look and choose school that is a bit lower ranked which happened to be her most expensive choice also. She felt that it matched her personality the best. She withdrew from one very highly ranked Med. School, she said she did not see herself going there after interview visit. What your other acceptances? Sometime it is hard to decide, got to go to Second Look, as D’s decision has changed after Second Look.</p>