<p>The real reason is that USNew med school rankings are totally irrelevant to the training of physicians. Do you really believe that a the average student who goes to Yale medical school to become an internist or pediatrian is a better doctor than one who goes to Brown. If a school gets more NIH grants per faculty member does that mean the students learn more anatomy or biochemistry.</p>
<p>In fairness to USN, they don't claim that their rankings are relevant to the training of physicians. The rankings are Research rankings. They're meant to be measures of the quality of research that the medical school provides and trains its students in.</p>
<p>It's not USN's fault that students use the rankings to measure other things. It's a Research ranking, and for that purpose, NIH grants are very relevant.</p>
<p>Brown has a very young medical school. They only began granting MDs in 1975! It takes decades to build credibility amongst residency directors and build a formidable medical research apparatus, both of which are very important factors in the US News rankings cited above. Brown is a great school, and considering the age of the school, especially when juxtaposed with the other schools ranked in the top tier, they are flying up the rankings.</p>
<p>Brown's youth plays some role. On the other hand, Dartmouth Medical School has been around for 200 years, and I would say it is similarly ranked by the professional community. It also is an Ivy in which the undergraduate program is more highly recognized than the medical one.</p>
<p>I would say that reputation is based upon research grant support (which helps build up the intellectual and physical intrafrastructure), physical resources, captured patient population (does not have to be urban as is the case for Duke), strong financial resources whether it be grants or endowment, and academic mission and career performance of faculty and graduates who become nationally-recogized leaders and innovators (e.g., probably 2/3 of graduates from Hopkins and Harvard go into academic medicine). This last group ends up populating academic medicine throughout the country, and not only impact medical education but enhance their schools reputation. Many leading academics will go through at least one of the dozen or so top schools during some phase of their training, whether it be for medical school, residency, or fellowship. Although Brown has a good reputation, it falls short in most of the foregoing categories in comparison to schools in Boston, New York, and New Haven. It is competing for the same patients, students, and faculty.</p>
<p>Having said this, I agree that prestige of medical school is not the same as for law and business school unless you plan to go into academics. Even then, there are so many levelers, that merit trumps your degree after a certain period of time. For patients, it really doesn't matter as long as you provide compassionate and competent care. I would say one can get excellent training at most of the U.S. Medical Schools.</p>
<p>southernazn918,</p>
<p>Brown's medical school is rather young. It started granting its first degree in 1975. In fact, what it has accomplished in the last three decades is quite impressive. The school is also very small, and only this year started accepting more applications from non Brown students (outside PMLE) in order to become more competitive. President Simmons is quite proud of the direction in which the school is going. Also, Providence is a referral center for the state and clinically the school is bound to do better than places like Gainesville (Florida) or Brody (East Carolina University) which was ranked 6th !!</p>
<p>Do not get too hang up on rankings. In Primary Care, John Hopkins was ranked at 28th, Duke was ranked at 34 and Northwestern at 44 all way below Brown. You would be more than lucky if you get admitted to Brown.</p>
<p>pmyen,
[quote]
This last group ends up populating academic medicine throughout the country, and not only impact medical education but enhance their schools reputation.
[/quote]
I believe this assumption is way overplayed. There are plenty of graduates of Harvard, Yale and Hopkins in very obscure positions in private practice all over the country, from rural areas to indian reservations, to VA Hospitals. I have met them. Unlike an MBA from a top university which is a almost a prerequisite to land a job in Wall Street or a law degree from a similar school which is needed to work in a top "Corporate Law Firm", any medical graduate has full access to academic medicine.</p>
<p>What matters in academia is that you do research and get published. Whether you are a graduate from Harvard or from the University of Kentucky Med School really does not matter much.</p>
<p>I don't think PMY has ever attributed this disproportionality to the branding of the schools, simply that the disproportionality exists. (He in fact goes out of his way to point out that "merit trumps your degree.") As at least one cause, the type of student at Harvard is more likely to want to enter academia.* His claim that research-school graduates are more likely to end up in research, and therefore in teaching, remains valid.</p>
<p>*On average, Harvard admits have more research as undergraduates than do those from the University of Kentucky.</p>
<p>I agree that the type of student that goes to one of the top universities is more likely to want to enter academia. It has to do more with the student than with the school and perhaps that's the confusion that many people have. Some schools atract specific "personalities". If a student at UofKentucky Med School, sets himself the goal to become Chairman of a Department in the future, he can do it.</p>
<p>I have seen many posts on this board that tend to suggest that if you want to go into a certain field of medicine, the "name" of the school matters. And unlike the fields already discussed, it does not matter much. What matters is what you do and how you utilize the available resources while you are in med school.</p>
<p>Most people at Hopkins or Duke aren't going into primary care, hence the low rankings.</p>
<p>I believe it's actually been 3 years since they've started accepting traditional AMCAS applicants, that's what the letter that came with their viewbook says anyway.</p>
<p>I've certainly suggested that those wanting to enter academic medicine receive a boost from branding. PMY's post above does not.</p>
<p>It's usually been, however, in the context of: "Unless you want to enter academics, there's definitely no point to branding." In other words, it's a qualifier to a claim in the other direction.</p>
<p>It is always true that qualifications trump branding. The question is whether branding can help a marginal applicant. We don't know. We just know for sure that there are many circumstances where it doesn't matter at all. Academia's not one of these.</p>
<p>
[quote]
I agree that the type of student that goes to one of the top universities is more likely to want to enter academia. It has to do more with the student than with the school and perhaps that's the confusion that many people have. Some schools atract specific "personalities". If a student at UofKentucky Med School, sets himself the goal to become Chairman of a Department in the future, he can do it.
[/quote]
</p>
<p>I can agree with the basic thesis that some schools will simply attract certain kinds of students, and in particular, that students who are attracted to academia will tend to attend certain schools.</p>
<p>
[quote]
What matters in academia is that you do research and get published. Whether you are a graduate from Harvard or from the University of Kentucky Med School really does not matter much.
[/quote]
</p>
<p>However, I am doubt that we can conclude this l- namely that it no longer matters which school you attend. The truth of the matter is, academic publication success is heavily influenced by sociological factors (See Kuhn 1962, Barber 1961). Like it or not, the chances of whether a particular article is going to get published often times depends heavily on the reputation of the person who wrote it. </p>
<p>For example, Barber recounts a famous incident in which a physicist submitted a paper to the British Association (one of the UK's oldest and most august scientific learned societies), yet the author's name had somehow become detached from the paper. The BA rejected the paper. However, later it was realized that the paper's author was actually John William Strutt (aka Lord Rayleigh, as in Rayleigh scattering, Rayleigh waves, the discoverer of argon, and a Nobel laureate in physics). As stated in Barber, "...When the authorship (by Rayleigh) was discovered, the paper was found to have merits after all." </p>
<p>In a perhaps more infamous incident, Peters & Ceci (1982) ran an experiment that submitted a number of social science papers that had already been published, having been written by prominent authors from famous universities. However, they resubmitted these papers under false author names from unprestigious universities. Only 8% of these papers were caught as resubmissions. Of those that weren't caught, 89% of them were rejected. Again, keep in mind what we are talking about - we are talking about papers that had already been accepted and published by those very same journals, but had done so under the names of famous scientists from famous universities. Submit them again under the names of no-name people from no-name universities, and they get rejected. </p>
<p>Even if a paper of yours does get published, the question is how much true credit you will get for that paper if the paper is coauthored (as most papers are). The eminent sociologists Robert Merton coined the term "The Matthew Effect" (after the Parable of the Talents in Matthew 25:29) to denote the phenomenom that the bulk of the credit for a particular piece of team-generated work tends to accrue to whoever among a particular team already has the most prestige. The most extreme example of this is the crediting of nearly all of the credit for the ground-breaking discovery of streptomycin, including contributing to the awarding of the Nobel Prize in Medicine in 1952, to the already quite eminent Selman Waksman even though it was discovered later that nearly all of the work had actually been completed by Albert Schatz, one of his grad students. The inference is therefore that if you go to a no-name school and your coauthor comes from Harvard, and all other things are equal (i.e. you are both in the same level at your career - i.e. grad students or assistant profs), the Matthew effect would dictate that the guy from Harvard will probably end up with the lion's share of the credit whether he deserves it or not. Sad but true.</p>
<p>Furthermore, significant work has been performed on the social networking aspects of the academic peer review process, and that in particular, those who happen to be well-connected socially tend to have their papers accepted more often than those won aren't well connected socially.<br>
For example, a lot of interesting work has been done to validate the notion that one's papers will tend to be more readily accepted if you just happen to be pals with the journal's editors and/or reviewers. Blind reviewship may help, but is far from a panacea, as Fisher et al (1994), Biggs (1990), and other studies have shown than many reviewers could ascertain the author of a paper they were reviewing, even though the review was supposedly "blinded". This should hardly be surprising. Most serious academics are highly aware of what their peers are working on through conferences or the social grapevine, such that when they review a supposedly "blinded" paper, they can often times deduce who wrote it. This is especially so if the paper uses data that you know only for which only certain people have access. Furthermore, many authors have distinct writing styles that you inevitably learn about as you read the literature. </p>
<p>Hence, if you just happen to be old pals of a particular person who is refereeing your paper, you are probably more likely to have your paper accepted. Furthermore, the truth of the matter is, you are more likely to develop a strong social network by doing to a top school where you have the opportunity to meet many of these people who will probably later become referees of top journals. </p>
<p>The point is, while it's nice to think that the peer review process is fair and balanced, the truth is, it is not. In fact, we should not expect it to be. Whether we like it or not, the peer review process is a social construct and is therefore subject to social forces. Like it or not, that's the reality. One of the benefits of going to a top school is access to a powerful social network that can pay off great dividends in the future through benefitting from social biases.</p>
<p>Look, I would like it for academic peer review to be truly fair and emotionless. I would like the process of academic job placement and promotion to be fair. But as long as these judgments are subjective, and they inevitably are, then people are going to inevitably bring in their social predilictions into the process. Sad but true.</p>
<p>Wow sakky that is deep and scary. Here I thought that business and law were corrupt, but medicine also. I mean this would mean that if a no-name scientist made a magnaminous discovery of like a new cure for a disease, then he may not be published. That is so unfair. </p>
<p>Also is the point that you are trying to convey that if one wants to have a successful research career, then he should go to like an ivy. If so, do you mean for undergrad or just grad or both?</p>
<p>I thought that peer-reviewers were blinded from the authors. I don't doubt that name makes a difference, but it seems that simple measures could be put in place - make publication dependent on evaluations from the peer reviewers, blind them from the authors, etc - to make the process less reliant on name. Certainly "credit" is a post-publication phenomena that probably can't be avoided, but publication likely could be made more impartial.</p>
<p>Of course all this is mostly irrelevant if you have no interest in research, aren't doing any, and are headed to private practice as soon as possible.</p>
<p>
[quote]
Wow sakky that is deep and scary. Here I thought that business and law were corrupt, but medicine also.
[/quote]
</p>
<p>Well, I don't know if I would necessarily call it "corrupt". That's a pretty strong word. Corruption denotes a situation where people know what is the right thing to do, but deliberately choose to do something else. </p>
<p>What I am talking about here are simple social pressures that affect your behavior in an unconscious manner. The truth of the matter is, you're inevitably and unconsciously going to treat your close friends better than you're going to treat strangers. That's just human nature. You probably won't even realize that you're doing it, but you're going to do it. You're going to treat people who are "similar" to you better than you will treat people who are different from you. For example, the cover story of the 387:22 (1997)issue of Nature was the (in)famous Wanneras & Wold article that documented strong evidence of gender bias and nepotism within the peer review process. The article can be found here.</p>
<p>Look, the truth of the matter is that peer review is a social construct, and as such, is subject to the same social forces that any other social construct is. </p>
<p>
[quote]
I mean this would mean that if a no-name scientist made a magnaminous discovery of like a new cure for a disease, then he may not be published. That is so unfair.
[/quote]
</p>
<p>Unfortunately, such is the way that academia works. The truth is, as Kuhn stated, whether we like it or not, science tends to be dominated via paradigms and controlled by gatekeepers, and those who are outside the mainstream and/or who present ideas that challenge the mainstream paradigm at the time will often times be ignored. </p>
<p>As a famous case in point, we probably all know of Gregor Mendel as the father of modern genetics for his (now) famous pea-plant hybridization experiments. However, Mendel's conference presentations and papers (which were not peer-reviewed, as there was no peer review process in those days) were deeply criticized at the time, ultimately causing him to stop further work on genetics and devote more time to his work as a monastery abbott. He eventually died in obscurity as a widely discredited scientist. The only reason why we know of him now is because his papers and work were rediscovered 16 years after his death and were found to be reproducible and hence, had merit. As another famous historical case in point, consider Copernicus's heliocentric model of the solar system. Not only was it resisted by the religious authorities of the day, it was also resisted by the leading scientists * of the day, especially by Tyco Brahe, who was arguably the leading astronomer of the time, and was unsurprisingly a strong proponent of his own geocentric system of the solar system known as the Tychonic system. As stated in *Science, vol. 134, by Barber (1961) "...Brahe remained a life-long opponent of Copernicanism; he was unable to break with the traditional patterns of thought about the earth's lack of motion. And his immense prestige helped to postpone the conversion of other astronomers to the new theory". As a more modern example, consider Stanley Prusiner's work on the prion that eventually won him the Nobel Prize in Medicine in 1997. As Prusiner stated regarding his travails as a young scientist:</p>
<p>"I had anticipated that the purified scrapie agent would turn out to be a small virus and was puzzled when the data kept telling me that our preparations contained protein but not nucleic acid. I was informed by the Howard Hughes Medical Institute (HHMI) that they would not renew their support and by UCSF that I would not be promoted to tenure....While it is quite reasonable for scientists to be skeptical of new ideas that do not fit within the accepted realm of scientific knowledge, the best science often emerges from situations where results carefully obtained do not fit within the accepted paradigms. At times the press became involved since the media provided the naysayers with a means to vent their frustration at not being able to find the cherished nucleic acid that they were so sure must exist. Since the press was usually unable to understand the scientific arguments and they are usually keen to write about any controversy, the personal attacks of the naysayers at times became very vicious."</p>
<p>
[quote]
Also is the point that you are trying to convey that if one wants to have a successful research career, then he should go to like an ivy. If so, do you mean for undergrad or just grad or both?
[/quote]
</p>
<p>Well, I wouldn't necessarily say an "Ivy" per se. Plenty of non-Ivy schools are better than Ivies. For example, I'd rather get my MD from Johns Hopkins (a non-Ivy) than, from, say Dartmouth (which is an Ivy). </p>
<p>I am simply saying that there are social reasons for why some people are more successful in publishing than are others. We can even point to another more benign reason than simply branding or nepotism. Some schools have a stronger research culture than others do. Let's face it. Human beings are social animals and tend to do what they see others around them are doing. When you see lots of your colleagues engaging in publishable research projects, then you will tend to also want to engage in a publishable research project, and probably be more successful in doing it. Not only is it easier to just follow the crowd, you will probably get better advice on how to publish. For example, it's easier to publish in a particular journal if you have nearby colleagues who you can talk to who have already attempted to publish in that journal and can therefore tell you what worked and what didn't work (as each journal has its own predilictions for what types of papers it tends to publish). Heck, some of these other students might become your collaborators and coauthors. It's easier to justify travel budget and time-off for conference if you go to a school where many students habitually attend conference than if you go to a school where students rarely go to conference. All these factors speak to the social advantages of attending a school where lots of students are interested in research and aim to be future academics. </p>
<p>That's not to say that you can't be successful going to some school where few students will become researchers. It become harder purely from a social standpoint. It's hard to be the only student, or one of the few, at a particular school who is trying to publish, as you don't have other students you can talk to or collaborate with. Yes, you can still do it. It's just harder.</p>
<p>
[quote]
I thought that peer-reviewers were blinded from the authors. I don't doubt that name makes a difference, but it seems that simple measures could be put in place - make publication dependent on evaluations from the peer reviewers, blind them from the authors, etc - to make the process less reliant on name. Certainly "credit" is a post-publication phenomena that probably can't be avoided, but publication likely could be made more impartial.
[/quote]
</p>
<p>As I stated above on post #32, blinding helps, but not that much. As stated in Fisher (1994) and Biggs(1990), blinding mechanisms are often 'pierced' quite easily, and many reviewers report not needing to see authorship to know exactly who they are reviewing. </p>
<p>Just think of the logistics of academia. Many (probably most) scientists will present their findings in conference months before they actually submit a paper for publication. Hence, through the mechanism of conference, as well as the academic grapevine, people usually know what their peers are all working on, so then when you see a submitted "blinded" paper that is regarding the precise topic that you saw in conference a few months ago (or that your colleague had told you about when he went to conference), it's not that hard to put 2 and 2 together. This is particularly true if you happen to work in a highly specialized subfield where there aren't many people working on the topic and so everybody basically knows everybody. For example, I was talking to a Harvard astronomy PhD candidate who works on a certain type of extrasolar planetary discovery, and he basically said that there are basically only about 25 people in the world who work on this topic, and they all know each other and what they're all working on, hence blinding makes no difference. I'm quite certain there are certain topics in academic medicine that are just as insular. </p>
<p>Conferences are far from the only example. Many scientists present working papers on the Internet (i.e. their own website or on open databases like arXiv), and these papers are not blinded. Many scientists will read the working papers of their colleagues as a way to keep up with their field (and, conversely, many scientists will present these working papers hoping for useful feedback). When you are refereeing a submitted paper that looks "suspiciously" exactly like a working paper that you had previously read, again, it's not that hard to put 2 and 2 together. </p>
<p>But the point is, the blinding process is far from impermeable. In many cases, you simply don't need to see a name to know exactly who wrote a particular paper, or at least have a very good idea about who probably wrote it. Again, if your have lunch every day with your buddy who works in the lab down the hall, and he is always telling you about how his research is going and what his data is looking like and his new results, and then you receive a "blinded" paper that has to do with exactly what he was talking about, step-by-step, it doesn't take a genius to figure out who the author is.</p>
<p>have you checked out GW medical school ranking; why is it so low...i have always heard such awesome things about it??</p>
<p>Interesting note, Brown actually did have an earlier medical school (early 19th century) but it was shut down relatively quickly (I think it lasted about 15-20 years?). The official reason it was shut down was because the president asked all Brown faculty to live on campus and wouldn't grant the physician-professors with private practices an exception. HOWEVER, a Brown professor I've talked to who specializes in the history of the institution claimed that the real reason that the physicians weren't granted an exception from the rule (which several other professors were) was because the school was under considerable pressure to close down from the governor of Rhode Island himself. The reason? There were reports that medical school students had been sledding down Thayer Street, using CADAVERS as their sleds...</p>