Traditionally top-ranked med schools balk at 'social mission' survey

If you're looking to recruit a physician, particularly in primary care, from a 'socially responsible' private U.S. medical school, you may be out of luck, according to a new survey published in this week's Annals of Internal Medicine.

Dr. Fitzhugh Mullan, professor of health policy and pediatrics at George Washington University, and his colleagues ranked the country's 141 medical schools by how well they produced graduates who practiced primary care, worked in areas with a federally designated shortage of health professionals and belonged to underrepresented minority groups.

Deans across the country were flabbergasted to learn that the survey ranked public medical schools higher than renowned private ones, including Harvard, Stanford and Johns Hopkins, largely because of smaller schools' traditional focus on educating primary care doctors. At the top of the list are Morehouse College, Meharry Medical College, Howard University, Wright State University Boonshoft School of Medicine and the University of Kansas. From the bottom up, Vanderbilt University, University of Texas Southwestern Medical Center, Northwestern University Feinberg School of Medicine, University of California, Irvine and New York University bring up the rear.

Dr. Karen Antman, dean of Boston University's School of Medicine, criticized the study authors' criteria. "I think that they are absolutely right to pay attention to primary care, diversity and service to underserved populations, but I think they've got a very, very restrictive definition of social mission," she told the Boston Globe. "Our mission is actually the Boston Medical Center [considered a safety-net hospital] mission, [which] is service to an underserved population. Medical students come here and in fact stay here for that mission. To be ranked in lowest 20 makes no sense. So we were shocked."

John Prescott, Chief Academic Officer of the Association of American Medical Colleges, also remarked to Kaiser Health News 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."

Nonetheless, study coauthor Dr. Candice Chen, one of the authors and an investigator at the George Washington University School of Public Health and Health Services, says that the survey is important because medical schools have a lot of say in what the primary care workforce will look like as 32 million newly insured deluge the system.

However, Mullan assured that that the rankings were not scorecards on quality."We do not see this as a judgment of medical schools," Mullan said. "We see this as a measure of an important function of medical schools. And we hope schools will use it to at least evaluate where they stand and consider whether they have a role to be more contributory in regard to social mission."

To learn more:
- read this piece in the Boston Globe
- see this post from NPR and Kaiser Health News
- check out the entry in the Wall Street Journal Health Blog
- here's the abstract in the Annals of Internal Medicine

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