Printed from: http://www.stfm.org/NewsJournals/STFMNews/STFMNewsJune152018
Family Medicine Questions US News & World Report about Medical School Rankings

USNEWS

June 15, 2018—As follow up to a letter initiated by the academic family medicine organizations and signed on to by all national family medicine organizations, Society of Teachers of Family Medicine leadership met with representatives of US News & World Report on June 14 to discuss concerns about the publication of the “2019 Best Medical Schools Rankings.”

Representing academic family medicine were Stephen Wilson, MD, MPH,  and Melly Goodell, MD, both past presidents of STFM, along with STFM Director of Government Relations Hope Wittenberg. US News attendees included the Editor and Chief Content Officer Brian Kelly as well as the organization’s key data personnel involved with the report.

The main concern presented to the publication was that family medicine had been withdrawn from the list of specialty rankings this year, while other specialties, such as anesthesiology and radiology, had been added. The publication staff explained that this year they had used an outside vendor to gather data and that the vendor’s process only allowed for seven specialties. And because of the process used to rank those specialties (see below), family medicine wasn’t one of them. Going forward, US News will move the process in house and add family medicine back into the rankings.

Although getting family medicine back into the list of ranked specialties was the prime goal of the visit,  what was even more important was the far-reaching discussion that followed. It turns out that to do the rankings, US News used an Association of American Medical Colleges roster1 that lists full-time faculty at US medical schools by department. The publication (or the vendor) ranked the top seven specialties in terms of number of faculty on the list. Consequently, due to the decentralized, clinical, part-time, and volunteer nature of most family medicine departments, family medicine did not rank in the top seven. For example, pediatrics has 22,609 faculty, internal medicine has 1,842, and anesthesiology has 8,889. Family medicine has 5,696 (#9 on the list).

The conversation then turned to the nature of family medicine education and a discussion of the historic change from family practice to family medicine. (The AAMC list still used the term family practice.) There was conversation about the way faculty are counted at medical schools and the various modes of faculty that family medicine employs, which is quite different than most departments. Drs. Wilson and Goodell explained the importance of family medicine to the primary care workforce of the country and how it differs from the other primary care specialties. Dr Wilson presented several slides, including one of the Kerr-White boxes, redone by the Graham Center in 2001, and Graham Center maps displaying the national Health Professional Shortage Areas with family medicine withdrawn. US News staff found them to be extremely persuasive. They noted that this information was very important to them. Interestingly, as part of this conversation, US News staff raised the question of whether the primary care rankings were important. Drs Wilson and Goodell responded affirmatively and explained the importance of visibility within the consuming public, and especially potential medical students, connecting to family medicine workforce concerns and the need for more family medicine doctors to strengthen the health of the population

The conversation then turned to the critical importance of when to measure primary care production. US News had asked medical school deans for their numbers of primary care graduates based on those entering the primary care specialties of family medicine, internal medicine, and pediatrics. The STFM representatives explained that it would be more accurate and reflective of the workforce to measure primary care production five years post medical school graduation. That resulted in a discussion about how to obtain that data. US News staff don’t necessarily have the capability to get that data on their own, so they were pleased to be offered contacts at the Robert Graham Center and the American Board of Family Medicine as possible resources.

Two other issues brought up by US News staff probed the nature of specialty medicine and its nexus with family medicine. The first was whether community medicine was its own specialty; the second was whether integrative care was a component of family medicine training. Dr Goodell described the nature of community medicine, its importance to population health, the way it’s incorporated within family medicine training, and explained that some departments are called Departments of Family and Community Medicine. Both Drs Wilson and Goodell described the increasing consequence of integrative medicine to mainstream medicine, but also included caveats that only evidence-based therapies should be promoted and supported.

The next US News survey of medical schools will take place this fall with resultant rankings due in the spring of 2019.

Drs Goodell and Wilson and Ms Wittenberg felt the meeting between US News staff and STFM leaders was extremely positive, and hope it is the beginning of a long-term relationship with family medicine organizations providing ongoing resources for accurate data.  


References

  1.  AAMC Faculty Roster, December 31, 2016 snapshot


Copyright 2018 by Society of Teachers of Family Medicine