By Jenny Gold
KHN Staff Writer
Provided by Kaiser Health News.
JUN 14, 2010
This story also appeared on NPR’s health blog, Shots.
A new study is turning the traditional medical school ranking list on its head. When it comes to “social mission” – graudating doctors who are minorities, practice primary care and/or work in underserved areas, private schools (especially those in the Northeast) are at the bottom of the barrel, according to the survey published today in the Archives of Internal Medicine.
Of the 141 schools surveyed, Columbia, Johns Hopkins, Northwestern, Duke, University of Pennsylvania and Stanford all rank in the bottom twenty. The schools with the highest “social mission” scores, on the other hand, include all three historically black colleges surveyed – Morehouse College, Meharry Medical College and Howard University– along with a slew of public universities, such as the University of Kansas, Michigan State University, and the University of Mississippi.
With 32 million newly-insured patients on the horizon due to the health overhaul, the shortage of primary care physicians is becoming more urgent. Dr. Candice Chen, one of the authors and an investigator at the George Washington University School of Public Health and Health Services, says medical schools have a lot of say in what the primary care workforce will look like in the future.
Medical schools, Chen explains, often claim whether students choose primary care has a lot more to do with financial worries – including paying off student loans – than with how the schools operate. “But the variation shows that some medical schools are obviously doing it better than others,” she says. “It allows us to give credit to medical schools that are doing the hard work, the good work, the social mission work. Medical schools have traditionally not gotten a lot of credit for this work.”
But John Prescott, Chief Academic Officer of the Association of American Medical Colleges, says 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.” He points to the Uniformed Services University of the Health Sciences, which educates the military physicians who treat service men and women but ranks in the bottom twenty.
But it doesn’t have to be all or nothing. Some major research institutions like the University of Washington, ranked 6th in the U.S. News & World Report survey but still managed to rank in the top 20 for producing primary care doctors. “We need our private schools to reevaluate their policies on recruitment and enrollment, curriculum choices, the culture they’ve established,” says Chen. “The University of Washington shows you can do both.”
This is one of KHN’s “Short Takes” – brief items in the news. For the latest news from KHN, check out our News Section.
This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.
The best way to help the poor is by advancing technology and graduating more qualified doctors. Yet this survey looks at feel-good measures like whether these schools graduate docs who happen to have the same skin color as underprivileged folks, completely orthogonal to the goal of graduating competent docs.
This list cares about advancing the interests of particular political tribes, and short-term feel-goodness. It is not serious about improving the medical treatment of the poor.
What a stupid list. I did pick my medical school for some poorly defined “Social Mission” – I went there to learn how to practice medicine. As the previous poster stated, this “social mission” has very little to do with helping the poor and is really nothing more than political nonsense.
Further, a lot of these programs provide more primary care docs because PC is not very competitive and the specialties are getting harder and harder to find a residency spot in. The people who ended up at the “elite” schools are likely to be driven medical students and on average have higher board scores making them more competitive come residency selection. Any student who choices a medical school based on this so-called “social mission” is shooting themselves in the foot by limiting their options when it comes time to choose what they will do for the rest of their lives.
I remember my African-American studies teacher told me that he when used o work in a private school it was nice because he worked in a more close-knit environment and got paid more, but after a while he decided to wok in a public university because it was easier to find ways to make a difference in the local community.
When I think about it, public medical schools are more strongly obligated to somehow provide immediate returns to the local community and state since a lot of tuition is paid by the state government and taxes.
Also, the high-ranked schools they mentioned have strong emphasis on research- I know for instance, Duke med students are required to spend their third year on some type of research thesis. As a result, students who apply to research oriented-schools might spend a lot of time doing that research that helps the schools receive more money and higher ranking overtime, but as a result not be able to keep up with schools whose complete mission is to provide primary care in local and underserved communities.
Where are these stupid articles coming from?
“Social mission”?
How about elite physicians: high MCAT, high GPA, good resume/communication skills.
Why is it that the low-ball schools (stats-wise) win a trophy for “social mission”?
We need well trained physicians, not ninny socialist feel-good underachievers who can’t hack pre-med/med/usmle/residency.
Give me a break.
AResident hit the nail on the head with his response. The people who end up in a top 20 med school tend to score better on the boards and get into the more competitive specialty.
PeterW: The best way to help the poor is to train specialists and advance technology? Interesting take. So health care will become cheaper and more affordable as it becomes more advanced? Every new technological advancement I’ve seen in the last 20 years has been more costly than what we had before.
Theres a reason why these top schools cannot admit underqualified students – because they have standards. How about instead of admitting minorities that cannot hack it (ie will turn out to be poor doctors) we address the problems in primary and secondary education that prevents us from having a pool of qualified minorities? That way, we won’t wonder every time we see a minority doctor if he/she is actually competent.
I’m struggling to find words to say to you. First and foremost, God bless. You wrote this on June 16th 2 years ago, probably without thinking twice about how your words may effect someone. Im 20 years old and applying to medical school this year and I am in tears because of what you have said. I came across this article because I’m looking for a medical school with a strong social mission. I want to become a doctor because I care about people. Isn’t that what this profession is about? If its about making the most money and being able to brag about graduating from an ivy league school then maybe this isn’t the profession for me. I prefer going to sleep knowing that I helped people with the intelligence God gave me instead cradling my degree to my ego to fall asleep at night. i am black, and im not “underqualified”. I hope i never have the privilege of practicing with any of you. You may laugh at this and go on about your day but I just pray that the next time you see a black doctor you just see a doctor. not an incompetent black person.
LOL: Last time I checked there was more to medicine than having a high MCAT, high GPA, good resume/communication skills. Maybe the fact that you refer to schools with low stats as “low-ball schools” means that you may be a low-ball yourself who made it into high-ball(??) school. Don’t fool yourself, well trained physicians are trained in primary care first.
I know several classmates with a high MCAT and a high GPA who have chosen residencies in primary care because they enjoy working towards the social mission of bettering the health care of our country. Fine if you want to specialize in a particular area but don’t criticize others who have made it into medical school and have chosen not to specialize simply because they do not want to deal with “feel-good underachievers” such as you, who can’t handle the idea of treating the millions of underserved individuals in our country.
True medicine: huh?
Dude….get off your high horse.
We need good docs of all specialties. We don’t need affirmative action low-stat touchy-feely socialist types. We need high scoring, intelligent, sociable, well-rounded folks.
This “social mission” crap is bs. What, neurosurgeons don’t have a “social mission”? How about intensivists? Retinal surgeons? This article breeds more idiocy, and I wonder why SDN promotes this kinda crap which is killing our profession by the day.
Pay primary care.
No money. No mission.
There’s no surprise here. Today’s elite medical students aren’t interested in primary care. Indeed, they never have been. Compensation is only part of the reason.
Did it just say “The schools with the highest “social mission” scores, on the other hand, include all three historically black colleges surveyed – Morehouse College, Meharry Medical College and Howard University” when the study was partly looking at which schools graduate more minorities? Well duh those schools ranked first, they admit minorities ONLY.
You really expect elite students in ivy league medical schools to go into primary care because it makes them warm and toasty inside? bottom line, primary care pays peanuts; fuzzy feelings don’t pay the mortgage and student loans.
The article’s definition of social mission is too narrow. Someone who goes to one of the research-oriented schools and becomes a medical researcher is still performing a desirable and important service to society. Someone has to teach medicine to all of these doctors who want to work with underserved patients. Also, someone has to develop the algorithms and treatment guidelines that are followed by the doctors practicing in the community, and someone has to create the equipment and drugs they use to treat their patients. Academic doctors get paid less than they would if they went into private practice. That should count as a social mission too.
I think the physician make up should reflect the general population. Don’t get me wrong I believe the best and the brightest should have their fair shake, but grades and good recommendations shouldn’t be the deciding factor. Recommendations especially because the can be easily embellished and not true to the recomendees character. And also some people are fortunate enough to have well connected parents who know influential people. And let’s be honest majority of the people against the notation of social mission are white. And I don’t say this to bash anyone, but alot of the time on forums and postings like this; There are people who blame minorities for not getting into medical school. To be more specific, at my school 70% is white, 20% Asian(non Arabic), and 10% black/Hispanic/Arabic. At one school I interviewed at their that didn’t have one African American for 3 consecutive classes! So it is amazing to me to hear some people blame minorities for their misfortune. Any with that said, if this pertains to you; I’m glad you didn’t get into med school because that same petty self conscious behavior will only bleed into your interactions with patients. White physicians will most likely serve in majority white areas due to money or personal racial preference(which there is nothing wrong with this). Black or Latino doctor will most likely serve in communities that reflect their culture. The majority of doctors don’t even us most of the information from their basic science course in undergrad and medical school. An OBGYN even told me he doesn’t need to know the function of ATP to deliver a baby. He said it is just a weed out process. The most important thing is to have worldly experience. This will help you not only understand your patients better, but allow you to critically think with a broader perspective. Being a good doctor requires understand the population you serve. Like knowing what that populace comes in contact with, common illnesses, and other environmental factors. Memorizing random trivial stuff out a book whose author decided for you want is important and what is not for you to know won’t cut it. I learn this the hard way when I became a medic. Real life medical situations rarely follow the processees in the book. Simple and short, good grades is just the icing on the cake.
@senorcat that is not true! There white student that attend these schools. In fact a friend of mine who is white goes to Meharry right now. You ovibiously have not visited any of these schools, because you would have not made that statement. Yes, the majority is composed of minorities but mostly every race is represented at these schools. Just like any other medical school who has a high white population and small minority population, no difference.
Jealous ass bitches. Can’t stand it when people of color do well.
Manny: Well stated
When I was eight years old, my father, newly diagnosed with alpha-1-antitrypsin defeciency (A1ATD), underwent his first liver transplant. His diagnosis and treatment underscore the importance of every day advances in medical discovery. In 1989, the DNA mutations underlying A1ATD had only recently been described, liver transplants were considered experimental surgery, and his survival hinged on successful immunosuppression–at the time bolstered by the recent introduction of cyclosporine. My father is a truck driver. We aren’t rich. But it’s been over 22 years since we knew he was going to die. Yet, he’s still alive thanks to the highest end specialty care and medical research.
I spent 4 years of my life at an “elite medical school” earning a PhD so I could train in medical research on top of my 4 years of medical school. That research will soon, I hope, be utilized towards better diagnosis and detection of disease. My reward is extended residency and fellowship training so I can fight to establish myself as a physician-scientist. To put it in perspective: I started medical scool when I was 22 and it is expected I will start as a junior attending at the age of 36. For this extensive training, I can expect much lower pay, lower job security, less location flexibility, and higher hours versus private practice. I do it because I believe in a greater good in my own work.
Through grants and donations my “elite medical school” supports a large number of future physician-scientists. This is a part of our school’s overall mission. We provide the highest level of specialty care and research in all areas for those patients who can not be served elsewhere. Of course we also provide vast amounts of general and uncompensated care for our community and for the many patients daily who are flown or ambulanced in from outlying hospitals.
With great personal sacrifice, I have dedicated my own life to discovering new ways to fight disease. Since I came from a lower middle class background with a father with A1ATD and a mother with severe mental illness, I grew up extremely disadvantaged. I grew up poor, in mostly african-american neighborhoods, and went to bad schools. I am a high school dropout. Yet based on this study, given my “Caucasian” skin color, and my seemingly unimportant “social mission”, I can not be counted towards the extensive mission of my medical school.
That is a pity. Because many of the world’s smartest, most driven physicians and physicians-in-training train and work the longest for the lowest salaries in the medicine for a social mission–the social mission of discovering new cures for disease.
This is the first time in my life I’ve wanted to go to a low ranked school.
Based on some of the disrespectful comments made earlier, it is evident that some are misinformed about the quality of applicants and education received at those institutions that are traditionally considered as minority institutions.
Most of these minority institutions have a diverse class — including blacks, white, asians, middle easterners, etc. Yes, the focus of these schools is to serve minority populations, but that does not mean that the classes are made up completely of minorities.
Second, there are people who choose to go to these schools who have above average MCAT scores and GPAs. Just because someone chose to go to a minority institution, does not mean that they were below average when compared to other applicants.
Third, once you start medical school, your MCAT scores and undergraduate GPA are irrelevant. There are plenty of people who struggle in medical school who were average or above average applicants, just like there are plenty of people who excel in medical school despite being considered average or below average applicants. Bottom line, medical school is what you make of it.
Fourth, what medical school you attended is secondary to your USMLE scores/recommendations, etc. Going to an “elite” medical school and scoring average on your USMLE does not make you better than someone who went to a minority institution who score above average on their USMLE. No one is going to accept someone from an “elite” institution with average stats into an orthopedic surgery program over someone with exceptional stats from a minority program. And yes, there are people who attend minority institutions who score very well on the USMLE.
If you take a look at the residency match list for minority institutions and compare them to those of other institutions, you will see that these minority institutions have just as many people going into specialties as other medical schools. Again, what residency you end up in is due in large part to your performance in medical school and on your USMLE — which is based on your own personal performance. We all learn the same material in medical school. It’s up to the individual to make sure that they are prepared.
And lastly, there are some people really want to go into primary care. There is absolutely nothing wrong with that. In fact, it makes sense that the person who went to a more expensive, “elite” medical school would not want to go into primary care due to the amount of loan debt. Whereas, the person who went to the less expensive school with less loan debt might see nothing wrong with primary care.
At the end of the day, medical school is medical school. Where you choose to go is your own personal business, but we’re all getting the same education. Just because one school may admit students whose stats are not as high as other applicants does not devalue the education at that institution. Medical school is what you make of it.
To premeds: For the rest of your life you will have something that people want, your medical education and skills, because you worked hard and were smart enough to achieve it. It’s a valuable commodity that many want control of but few can earn. Like in this article, they will try to convince you to use it in a certain way. Don’t sell yourself short. You can still go into primary care from an elite school, or into anything else you want. Achieve what you want to achieve, get into the best school that you can, find a job that excites and challenges you. A doctor does more ‘social good’ in one week than most people do in their entire lives. Don’t fall victim to the bullshit.
Is it too much to ask that minority applicants get the scores/grades similar to the other applicants going to med school???? Why should a poor white/asian kid be disadvantaged compared to a poor black/hispanic kid? And grades/scores/MCATs are important, becuase they are a good predictor of how well you LEARN, STUDY, and how hard you WORK (don’t give me any anectodtal BS if you disagree).
Bottom Line: As an attending, I see too many incompetent minority students flunking out. Don’t lower the bar for applicants, adress the MAJOR societal, and primary/secondary education problems with these groups. Letting them in to med school with a lower bar will only cause more problems.
Tran, isn’t the point of having minimum passing requirements for standardized tests to make sure students are competent enough to take the next step? It’s not like minority students have a lower minimum passing score on Step 1.
Sometimes under-qualified applicants can slip through the cracks at a lower ranked institution (because they realize the MCAT is not the best predictor at all for med school success) but those under-qualified people will not be able to get through the coursework or the boards.
Unless you are suggesting there should be a strict numerical MCAT cut-off for acceptance into med school, so-called “under-qualified” ppl will slip in sometimes. The “elite” people will not be affected
I agree with other posters about the methods of interpreting this “social mission”. Research is invaluable and should not be disregarded. With that said, someone who does FP in the Bronx probably has more “social” impact than someone who does strictly cosmetic plastics in Beverly Hills. This is not to look down upon a particular field but it is what it is.
@Tran you seem hostile towards the notation of social mission. Why is that? Do you blame minorites for not getting into your 1st choice medical school or something? Look, knowing the information is important. I can’t argue that, but as an attending you of all people should know that just knowing your gross anatomy book cover to cover is not enough without a steady hand has a surgeon. Or knowing the anatomy of the female reproductive organs and their spelling and can’t coach an anxious teenage mother through her pregnancy is an issue. Another thing, you generalize minorities has if they are all incompetent (I know you don’t mean to but that how is comes off). Haven’t seen you mention any of the people who get into elite schools because daddy gives a large donation or knows powerful people (ie George W. Bush). Why aren’t you attacking students like him? You want to talk about fair right?
MM: Would you rather have “expensive” modern medical care, even the limited amount available to the poor, or the much cheaper medical care available in 1900?
It is truly disheartening to read all the negative comments left here. Coming from an underserved community and a Hispanic family, I think it is really easy to say that serving the underserved, low-income communities, etc. is bs or whatever other negative remark when you have never really experienced what it’s like to be underserved or have your family members suffer due to inadequate care and medical resources. I simply don’t understand why some people feel that in order to gear/motivate medical students to go into primary care or work in underserved areas, medical schools must compromise selectivity in the admissions process or curricular rigor for some reason. I do think that this reasoning is irrational because it is possible for a “top” medical school or any medical school, for that matter, to adopt a curriculum that motivates or inspires students to become physicians for the underserved. I am also fortunate enough to be starting medical school in a very good school that does serve an underserved population so I can safely say it is possible to “have your cake and eat it too” when it comes to great schools preparing physicians to serve these communities.
by the way I also agree w/ HereWeGoAgain that “medical school is medical school”; just because a school is ranked low on U.S. News doesn’t mean it’s a bad school or produces incompetent physicians. There are certain differences in medical curriculum and funding from school to school, but medical education, for the most part, is standardized. This allows all medical students who graduate from a U.S. school to be able to practice medicine anywhere. Furthermore, as a Hispanic student, shutting down medical students for being minorities and claiming that it somehow makes them stupid or incompetent is racist, for lack of a better term. I, just like any other medical student, have had to go to college, get decent grades, get a decent MCAT score (a standardized test, keyword: STANDARDIZED), and do tons of extracurricular activities/research to be accepted to medical school.
One of the weaknesses of humanity is the tendency to make overly simplified, bone-headed discriminations based on skin color or ‘minority group’. Remember – There are ‘minority students’ who score sky high in terms of GPA, MCAT and USMLES and attend both “elite schools” and the schools mentioned in this article.
The Generalizations being made here do a disservice to those high flying performers.
In my personal experience as a minority student who was doing straight As at a top ranked majority school, I would still have to put up with majority students talking trash about how I’m going to get into med school just because I’m ‘a minority’ – despite a 4.0 and tremendous extra curriculaars. ( This came from a classmate who was also complaining that there were too many minority students at Cornell Med – never mind that minority physicians make up only 2-3% of physicians)
Listen ! It’s a bad attitude and the tendency to generalize too broadly that causes this problem we call racism.
Remember “minority physicians” should not be lumped in 1 group.
Don’t be a bone-head and overgeneralize. It insults as all – even the best of us like famous neurosurgeon Ben Carson etc etc.
Additionally, there is a legitimate need for physicians to practice in underserved areas. If kudos are being given to institutions who carefully select people with a specific intent to practice in those areas, then the recognition is well deserved.
I was accepted at several med schools – on ranked top 5.
I decided to start at Howard U in the fall.
Their screening process is geared to looking for people who are committed to serving underserved populations. The results are not accident, it is BY DESIGN. The recognition is well deserved.
I hope this helps clarify the issues.
Howard Class of 2014
I’m in Howard Class of 2014 and Proud about It !!!!
Social mission? More like, which students couldn’t match into good specialties/couldn’t get jobs in desirable locations. Is it a surprise that Penn, Duke, Harvard, Cornell, Columbia, Hopkins, and Northwestern are all at the bottom of the PCP list? Or that Penn, Columbia, Duke, Stanford, and Hopkins are on the bottom of the “social mission” ranking? Course not.
A couple of points:
Not only do med students incur $250,000 to $400,000 in student loans, they are giving up 8-10+ years of earnings while attending medical school, and then earning less than many nurses while in residency. It’s pretty clear that NO medical field is chosen for the money. (It’s a pretty simple discounted cash flow calculation over a person’s lifetime.) You’d be much better off going into another profession. (Especially in the current political situation where the power hungry government is taking over this sector of the economy).
People criticize students or not wanting to go into primary care, saying they don’t have a social mission. There’s lots of reasons for not going into primary care: who wants to babysit a society of individuals who won’t follow doctor’s orders, who just want you to prescribe a magic pill to solve their problems…
The idea that anyone who isn’t in primary care doesn’t have a social mission is nuts. The only reason to go into medicine IS social mission. Why is it that only doctors are required to consider social mission? Their patients certainly don’t. I give you an example: My uncle was an orthopedic surgeon who would do free surgeries for those who couldn’t pay. He had one requirement: If he did a free procedure for you, you would have to do some community service. Care to guess how many people told him to drop dead?
Why is it that we all are capable of giving back socially, no matter what social/economic/educational background we have, but physicians are held to a different standard than everyone else…
Reading some of the comments here it seems that “social mission” is somehow associated with primary care i.e. peds, IM, FM, OB/GYN (both primary care and specialty field). What I interpret as our social mission as physicians is to provide competent, evidence based, care to all patient’s regardless of race, religion, ability to pay. Is a radiation oncologist working at a county hospital (for signficantly less money then he/she would be making if her worked at “cancer center of excellence”) have less of social conscience then the hospitalist or pediatrician at that same hospital. Lower income people have cancer too and require radiation, by working at said hospital the radonc is providing a service to people who would otherwise have to pay out the wazzoo for this. Do the anesthesiologists, radiologists, interventionalist, ENTs, plastic surgeons who work at the same hospital and provide these people with excellent specialty care, are they less socially conscientious they their PCP colleagues. The reason I use these “high end” specialties, is b/c they are typically produced from so called “elite” schools. Not to say that “lower end” schools (however you want to define it, though it’s hard to call any MEDICAL school “low end”) dont produce the majority of these specialists, b/c they make it sound like they are soulless, money grubbing automotons. Furthermore, MOST people that go into primary care residency, end up doing a fellowship and are there for sub-specialits, I’ve talked to many people with AOA status, high grades etc from many schools who chose IM, FM, peds etc. ONLY to do a fellowship. Do not indicte people b/c they don’t get goosebumps about prescribing insulin and anti-HTN medications, some people have a passion for a specific field, that and a so called “social mission” are not mutually exclusive. Do what you love, do not let people coerce you into a specific in field b/c of THEIR OWN personal beliefs.
PeterW: I don’t think there is anything wrong with advancing medicine. I’m just pointing out how ridiculous it sounds when you claim that the best way to help the poor is by making health care more expensive.
“The mission and function of all schools won’t be and shouldn’t be the same,” Dr. Mullan added. “But we all might think about how we could be a little more responsive to the ongoing needs of patients and of our country. If we continue to produce more doctors in the system we have now, we won’t be able to address the needs, the health outcomes and certainly the populations that are underserved, dying and suffering as a result of it.”
@MM:
Why do you assume that new technological developments equate to more expensive care? A new drug, device, procedure, or diagnostic tool could result in reduced cost, e.g., when a drug is developed that treats a condition that previously required surgery. In fact, reducing cost is one of the most important motivators in development of new technology. If you’re the one who finds a cheaper way to get the job done, you just hit the jackpot! Or what about when we find a CURE for a disease that previously was simply managed for years using lots of drugs? The lifetime cost of caring for a patient’s illness could easily trump the cost of an “expensive”, fancy, new cure.
AUnontrad: We put quality of care secondary to cost in this country. Technological advancements in health care are not being made to reduce cost – they are being made to provide better treatments. While I agree that some advancements have reduced cost in the long run, I would argue that many of them do not. They simply allow us to live longer and more comfortably but at a substantial price that many people cannot afford.
MM:
I think you intended to say that cost is treated as secondary to quality.
I agree that the current state of the system leans more toward quality than cost. Not to turn this discussion in another direction, but I think that is a direct result of patients’ being largely divorced from consideration of cost, which is in turn caused by too much involvement of government and, to a lesser extent, insurance companies. As far as the government’s role goes, the emphasis on quality is related to the same philosophy that produces this “social mission” drivel and the idea that people have a right to receive services for which they cannot pay. Cost be damned! Simply by virtue of their being alive, people DESERVE to receive the best health care money can buy, and it doesn’t matter whose money is used to pay for it.
Eventually, I think most MDs come to the realization that on a day-to-day basis, practicing medicine is just a job. One might as well try to pick the job that results in the greatest overall satisfaction. If that happens to be some area of medicine other than primary care, I say the people who don’t like it can stick it. I am disgusted by administrators and faculty at med schools who push primary care this and underserved or rural that. If those jobs are so worthwhile, why aren’t they doing them? Perhaps it is because they earn twice as much in their academic jobs.
AUnontrad: Sorry, I mistyped. I meant cost is secondary to quality.
Agree wholly with the general consensus of criticism toward the article. The “warm fuzzy feeling” does not ever accomplish anything positive for society. We reward neediness and perpetuate an expectation that is unsustainable. Sorry, I don’t have 90 minutes to expand my proposition or cite any references. Good lucky everyone!
To put this in its simplest form, even at those top 20 ranked “social mission” schools, students who performed at the top WILL choose to specialize. Period! ;D
Our system is driven to put more “qualified” candidates into competitive residencies. It is the simple supply and demand mech at work. Unless, pri care receives the same kind of return as other medical fields, MOST of the students who can do something else will skip over it ;D just my 2 cents from one of the lowest ranked top 20 “social mission” schools
MM: Perhaps you are confusing absolute vs. relative well-being. I submit that poor people today get better healthcare than poor people in 1900, due to improvements in technology. The fact that rich people also get better healthcare is not terribly relevant to poor people’s actual well-being – we’re better off with technology than without.
BBBB: You are realer than Real Deal Holyfield
Clearly there are some minorities that are far above the bar, and they should gain acceptance to med school.
These are the people that should be the most angry that the bar is being lowered for others just because of their skin color. Call it racism or human nature or whatever you want, people WILL wonder about YOU when the bar is lowered for everyone that looks like you.
Again, solve the problems that lead to fewer qualified minorities. Don’t lower the bar.
This study was one measure of how schools are ranked. If Harvard isnt ranked at the top, then deal with it! The three HBCU’s dominate this ranking and all hell breaks loose. Get a life! Im proud of these schools. Some of the previous comments sicken me. I am an African American and I perform just as well or better than most white students. I chose to attend one of the HBCU’s because of the schools purpose. Not because of a low ranking or because the majority of the students at these schools are minorities. Its crazy how people just cant give credit when it is due.
I shudder to think some of you will be my classmates this coming fall. Yes, I am a minority and I also graduated with the highest distinction (impossible, right?) Some comments above remind me that some premeds are just plain old smart, with very narrow world views.
When you are not aware that people live in under-served communities with little access to health care, then you can yap about social missions.
Insurance companies can help solve the primary care shortage by adjusting the compensation – more for primary care and less for specialties. Like it or not, money DOES mean a lot to people when choosing a residency.
Also, the military solved this type of problem years ago with a thing call “quality spread.” Every pilot wanted to fly fighter jets, but only a small percent could. So, before “quality spread” was implemented all the best pilots went into jets. The other communities didn’t appreciate this – because all the communities (specialties) need top performers. “Quality spread” would give the #1 person in each class their first choice and then the rest of the class was quality spread (randomly) into the other fields to distribute the top (and bottom) students. Would this work for medicine? Probably not, but it’s something to think about.
The people who can do the jobs should get the jobs. When we start giving opportunities to those who need them, rather than people who have earned them; we start to destroy our society. Admission should be based on scores, GPA and extracurricular activities. A Social-Mission, based on race is idiotic and fundamentally un-American!
My hat goes off to those who enter the PC realm. I love how they are rewarding for their choice…lets give them more patients to see, cut their medicare reimbursement by 20-30% on top of having a lower salary then most other fields, and to top it off we will have NPs move up along side of PC doctors and give them similar privileges and salary.
As a side note the rankings are in ANNALS of Internal Medicine not Archives
To be a “good” doctor, you’ve gotta be good at BOTH scoring well on tests AND actually CARING about people! If you’ve got the scores, that doesn’t mean that patients will automatically give you their TRUST. And if you DON’T have the scores, that doesn’t mean you won’t be a good practicing physician. Seriously. It all depends on how dedicated the student is to providing quality care. I’ve seen so-called “superstar” med students/residents on campus (Ivy-League school, by the way) and they have such arrogance about them! Then they’ll cough on you and treat you like crap if you “have the nerve to ask questions” or if you don’t pay cash! Beware of those MDs who solely “look good on paper,” there’s usually something lacking somewhere personality-wise.
And the best way to help the poor is NOT better technology!! The poor can barely afford basic medication! The best way to help the poor is to care about them enough in the first place to help them PREVENT illness. When they’ve already arrived at the hospital, they’re already losing whatever little money they have (gotta love U.S. healthcare policy). Had to share. I’m also going to med school next month, and since I have an MPH degree AND have been a PATIENT at a so-called top-notch hospital, choosing a school that “cares” was/is VERY important to me. Besides, it’s not about the school. A medical student can excel or fail ANYWHERE. However, the reality-check question is: How are you going to pay back those LOANS?!
@Z Mzuriwesi
You are immature and unrealistic. You’ll understand MORE things when you start going to medical school. Until then, I’ll let you be naive. But I must warn you, it isn’t going to be easy for the likes of you.
And do not generalize, it just makes you look more idiotic. And leave the “superstars” alone since there are assholes in each profession, whether they are “superstars” or not.
“Beware of those MDs who solely “look good on paper,” there’s usually something lacking somewhere personality-wise.”
I can say one thing to that statement of yours: STUPID. Most of these MD’s who solely look good on paper are usually great doctors. I don’t think I have met doctors that are great in written exam but sucked at dealing with patience.
“The best way to help the poor is to care about them enough in the first place to help them PREVENT illness”
Elaborate that part because I hardly understood it. I think PREVENTING illness is ALSO part of anyone’s job, not only doctors. You can prevent illness in simple ways like washing your hands. Doctors are there to prevent it to get worsened or to cure it.
Oh trust me, sometimes it IS about the medical school that you went to. There are great AND crappy medical schools. Do you wonder why there are more ‘notable alumni’ from let’s say Hopkins compared to some unknown med school?
Missie, when you sit on a high horse to chastise the young and idealistic (you call her naive, I call you a jaded loser; 6 to one, half-dozen to another), you might want to at least use semi-decent English grammar. I don’t have the patience for arrogant a-holes who don’t know that patients and patience are different words.
Medical Schools and Specialty schools (e.g., O.D. School, Dentistry, Podiatry etc.) should NOT be focused on a “social mission” of graduating minorities – but rather be focused on and “overall mission” of graduating the best and brightest students possible! A “social mission” is just a recipe for inept individuals in positions they have no business being in (see: Affirmative Action) and all that will create is inadequate care for the patient community. I can’t speak for anyone else but I, personally, want the best and most qualified doctor addressing my needs… I think you do too.
“ranks low in social mission”=”does the poorest job of discriminating against white men”
Dear Matt and CDG:
You guys are ignorant, and not paying attention to the institutional racism that has plagued medical schools well into the 60′s or 70′s. There are some schools, like Northwestern, that take one or two underrepresented minority students a year. That is absurd, especially since it is in Illiois and there are all kinds of bright students of every race. Then, look at schools like University of Washington and University of California-Los Angeles who have top notch programs and turn out underrepresented minorities like clock work. At UCLA, the URM may have “lower stats,” but they pass the boards and become licensed just like everyone else. You have to look at the social inequalities that cause people to have lower marks. Everyone has to take the same Step tests. If URMs pass them at the same rate as their white counterparts, what does that say about their so called “ineptness” based on undergraduate marks?
*Illinois
So medical schools are ranked “higher” in social mission for graduating more minorities huh? Good to see racial discrimination is still in full swing in 2010..
Here is a thought, why don’t schools admit the most qualified applicants regardless of skin color!
Missie, let me just say that I would not want a doctor like you if I’m correctly interpreting your attitude problem.
If I were a medical school, I would look at two things, primarily:
MCAT
Interview
Only after that would I consider anything else, and I wouldn’t consider skin color at all.
Activities such as volunteering are mostly BS, and can easily *be* BSed, and so can grades too. What determines your grades? How hard you study? Or how many friends with old exams you had?
MCAT
Interview
Honestly, what else matters? What else is genuine?
Of course I went to Hopkins to become a superspecialist and go into academic medicine and do research and become a leader in my field, not to go into primary care. This was true for most of my classmates. Training garden-variety doctors is just not the hopkins motto. If you want to become a family practitioner, you wouldn’t go to Hopkins. I’m not sure why anyone is suprised by the results of this survey. Also, Hopkins pours tons of $$ into public health…more than any other hospital in the country…I’d say that’s a “social mission.”
Also, I graduated from Hopkins with plenty of minorities and immigrants in my class. I don’t know what they are talking about and I sure hope they didn’t use my tax $$ to conduct their survey. HA.
I came across this article because I’m looking for a medical school with a strong social mission. I want to become a doctor because I care about people. Isn’t that what this profession is about? If its about making the most money and being able to brag about graduating from an ivy league school then maybe this isn’t the profession for me. I prefer going to sleep knowing that I helped people with the intelligence God gave me instead cradling my degree to my ego to fall asleep at night. by the way. i am black, and im not stupid. the comments ive read here are rude and ignorant. I hope i never have the privilege of practicing with any of you.