Prestigious medical schools do not make better doctors: study

Medicine

By Tessa Hoffman

2 Oct 2018

It’s official: the most prestigious medical schools do not produce better doctors.

At least that is according to a new study from the US, which found the ranking of the medical school a physician had graduated from had no bearing on the mortality rates of their patients.

Medical school rankings also had little influence on patients’ readmission rates and costs of care, according to an analysis of almost 100,000 emergency admissions by over 30,000 general internists between 2011 and 2015.

The study authors used US News and World Report (USNWR) medical school rankings, which are based on four measures: reputation, research activity, student selectivity and faculty resources.

The study found 10.6% of patients died within 30 days of admission and there was no systematic relationship between mortality rate and the treating doctor’s university ranking. Patients treated by physicians from lower-ranked medical schools had slightly higher 30-day readmission rates (15.7% vs 16.1%) than those treated by doctors from higher ranking schools, but the difference was not statistically significant.

Medicare spending was slightly lower per-capita for patients who saw physicians from the top 10-ranked schools, compared to colleagues from schools ranked 50 or greater ($1050 compared to $1067).

The study authors said medical education and training were potentially important determinants of a physician’s practice style, and patients and peer physicians might use a physician’s medical school ranking as a signal of provider quality. But there was surprisingly little evidence about the association  between where a physician completed medical school and subsequent patient outcomes, said Dr Yusuke Tsugawa and co-authors from UCLA and Harvard Medical School.

For physicians practicing within the same hospital, the ranking of the medical school from which they graduated bears little or no relation with patient mortality after hospital admission, readmissions, and costs of care, they concluded.

Professor Richard Murray, president of  Medical Deans Australia and New Zealand, said there was no surprises in the findings.

Status or academic ranking of medical schools in Australia or New Zealand was not a factor in hiring or selection for training, and strong accreditation systems through the Australian Medical Council meant students had comparable abilities upon graduation, he told the limbic.

“There is not, either in the profession, amongst employers or in the community, any sort of snobbery about ‘I got my medical degree from X’, said Professor Murray, who is Dean of the College of Medicine and Dentistry at James Cook University in Queensland.

“Whereas in the UK there may be quite a strong perception of status around even the secondary school you went to – ‘are you an Eton boy?’ – that doesn’t exist here, no one cares.

“In this country opportunities in a medical career are much more determined what you have done subsequent to (university). What may vary between universities are the sort of choices that graduates make – for instance, rural practice,” he said.

Four Australian medical schools feature in the top 50 of the World Medical School rankings 2018, compiled by QS. They are: University of Melbourne (ranked 17th), University of Sydney (18th), Monash University (29th) and University of Queensland (50th).

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