Rethinking the Mission of Medical Schools
By Jemma Weymouth, July 6, 2010
As the U.S. girds for an influx of newly-insured patients under health reform, attention is shifting to whether medical schools are producing doctors that meet the country’s health care needs. Helping to spark this debate is a recent study that ranks U.S. medical schools in a new, provocative way: on the extent to which they produce doctors who practice primary care, work in underserved areas, and are minorities.
By measuring schools against this “social mission” criteria, Dr. Fitzhugh Mullan of George Washington University and his colleagues (with support from the Josiah Macy Jr. Foundation, a Burness client) have created a new “best medical schools” list that turns traditional rankings on their head. Historically black schools Morehouse School of Medicine, Meharry Medical College and Howard University lead the pack (PDF), while more “prestigious” medical schools such as Vanderbilt, Duke, Stanford and Johns Hopkins fall into the bottom 20.
The study has come under fire from the Association of American Medical Colleges (AAMC) and by some of the low-ranking schools for what they claim is a too-narrow definition of social mission. The authors reply that the intention of the study is not to point fingers but to help schools examine how they are meeting the nation’s health care needs. Faced with a primary care shortage, Americans across the country are struggling to find family doctors, and sometimes waiting months for appointments or hours in emergency rooms. While lower-ranking schools may produce more great researchers and specialists, there is no question that the nation needs more frontline doctors who practice primary care for underserved people.
By training more primary care doctors and encouraging graduates to work in areas where there are not enough doctors, medical schools can make a big difference. As the U.S. health care system prepares to accept millions of new patients, this debate couldn’t be more timely.
The study appeared in the June 15 Annals of Internal Medicine, and is available online here.
Listen to lead author Dr. Fitzhugh Mullan and Dr. John Prescott from the AAMC debate the study on WBUR, Boston’s NPR station: http://www.wbur.org/2010/06/15/doctor-training