Entry of US Medical School Graduates Into Family Practice Residencies: and 3-year Summary

Transcription

1 554 September 1998 Family Medicine Special Articles: 1998 Match Results Entry of US Medical School Graduates Into Family Practice Residencies: and 3-year Summary Norman B. Kahn, Jr, MD; Gordon T. Schmittling, MS; Julea G. Garner, MD; Robert Graham, MD This is the 17th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school s graduates entering family practice residency programs. Approximately 16.6% of the 15,894 graduates of US medical schools between July 1996 and June 1997 were first-year family practice residents in October 1997, compared with 15.9% in 1996 and 14.6% in This is the highest percentage since this series of studies began in (12.8%). Medical school graduates from publicly funded medical schools were almost twice as likely to be first-year family practice residents in October 1997 than were residents from privately funded schools, 19.8% compared with 11.8%. The Mountain region reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 1997 at 25.8%; the Middle Atlantic and New England regions reported the lowest percentages at 11.7% and 10.7%, respectively. Nearly half of the medical school graduates (48.1%) entering a family practice residency program as first-year residents in October 1997 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates of colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family practice residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine. (Fam Med 1998;30(8): ) From the Division of Education (Drs Kahn and Garner), the Division of Research and Information Services (Mr Schmittling), and the Executive Vice President (Dr Graham), American Academy of Family Physicians, Kansas City, Mo. No single factor can be attributed as the ultimate influence causing a medical student to choose family practice as a career. There are, however, many factors that influence the specialty choice of graduates on a year-by-year basis. 1-2 Since 1977, the American Academy of Family Physicians (AAFP) has recognized the need for efforts to enhance interest among medical students in family practice as a career choice. The AAFP has implemented a number of initiatives but none so direct as the formation in 1988 of the Task Force on Student Interest. 3 The task force includes representation from the Society of Teachers of Family Medicine, the Association of Family Practice Residency Directors, the Association of Departments of Family Medicine, and the American Board of Family Practice, with liaisons from the Association of American Medical Colleges (AAMC), the American Medical Association (AMA), and the Bureau of Health Professions, Division of Medicine. The task force goals are that all medical schools have a department of family medicine; that at least 25% of all medical school graduates complete family practice residency training and pursue a career in family practice; and that the production of qualified clinicians, teachers, and researchers in family practice be increased. The projects that the task force has initiated to accomplish its goals include 1) making information and consultations available on how to start a department of family medicine, 2) supporting the development and enhancement of a growing network of family medicine interest groups in medical schools, 3) supporting the growth of the AAFP National Congress of Student Members, 4) increasing the availability of

2 Special Articles: 1998 Match Results Vol. 30, No Table 1, by Type of Medical School, October 1997 Number Percent US medical school graduate,7/96 6/97* 2, US medical school graduate, outside 7/96 6/ Osteopathic school graduate, 7/96 6/ Osteopathic school graduate, outside 7/96 6/ International medical school graduate TOTAL 3, * Tables 2 5, 7, and 8 relate to 2,634 residents who graduated within the time period, including 48 who were promoted to the second year of residency by October Source: American Academy of Family Physicians family practice residency information, and 5) tracking available influences and statistics relevant to student interest, such as the amount of exposure to family practice, particularly during the third year of medical school, and the percentage of students from each medical school who enter family practice residency programs. 4 In February and June 1998, the Task Force on Student Interest held special focused discussions reviewing issues that affect medical student perceptions of family practice. Many of the issues that were present in 1988 remain issues for medical students in However, the task force recognizes that the efforts in 1998 to maintain and increase student awareness and interest in family practice must increase significantly. Methods This is the 17th national study conducted by the AAFP to determine the percentage of graduates from each medical school who enter family practice residency programs 6-19 (2 years study results were not published). Since June 1972, the AAFP has annually performed a census of all residents in family practice residency programs. Program directors listed all firstyear residents and their medical schools, including the month and year of graduation. The residency program directors also verified the status of second- and third-year residents and the graduates originally reported on in previous years. After all census forms were returned by program directors in June 1997, the medical school information was coded and keyed. In mid-september 1997, a verification of the census information was made with program directors, allowing them to add the names of first-year residents who entered their programs later than July 1 and delete the names of residents who failed to enter the program as expected. A 100% response rate was achieved. Through this method, 38 first-year residents were deleted from the file from those reported in June, and 70 additional first-year residents were added, for a net gain of 32. In 1997, there were 10 adds and 10 deletes for a net gain of 0. In 1996, there were 57 adds and 57 deletes for a net gain of 0. In 1995, there were 105 adds and 66 deletes for a net gain of 39. In 1994, there were 99 adds and 73 deletes for a net gain of 26. These data reflect two trends: medical students choosing family practice through the NRMP are sticking with their choices, and positions in family practice residencies, if vacated, are quickly filled. After the corrections were made to the file in November, the resident file was re-sorted by medical school, and each respective listing was sent to the appropriate registrar s office. At the same time, a copy of the listing was sent to the family medicine department/division chair at the respective medical school. To obtain percentages of graduates entering family practice residency programs from each medical school, the AAFP used AMA data that reports graduates from each medical school based on a July 1, 1996, to June 30, 1997, graduation date. 20 The AAFP uses data from the AAMC to determine the type of medical school, public or private. 21 For the fourth year, the study included graduates of colleges of osteopathic medicine and used the same methods outlined above. After the data were returned by the family practice residency program directors, the registrars of colleges of osteopathic medicine were contacted to verify the graduation month and year of osteopathic physicians who were first-year residents in Accreditation Council for Graduate Medical Education (ACGME)-accredited family practice residency programs. The American Association of Colleges of Osteopathic Medicine provided estimates of the number of graduates from each college of osteopathic medicine. Results Of the 3,514 first-year residents on October 1, 1997, 2,586 (73.6%) were identified as having graduated from US Liaison Committee on Medical Education (LCME)-accredited medical schools between July 1996 and June 1997 (Table 1). In addition, there were 310 first-year residents (8.8%) who graduated from US LCME-accredited medical schools outside the reporting period. Therefore, 82.4% (2,896/3,514) of all first-year family practice residents in October 1997 graduated from US LCME-accredited medical schools, compared with 78.4% (2,751/3,510) in 1996, 77.3% (2,511/3,249) in 1995, and 73.8% (2,257/ 3,060) in At least one in four graduates of the following 22 medical schools in the reporting period was in a family practice residency program as a first-year resident in October 1997 (Table 2): University of South Alabama (36.9%), University of Arkansas (34.1%),

3 556 September 1998 Family Medicine Table 2 Number and Percentage of Medical School Graduates Who Were Family, by US Medical School, October 1997 Medical School ALABAMA Alabama, University of South Alabama, University of ARIZONA Arizona, University of ARKANSAS Arkansas, University of CALIFORNIA California, Davis, Univ of California, Irvine, Univ of California, Los Angeles, Univ of California, San Diego, Univ of California, San Francisco, Univ of Loma Linda University Southern California, Univ of Stanford University COLORADO Colorado, University of CONNECTICUT Connecticut, University of Yale University DISTRICT OF COLUMBIA George Washington University Georgetown University Howard University FLORIDA Florida, University of Miami, University of South Florida, University of GEORGIA Emory University Georgia, Medical College of Mercer University Morehouse School of Medicine HAWAII Hawaii, University of ILLINOIS Chicago, Pritzker, Univ of Chicago Med School, Finch Univ Illinois, University of Loyola Univ of Chicago, Stritch Northwestern University Rush Medical College Southern Illinois University INDIANA Indiana University Medical School KANSAS Kansas, University of KENTUCKY Kentucky, University of Louisville, University of LOUISIANA Louisiana State Univ, New Orleans Louisiana State Univ, Shreveport Tulane University MARYLAND Johns Hopkins University Maryland, University of Uniformed Services University MASSACHUSETTS Boston University Harvard Medical School Massachusetts, University of Tufts University MICHIGAN Michigan State University Michigan, University of Wayne State University MINNESOTA Mayo Medical School Minnesota, University of MISSISSIPPI Mississippi, University of MISSOURI Missouri, Columbia, Univ of Missouri, Kansas City, Univ of St Louis University Washington Univ, St Louis NEBRASKA Creighton University Nebraska, University of NEVADA Nevada, University of NEW HAMPSHIRE Dartmouth Medical School NEW JERSEY UMDNJ-New Jersey, Newark UMDNJ-Robert Wood Johnson NEW MEXICO New Mexico, University of IOWA Iowa, University of

4 Special Articles: 1998 Match Results Vol. 30, No Table 2 (continued) Medical School NEW YORK Albany Medical College Albert Einstein College of Med Columbia University Cornell University Mount Sinai School of Medicine New York Medical College New York University Rochester, University of SUNY, Brooklyn SUNY, Buffalo SUNY, Stony Brook SUNY, Syracuse NORTH CAROLINA Bowman Gray School of Medicine Duke University East Carolina University North Carolina, University of NORTH DAKOTA North Dakota, University of OHIO Case Western Reserve Univ Cincinnati, University of Medical College of Ohio Northeastern Ohio Universities Ohio State University Wright State University OKLAHOMA Oklahoma, University of OREGON Oregon Health Sciences Univ PENNSYLVANIA Allegheny University Jefferson Medical College Pennsylvania State Univ, Hershey Pennsylvania, University of Pittsburgh, University of Temple University PUERTO RICO Universidad Central del Caribe Ponce School of Medicine Puerto Rico, University of RHODE ISLAND Brown University Medical School SOUTH CAROLINA South Carolina, Medical Univ of South Carolina, University of SOUTH DAKOTA South Dakota, University of TENNESSEE East Tennessee State Univ Meharry Medical College Tennessee, University of Vanderbilt University TEXAS Baylor College of Medicine Texas A&M University Texas Tech University Texas, Galveston, Univ of Texas, Houston, Univ of Texas, San Antonio, Univ of Texas, Southwestern, Univ of UTAH Utah, University of VERMONT Vermont, University of VIRGINIA Eastern Virginia Med School Virginia Commonwealth Univ Virginia, University of WASHINGTON Washington, University of WEST VIRGINIA Marshall University West Virginia University WISCONSIN Wisconsin, Medical College of Wisconsin, University of TOTAL (124) 15,894 2, * American Medical Association: Medical Schools in the United States. JAMA 1997;278: ** American Academy of Family Physicians, annual survey of medical schools

5 558 September 1998 Family Medicine Table 3 Number and Percentage of Medical School Graduates Who Were Family, by Census Region and State of Medical School, October 1997 Region and State EAST NORTH CENTRAL 2, Illinois 1, Indiana Michigan Ohio Wisconsin EAST SOUTH CENTRAL Alabama Kentucky Mississippi Tennessee MIDDLE ATLANTIC 2, New Jersey New York 1, Pennsylvania 1, MOUNTAIN Arizona Colorado Idaho 0 0 NA Montana 0 0 NA Nevada New Mexico Utah Wyoming 0 0 NA NEW ENGLAND 1, Connecticut Maine 0 0 NA Massachusetts New Hampshire Rhode Island Vermont PACIFIC 1, Alaska 0 0 NA California 1, Hawaii Oregon Washington University of California, Davis (30.4%), Mercer University (36.2%), Morehouse School of Medicine (35.3%), University of Hawaii (27.3%), University of Iowa (27.2%), University of Kansas (26.8%), Michigan State University (37.1%), University of Minnesota (34.1%), University of Missouri-Kansas City (30.1%), University of Nebraska (27.4%), University of North Dakota (46.7%), Case Western Reserve University (25.5%), Wright State University (28.7%), University of Oklahoma (28.3%), Allegheny University (26.5%), University of South Dakota Region and State SOUTH ATLANTIC 2, District of Columbia Florida Georgia Maryland North Carolina South Carolina Virginia West Virginia WEST NORTH CENTRAL 1, Iowa Kansas Minnesota Missouri Nebraska North Dakota South Dakota WEST SOUTH CENTRAL 1, Arkansas Louisiana Oklahoma Texas 1, PUERTO RICO TOTAL 15,894 2, * American Medical Association: Medical Schools in the United States. JAMA 1997;278: ** American Academy of Family Physicians, annual survey of medical schools (38.0%), East Tennessee State University (30.6%), Texas A&M University (26.1%), University of Utah (39.8%), and University of Washington (28.0%). The University of Minnesota graduated the highest number of medical school graduates who chose family practice residency programs with 76, followed by the University of Illinois with 65. Of the 15,894 graduates of LCMEaccredited medical schools between July 1996 and June 1997, 16.6% were first-year family practice residents in October 1997, an increase of.7 percentage points over The University of Minnesota has a separately accredited Duluth branch where medical students complete the first 2 years of study. After successful completion of their studies, the students are guaranteed transfer to the University of Minnesota, Twin Cities campus, in Minneapolis. As indicated in

6 Special Articles: 1998 Match Results Vol. 30, No Table 4 Table 5 Number and Percentage of Medical School Graduates Who Were Family, by Type of Medical School, October 1997 Programs Public (73) 9,418 1, Private (51) 6, TOTAL (124)*** 15,894 2, * American Medical Association: Medical Schools in the United States. JAMA 1997;278: ** American Academy of Family Physicians, annual survey of medical schools *** Includes 4-year LCME-accredited US medical schools Number and Percentage of Medical School Graduates Who Were Family, by Type of Family Medicine Administrative Structure, October 1997 Administrative Structure Department of FM (112) 14,416 2, Division of FM (2) None (10) 1, TOTAL (124) 15,894 2, * American Medical Association: Medical Schools in the United States. JAMA 1997;278: ** American Academy of Family Physicians, annual survey of medical schools Table 2, the AMA reported 223 graduates from the University of Minnesota between July 1996 and June 1997, with no distinction between the Duluth or Twin Cities campuses. We contacted the registrar s office at the university and learned that 173 had spent their first 2 years at the Twin Cities campus, and 46 had attended the Duluth campus. Four graduates had transferred into the third year from the other medical schools. The registrar s office also verified that 55 first-year family practice residents had spent the first 2 years at the Twin Cities campus, and 21 had spent the first 2 years at the Duluth campus. Thus, a refinement of the number of graduates who entered family practice residencies from the University of Minnesota indicates that 45.7% of those who completed 2 years at the Duluth campus later entered a family practice residency, compared with 31.8% of those who spent their first 2 years at the Twin Cities campus. The Mountain region had the highest percentage (25.8%) of medical school graduates who were firstyear family practice residents in October 1997 (Table 3). The Middle Atlantic and New England census regions reported the lowest percentages, 11.7% and 10.7%, respectively. Ohio (205), Pennsylvania (184), Texas (177), California (170), Illinois (154), and New York (126) produced the highest number of medical school graduates who entered family practice residency programs. Graduates from the 73 publicly funded medical schools were almost twice as likely to be first-year family practice residents than were graduates from the 51 privately funded medical schools (19.8%, compared with 11.8%) (Table 4). Medical schools with family medicine departments continue to produce graduates who are more likely to enter family practice residency programs than medical schools with other or no administrative structure in family medicine. In October 1997, 17.9% of all graduates of medical schools with departments of family medicine were first-year family practice residents (Table 5). Approximately 6.7% of graduates from the two medical schools with family medicine divisions were first-year family practice residents; 2.7% of the graduates from the 10 medical schools with no administrative structure for family medicine were first-year residents. There were 334 (9.5%) graduates of American Osteopathic Association (AOA)-approved colleges of osteopathic medicine who were first-year residents in ACGME-accredited family practice residency programs in October 1997 (Table 1). In the first 3 years of this study ( ), this percentage was 2% to 2.3%. In the school years, it ranged from 4.2% to 5.9%. In , it has ranged from 6.6% to 10.0%. Although there were 334 first-year family practice residents in October 1997 who graduated from colleges of osteopathic medicine, not all of them completed their medical education in the previous year. Of the 2,007 graduates between July 1996 and June 1997, 294 (14.6%) were in ACGME-accredited family practice residency programs in October 1997 (Table 6). The University of North Texas Health Science Center, College of Osteopathic Medicine had the highest percentage (25.3%) of graduates in

7 560 September 1998 Family Medicine Table 6 Number and Percentage of Graduates of Colleges of Osteopathic Medicine Who Were Residents in ACGME-accredited Family Practice Residencies, by US Osteopathic Medical College, October 1997 Osteopathic Medical School CALIFORNIA College of Osteopathic Medicine of the Pacific, Pomona FLORIDA Nova Southeastern Univ Coll of Osteopathic Med, N Miami Beach ILLINOIS Chicago Coll of Osteopathic Med, Midwestern Univ, Downers Grove IOWA University of Osteopathic Med and Health Sciences, Des Moines MAINE University of New England, Biddeford MICHIGAN Michigan State Univ, East Lansing MISSOURI University of Health Sciences, Kansas City Kirksville College of Osteopathic Medicine NEW JERSEY Univ of Med and Dentistry of New Jersey, Stratford Osteopathic Medical School NEW YORK New York Coll of Osteopathic Med, Old Westbury OHIO Ohio University, Athens OKLAHOMA Oklahoma State Univ, Tulsa PENNSYLVANIA Lake Erie Coll of Osteopathic Med Philadelphia College of Osteopathic Medicine TEXAS Univ of North Texas HSC, Coll of Osteopathic Med, Fort Worth WEST VIRGINIA W Virginia School of Osteopathic Medicine, Lewisburg TOTAL 2, * American Osteopathic Association, Department of Education ** American Academy of Family Physicians, annual survey of medical schools Counts from American Association of Colleges of Osteopathic Medicine are estimated or unverified. ACGME-accredited family practice residency programs. Fewer international medical school graduates have been entering family practice residencies on a yearly basis. There were 284 first-year family practice residents (8.1%) in October 1997 who were international medical school graduates, compared with 405 (11.5%) in 1996, 471 (14.5%) in 1995, 539 (17.6%) in 1994, 547 (19.6%) in 1993, and 620 (24.2%) in Nearly half of the US medical school graduates who entered a family practice residency program in October 1997 stayed in the same state as their medical school for their residency (48.1%) (Table 7). Seven in 10 graduates of the medical schools in Arkansas (73.8%), California (75.9%), Puerto Rico (70.0%), Texas (71.8%), and West Virginia (72.0%) who entered a family practice residency did so in the same state or territory. Discussion It is difficult to measure the effectiveness of some medical schools in producing graduates who choose family practice when so many factors can influence graduates on a year-by-year basis. Therefore, the average percentage of graduates who enter family practice residency programs was computed from the yearly percentage for each medical school based on the last 3 years of data collected by the AAFP. All medical schools were ranked in descending order based on the average percentage of their graduates who entered family practice residency programs in the last 3 years (Table 8). The schools were then

8 Special Articles: 1998 Match Results Vol. 30, No Table 7 Percentage of Medical School Graduates by State or Territory Who Entered a Family Practice Residency Program in the Same State, October 1997 % Entering FP Residency in the Same State State of Medical School Alabama 52.1 Alaska Arizona 47.4 Arkansas 73.8 California 75.9 Colorado 48.3 Connecticut 25.0 Delaware District of Columbia 1.8 Florida 57.1 Georgia 44.4 Hawaii 33.3 Idaho Illinois 48.7 Indiana 68.0 Iowa 43.5 Kansas 52.3 Kentucky 44.4 Louisiana 44.6 % Entering FP Residency in the Same State State of Medical School Maine Maryland 8.2 Massachusetts 26.3 Michigan 58.7 Minnesota 64.3 Mississippi 25.0 Missouri 32.8 Montana Nebraska 43.9 Nevada 54.5 New Hampshire 10.0 New Jersey 55.0 New Mexico 30.8 New York 36.5 North Carolina 31.8 North Dakota 46.4 Ohio 52.2 Oklahoma 36.6 Oregon 20.0 % Entering FP Residency in the Same State State of Medical School Pennsylvania 38.0 Puerto Rico 70.0 Rhode Island 11.1 South Carolina 61.3 South Dakota 42.1 Tennessee 53.6 Texas 71.8 Utah 15.4 Vermont 12.5 Virginia 48.1 Washington 45.2 West Virginia 72.0 Wisconsin 53.0 Wyoming OVERALL 48.1 Source: American Academy of Family Physicians divided into four quartiles, with each quartile containing 31 schools. The highest three quartiles contained only medical schools with family medicine departments; the University of South Dakota ranked first with a 3-year average of 35.1%. The lowest quartile contained 19 medical schools with family medicine departments, 2 with divisions, and 10 with no administrative structure for family medicine. The association between departmental status and increased percentage of graduates matching in family practice continued in The 100% response rate by medical schools, colleges of osteopathic medicine, and family practice residency programs makes this study unique. The process of verifying graduates and first-year residents by name further ensures reliability of data. The AAFP will continue its annual medical school study to monitor these trends over the long term. Academic year is the sixth consecutive year that an increasing number of graduates of US medical schools have chosen family practice as a career by entering ACGME-accredited family practice residency programs. Although it is difficult to identify one factor as the reason for increased interest in the specialty of family practice by medical students, contributing factors likely include the efforts of the AAFP s Student Interest Initiative, the change of the infrastructure of medical schools to develop departments of family medicine and required clinical clerkships in family medicine (resulting in part from the LCME revising its medical school accreditation standards to give parity to family medicine with the other core disciplines in 1993), 22 and the market demand for more primary care physicians and fewer subspecialists. The AAFP Task Force on Student Interest will continue to monitor the factors that affect medical student specialty choice to support efforts that increase student awareness of and interest in family practice and make strong efforts to bring medical student awareness of and interest in family practice into the 21st century. Corresponding Author: Address correspondence to Mr Schmittling, American Academy of Family Physicians, 8880 Ward Parkway, Kansas City, MO Fax: gschmitt@aafp.org.

9 562 September 1998 Family Medicine Table 8 Ranked Order of Medical Schools Based on the Last 3 Years Average Percentage of Graduates Who Were Family, by Type of Administrative Structure, October 1997 Administrative Medical School Percent Structure South Dakota, University of 35.1 Department Iowa, University of 32.7 Department Washington, University of 30.4 Department Minnesota, University of 29.3 Department North Dakota, University of 29.2 Department Wright State University 28.5 Department Southern Illinois University 27.5 Department Nevada, University of 27.0 Department East Carolina University 26.8 Department East Tennessee State University 26.2 Department Mercer University 25.6 Department Arkansas, University of 25.3 Department Mayo Medical School 25.2 Department Kansas, University of 25.1 Department Missouri, Columbia, University of 24.6 Department Indiana University 24.4 Department Meharry Medical College 24.3 Department Michigan State University 24.2 Department Marshall University 23.0 Department Oklahoma, University of 22.7 Department New Mexico, University of 22.6 Department South Alabama, University of 22.3 Department Arizona, University of 22.3 Department Morehouse School of Medicine 22.2 Department Texas A&M University 21.7 Department South Carolina, Med University of 21.6 Department California, Irvine, University of 21.5 Department South Carolina, University of 21.3 Department Virginia Commonwealth University 21.3 Department Wisconsin, Medical College of 21.1 Department Uniformed Services University 21.0 Department Loma Linda University 20.8 Department Nebraska, University of 20.7 Department Utah, University of 20.5 Department Massachusetts, University of 20.3 Department Colorado, University of 20.2 Department Northeastern Ohio Universities 20.2 Department Texas, San Antonio, University of 20.0 Department Rush Medical College 19.9 Department Texas Tech University 19.5 Department Albany Medical College 19.3 Department California, Davis, University of 19.1 Department Kentucky, University of 19.1 Department Eastern Virginia Medical School 19.1 Department Ohio State University 19.0 Department Texas, Houston, University of 18.9 Department Oregon Health Sciences University 18.7 Department Mississippi, University of 18.6 Department Creighton University 18.2 Department West Virginia University 18.0 Department Connecticut, University of 17.8 Department Wisconsin, University of 17.6 Department Hawaii, University of 17.3 Department Wayne State University 16.6 Department Texas, Galveston, University of 16.6 Department Louisiana State Univ, Shreveport 16.4 Department Florida, University of 16.2 Department Cincinnati, University of 15.8 Department Medical College of Ohio 15.7 Department Missouri, Kansas City, University of 15.6 Department Dartmouth Medical School 15.6 Department North Carolina, University of 15.4 Department Temple University 15.3 Department Administrative Medical School Percent Structure Georgia, Medical College of 15.0 Department SUNY, Syracuse 15.0 Department California, Los Angeles, Univ of 14.6 Department Bowman Gray School of Medicine 14.6 Department Jefferson Medical College 14.6 Department Vermont, University of 14.5 Department Louisiana State Univ, New Orleans 14.3 Department South Florida, University of 13.9 Department Pennsylvania State Univ, Hershey 13.9 Department Virginia, University of 13.9 Department Case Western Reserve University 13.8 Department Louisville, University of 13.5 Department Illinois, University of 13.3 Department Howard University 12.9 Department Tennessee, University of 12.4 Department Maryland, University of 12.2 Department Ponce School of Medicine 11.8 Department Loyola Univ of Chicago, Stritch 11.4 Department California, San Francisco, Univ of 11.3 Department Chicago Medical School, Finch Univ 11.2 Department Texas, Southwestern, Univ of 11.0 Department UMDNJ-New Jersey, Newark 10.7 Department California, San Diego, Univ of 10.6 Department Southern California, Univ of 10.5 Department Alabama, University of 10.3 Department St Louis University 10.1 Department UMDNJ-Robert Wood Johnson 10.1 Department SUNY, Buffalo 9.8 Department SUNY, Stony Brook 9.4 Department Brown University 9.4 Department Baylor College of Medicine 9.4 Department Stanford University 9.2 Division Pittsburgh, University of 9.2 Department Michigan, University of 8.8 Department George Washington University 8.7 Division Rochester, University of 8.7 Department Northwestern University 8.5 Department Allegheny University 8.2 Department Tulane University 8.0 Department Tufts University 7.8 Department Miami, University of 7.7 Department Pennsylvania, University of 7.6 Department Emory University 7.3 Department Boston University 6.7 Department Duke University 6.7 Department Puerto Rico, University of 6.4 Department Washington University, St Louis 5.9 None Universidad Central del Caribe 5.1 Department Georgetown University 5.0 Department Cornell University 4.8 None Chicago, Pritzker, University of 4.6 None New York Medical College 4.5 Department Columbia University 4.4 None Albert Einstein College of Medicine 4.4 Department Johns Hopkins University 3.8 None Mount Sinai School of Medicine 3.6 None SUNY, Brooklyn 2.8 Department Yale University 2.6 None Vanderbilt University 2.4 None Harvard University 2.1 None New York University 2.0 None OVERALL 14.6

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