In the first study of its kind, a group of researchers has evaluated medical schools on how well they meet their social mission, and found that none of the five Philadelphia schools ranked in the top third.
Researchers from George Washington University defined social mission in three ways: the percentage of graduates practicing primary care, the number of graduates from underrepresented minorities, and how many work in health-professional-shortage areas.
The intent is partly "to bring attention to an issue that hasn't really been talked about and maybe should be," said Candice Chen, an assistant professor and one of the study's authors.
Drexel University came out the best locally, coming in 54th, followed by Temple University (75), UMDNJ at Stratford (93), Philadelphia College of Osteopathic Medicine (115), University of Pennsylvania (129), and Thomas Jefferson University (134). The study, which appeared Monday in the Annals of Internal Medine, looked at 141 allopathic and osteopathic schools.
School officials here said the study, which followed graduates between 1999 and 2001, was outdated. They pointed out that high student loans, low salaries, and malpractice costs keep young doctors from entering primary care in this region. They also noted it can be hard to reverse years of poor schooling to attract minority applicants.
Plus, the study is hardly all-encompassing, they said.
"We define social mission differently," said John M. Daly, the dean of Temple University School of Medicine. "It is providing everything we can to our community, even specialists.
"Temple has been caring for the poor. That is who we are and what we do."
Not everyone was critical. "I think the overall study is a healthy start to get medical schools to answer the call," said Ken Veit, the dean of Philadelphia College of Osteopathic Medicine. "The pressure to produce primary care physicians is on."
The study's authors acknowledged that schools in the Northeast tended to fare worse because students here are more likely to become specialists. Johns Hopkins, Columbia, and Boston Universities all ranked in the bottom 20 while three historically black schools achieved the top three rankings: Morehouse, Meharry, and Howard.
Reversing the dearth of family doctors is a big concern. The new health-care laws will bring coverage to an estimated 32 million more people after 2014, creating an even greater need for primary-care doctors.
"We need to make it that people want to become primary-care physicians again," said Barbara Schindler, vice dean for educational and academic affairs at Drexel. "But what bright 22-year-old kid would want to go into a specialty where they are paid a fifth of what other doctors make, when you have so much debt to pay off?"
Many people evaluate medical schools on the strength of their research and the money they attract in federal funding. U.S. News & World Report's well-known ranking of American colleges uses research funding, surveys from professors and administrators, and the selectivity of the schools. This year the University of Pennsylvania ranked second among the best research schools and seventh for primary care.
Several factors kept down Penn's score in the George Washington study, said Gail Morrison, the vice dean of education and professional medicine. Rural areas are worse off than the inner city where Penn is situated. "It's the middle of the country where there is no care," she said.
Also, the numbers cited are outdated, she said. "I think five years from now, if they looked at the data, it's going to look different."
Jefferson officials did not make anyone available to discuss the study. But Blythe Vaccaro, 28, who just completed her first year at Jefferson Medical College, said she is aiming to work as a family doctor in an underserved area.
"Family medicine is sort of cool at Jefferson," she said. "It was a desire for social justice that led me to go into medicine."
Garrick Baskerville, 29, is another convert to the cause. He grew up in Blue Bell and graduated from the Penn State College of Medicine in Hershey, which the study ranked 29th, the highest in the state. He just finished his residency program in Delaware and will start practicing medicine at the Spectrum Clinic in North Philadelphia in August.
"I wound up choosing family medicine because you have the opportunity to look at the whole patients and look at them as they journey through their lives," he said.
"I'd rather have a career at something I love rather than looking at money," he added.