Dermatology Online Journal

Ranking the dermatology programs based on measurements of academic achievement
Jashin J Wu MD¹, Claudia C Ramirez MD², Carol A Alonso MD³, Brian Berman MD PhD⁴, Stephen K Tyring MD PhD MBA³
Dermatology Online Journal 13 (3): 3

1. Department of Dermatology, University of California, Irvine, Irvine, California, USA. jjwu@uci.edu 2. Department of Dermatology, University of Chile School of Medicine, Santiago, Chile 3. Department of Dermatology, University of Texas Health Science Center, Houston, Houston, Texas, USA 4. Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA

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Abstract

Background: The only dermatology rankings in the past were based on National Institutes of Health (NIH) funding and journal citations. Objective: To determine the highest ranking academic dermatology programs based on 5 outcome measures and on an overall ranking scale. To the best of our knowledge, this is the first report to rank the dermatology programs on 4 of the following outcome measures of academic achievement and with an overall ranking. Methods: We collected extensive 2001 to 2004 data ranging from total publications to grant funding on 107 U.S. dermatology programs and their full-time faculty. Data from part-time and volunteer faculty were not used. Main outcome measures: Publications in 2001 to 2004; NIH funding in 2004; Dermatology Foundation grants in 2001 to 2004; faculty lectures in 2004 delivered at national conferences; number of full-time faculty members who were on the editorial boards of the top 3 U.S. dermatology journals and the top 4 subspecialty journals Results: We used the 5 outcome measures to tabulate the highest ranking programs in each category. Using a weighted ranking system, we also tabulated the overall top 30 dermatology programs based on these 5 outcome measures. Limitations: We were not able to determine the total amount of NIH funding in dollars of the dermatology divisions. The impact factors of the journal in which these publications appeared was not factored into our calculations. Since faculty members may collaborate on the same publication, some publications may have been double-counted. Conclusion: In descending order, the 5 highest ranked academic programs are the University of Pennsylvania; University of California, San Francisco; Yale-New Haven Medical Center; New York University; and University of Michigan. This ranking system may allow residents and faculty to improve the academic achievements at their respective programs.

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The periodical U.S. News and World Report ranks each medical discipline on an annual basis [1]. For 2006 they listed rankings for the following disciplines: cancer; digestive disorders; ear, nose & throat; endocrinology; gynecology; heart and heart surgery; kidney disease; neurology and neurosurgery; ophthalmology; orthopedics; pediatrics; psychiatry; rehabilitation; respiratory disorders; rheumatology; and urology. each of these disciplines is rated on patient-based factors, such as reputation and mortality.

U.S. News and World Report does not rate dermatology programs. We hope to rank the dermatology programs on a regular basis with a focus on academic achievement rather than patient-based factors. To the best of our knowledge, this is the first report to rank the dermatology programs on these 5 outcome measures of academic achievement (except for National Institutes of Health (NIH) funding rankings) and with an overall ranking.

Methods

In a prior study we collected extensive data ranging from total publications to grant funding on 107 U.S. dermatology programs as of December 31, 2004 [2]. We have used this data to tabulate the rankings.

Of all of the characteristics that we collected, the following 5 were deemed by the authors to be the most reflective of scholarly achievement: publications in 2001 to 2004; NIH funding in 2004; Dermatology Foundation (DF) grants in 2001 to 2004; faculty lectures in 2004 delivered at national conferences; and number of full-time faculty members who were on the editorial boards of the 3 highest ranking U.S. dermatology journals (Journal of Investigative Dermatology, JID), Archives of Dermatology, and the Journal of the American Academy of Dermatology, JAAD) and the highest ranking subspecialty journals (Dermatologic Surgery, Journal of Cutaneous Pathology, Pediatric Dermatology, and Cosmetic Dermatology) (as based on 2004 impact factors if available). Only data of full-time faculty were used. Data of part-time or volunteer faculty were not used.

The annual meetings included those of the American Academy of Dermatology (AAD); Society of Investigative Dermatology (SID); American Society of Dermatopathology; Society for Pediatric Dermatology (SPD); and the American Society of Dermatologic Surgery/American College of Mohs Micrographic Surgery and Cutaneous Oncology (ASDS-ACMMSCO).

In the instance of publications or presentations, if the faculty member had multiple affiliations, the primary institution that provided the faculty member with salary as a full-time faculty would receive the credit.

The top 20 programs were determined in each of the 5 categories. Each program was given a score based on its rank order from 20 down to 1 in a descending fashion. In the event of a tie, the points assigned to those rank orders were equally divided amongst the tied programs. For example, if 3 programs were tied as the 19th and 20th programs, the number of points for ranks #19 (2) and #20 (1) were added (3), which was divided by the number of tied programs (3), and then distributed equally to the programs (1). An overall ranking of the top 30 programs was determined based on the total of points from each of the 5 categories, which were weighted equally. Selecting 30 programs would roughly correlate with the highest quartile of programs.

According to the guidelines on their Web site, this study did not require review by the institutional review board of the University of California, Irvine.

Results

Table 1 shows the programs with the most publications in 2001 to 2004. As mentioned in our prior study, each individual faculty member publications were summed to determine the program's total Pubmed publication tally.

Table 2 shows the 39 dermatology departments with NIH funding and their total awards in dollars, which can be found at http://grants2.nih.gov/grants/award/rank/dermatology04.htm. This website lists the total awards in dollars for department departments only but not divisions of dermatology. These divisions are parts of a department of medicine, and the NIH listed the total awards of medicine departments. It was not possible to separate the dollar amounts secured by divisions of dermatology.

By using the CRISP website http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen and entering the name of each faculty member in a division of dermatology, we were able to determine the absolute number of NIH awards (but not in dollars) (Table 2).

Programs with the most Dermatology Foundation grants in 2001 to 2004 are listed in Table 3.

Table 4 shows the programs with the most 2004 faculty lectures given at the annual meetings at the AAD, SID, American Society of Dermatopathology, SPD, and ASDS-ACMMSCO.

Table 5 shows the programs with the most full-time faculty members who were on the editorial boards of the top 3 U.S. dermatology journals and the top 4 subspecialty journals.

A total of 44 programs received points in the overall composite of points. Using the rankings and weighted point system, an overall ranking of the top 30 dermatology programs was determined (Table 6).

Comment

Several recent studies have examined various aspects of academic dermatology such as workforce issues [3], educational debt [4], dermatologic surgery [5], and factors that correlate with entering academics [2]. These studies help bring to light the current difficulties the field presently has in recruiting and retaining faculty in an age when successively younger generations desire a controllable lifestyle and higher incomes rather than scholarly achievement and prestige.

Past articles have ranked authors based on the number of citations of their publications in dermatology journals[6] and in general medicine journals [7]. Other articles have ranked countries based on journal citations, and the U.S. has been found to be the top contributor to the dermatology literature [8, 9].

Dermatology organizations have been ranked based on NIH funding and on journal citations [10]. In decreasing order, the top 5 U.S. organizations based on total citations for the time period between 1981 and 1994 were Harvard University; Veterans Administration Medical Centers; University of California, San Francisco; University of Michigan; and the National Cancer Institute [10].

On January 12, 2004 Thomson Scientific ranked the top 5 universities by average citations per paper [11]. The parameters were the top 100 federally funded U.S. universities that published at least 75 papers in Thomson ISI-indexed dermatology journals between 1998 and 2002. The University of Michigan had 5.90 citations per paper; University of California San Francisco had 5.77; Harvard University had 5.46; University of Pennsylvania had 4.97; and Johns Hopkins University 4.59.

To the best of our knowledge, no formal rankings of the dermatology programs on 4 of our measurements of academic achievement and on an overall ranking scale have been described.

Many would agree that funding and publications are generally regarded as standard measuring sticks of scholarly prowess. Within the specialty of dermatology, NIH and DF funding could be considered the most prestigious. Faculty are encouraged and even expected to develop expertise in a focused area. Publishing manuscripts in peer-reviewed journals with high impact factors is one of the most common ways of attaining tenure and achieving national or international recognition.

Giving lectures at national conferences that summarize new developments in their field or their research findings can be another way to stand out in a particular area. In developing a specific expertise, faculty may distinguish themselves so such an extent that they are asked to sit on editorial boards of prestigious dermatology journals. This is our justification for selecting these 5 categories to determine the rankings.

Many of the programs on these rankings were expected, as they have strong academic reputations. Our rankings have some overlap with the prior dermatology program rankings. In our top 5, University of Pennsylvania, University of California San Francisco, and University of Michigan were also ranked in the organization study [10] and in the Thomson Scientific study [11].

This ranking system may give some guidelines on how residents and faculty can improve the academic achievements at their respective programs. Further, it may allow residency applicants and faculty job-seekers to compare programs based on objective achievement achievements.

When we set out to determine these rankings, we knew that it would be a contentious and controversial topic. Who is to say that these 5 measurements are the best to determine the rankings? Many different criteria could be used to gauge the relative prominence and importance of programs. Some could argue that the characteristics of the program itself such as number of faculty and residents should have been included in the rankings. Some could argue that NIH funding should have a higher weight than the number of editorial board members. Others may have preferred to include more subjective categories such as location. However, we felt that these rankings provide some quantification of scholarly achievement.

Our study should be interpreted with a few caveats. We were not able to determine the total amount of NIH funding in dollars of the dermatology divisions. These programs' total funding in dollars is included in their respective internal medicine departments. University of California, Los Angeles (6); University of California, San Diego(6); and University of Southern California (5) all had a high number of NIH grants, and the overall funding in dollars may have allowed these programs to be ranked.

As mentioned in our prior study, the impact factors of the journal in which these publications appeared was not factored into our calculations. As explained in our prior study, each individual faculty member's totals were summed to the program's total number of publications. Since faculty members may collaborate on the same publication, some publications may have been double-counted. Journal citations rather than publications may be seen as having more value in a ranking scale.

It could be argued that different journals or annual meetings could have been used in the rankings. These rankings would favor larger programs, as they have more faculty to secure funding, produce manuscripts, delivers lectures, and sit on editorial boards. These limitations may have excluded some programs from our rankings.

It can not be stressed enough that programs should not divert resources from other important academic or non-academic pursuits to improve their scores based on this report. Different dermatology programs have different missions and focus on different aspects of dermatology, be it research, teaching, clinical training, and/or patient care. Research funding may not be relevant for a program whose mission and focus is clinical. In this regard, the clinical program is put at an inappropriate disadvantage in our ranking system. This ranking should not be interpreted as the programs with the best clinical care and teaching, but as a ranking based on 5 specific academic criteria of programs and their full-time faculty, not part-time or volunteer faculty.

Finally, our intent is certainly not to offend programs by misrepresenting the academic achievements of their programs. Inevitably, in collecting a database of information with this large of a magnitude by a small team of researchers, some inaccuracies may occur. One of the authors (JW) is currently working with the organizational leadership of dermatology to develop a "dynamic" version of the database that would allow each individual program to update their information on an annual basis, which would decrease inaccuracies and be less likely to affront certain parties. Such a dynamic table could be studied at a specific "static" year to determine new (and presumably more accurate) academic correlations[2] and rankings.

In conclusion, according to our rankings of academic achievement, in descending order, the five highest ranked programs are the University of Pennsylvania, University of California San Francisco, Yale-New Haven Medical Center, New York University, and University of Michigan.

References

1. U.S. News and World Report Web site. http://www.usnews.com/usnews/health/best-hospitals/tophosp.htm. Accessed July 21, 2006.

2. Wu JJ, Ramirez CC, Alonso CA, Mendoza N, Berman B, Tyring SK. Dermatology residency program characteristics that correlate with graduates selecting an academic dermatology career. Arch Dermatol 2006; 142:845-50.

3. Resneck JS Jr, Tierney EP, Kimball AB. Challenges facing academic dermatology: survey data on the faculty workforce. J Am Acad Dermatol 2006; 54:211-6.

4. Salter SA, Kimball AB. Rising educational debt levels in recent dermatology trainees and effects on career choices. J Am Acad Dermatol 2006; 54:329-31.

5. Miller CJ, Wood GC, Miller JJ, Marks VJ. Academics or private practice? The future of dermatologic surgery education. Dermatol Surg 2006; 32:70-8.

6. Stern RS, Arndt KA. Top cited authors in dermatology: a citation study from 24 journals: 1982-1996. Arch Dermatol 1999; 135:299-302.

7. Stern RS, Arndt KA. Top-cited dermatology authors publishing in 5 "high-impact" general medical journals. Arch Dermatol 2000; 136:357-61.

8. Stern RS, Arndt KA. Growth of international contributors to dermatologic literature. Arch Dermatol 1999; 135:1074-6.

9. Dubin DB, Arndt KA. The homelands of top-cited articles. Arch Dermatol 1997; 133:21-2.

10. Dubin DB, Arndt KA. Organizational impact in the dermatologic literature. Arch Dermatol 1996; 132:1293-4.

11. Thomson Scientific Web site. http://in-cites.com/research/2004/january_12_2004-2.html. Accessed July 21, 2006.

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