Introduction

Reviews

Checking a Doctor's Credentials, Part 1

Timothy B. McCall, M.D.

Credentials are one way to assess a doctor’s competence. Many people, in fact, equate stellar credentials with “state-of-the-art” medical care. Doctors on the faculty of a medical school, for example, are likely to be up-to-date in their medical knowledge, at least in their area of expertise and well-versed on the latest developments in high technology.

While credentials are important, great credentials don’t guarantee a great doctor. A doctor educated at a prestigious medical school may know a lot but lack judgment. Credentials also say little about a doctor’s agenda or philosophy of practice. Ultimately it’s how well a doctor practices that matters. Many fine doctors may have less-than-stellar credentials. Good credentials increase the odds a doctor is good but they aren’t as important as is commonly assumed.

Where the Doctor Went to Medical School

A lot of weight tends to be placed on where a doctor went to medical school. Within the United States, this tends to reflect hype more than reality. All U.S. medical schools are accredited and offer a good education. Someone who went to Harvard or Johns Hopkins may have had better college grades or higher exam scores than the average medical student but whether they make better doctors is far from clear. All U.S. medical schools turn out some excellent doctors and some not-so-hot doctors. Whoever graduated last in Harvard’s class is still billed as a Harvard M.D.

In addition to schools granting M.D.s, the are several schools of osteopathy in this country granting D.O.s. Doctors of osteopathy receive similar training to M.D.s but they are taught spinal manipulation similar to chiropractors and a somewhat more holistic approach to medical practice. Osteopaths have all the same legal rights to prescribe drugs and perform surgery as M.D.s. Some D.O.s train in the identical residency programs as M.D.s but in general, these doctors are frowned on by the medical establishment and are discriminated against in training opportunities. I have seen both excellent and poor osteopaths. The majority of osteopaths are general practitioners working in small towns.

Medical schools outside of the United States are more variable in quality. Some are excellent, others not so great. Doctors trained in medical schools in other countries include some of the best and some of the worst doctors I’ve seen. It’s hard to generalize, although doctors trained in third-world countries may not have the exposure to the high-tech brand of medicine favored in this country.

Many Americans who don’t have the grades or test scores to get into stateside medical schools, enter programs in the Caribbean specifically designed to educate Americans. Some of the schools are decent, although they generally lack facilities, while others are little more than diploma mills. Similarly, many Americans enter medical schools in Mexico and occasionally in other countries. Unless you inquire, it might never occur to you that these doctors were educated outside of the United States.

Although a doctor trained at Johns Hopkins certainly receives a better education than one trained at a medical school in Granada, the predictive value of knowing where a doctor was educated is often overstated. Even a doctor who trains in a second-rate medical school may overcome its shortcomings through hard work. Conversely, physicians trained in excellent schools may not have the temperament or common sense to practice medicine well. It’s worth finding out what school your doctor attended, but, ultimately, each doctor should be evaluated individually.

Where the Doctor Trained after Medical School

The first thing most physicians would want to know when evaluating other doctors’ credentials is where those doctors trained. By training, they mean in what hospital or hospitals did the doctors do their internships and residencies and, in the case of specialists, fellowships.

In the United States, the quality of different residency and fellowship programs varies more than the quality of different medical schools. University-affiliated hospitals are considered more prestigious than community hospitals without medical school affiliations. Prestigious university hospitals are more oriented toward superspecialization, however, and tend to turn out doctors with a similar bent.

Training programs generally consider graduates of American medical schools as more desirable and the more prestigious programs usually have more luck attracting them. You can therefore roughly gauge how prestigious a program is by the percentage of American grads among their trainees. This method is not completely reliable, however, because some prestigious programs attract star students from all over the world—students more talented than the average American.

Where a doctor trained is important but, once again, it’s what the doctor does with that training that matters most.

Next: Checking a Doctor's Credentials, Part 2

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