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Medical school attended as a predictor of medical malpractice claims

¹ Center for Health Services Research, The University of Tennessee Health Science Center, Memphis, TN 38163, USA
² Department of Medicine, Division of General Internal Medicine, The Feinberg School of Medicine of Northwestern University, Chicago, IL, USA
³ Department of Health Administration and Policy, College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, OK, USA.

Correspondence to:
Dr T M Waters, Center for Health Services Research, The University of Tennessee Health Science Center, 66 North Pauline, Suite 463, Memphis, TN 38163, USA;
twaters{at}utmem.edu

Objectives: Following earlier research which showed that certain types of physicians are more likely to be sued for malpractice, this study explored (1) whether graduates of certain medical schools have consistently higher rates of lawsuits against them, (2) if the rates of lawsuits against physicians are associated with their school of graduation, and (3) whether the characteristics of the medical school explain any differences found.

Design: Retrospective analysis of malpractice claims data from three states merged with physician data from the AMA Masterfile (n=30 288).

Study subjects: All US medical schools with at least 5% of graduates practising in three study states (n=89).

Main outcome measures: Proportion of graduates from a medical school for a particular decade sued for medical malpractice between 1990 and 1997 and odds ratio for lawsuits against physicians from high and low outlier schools; correlations between the lawsuit rates of successive cohorts of graduates of specific medical schools.

Results: Medical schools that are outliers for malpractice lawsuits against their graduates in one decade are likely to retain their outlier status in the subsequent decade. In addition, outlier status of a physician’s medical school in the decade before his or her graduation is predictive of that physician’s malpractice claims experience (p<0.01). All correlations of cohorts were relatively high and all were statistically significant at p<0.001. Comparison of outlier and non-outlier schools showed that some differences exist in school ownership (p<0.05), years since established (p<0.05), and mean number of residents and fellows (p<0.01).

Conclusions: Consistent differences in malpractice experience exist among medical schools. Further research exploring alternative explanations for these differences needs to be conducted.

Keywords: medical education; medical malpractice; medical school; negligence

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