Article Text

Download PDFPDF
Medical school attended as a predictor of medical malpractice claims
  1. T M Waters1,
  2. F V Lefevre2,
  3. P P Budetti3
  1. 1Center for Health Services Research, The University of Tennessee Health Science Center, Memphis, TN 38163, USA
  2. 2Department of Medicine, Division of General Internal Medicine, The Feinberg School of Medicine of Northwestern University, Chicago, IL, USA
  3. 3Department of Health Administration and Policy, College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, OK, USA.
  1. 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; 


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.

  • medical education
  • medical malpractice
  • medical school
  • negligence

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • * ”High” and “low” outliers are defined as above the 90th percentile or below the 10th percentile of the distribution of the percentage of graduates sued. A second analysis adjusts the percentage of graduates sued for various “risk factors” such as (eventual) specialty of the graduate and age.

  • Time periods of graduation were defined as: pre-1960, 1960–9, 1970–9, and 1980–9. Since physicians who had graduated from medical school after 1990 would hardly have had a chance to be sued, we omitted this time category from our analyses.

  • Inserting the actual values of the independent variables provides the value x′α. The predicted probability is actually ex′α/(1 + exα).

  • § This variable was included to control for any selection bias that might results from over-representation of certain schools in the dataset (e.g. more University of Florida graduates than University of Utah graduates in the three states).

  • See editorial commentary, pp 324–5

  • This research was supported by Division of Quality Assurance, Bureau of Health Professions, Health Resources and Services Administration, Department of Health and Human Services (Contract #240-97-0003). The design, conduct, interpretation, analysis, and manuscript development were the sole responsibility of the authors and were not subject to funding agency approval.

Linked Articles