Ranking Spain's medical schools by their performance in the national residency examination.

Background: Medical school graduates in Spain must take a uniform national exam (called "examen MIR") in order to enter postgraduate training in a specialty. Its results offer a unique opportunity to rank medical schools according to this exam.
Objectives: We measured differences in the MIR exam results among Spanish medical schools and assessed the stability of the MIR-based rankings for the period 2003-2011.
Results: In the year 2011 a total of 6873 residency positions nationwide were offered by the Spanish Ministry of Health, Social Services and Equality. These positions covered 47 specialties distributed over 231 training centers. A total of 11,550 medical graduates (including 1997 foreign graduates) took the MIR examination. Marked differences among medical schools were evident. The median graduate from medical school #1 and #29 occupied the positions 1477 and 5383, respectively. These figures correspond to a standardized ranking of 21 out of 100 for medical school #1 (that is, 1477/6873; half of medical school #1 obtained better [below position 21%] and half worse [over position 21%] results) and a standardized ranking of 70 out of 100 for medical school #29. While 81% of the medical school #1 graduates were amongst the best 3000 MIR exams and only 5% above the 5000 position the corresponding figures for medical school #29 graduates were 21% and 44%, respectively. The ranking position of the 29 medical schools was very stable between the years 2003 and 2011.
Conclusion: There are marked differences in medical schools in Spain and these differences are very consistent over the years 2003-2011.
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