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A new paper in the journal Academic Medicine questions the validity of the rankings by U.S. News & World Report of primary care programs at medical schools. The study noted that while there is some consistency from year to year, the variability among institutions outside of the top 20 "is greater than could be plausibly attributed to actual changes in training quality. These findings raise questions regarding the ranking's validity and usefulness." Robert Morse, who directs the rankings at U.S. News, said he hadn't seen the research and would need to study it before commenting.