This Invited Commentary amplifies the continuing critique of the U.S. News & World Report rankings of U.S. medical schools and academic medical centers. The article begins with a critical quote about the medical school rankings published in this journal nearly 20 years ago and points out that little has changed in nearly two decades. The author then reports how the flawed rankings are performed and why U.S. medical school rankings are taken seriously, addresses the varied missions of U.S. medical schools, describes what really matters for success in medical school and professional life, sets a path forward to improve methods of medical school evaluation, and speaks to the irony of dismissing the rankings while still using them for marketing and fund-raising. The article concludes with a critical argument about the U.S. News & World Report rankings not only of medical schools but also of schools across the learned professions.