­To solve this question, let us deploy IMS's four-step technique.

STEP #1 -> IDENTIFY THE QUESTION TYPE

Let us read the question stem to identify the question type.



The stem indicates a weakening question.

STEP #2 -> DECONSTRUCT THE ARGUMENT

In a weakening question, it is a must to deconstruct the argument by figuring out the conclusion and the premise. Let us therefore read the argument first and deconstruct it soon after.



CONCLUSION: The quality of care at university hospitals is lower than that at other hospitals.
PREMISE: University hospitals have a lower survival rate for patients than do other hospitals.

STEP #3 -> FRAME A SHADOW ANSWER

In order to frame a shadow answer, we need to know what the right answer should do. In this question, the right answer must undermine the author's argument. A perfect way to undermine the argument is to call into question its conclusion by challenging its premise.

SHADOW ANSWER: Any situation that leads us to believe, after having taken the premise into consideration, that the quality of care at university hospitals is not necessarily lower than that at other hospitals.

STEP #4 -> ELIMINATE INCORRECT OPTIONS

Answer options that do not match the shadow answer can be eliminated.

(A) Many doctors divide their working hours between a university and a community or private hospital. - NOT A MATCH - Even if many doctors divide their working hours between a university and a community or private hospital, it does not give us a reason to form an opinion about the quality of care in university hospitals. The author could still argue that the quality of care is poor based on the stated premise. Remember, this option does not tell us about how well the very same doctors care for patients in the hospitals they visit. They could provide great care for patients in community or private hospital and not do the same in university hospitals, leading to lower survival rate for patients in the latter. - ELIMINATE

(B) Doctors at university hospitals often earn less than doctors at private hospitals. - NOT A MATCH - If doctors at university hospitals often earn less than doctors at private hospitals, it gives more of a reason to believe the argument of the author, and remember, we are looking to undermine the argument, not support it. - ELIMINATE

(C) University and community hospitals often cannot afford the elaborate facilities of private hospitals. - NOT A MATCH - If university and community hospitals often cannot afford the elaborate facilities of private hospitals, we do have a reason to believe that their quality of care might not be great on account of not having the elaborate facilities, but the author draws the conclusion based on the survival rate of the patients, meaning despite not being able to afford the elaborate facilities of private hospitals, community hospitals still have a better survival rate for patients than university hospitals, and the author's conclusion is therefore unimpacted. - ELIMINATE

(D) The emphasis at many university hospitals is on pure research rather than on the treatment and care of patients. - NOT A MATCH - This option strengthens the argument. - ELIMINATE

(E) The patients who seek help at university hospitals are usually more seriously ill than those at private or community hospitals. - MATCHES THE SHADOW ANSWER - If what is given in this option is true, we have a reason to believe that the quality of care at university hospitals is not necessarily lower than that at other hospitals. Notice that this option challenges the author's reasoning by indicating that the patients in university hospitals have lower survival rate not because of the hospitals' lower quality of care but because patients seeking help at these hospitals are usually more seriously ill than those at other hospitals. - MARK AND MOVE

Hence, (E) becomes the right answer. ­­