Thanks for your feedback. I hope you don't mind me sharing some of my first-hand experience here at sites I've rotated at so far...
Rancho Los Amigos: On my rotation there, I saw around 1-2 patients PER DAY. We had a lecture about 3 times a week. That was it. Not the best experience for 3rd year.
Pacific Hospital of Long Beach: Everybody I've spoken to (in 3rd an 4th year that rotated here) agrees that you do not see enough patients in the FP rotation, the OB rotation has close to ZERO gyn and hence does not prepare you well for the shelf exam. I experienced only 1 rotation here and could not agree more.
North Orange County Pediatrics: This is an outpatient clinic which pretty much only sees well baby checks, physical exams before school starts and a few rash or injury typicallly seen in outpatient. On top of that, the student isn't allowed to take history or do a physical. You can only shadow like in undergrad. That, my friend, cannot provide good clinical training or preparation for the shelf exam.
City of Hope: This might be a good sub-specialty for a surgeon going into oncology, but for a general surgery rotation for 3rd years? I don't think so. You're worked all day M-F giving enough time to drive home and sleep. Then you're tested on the shelf exam, known to be one of the hardest, on general surgery.
As you can see, a common theme here is inadequate training and preperation for the shelf exam. If you're interested in any competitive specialty, you better be honoring your 3rd year rotations (one recent study showed significant results that program directors look at these grades as the most important when deciding to invite you for an interview - more important than Step 1). With inadequate prep for the shelf exam, you can forget about your honors evaluations as the school requires you to HONOR the MD shelf exams written by the NBME in order to honor the rotation. Keep in mind - the school started using the above grading with the shelf exam last year so we have not had a class match yet after having to let go of their honors evals. This is not bashing the school, just making sure the pre-DOs take the glorifying posts by above poster with a grain of salt.
Someone asked me to respond to this post and I'd like to do this only once, because I have no way of knowing the details of everyone's experience and feelings if everyone decided to share specific happenings.
Instead, I'd like to do this posting as an advice to the LoveDO and others that are equally confused, and counting on clinical rotations to prepare them to honor on shelf exams. The way to score top percentile on national standardized shelf exams is to find some review books, and spend HOURS and HOURS memorizing and studying. Expecting clinical rotations and further blaming them for personally not acheiving top percentile on shelf exams is as naive as expecting going to microbiology lab and then expecting to score top percentile on the microbiology section on the USMLE, and blaming the labs for not preparing enough. I've noticed this kind of naive thinking more common at Western than with other bigger name MD med students that i've met. Those students perfectly understand what it takes to do well on a standardized exam and aren't counting on their clinical experience to prepare them much(especially when some of them don't get to see/do much.) If they want to out score everyone nationally on a written exam, they study their butts off, reading for hours
everyday, on top of the hours they spend clinically. Same thing with residents in residency. If they want to pass subject exams or specialty boards,they study and study on the side, and no one blames the program for their need to study during their own time or doubt the quality of training they're receiving, because that is simply how the game is played. If they want to pass a standardized exam, they just have to study.
I'm not sure if it's our infeority complex as DO students or what, but when something like this happens we first think it's our short-comings instead of realizing that's just how the game is played. When you don't do well on an obgyn shelf, you immediately blame the rotation for not giving you enough Gyn exposure. No rotation ANYWHERE, will give you the perfect exposure of ALL, or even MOST, of the material that those damn shelf exams will cover. Are you studying 3-4 hours
everyday after you get home from the hospital? If not, then it's a little unfair for you to think you deserve scoring top percentile when you are compared nationally with people that are studying that much or more. I don't know what service you were on at Rancho Los Amigos, but I know that after King Drew closed that place has gotten really busy and students on Int. Med and Endocrine could easily stay late on a busy day, but if you really were only seeing 2-3 patients at Rancho Los Amigos per day, and had all that free time to study, that would actually be a popular rotation in many schools, and I expect you to score honors on shelfs. My lighter rotations were the ones that I could study more, and actually did better on the shelfs, and that's a common expereince amongst all med students and residents.
If you think a G. Surg rotation that lets you see more appendicitis or cholecystectomy instead of surgery at City of Hope will MAKE THE DIFFERENCE between you scoring honors or not on a shelf exam then you are seriously mistaken. The surgery shelf is almost all about pre and post surgical care of a patient and the fundamental medical/surgical principles behind it than the specific surgeries themselves, that in reality you can do well on the shelf with lots of studying and patient contact(no matter what type) and it really doesn't matter what kind of surgeries you get to scrub in.
As you can see, a common theme here is inadequate training and preperation for the shelf exam.
You mainly talked about the rotations not preparing for honors on shelf exams, and then no honors meaning less competative for residencies. I know where you're coming from, but other readers might not. To make a long story short, Western Admin recently changed the grading policy starting with my class so that in order to get honors on clinical rotations you need ALL 4 things, 1)certain top percentile on the shelf 2)Attending's personal opinion(this student gets honors/pass/fail) 3)certain top score on clinical exams(seeing fake patients while being scored) 4)attendance of lectures during shelf/clincial exam week. As you can see, that makes getting honors harder, especially when many schools are simply letting an attending decide what grade you get, and Western was like that before the change. As you can imagine, with medical students, what their complaints were with the old system when a single attending had the power to honor/fail you based on who knows what. With student inputs, the school changed it to a system that they believe is fairer, but now you can imagine what the med students complain about with the new grading scheme. I personally think it's a fair grading system, with 4 grading criteria instead of 1, but I also agree that the school has set the standards TOO HIGH. So instead of blaming your lack of honors on the lack of preparation from your rotations, you could either follow the rules and beat the game by studying harder, or ask the rule makers to change the rules. But honestly, for the other readers, don't be too alarmed by this grading scheme, because if your attending decides that you deserve "honors", it WILL say that on your MSPE(dean's letter) and residency directors WILL see that even if you don't get honors for the rotation because of shelf exams or whatever. They might be a bit confused as to why Western wanted to use such a complicated grading scheme, but I think they can still adequetely assess your worthiness, if not more so, when they will see something like this on your MSPE under every rotation:
"
Surgical rotation
Shelf: pass
Attending's Eval: Honors
Clinical Exam: Honors
Attendance: Honors
The student gets a pass for the rotation because all 4 criteria are needed for honors at Western University
(and then herewill be a paragraph from your attending's own words about their opinion about you. i.e. one of the best students i've ever had....etc)
"
So if LoveDO thought my post was "gloryfying," then maybe it's because the post was indeed glorfying coming from me who's gone through 3rd year and was able to see the bigger picture and compare and contrast with other places and I've forgotten all of the annoying little details that really bugged me as well. However I hope I at least did some applicants SOME service by giving my account, in a lot more writing than I had expected to do but hopefully that explains a lot for the applicants the complicated life in med school. But if I'm willing to acknowledge my post as being "glorfying," then I hope others are willing to acknowledge the possibility of LoveDO's post as written by someone who's in the thick of it, perhaps stressed, and not knowing for sure how to make sense of all of it, and take that with a grain of salt as well.
Don't blame the school. The scores are up to individual efforts.
