clinical clerkships

[adesua]

Are there any merits or demerits of starting the clerkship early either for MD/Phd or straight MD candidates?
I know Cornell starts its clinical clerkships late in the 2nd year (rather than the 3rd year).

Thanks.

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[noy]

So does Hopkins. They are also flexible with regards to splitting time in the program, and let you do a 3-4-1 intead of the usual 2-4-2.... (I feel lke a soccer analyst)

I think there is a lot to be said for having clinical experience before you go on to do your thesis work. You start clinical with people you already know, and when you go back, you have an idea of what you are getting into...

Anyone know of any other schools?

 

[GlcNac]

I think Baylor also starts clinical work midway through the second year. Most of the students there said this works out pretty well since it helps them to put the textbook knowledge in an applicable context before taking the boards.

 

[Neuronix]

Penn also has a 1.5 year basic science cirriculum, allowing you two rotations before beginning grad school.

As for merits? I think the two big ones have been named. Demerits? I can't think of any. I think that conventially most schools go for two years of basic science and then break for grad school, and it's just hard to break conention. There seems to be a lot of resistance to shortening cirriculums, but it's happening more and more. I wouldn't be suprised if some programs let you do a couple rotations even after doing two years of basic science and going into grad school, but this would be up to the med school.

Duke has a 1 year basic science cirriculum. The MD/PhDs there typically do a full year of clinics before leaving for graduate school. Adding Duke to all the other schools listed in the thread completes my personal knowledge of clinical clerkships pre-PhD.

 

[whodenie]

One down side to clinical time before grad school is the effect on your application to residency programs. If your med rotation was 3 years ago and you jump in to neuro as your first rotation back and you want to go into neuro then you will not be as sharp as if you were in the full swing of clinic. Having the basic rotation left before you finsih your PhD gives you a buffer to get back in to the swing of clinical work before you have to impress folks to get the letters that you will need. I am sure this cuts the other way as well. (More time to pick a field and all that.)
a

 

[surge]

At Yale, most MD/PhDs do 6 months of clinical rotations before starting thesis work. If you do medicine as one of those rotations, you become eligible to do what's called a longitudinal rotation. Bascially, throughout your PhD years, you can spend one afternoon a week working in a clinic and over time it ends up fulfulling an outpatient rotation requirement. I think it's currently available in ambulatory medicine and something else, but they keep adding eligible rotations (outpatient peds is coming, I think). So if you choose to do it, you come out with only about a year of rotations left (6 months proper prior to PhD + longitudinal). Most people still take two years after completing a PhD, but it has more to do with their pace and residency application.
I've also heard you can argue to do a full year of clinicals before thesis work.
So here it's more like 2.5+ 3(+0.5) +1(+1) [try figuring this one out ]
They are very, very flexible.

 

[adesua]

Originally posted by whodenie
One down side to clinical time before grad school is the effect on your application to residency programs. If your med rotation was 3 years ago and you jump in to neuro as your first rotation back and you want to go into neuro then you will not be as sharp as if you were in the full swing of clinic. Having the basic rotation left before you finsih your PhD gives you a buffer to get back in to the swing of clinical work before you have to impress folks to get the letters that you will need. I am sure this cuts the other way as well. (More time to pick a field and all that.)
a

Interesting point Whodenie. I didn't realize that there was this basic rotation which you will not have the opportunity of repeating after your PhD years. I heard though that some schools have a program that eases the transition from PhD years to M3 - some kind of a clinical review at the end of the PhD years before you get into completing your rotations with people who will eventually be writing your recommendations.

I guess curricular features like the "longitudinal rotations" which Surge mentions happens at Yale is also 1 way of keeping you in the swing of clinical work before you start your fate determing rotations in M3.

Any more schools with either a transitioning rotation before M3 or longitudinal rotations during PhD years?

 

[Neuronix]

All MSTPs that I know of have some sort of opportunity to do research-clinic transition work during your PhD thesis and/or before you return. However, it's not really the real thing. Some schools boast something where you can do a day a week or month during your grad work. Participation is low because people are trying to get done. I can't imagine being in a thesis lab and taking an afternoon out every WEEK. Other schools boast a certain number of week preparatory transition before you get graded. Any way you go, you're going to have a long time out AND spending 4 - 8 hours a month or even a week in a clerkship shadowing is not going to keep your clinical skills in check.

Anyways, I don't think it matters much. You're going to get nailed when you return, so pick something relatively easy or something you know you don't want to go into so you can return to the clincs.

PS: When you return to the clinics at Penn you have a whole 11 months left if you know exactly what you want to do. Most people take longer because they're not sure or they want to do more away rotations to try to get that top residency.