Dismissed from DO School, Want Back In, Need Help!!

[bleeker10]

Bleaker - while I appreciate the feedback, don't repost the same advice just because I'm not in agreement. When there are a lot of posts to read with valuable and insightful criticism, it's really annoying to have to reread the same post with the same close-minded comments. I get your point, but if you don't like the way I choose to progress then stop reading this thread and move on.

Prove me wrong then

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[Total180]

I have no experience with lawyers and lawsuits of this kind, so I won't comment on that. It was accommodations for the pain/injury and not the ADHD that you were requesting right? And those were the accommodations you received from the NBME? If so, if you do decide to hire a lawyer, I could foresee there being an issue with the fact that you received the accommodations for the USMLE and still failed. Again, I don't know anything about lawsuits and the like, so I don't know if that is a valid argument, but it seems like something that might be brought up. Do you have an explanation for why, even with the accommodations, you still had trouble passing? Obviously, you have nothing to lose by taking it again, and I sincerely hope you pass. If you do, I think you could have a chance, but I think the lawsuit idea might make matters even worse. If you do end up passing, and you are tangled up in a lawsuit against your school, I doubt another one would want to take a chance on you....and if you do somehow get back into your original school because of a lawsuit, it could make things really tense and difficult between you and the administration and faculty to the point of being a real issue. Just a couple things to think about. Good luck!! Just focus on passing your retake for now! That definitely needs to be top priority!

 

[DD214_DOC]

A couple of things to add, despite having mostly skimmed through this thread ...


1) Whoever mentioned in a previous post that COMLEX 3 is a 2-day exam is incorrect. I'm already done with the COMLEX series and it was basically the same as COMLEX 2. USMLE Step III is a 2-day exam.


2) I'm not sure why you're wanting to, "transfer" to another school. You were dismissed. You would not be, "transferring", you would have to matriculate all over again, and I do not know of a single medical school that would allow someone to matriculate with your situation. At least, I don't know of any outside of the Caribbean.

3) I may be wrong about this, but I remember my school had to approve and sponsor each individual student to take the COMLEX. Given that you are no longer a student at any school, I'm not sure if you can even retake it.

4) The NBOME places its own restrictions on how often anyone can retake the exam and how much time must be in between any retakes.

5) The fact that you're blaming everything but yourself is not a good sign. Regardless of whether you were having pain from surgery or a myriad other stressors, the fact that you went ahead and took the exam without self-monitoring and indicating that you needed a LOA or some other type of break is the fault of nobody but yourself. Part of being an independent professional is self-monitoring and knowing when you're not in a position to perform your duties.

6) The reason the NBOME and NBME would not provide accomodations for ADHD is because this is a very treatable problem that should not be an issue with proper treatment. Another reason would be because the testing conditions are already designed to minimize distraction.

I say you're probably done and should look for a different career.

 

[LSU Alex]

Ok so there has been a lot of chatter, which is great. But i'm only going to respond to the productive stuff.

6) I really appreciate all the feedback and ideas and discussion going on. But i'd just like to add that those of you fearing i'd make an incompetent physician because i repeated a year and have failed the boards this many times - don't lose any sleep. Because of my situation, I've actually studied that material way more times than you and regardless of my ability to display this knowledge on a multiple choice exam, my attendings and patients have never had a moment's hesitation about my capabilities. So you may not know i'm good, but that's because you don't know me. I'm good. And if anything, my future (fingers crossed) patients will get a physician who knows how to FIND the answers when I don't know them off the top of my head. So i'm going to exhaust this thing until I have nothing left because that's how much medicine means to me.

Bleaker - while I appreciate the feedback, don't repost the same advice just because I'm not in agreement. When there are a lot of posts to read with valuable and insightful criticism, it's really annoying to have to reread the same post with the same close-minded comments. I get your point, but if you don't like the way I choose to progress then stop reading this thread and move on.

1. "Productive" should not equal approval or futile encouragement. We'll get to more of this in a second.

2a. It's presumptive to say you've studied the material way more than more successful students. It has been my experience that the really successful medical students tend to be anal enough to refresh themselves on the material to keep those evil pimp questions in control. Or maybe that was just me and the circle I associated with.

2b. Step 1 doesn't test whether or not you are going to be a capable physician. Everyone knows "Step Geniuses" who knocked out a 260, but should never be anywhere near a patient. Just like we all know a "190 Scrub" who just has a knack for coming up with the right plan of care.

3. This is more of a continuation of #1. Bleaker is giving you good advice. I understand it isn't what you want to hear, but it's good advice. There is nothing "close-minded" about it. I would propose that you are being close-minded at this point. Perhaps medicine is not suited for you. There is no way around the fact that you still have 3 levels of board exams to pass. Then there will be certification boards if you are lucky enough to secure a residency. In addition, you will have in-service exams during residency. Board examinations are going to stay with you your entire career. You can't escape that. We live in a society now that wants to give everyone participation trophies and declare that there is no winner... or that we are all winners cause we played the game. That's not real life. Sometimes we fail. When we mature, we own up to that failure. Sure, we can try again... and we do. But when reality shows us the we need to take a different path, we swallow our pride and find that new path.

Just think on it. Good luck in whatever you do.

 

[Memorex]

To be honest, I think all this in-depth analysis of hypotheticals will only increase your anxiety level in the future. Keep things simple.

Right now, we all can agree that unless you pass your 4th attempt of Step 1, you can say goodbye to a career in medicine. So study your butt off, and pass it first.

After you have received that passing score, return to this thread, and then discuss this.

All this worrying is accomplishing nothing.

 

[DocEspana]

are we still discussing this?

I guess my advice will then be "prove me wrong by doing something, if you wont agree im right and get out into something else". and also "chatting about it on SDN is not the best way to turn it around"

 

[Dissected]

I'm so tired of hearing these things - it's NOT ABOUT COMPETITION!!! Its about TAKING CARE of people.

Ultimately it is not about the competition, but there are standards for a reason. They are to protect the public. The reason you have to score a 400 or a 188 on these exams (and the one's thereafter) is so that you are deemed knowledgeable enough to bear the responsibility of being someone's physician. Like it or not, it is a red flag to not be able to pass after that many tries and that much time spent reading. Good luck, but I think you need to consider a different career path.

In response to the latter part of your quote above -- there are lot of careers where you can take care of people. In fact, if you enjoy taking care of people you should consider the field of nursing. In my opinion they have a more direct role in patient care in most circumstances, and they actually get to spend time with their patients. It is more hands on and rewarding in a lot of ways. Pays well too!!

You are bleeding $$$$ out the ears and taking the comlex again is not likely a solution to your problem. Especially since you will not be considered a transfer student!!

 

[SpecterGT260]

I'm so tired of hearing these things - it's NOT ABOUT COMPETITION!!! Its about TAKING CARE of people.

the best of intentions will never heal the sick or help anyone. It is most definitely about competition because without competition the people who need help will not receive the quality of help they need. I don't give a damn how passionate someone is about the subject matter if they do not have the talent required to be competent and proficient.

 

[FuturePharm21]

Some people are going to be brutally honest and just plain mean to you. You need to talk to school officials and your parents because I think you have enough opinons from SDN. Best of luck and I'm sorry to hear about your situation.

 

[504girl]

Thanks everyone for all the info and points to consider. I'm reading them all but can't respond to all the posts anymore. Too many are redundant anyways and by now I've gotten the opinions I need to consider my next step. I also realize that my entire saga of a situation cannot be explained in its entirety in 1000 words so I'm taking that into consideration as well. When this matter resolves or any major updates occur, I will post them for the benefit of any others who might be in a similar situation. Thanks guys!

 

[deleted245139]

good luck

 

[The kitchen sink]

2b. Step 1 doesn't test whether or not you are going to be a capable physician. Everyone knows "Step Geniuses" who knocked out a 260, but should never be anywhere near a patient. Just like we all know a "190 Scrub" who just has a knack for coming up with the right plan of care.

.

SO there is hope after all

 

[235009]

Hard to say if getting back in is possible, but one would have to assume that numerous schools would like to collect 40k/year from you for absolutely nothing (if you're out on rotations somewhere that relies on community volunteer preceptors). This varies widely from admitting someone into the preclinical years where the profit margin isn't nearly as high. So, from a purely economical standpoint it may be argued one of these schools could pick you up. Maybe doubtful, but I wouldn't underestimate the almighty dollar.

This is the exact opposite of the truth. The clinical years cost schools tons more than pre-clinical years! You can't just get a bunch of "community volunteer preceptors" ...it doesn't work that way. You have to do your rotations at a hospital and all carib and most DO schools don't have their own academic hospital and therefore have to shell out millions of dollars to hospitals for them to host their students. On the other hand for the pre-clinical years, the professor is already there lecturing in a classroom, it costs nothing to add another student to the class that is going to happen no matter what. There is an enormous profit margin during pre-clinical years and that's why all carib schools and some DO schools overaccept and let attrition take its toll because its not costing them anything to add more students and fill the lecture halls to capacity.

 

[SpecterGT260]

yes... I am not aware of "volunteer preceptors". Most clerkships are highly organized and facilitated. It isnt just Dr. John feeling like "showing you the ropes" for the hell of it.... but maybe DO/Carib do this differently..... A friend of mine in a DO school has gotten to set up rotations with community physicians. I am not aware if the school pays the physician for this or not, however.

 

[bleeker10]

This is the exact opposite of the truth. The clinical years cost schools tons more than pre-clinical years! You can't just get a bunch of "community volunteer preceptors" ...it doesn't work that way. You have to do your rotations at a hospital and all carib and most DO schools don't have their own academic hospital and therefore have to shell out millions of dollars to hospitals for them to host their students. On the other hand for the pre-clinical years, the professor is already there lecturing in a classroom, it costs nothing to add another student to the class that is going to happen no matter what. There is an enormous profit margin during pre-clinical years and that's why all carib schools and some DO schools overaccept and let attrition take its toll because its not costing them anything to add more students and fill the lecture halls to capacity.

Wrong. I know that my school does not pay for rotations. It's one of the reasons tuition is cheaper here.

 

[SpecterGT260]

so your school only has volunteer docs doing glorified shadowing then? The only comparison I have is my school where each department has a clerkship coordinator and a team of people organizing the whole mess.... they dont work for free. I dont expect that the docs are making a little off the top from showing med students around, but doctor-pay isnt really what was being discussed here.

 

[bleeker10]

so your school only has volunteer docs doing glorified shadowing then? The only comparison I have is my school where each department has a clerkship coordinator and a team of people organizing the whole mess.... they dont work for free. I dont expect that the docs are making a little off the top from showing med students around, but doctor-pay isnt really what was being discussed here.

Never said it was glorified shadowing. My school works with hospitals to allow us to rotate with their physicians. Some of my friends have done 4th year student/intern level of work.

We have a clinical education dept at my school with one person in charge of each class. The clinical experience at each hospital is variable. It's one reason my school is trying to move towards regional campuses where the students rotate at one hospital rather than moving around each month to different hospitals.

 

[SpecterGT260]

so the school doesnt have to shell out for any of this? are there liability issues with medical students working in those clinics not under physicians on school pay-roll? or are the students limited in their hands-on access? im just curious how all of this works. My school is affiliated with a hopsital and we have some satellite facilities and collaborating institutions but otherwise there isnt a whole lot of moving around

 

[bleeker10]

so the school doesnt have to shell out for any of this? are there liability issues with medical students working in those clinics not under physicians on school pay-roll? or are the students limited in their hands-on access? im just curious how all of this works. My school is affiliated with a hopsital and we have some satellite facilities and collaborating institutions but otherwise there isnt a whole lot of moving around

Well we have malpractice insurance through my school which protects us at the hospitals. I'm not sure of the specifics of everything. I'm sure there has to be some advantage for the hospitals to accept us without being paid. I'm wondering if it may be a tax break or some other financial/professional advantage.

We are allowed to do as much as the hospital will allow. I've delivered a baby, done some minor office procedures skin to skin, assisted on surgeries (not just watched or drove the camera), done pap/vaginal exams, etc.

 

[ensuii]

This is the exact opposite of the truth. The clinical years cost schools tons more than pre-clinical years! You can't just get a bunch of "community volunteer preceptors" ...it doesn't work that way. You have to do your rotations at a hospital and all carib and most DO schools don't have their own academic hospital and therefore have to shell out millions of dollars to hospitals for them to host their students. On the other hand for the pre-clinical years, the professor is already there lecturing in a classroom, it costs nothing to add another student to the class that is going to happen no matter what. There is an enormous profit margin during pre-clinical years and that's why all carib schools and some DO schools overaccept and let attrition take its toll because its not costing them anything to add more students and fill the lecture halls to capacity.

so the school doesnt have to shell out for any of this? are there liability issues with medical students working in those clinics not under physicians on school pay-roll? or are the students limited in their hands-on access? im just curious how all of this works.

It's incredible how misinformed you can be and speak as if you have extensive knowledge on the subject.

My school is affiliated with a hopsital and we have some satellite facilities and collaborating institutions but otherwise there isnt a whole lot of moving around

That's how my school is too. Shocking isn't it?

 

[235009]

Never said it was glorified shadowing. My school works with hospitals to allow us to rotate with their physicians. Some of my friends have done 4th year student/intern level of work.

how do you "know" that your school doesn't pay the hospitals for this. They are absolutely paying for it, there is zero advantage for these hospitals to have med students hanging around. For example: "St. George’s alone sends about 1,000 students, many through a 10-year, $100 million contract with the New York City Health and Hospitals Corporation, which runs public hospitals."from a recent NYT article http://www.nytimes.com/2010/12/23/nyregion/23caribbean.html?pagewanted=all)

 

[235009]

My school is affiliated with a hopsital and we have some satellite facilities and collaborating institutions but otherwise there isnt a whole lot of moving around

That's how my school is too. Shocking isn't it?

This is how my school and every other US MD school is set up. What's your point. That's not what we're talking about here. We're talking about schools that OP might have a chance of getting into which means carib schools and low tier DO schools.

 

[deleted103644]

how do you "know" that your school doesn't pay the hospitals for this. They are absolutely paying for it, there is zero advantage for these hospitals to have med students hanging around. For example: "St. George's alone sends about 1,000 students, many through a 10-year, $100 million contract with the New York City Health and Hospitals Corporation, which runs public hospitals."from a recent NYT article http://www.nytimes.com/2010/12/23/nyregion/23caribbean.html?pagewanted=all)

St George's has received a lot of flak over this though, and it's why they have so many more rotations available than the other Caribbean schools. Because they were singled out, I think the other Caribbean schools generally weren't paying (until recently at least).

Thanks to their example though, I think even the US schools will eventually have to pay hospitals for rotations (unless they're providing other equally valuable resources).

 

[bleeker10]

how do you "know" that your school doesn't pay the hospitals for this. They are absolutely paying for it, there is zero advantage for these hospitals to have med students hanging around. For example: "St. George’s alone sends about 1,000 students, many through a 10-year, $100 million contract with the New York City Health and Hospitals Corporation, which runs public hospitals."from a recent NYT article http://www.nytimes.com/2010/12/23/nyregion/23caribbean.html?pagewanted=all)

I've spoken many times with the DME at the hospital I'm at now and he has confirmed, on more than one occasion, that my school does not pay for rotations. Like I alluded to in my previous post, there is probably some other advantage the hospital gets besides direct payment.

 

[SpecterGT260]

It's incredible how misinformed you can be and speak as if you have extensive knowledge on the subject.



That's how my school is too. Shocking isn't it?

Allow me to help you:
http://www.thefreedictionary.com/question
http://www.thefreedictionary.com/knowledge


I asked this guy a couple of questions about how his school works - since he stated that the reason his tuition is low is due to not having to pay for physicians.
see, #6 of the first link (aside from obvious implications) indicates that I was not speaking as if I have extensive knowledge (at least past my own experience.... which is what my example was).

I do understand that my usual level of sarcasm can somewhat put a target on my back, but if you choose to shoot make sure you are not aiming at your own foot

I am not shocked that your school is set up like mine or most other US MD schools in the country. Since it is, I would expect you to have a similar level of unfamiliarity with the sort of system that bleeker was describing in which his does not have a hospital to call home and relies on agreements with community hospitals/practices to get rotation spots.

I did notice that you also quoted SkinMD in this post.... did you happen to notice in my thumbs up to him that I still restricted my statement to US MD schools and cited an example from a DO student on the matter? no... no you probably didnt.

you know what I find incredible? how you could make such a strong statement with no clear idea of what is really going on

are you drunk? that would make this make more sense....

 

[scotchtapetest]

This is the exact opposite of the truth. The clinical years cost schools tons more than pre-clinical years! You can't just get a bunch of "community volunteer preceptors" ...it doesn't work that way. You have to do your rotations at a hospital and all carib and most DO schools don't have their own academic hospital and therefore have to shell out millions of dollars to hospitals for them to host their students. On the other hand for the pre-clinical years, the professor is already there lecturing in a classroom, it costs nothing to add another student to the class that is going to happen no matter what. There is an enormous profit margin during pre-clinical years and that's why all carib schools and some DO schools overaccept and let attrition take its toll because its not costing them anything to add more students and fill the lecture halls to capacity.

Even if you have an academic hospital attached to your school, your school still pays for your rotation at the hospital (that's where your tuition goes); They are paying those attendings a lot of money so when they are slowed down to teach you, someone needs to reimburse the hospital. Also what DO schools pay is on par with the an acceptable rate for MS rotations as they don't have extra money to spare (Private and public DO school tuition is similar to private and public US MD school tuition with similar attrition rates [see below]). Carib schools, as mentioned in the NYT articles, pay orders of magnitude more thanks to all the money they get from pre-clinical kids who drop out.

Also, lack of academic hospitals is not unique to DO schools. There are multiple US MD schools which have affiliations with other hospitals and away clinical sites, similar to some DO schools, to host their students and their students have to move during 3rd and 4th yr rotations to their assigned sites.

Furthermore, the overall attrition rate at DO schools is less than 10% (for 4yrs); it has been discussed on SDN ad nauseam and based on the available data is similar to US MD schools (do a search). On the other hand carib schools have an attrition rate close to 50%. So do not equate the two.

yes... I am not aware of "volunteer preceptors". Most clerkships are highly organized and facilitated. It isnt just Dr. John feeling like "showing you the ropes" for the hell of it.... but maybe DO/Carib do this differently..... A friend of mine in a DO school has gotten to set up rotations with community physicians. I am not aware if the school pays the physician for this or not, however.

I don't know of any school that pays for 4th yr away/elective rotations. Most schools (DO/US MD/Carib) however do pay for 3yr/core rotations regardless of how affiliations are setup.

Each DO school does it differently; For instance even though we don't have a hospital attached to our school, we have clinical campuses for 3rd yr with firm/long-term hospital affiliations where once assigned to a location, all rotations are within 30min driving time within that campus (and most of the rotations are at a single facility).

Wrong. I know that my school does not pay for rotations. It's one of the reasons tuition is cheaper here.

how do you "know" that your school doesn't pay the hospitals for this. They are absolutely paying for it, there is zero advantage for these hospitals to have med students hanging around. For example: "St. George's alone sends about 1,000 students, many through a 10-year, $100 million contract with the New York City Health and Hospitals Corporation, which runs public hospitals."from a recent NYT article http://www.nytimes.com/2010/12/23/nyregion/23caribbean.html?pagewanted=all)

Bleeker 10 is correct; his/her school doesn't pay for rotations at all (I know this for a fact)! That's why they have really cheap tuition and also get to travel the country during 3rd year (pluses and minuses to everything). The only reason for it is that the school refuses to pay and therefore they get variable rotations with little to no support while on site (not because 4th yrs are doing intern work or other excuses).

 

[bleeker10]

The only reason for it is that the school refuses to pay and therefore they get variable rotations with little to no support while on site (not because 4th yrs are doing intern work or other excuses).

Oh yea I completely agree. It really is variable and unfortunate. Honestly I think a lot of students would prefer they pay for rotations just so we had a better clinical experience and didn't have to travel around so much. At first people like traveling around but it really wears on you after a few rotations.

 

[deleted103644]

Even if you have an academic hospital attached to your school, your school still pays for your rotation at the hospital (that's where your tuition goes); They are paying those attendings a lot of money so when they are slowed down to teach you, someone needs to reimburse the hospital. Also what DO schools pay is on par with the an acceptable rate for MS rotations as they don't have extra money to spare (Private and public DO school tuition is similar to private and public US MD school tuition with similar attrition rates [see below]). Carib schools, as mentioned in the NYT articles, pay orders of magnitude more thanks to all the money they get from pre-clinical kids who drop out.

Wrong. None of the established MD programs were paying per student fees for hospital rotations.

I have no idea about newer MD programs or DO schools, but this is definitely NOT the case for most if not all MD programs.

To be honest, I'm not sure why they don't pay money for rotations, just know that they don't.

http://www.nytimes.com/2008/08/05/nyregion/05grenada.html?pagewanted=all

"Traditionally, medical schools have sent third- and fourth-year students into city hospitals to work — and learn — alongside doctors without being charged."

 

[SpecterGT260]

that is hair splitting.... the new MD schools are operated pretty similarly to DO schools since neither have hospitals (no need to cite specific exceptions.... lets think big picture here, errybuddy )

 

[deleted103644]

that is hair splitting.... the new MD schools are operated pretty similarly to DO schools since neither have hospitals (no need to cite specific exceptions.... lets think big picture here, errybuddy )

I try not to dwell too long on any of those programs. But I'll bite my tongue to play nice.

As I said, the established MD programs were not paying for rotations.

They might need to start now since others are willing, but it was definitely not the status quo as little as 3 years ago.

 

[scotchtapetest]

Wrong. None of the established MD programs were paying per student fees for hospital rotations.

I have no idea about newer MD programs or DO schools, but this is definitely NOT the case for most if not all MD programs.

To be honest, I'm not sure why they don't pay money for rotations, just know that they don't.

http://www.nytimes.com/2008/08/05/nyregion/05grenada.html?pagewanted=all

"Traditionally, medical schools have sent third- and fourth-year students into city hospitals to work — and learn — alongside doctors without being charged."

Well traditionally could mean 20-50+ years ago. Actually I know for a fact that most of the schools your referring to (you know, the ones in the city) pay for their rotations. Honestly where do you think your 3rd/4th year tuitions are going to? Match Day Ceremonies?

Now I can't speak for every single school but the vast majority of medical schools (DO/US MD/Carib) pay hospitals for MS rotations. It might not be per student; it could be a big sum of money on annual basis. But they do pay.

Bigger academic places even have it down to the number of hours students work with attendings and charge the school based on that. Each time a student shows up, the number of patients attendings see decreases, because they have to listen to the kid's presentation then teach him/her something semi-useful, correct the note and then yell at the intern. Someone has to reimburse the hospital for the attending's time.

 

[scotchtapetest]

that is hair splitting.... the new MD schools are operated pretty similarly to DO schools since neither have hospitals (no need to cite specific exceptions.... lets think big picture here, errybuddy )

This is not the case just for the new MD schools; There are multiple established US MD schools that send their kids away for clinical years. I have multiple friends at multiple different very established MD schools who do clinical rotations far away from their main hospital/med school.

 

[deleted103644]

Well traditionally could mean 20-50+ years ago. Actually I know for a fact that most of the schools your referring to (you know, the ones in the city) pay for their rotations. Honestly where do you think your 3rd/4th year tuitions are going to? Match Day Ceremonies?

Now I can't speak for every single school but the vast majority of medical schools (DO/US MD/Carib) pay hospitals for MS rotations. It might not be per student; it could be a big sum of money on annual basis. But they do pay.

Bigger academic places even have it down to the number of hours students work with attendings and charge the school based on that. Each time a student shows up, the number of patients attendings see decreases, because they have to listen to the kid's presentation then teach him/her something semi-useful, correct the note and then yell at the intern. Someone has to reimburse the hospital for the attending's time.

In the article they mention some programs were giving a "gratuity" of around $250k per year, which would come down to a few hundred dollars per student per year. That's nothing compared to SGU offering $500 per student per week.

Of course there are other factors, like joint research grants, attendings with academic appointments, etc, but the overall picture is that SGU was doing something unprecedented in NYC.

 

[scotchtapetest]

In the article they mention some programs were giving a "gratuity" of around $250k per year, which would come down to a few hundred dollars per student per year. That's nothing compared to SGU offering $500 per student per week.

Of course there are other factors, like joint research grants, attendings with academic appointments, etc, but the overall picture is that SGU was doing something unprecedented in NYC.

I wasn't arguing about SGU and their practices! I was talking about the money DO schools pay hospitals which is on par with what hospitals get from US MD schools in response to an earlier post. Also, I will assure you that schools pay a lot more than few hundred dollars per year for their students.

 

[ensuii]

Allow me to help you:
http://www.thefreedictionary.com/question
http://www.thefreedictionary.com/knowledge


I asked this guy a couple of questions about how his school works - since he stated that the reason his tuition is low is due to not having to pay for physicians.
see, #6 of the first link (aside from obvious implications) indicates that I was not speaking as if I have extensive knowledge (at least past my own experience.... which is what my example was).

I do understand that my usual level of sarcasm can somewhat put a target on my back, but if you choose to shoot make sure you are not aiming at your own foot

I am not shocked that your school is set up like mine or most other US MD schools in the country. Since it is, I would expect you to have a similar level of unfamiliarity with the sort of system that bleeker was describing in which his does not have a hospital to call home and relies on agreements with community hospitals/practices to get rotation spots.

I did notice that you also quoted SkinMD in this post.... did you happen to notice in my thumbs up to him that I still restricted my statement to US MD schools and cited an example from a DO student on the matter? no... no you probably didnt.

you know what I find incredible? how you could make such a strong statement with no clear idea of what is really going on

are you drunk? that would make this make more sense....

 

[deleted103644]

I still don't get that meme. If that's who I think that is, he is a bad ass, but still seems very random.

(And the Daily Show's globe still goes the wrong way, despite him pointing it out...)

 

[SpecterGT260]

This is not the case just for the new MD schools; There are multiple established US MD schools that send their kids away for clinical years. I have multiple friends at multiple different very established MD schools who do clinical rotations far away from their main hospital/med school.

Yes, we have some too. But I do not think that our students are going over to these other places for free.

don't get all butthurt just because your callout failed you will do better next time.... I'm sure you will

 

[SpecterGT260]

I still don't get that meme. If that's who I think that is, he is a bad ass, but still seems very random.

(And the Daily Show's globe still goes the wrong way, despite him pointing it out...)

it is supposed to be NDT calling someone else a badass sarcastically. i.e. I called out ensuii for some douchbaggary and since there was no legitimate retort he chooses to divert by insinuating that I think I am a badass.

 

[scotchtapetest]

Just to respond to people suggesting a 4th attempt, as the OP knows or will find out soon, once one has been dismissed from a COM, they will lose their eligibility to (re-)take COMLEX; therefore, the OP is not eligible to retake COMLEX unless s/he gets back in. As per NBOME rules, one has to be eligible (i.e. be in good standing at a COM among other requirements) on the day of examination.

Also you need to look at each state's requirements a little more closely - Alaska has a "no more than five attempts for all steps combined". OP, you will never be allowed to practice in Alaska. Several other states have similar restrictive number of attempts. You will be restricted in where you can get a residency and where you can practice if you should manage to pass your boards.

One can always depend on ShyRem to point out what is really important. Having failed 3 times, precludes the OP from getting licensed in many states even if she gets readmitted and graduates with flying colors and goes to MGH for optho, still won't be able to get licensed in many states.

I may be wrong, but I don't know that medical schools (especially private, as most DO schools are) are under any legal obligation to provide accommodations. Many do... but there are also the technical standards that you agree to at the get-go, which could easily include the ability to stay focused. This is why there are not many hook-handed surgeons out there (and in other contexts these guys WOULD be covered by the ADA)

Even private institutions have to comply with the ADA (if for no other reason than because they get federal loan eligibility for their students along with federal research grants, etc.).

However, ADA requires "reasonable" accommodations which doesn't cover hook-handed surgeons.

Also, NBOME does provide accommodations for ADHD (upon approval they get extra time on the exam) but the burden of proof is on the applicant. If the OP thought she was being denied accommodations unfairly, she should've dealt with it before taking the exam or before taking it the second time around.

Anyways, I wish OP the best of luck!

 

[SpecterGT260]

However, ADA requires "reasonable" accommodations which doesn't cover hook-handed surgeons.

that is kind of what I was getting at there.
The language is not explicit especially when it comes to technical standards. It isnt as if mental illness is unilaterally covered. not many schizophrenic doctors either (I think.... at risk of being incredible to ensuii again....) The technical standards that we sign also state pretty clearly that any and all disabilities need to be disclosed up front. You cant blame a school for not providing accommodations you did not ask for.

 

[deleted103644]

that is kind of what I was getting at there.
The language is not explicit especially when it comes to technical standards. It isnt as if mental illness is unilaterally covered. not many schizophrenic doctors either (I think.... at risk of being incredible to ensuii again....) The technical standards that we sign also state pretty clearly that any and all disabilities need to be disclosed up front. You cant blame a school for not providing accommodations you did not ask for.

For a closer analogy, you can't be a surgeon if you are having seizures once a month.

Your physician would be ethically required to report you if you tried to continue to practice.

 

[SpecterGT260]

that is a better example

 

[michaelrack]

. But if you knew me personally, you would see that I fit in MUCH MORE as a physician than I do as a drug rep, and ladder-climbing, money making, and hierarchy have no appeal for me.

there is a lot of ladder-climbing and hierarchy in medicine; but not so much money making these days

 

[DocEspana]

This is the exact opposite of the truth. The clinical years cost schools tons more than pre-clinical years! You can't just get a bunch of "community volunteer preceptors" ...it doesn't work that way. You have to do your rotations at a hospital and all carib and most DO schools don't have their own academic hospital and therefore have to shell out millions of dollars to hospitals for them to host their students. On the other hand for the pre-clinical years, the professor is already there lecturing in a classroom, it costs nothing to add another student to the class that is going to happen no matter what. There is an enormous profit margin during pre-clinical years and that's why all carib schools and some DO schools overaccept and let attrition take its toll because its not costing them anything to add more students and fill the lecture halls to capacity.

I havent read the other parts of this thread yet, so IDK if someone corrected you on this, but in all american medical schools (MD or DO) the money making time is the *clinical* years. Pre-clinical is where the "profit" margin becomes very small or non-existant. Most DO schools pay extremely little, to nothing, for rotations. This is the same as MD schools. Both are forbidden from paying for clinical education. MDs are explicitly forbidden for paying for it. DOs are explicitly forbidden from using payment to acquire spots. It effectively means the same thing. That a school establishes a number, somewhere between $0 and $500 a month per student that they can justify as "academic offsets" of training a medical student. In both cases all of that money (if it exists) comes with many many strings that it *cannot* go to paying preceptors or faculty directly, but can only be used for directly covering costs the medical student induced, or for establishing educational programs.

So you're a bit off on the payment thing, since MD and DOs have the same rules there. Nothing like the Caribbean schools (who are paying $2500 per month per student or more). And the idea of pre-clinical being the money making period is completely wrong. At least when compared to clinical years. I cant disagree that one more person paying $40,000 is $40,000 more into the schools pocket. But thats true regardless of the year.

 

[DocEspana]

K after reading all of this I just want to make a small clarification for someone.

Both MD and DO schools are *prohibited* from paying for clerkships directly by the rules of their accreditation. The rules of the LCME are more restrictive, the rules of COCA are more permissive, but in the "big picture" they're both equally prohibited in an absolute sense.

The reality is that about a 1/4 of MD schools pay $0.00 per student to their clerkships. And around 1/8 of DO schools pay $0.00. The remainder make their payments under the guise of "academic kickbacks" and "student education investment". Basically its small sums of money that is highly tied up so that it cannot be construed as a "payment" but rather as compensation for any direct costs (NOT EDUCATION OR TIME LOST) by the student, or simply to fund education.

This varies immensely from caribbean schools which give >5x the maximum of any american school and give the money carte blanche for anything the hospital may wish to do.

The majority of the money you pay for tuition your 3rd and 4th year goes towards your malpractice insurance and subsidizing the costs of the first 2 years, where its not unusual to be running in the red from the budget of those two years alone.

source: I am a primary source on this matter.

 

[scotchtapetest]

I havent read the other parts of this thread yet, so IDK if someone corrected you on this, but in all american medical schools (MD or DO) the money making time is the *clinical* years. Pre-clinical is where the "profit" margin becomes very small or non-existant. Most DO schools pay extremely little, to nothing, for rotations. This is the same as MD schools. Both are forbidden from paying for clinical education. MDs are explicitly forbidden for paying for it. DOs are explicitly forbidden from using payment to acquire spots. It effectively means the same thing. That a school establishes a number, somewhere between $0 and $500 a month per student that they can justify as "academic offsets" of training a medical student. In both cases all of that money (if it exists) comes with many many strings that it *cannot* go to paying preceptors or faculty directly, but can only be used for directly covering costs the medical student induced, or for establishing educational programs.

So you're a bit off on the payment thing, since MD and DOs have the same rules there. Nothing like the Caribbean schools (who are paying $2500 per month per student or more). And the idea of pre-clinical being the money making period is completely wrong. At least when compared to clinical years. I cant disagree that one more person paying $40,000 is $40,000 more into the schools pocket. But thats true regardless of the year.

1) For most schools, pre-clinical years (especially 2nd yr) and 4th yr are the times where profit margins are huge. Depending on how much they spend on Anatomy lab, 1st year could be a lucrative year as well. How much do you think a 2 hour talk on acid-base costs? That's why carib schools have so much money; They take something around 2000 kids/yr/school who pay tuition for 2yrs, then about half of them drop out and the school pockets all the money. Third year, most schools lose money.

2) Again, your school is another one of those that doesn't pay much for rotations (at least yours is willing to pay a little). Almost all other schools (DO/US MD/Carib) except yours and Bleeker's (no need to name schools here) pay dearly for rotations. This is well known in the hospitals. If what you are saying is the excuse your school is using, they are full of it.

2a) Could you imagine a public school charging $20,000+ and only shelling out $5,000/student as you are suggesting for rotations? Students should/would revolt and legislature would be on their a**.

3) You can call it whatever you want; offsetting cost of education/hospital contract/paying for lectures/donation/gratuity/etc. the vast majority of schools (DO/US MD/Carib) pay for rotations in one form or the other (with some notable exceptions). However, some schools (i.e. Carib schools) pay amounts that DO/US MD can't compete with. That's the only difference! Now the US schools (specifically NYC schools are trying to fight back through legislature because they can't compete financially)!

Disclaimer: I am not defending SGU; I think taking students knowing 50% of them will fail and charging them tuition is ethically and professionally despicable; but economically is a great model.

 

[scotchtapetest]

K after reading all of this I just want to make a small clarification for someone.

Both MD and DO schools are *prohibited* from paying for clerkships directly by the rules of their accreditation. The rules of the LCME are more restrictive, the rules of COCA are more permissive, but in the "big picture" they're both equally prohibited in an absolute sense.

The reality is that about a 1/4 of MD schools pay $0.00 per student to their clerkships. And around 1/8 of DO schools pay $0.00. The remainder make their payments under the guise of "academic kickbacks" and "student education investment". Basically its small sums of money that is highly tied up so that it cannot be construed as a "payment" but rather as compensation for any direct costs (NOT EDUCATION OR TIME LOST) by the student, or simply to fund education.

This varies immensely from caribbean schools which give >5x the maximum of any american school and give the money carte blanche for anything the hospital may wish to do.

The majority of the money you pay for tuition your 3rd and 4th year goes towards your malpractice insurance and subsidizing the costs of the first 2 years, where its not unusual to be running in the red from the budget of those two years alone.

source: I am a primary source on this matter.

Although I'm not sure about the proportion of your non-paying schools (not arguing, just don't know), I can agree with the rest!

 

[DocEspana]

Edited because I'm not sure giving up my last shreds of anonymity are worth telling Bala he is wrong on most of his numbered points above. What you assume to be the case is not. My suggestion go to point 2a. That is absolutely 100% what's going on. If it bugs you, then do protest. Because thats the reality. Your attempts to use logic are admirable, but logic doesnt apply here. The fact is that what I said above is totally true. I dont really want to have to lose anonymity to prove my point.

 

[scotchtapetest]

Edited because I'm not sure giving up my last shreds of anonymity are worth telling Bala he is wrong on most of his numbered points above. What you assume to be the case is not. My suggestion go to point 2a. That is absolutely 100% what's going on. If it bugs you, then do protest. Because thats the reality. Your attempts to use logic are admirable, but logic doesnt apply here. The fact is that what I said above is totally true. I dont really want to have to lose anonymity to prove my point.

I'm really glad you edited that post! I was just about to PM you to suggest that! And I'm not sure how I'm wrong when your own post (#97) says exactly what I said in my post.

Summary: I made the point that contrary to what was stated in earlier posts, most medical schools (DO/US MD/Carib) pay for rotations (one way or the other) and Carib schools pay much, much, much more while DO schools and US MD schools pay a similar rate (whatever that is) again contrary to what was stated in earlier posts regarding DO schools. It appears that you now agree as well.

Now let's get back to the OP's dilemma!

 

[235009]

I havent read the other parts of this thread yet, so IDK if someone corrected you on this, but in all american medical schools (MD or DO) the money making time is the *clinical* years. Pre-clinical is where the "profit" margin becomes very small or non-existant. Most DO schools pay extremely little, to nothing, for rotations. This is the same as MD schools. Both are forbidden from paying for clinical education. MDs are explicitly forbidden for paying for it. DOs are explicitly forbidden from using payment to acquire spots. It effectively means the same thing. That a school establishes a number, somewhere between $0 and $500 a month per student that they can justify as "academic offsets" of training a medical student. In both cases all of that money (if it exists) comes with many many strings that it *cannot* go to paying preceptors or faculty directly, but can only be used for directly covering costs the medical student induced, or for establishing educational programs.

So you're a bit off on the payment thing, since MD and DOs have the same rules there. Nothing like the Caribbean schools (who are paying $2500 per month per student or more). And the idea of pre-clinical being the money making period is completely wrong. At least when compared to clinical years. I cant disagree that one more person paying $40,000 is $40,000 more into the schools pocket. But thats true regardless of the year.

again i will reiterate that i was talking about schools OP might possibly have a chance of getting into (carib schools) .....so it seems we all agree on my actual point that accepting her would not be an economically motivated decision for these carib schools since they won't be profitting off of her.

OP obviously has no chance in the US MD or DO realm, and IMHO I think she should start looking at another career, allowing herself to fail both COMLEX and step 1 three times is simply unacceptable. Should've done much more the second and third time around and taken any steps necessary to ensure a pass (for instance going to Falcon's sleep away step 1 study camp and hearing the words come right out of Goljan's mouth)