MSU Clinical rotations: is your school pass/fail?

[Smeece_]

Hi everyone!!

I'm trying to get a sense of what vet schools have a pass/fail system for their clinical rotating students.

Michigan state still uses numerical grading, as well as 60 required hours for rotating students and sometimes its as high as 80 hours. It's very exploitative in my opinion, and C/O 2023 did pretty badly on their NAVLE due to overexertion and not enough time outside of clinics for studying. When I brought this up during orientation, their answer was "its just always been that way", excuse me, WHAT?

I'm a previous dual DVM/PhD student that left their program due to exploitation plus a whole slew of other issues, so I'm transitioning to C/O 2024's rotating class, and I don't want to spend my clinical year being exploited even more, when we need time to actually prepare for the NAVLE. I know that human medicine utilizes pass/fail during clinics so why can't we? Why is it a standard that students are overworked when hospitals are understaffed? This needs to change.

I plan on gathering data from other schools to present to our clinical faculty directors, as well as starting a poll with C/O 2024 on whether pass/fail should be standard or not.

thank you everyone!

---

Members don't see this ad.

 

[SkiOtter]

UIUC is pass/fail for clinics.

Also, what do you mean by 60-80 required hours?

 

[Smeece_]

UIUC is pass/fail for clinics.

Also, what do you mean by 60-80 required hours?

I'll put them on my list! Thank you!

Their listed "duty hours" in the student handbook and what was presented during orientation says that for core rotations on MSU's campus we should expect an average of working 60 hours... and I know from classmates in 2023 that, they were in clinics between 70-80 hours depending on the rotation. Spending 13,14, even 16 hours in the clinic and still expected to come in the next day having treatments done by 8am. Like what? When are we supposed to actually be humans and have a life?

Off-campus externships only require 40 hours minimum. So why are core MSU rotations requiring students to work overtime and pay tuition to be exploited? Our administrators couldn't/wouldn't even address my questions.

 

[JaynaAli]

My school had graded clinics when I was a student. No idea what they do now because I graduated 8 years ago. It actually helped my GPA (which needed helped because I specialized) because I performed better on clinics than I did in didactics. I’m not saying one is inherently better because they both have pros and cons but just giving an alternate viewpoint.

 

[Smeece_]

My school had graded clinics when I was a student. No idea what they do now because I graduated 8 years ago. It actually helped my GPA (which needed helped because I specialized) because I performed better on clinics than I did in didactics. I’m not saying one is inherently better because they both have pros and cons but just giving an alternate viewpoint.

I appreciate this insight, I know for sure that it can be beneficial to some GPAs, especially since COVID could have impacted some GPAs in our class. My main concern is, with numerical grading in our system, we don't see our grade until the end of the rotation. A lot of my 2023ers have said that its almost impossible to 4.0 or "do well" in our core rotations because clinicians have unrealistic expectations of the students, and those that stand up for themselves are labeled with a "bad attitude?"

My other concern is, if I begin advocating for myself to say, leave on time for instance, that will negatively reflect on my grade at the end of the rotation, because I'm valuing my mental health over being overworked.

 

[sam125]

Most of what I’ve learned about medicine and applying knowledge has come from clinics, so it certainly helps with navle prep more than studying in my opinion. I would hesitate to blame navle performance on clinical commitments. From what I’ve heard, it’s pretty common for a large portion of a class to fail the navle the first time they take it. The navle pass rate you hear about is not after one try.

An average of 60 hours, needless to say, means some will be more and some will be less. There are certainly times where you will be at the hospital, not yet dismissed, just waiting around. There will be times you are running around until the last minute. I have rarely been at school late without a doctor also there late with me. Exploitation is a strong word. Sometimes it might be accurate, but I also think we pay to learn as much as we can in one year and sometimes that requires some grit and long hours.

 

[WildZoo]

UTK transitioned to pass/fail with an extra "pass with honors" category for clinics a couple years ago. They did a lot of research to support that action, I might be able to dig through old emails to find it. My memory is that while some students did see their GPA increase a little bit (I was one of them) overall GPA changes were insignificant, particularly for the people for whom it actually mattered (those wanting to specialize). Meanwhile not having the pressure of trying to get an arbitrary and subjective grade allowed students to focus on learning and patient care.

SAVMA published some duty hours recommendations not that long ago, I don't remember all the details of those but might be worth perusing. I do think schools should be working towards allowing their students (and house officers) a certain amount of time away from the hospital after they've been there long past their scheduled day, but the wheels on that turn slowly everywhere. We had a couple rotations where if you were called in overnight or had to stay really late for a procedure or something you were allowed to come in late the next day.

I agree with the other posters that I doubt NAVLE pass rate had anything to do with not having time to study during clinics - it's not like the long hours are a new phenomenon. Participating in clinics helps you learn for NAVLE after all. The pass rate that is reported publicly is after both the fall and spring dates for each class, not after fall alone. So you'd have to contact individual school admins to know what their fall-only rate is. All accredited schools are over 80% after the spring testing (and the majority are in the high 90s, which is ideal). If there was a significant difference compared to prior years, it's unlikely it was caused by clinic hours.

 

[Smeece_]

Most of what I’ve learned about medicine and applying knowledge has come from clinics, so it certainly helps with navle prep more than studying in my opinion. I would hesitate to blame navle performance on clinical commitments. From what I’ve heard, it’s pretty common for a large portion of a class to fail the navle the first time they take it. The navle pass rate you hear about is not after one try.

An average of 60 hours, needless to say, means some will be more and some will be less. There are certainly times where you will be at the hospital, not yet dismissed, just waiting around. There will be times you are running around until the last minute. I have rarely been at school late without a doctor also there late with me. Exploitation is a strong word. Sometimes it might be accurate, but I also think we pay to learn as much as we can in one year and sometimes that requires some grit and long hours.

Thank you for this insight, I didn't know that the first pass rate wasn't the official pass rate so that does change my opinion slightly. I do agree with you that learning during clinics is a good way to prepare for the navle. I chose the word exploitation, because of the consistent 80 hr work weeks I've been hearing, but I never expected that to be the case for all rotations.

 

[Smeece_]

UTK transitioned to pass/fail with an extra "pass with honors" category for clinics a couple years ago. They did a lot of research to support that action, I might be able to dig through old emails to find it. My memory is that while some students did see their GPA increase a little bit (I was one of them) overall GPA changes were insignificant, particularly for the people for whom it actually mattered (those wanting to specialize). Meanwhile not having the pressure of trying to get an arbitrary and subjective grade allowed students to focus on learning and patient care.

SAVMA published some duty hours recommendations not that long ago, I don't remember all the details of those but might be worth perusing. I do think schools should be working towards allowing their students (and house officers) a certain amount of time away from the hospital after they've been there long past their scheduled day, but the wheels on that turn slowly everywhere. We had a couple rotations where if you were called in overnight or had to stay really late for a procedure or something you were allowed to come in late the next day.

I agree with the other posters that I doubt NAVLE pass rate had anything to do with not having time to study during clinics - it's not like the long hours are a new phenomenon. Participating in clinics helps you learn for NAVLE after all. The pass rate that is reported publicly is after both the fall and spring dates for each class, not after fall alone. So you'd have to contact individual school admins to know what their fall-only rate is. All accredited schools are over 80% after the spring testing (and the majority are in the high 90s, which is ideal). If there was a significant difference compared to prior years, it's unlikely it was caused by clinic hours.

Thank you for this! Its good to know that I can actually learn while on clinics and not necessarily need to rely so much on outside studying. I also appreciate the SAVMA data you gave as well, I will for sure look into their data!

Again, I had no idea pass rates were reported after both fall and spring, I'll wait until both semester data are reported before I turn into an angry noodle right away. Thank you!

 

[SkiOtter]

SAVMA published some duty hours recommendations not that long ago, I don't remember all the details of those but might be worth perusing.

I don’t remember the full details either, but I do remember that their “max recommended hours” is 80 hours per week and not more than 24 hours consecutively 🥲

So uh
Still not great.

I do think that there’s a recommended amount of time you’re supposed to have between shifts but I couldn’t tell you what it is

 

[WildZoo]

I don’t remember the full details either, but I do remember that their “max recommended hours” is 80 hours per week and not more than 24 hours consecutively 🥲

Oh lol was that including being on-call perhaps? I don't think I ever came close to being in the hospital for 24 hours consecutively, think my highest was 14. And that wasn't common...it was a few times for one rotation (farm animal, I had time-intensive patients and unhelpful rotationmates lol) and then never really happened again.

I honestly didn't keep track of my weekly hours, so I have no helpful insights there.

 

[SkiOtter]

Oh lol was that including being on-call perhaps? I don't think I ever came close to being in the hospital for 24 hours consecutively, think my highest was 14. And that wasn't common...it was a few times for one rotation (farm animal, I had time-intensive patients and unhelpful rotationmates lol) and then never really happened again.

I honestly didn't keep track of my weekly hours, so I have no helpful insights there.

Maybe? I’m not sure. I don’t think illinois followed the savma guidelines that closely especially with large animal. We had on call and walkby students scheduled every night and all weekend days so depending on how you were scheduled you could be there from 7 am to 1 am iirc (can’t fully remember treatment times and walkby shifts) if it was a weekday and they needed you to stay for the afternoon/evening walkby shift (depended on the day and if there was tech coverage or not). Usually if you were the 12a-8a shift you got to go home and sleep and either come in in the afternoon or not even come in that day depending on the clinician and schedule.

I also didn’t keep track of my weekly hours but I know I didn’t have more than like 14-15 hours a day in the hospital aside from LA with walkby shifts. And those long days were on the more intensive rotations like surgery and SAIM and weren’t every day. Surgery usually was semi good iirc about dismissing students earlier even if there was still a surgery going with 1 student still.

 

[WildZoo]

Maybe? I’m not sure. I don’t think illinois followed the savma guidelines that closely especially with large animal. We had on call and walkby students scheduled every night and all weekend days so depending on how you were scheduled you could be there from 7 am to 1 am iirc (can’t fully remember treatment times and walkby shifts) if it was a weekday and they needed you to stay for the afternoon/evening walkby shift (depended on the day and if there was tech coverage or not). Usually if you were the 12a-8a shift you got to go home and sleep and either come in in the afternoon or not even come in that day depending on the clinician and schedule.

I also didn’t keep track of my weekly hours but I know I didn’t have more than like 14-15 hours a day in the hospital aside from LA with walkby shifts. And those long days were on the more intensive rotations like surgery and SAIM and weren’t every day. Surgery usually was semi good iirc about dismissing students earlier even if there was still a surgery going with 1 student still.

Dang. We have a large animal ECC rotation so all overnight stuff is done by those students during the week, others are on call but very rarely called in. The ECC students get weekend nights off so there would be one equine and one farm animal student assigned those nights, but then those students would get the next day (and one other day during the week) off. I honestly can't think of any situation where anyone could manage to be in the hospital here for even close to 24 consecutive hours. I also think it would be pretty hard to hit 80 hours in a week unless you got really unlucky with your on call schedule, but I imagine it might happen occasionally.

 

[SkiOtter]

Dang. We have a large animal ECC rotation so all overnight stuff is done by those students during the week, others are on call but very rarely called in. The ECC students get weekend nights off so there would be one equine and one farm animal student assigned those nights, but then those students would get the next day (and one other day during the week) off. I honestly can't think of any situation where anyone could manage to be in the hospital here for even close to 24 consecutive hours. I also think it would be pretty hard to hit 80 hours in a week unless you got really unlucky with your on call schedule, but I imagine it might happen occasionally.

Yeahhh it was rough. A LA ECC rotation would definitely be beneficial for that but idk how much they’d actually have on a regular basis (I just don’t fully know what our LA emergencies and freq actually look like). If there was a tech on for the night you often didn’t have to come in or at least not the overnight student since a main treatment time was before the evening student was gone and depending on how many horses were in hospital the tech may be able to do it all themselves or with just 1 student (we had 2 scheduled for each walkby shift) and there might not be a patient needing an early morning treatment so you got off the hook 😂 we also split it up between Farm animals and equine so those services only took care of their own patients and on call. Farms often didn’t have any inpatients so didn’t need any students to come in. When they did, more often they didn’t need treatments overnight. Sometimes if the equine students didn’t have a ton, they’d offer to do the farms WBs so they didn’t have to come in just for a life check every few hours.

 

[WildZoo]

Yeahhh it was rough. A LA ECC rotation would definitely be beneficial for that but idk how much they’d actually have on a regular basis (I just don’t fully know what our LA emergencies and freq actually look like). If there was a tech on for the night you often didn’t have to come in or at least not the overnight student since a main treatment time was before the evening student was gone and depending on how many horses were in hospital the tech may be able to do it all themselves or with just 1 student (we had 2 scheduled for each walkby shift) and there might not be a patient needing an early morning treatment so you got off the hook 😂 we also split it up between Farm animals and equine so those services only took care of their own patients and on call. Farms often didn’t have any inpatients so didn’t need any students to come in. When they did, more often they didn’t need treatments overnight. Sometimes if the equine students didn’t have a ton, they’d offer to do the farms WBs so they didn’t have to come in just for a life check every few hours.

It helps with overall workload across the large animal rotations, but has its own drawbacks. A lot of the time is just spent doing life checks and treatments for inpatients, we don't get a *ton* of overnight emergencies so not a lot of case workup, most of the learning is more didactic. Granted while I was intimately familiar with how that rotation ran while I was in school since I worked alongside those students in my ECC assistant job, I can't speak to how it might have changed in the last few years.

 

[finnickthedog]

Full disclosure I have not read the whole thread, just the opening post but... did MSU change something? When I was there (c/o 2021) they had recently instituted a policy where we were the maximum was supposed to be 60 hours per week.

Now I'll grant you this was not strictly enforced and plenty of people did go over but as someone who did track my own hours... if I was over and I pointed this out then they adhered to it. I just had to advocate for myself on that front. And when I was there for 20 hours one shift because I was the assigned on call--they told me to stay home the next day.

I'm surprised if they moved so backwards as to make 60 hours a minimum.

 

[SkiOtter]

It helps with overall workload across the large animal rotations, but has its own drawbacks. A lot of the time is just spent doing life checks and treatments for inpatients, we don't get a *ton* of overnight emergencies so not a lot of case workup, most of the learning is more didactic. Granted while I was intimately familiar with how that rotation ran while I was in school since I worked alongside those students in my ECC assistant job, I can't speak to how it might have changed in the last few years.

Yeah def can see that it would have drawbacks (and uiuc would prob not even have enough students to staff it unless it was required). I know we didn’t get *tons* of overnight emergencies either but did have the occasional ones, which is why I wasn’t sure if it’d even be beneficial at uiuc 😂

 

[supershorty]

Many schools have had dips in NAVLE pass rate in the last couple of years. It's much more likely due to the effects of COVID learning than clinic hours, IMO.

Our rotations are graded as pass/pass with reservations/fail, I don't know yet how many hours we tend to spend per week, but I should get an idea of the worst it can be given my first 2 blocks

 

[supershorty]

I plan on gathering data from other schools to present to our clinical faculty directors, as well as starting a poll with C/O 2024 on whether pass/fail should be standard or not.

Also, as someone working on a similar type of project - be sure that you're presenting this in a collegial and productive way. Your posts right now come across as very bitter and angry at the school, and while I very much understand the feeling (my own personal project is in demonstrating to my program the deficiencies in the dual degree program that need to be rectified, so truly, I get it), the only way these kinds of conversations are productive is if you make sure to find some positives too. Rather than addressing this as grievances against the program, I encourage you to look for actionable items and present plans for tackling those, as well as finding some positives in the program or things that they do well.

It can be hard to find those sometimes, but coming out of the gate swinging just puts people on the defense and then it's very difficult to work together to identify and act on clear solutions.

 

[supershorty]

I'm not sure how long we've had the current grading system for rotations though because I *think* my class had A-F grading

 

[WildZoo]

I am not sure if it is kosher for me to share our internal grading change proposal since it's unpublished, but there are some publications out there about it

https://jvme.utpjournals.press/doi/10.3138/jvme.2019-0103

The Association of Grade Reporting Method, Student Performance, and Student Motivation on a Veterinary Clinical Rotation

The purpose of this study was to investigate factors influencing student motivation for learning and performance on a small animal internal medicine (SAIM) rotation, with a particular emphasis on the impact of the type of grade reporting system utilized. Veterinary students rotating through...

pubs.sciepub.com

 

[WhtsThFrequency]

Also, as someone working on a similar type of project - be sure that you're presenting this in a collegial and productive way. Your posts right now come across as very bitter and angry at the school, and while I very much understand the feeling (my own personal project is in demonstrating to my program the deficiencies in the dual degree program that need to be rectified, so truly, I get it), the only way these kinds of conversations are productive is if you make sure to find some positives too. Rather than addressing this as grievances against the program, I encourage you to look for actionable items and present plans for tackling those, as well as finding some positives in the program or things that they do well.

It can be hard to find those sometimes, but coming out of the gate swinging just puts people on the defense and then it's very difficult to work together to identify and act on clear solutions.

Absolutely. This is the core of feedback, something that at my institution(s) we place a huge emphasis on. If something doesn't work, explain why and suggest a plan of action or alternatives. Don't make it personal, don't involve emotions. I use the "sandwich method" with my students - something they do well, followed by something they can improve upon (I never call it something they are "bad" at), followed by something else they do well. If you just aggressively come at anyone with "this isn't fair" they are going to shut down, even if you are in the right.

That being said, I totally get being overworked and, as a student, having less agency in being able to say "no." As a junior faculty member, I often feel the same. I also feel that tuition should me much lower in the fourth year due to clinical labor, but that's another argument altogether.

It sounds more like they are being safe in telling students "what to expect" rather than actually "requiring" 60 hours, based on what the OP said the handbook said. Also from a faculty perspective - saying "an average of 60 hours is to be expected" may not be the actual reality. Estimating hours on the high end is a way to ensure that in the event that hours become high on a certain rotation, we can still state that would be expected and not get blowback - because it's so difficult to give a true average across a wide variety of rotations. For example, say we told students "expect 40 hours" because most students averaged 40 hours in their rotations. Then everyone who ended up on a rotation where they worked 60 would be super pissed.

It's better to aim high in terms of estimations like that. Sort of like cooking temperatures. Do you really HAVE to blast the actual feck out of that chicken? No, if you cooked it to 5-10 degrees lower it would likely be fine. But if you made 10 degrees lower the guideline, and a few people get Salmonella, it makes you look like an liar. Best comparison I can come up with.

 

[Teepster87]

My own anecdotal experience from being in MSU clinics:

I did much better than I expected to, grade-wise. I was already planning on entering government work upon graduation, and I didn't have a ton of clinical knowledge/experience beforehand. I don't think I ever spent 60 hours a week in clinics, with the exception being emergency. I made an serious effort to also try and structure my rotations so I didn't have really difficult ones back to back. Pepper in some off campus rotations, necropsy, etc. That really had a great impact on me not continually being burnt out. I also enjoyed having pathology early on, as it helped me build skills to really fill out my differentials.

I had two young kids at home during clinics so I wasn't looking to spend all my time there. And I'd maybe spend 4-6hours a week doing vetprep.

 

[WonderingStudent]

Tufts is Pass/Fail type grading for clinics with the potential to get honors. I feel like admins told us they changed to this system about 10 years ago. For the last two years Tufts has collected data regarding how many hours clinical students have been spending on each rotation and based on what they showed us it is a large range with some rotations reaching 80 hrs/week and most having an upper range of 60 hrs. But we don’t have any sort of minimum number of hours at least to my knowledge.

 

[SnowJ]

I'm not sure how long we've had the current grading system for rotations though because I *think* my class had A-F grading

UMN switched to pass/fail because of COVID, so I think the c/o 2020 had mostly A-F rotations until everything shut down. c/o 2021 would have had pass/fail the whole time, and they've decided to keep that system ever since.
At least that's what I remember being told

 

[WildZoo]

UMN switched to pass/fail because of COVID, so I think the c/o 2020 had mostly A-F rotations until everything shut down. c/o 2021 would have had pass/fail the whole time, and they've decided to keep that system ever since.
At least that's what I remember being told

Oh hey this is almost exactly what happened at UT. The plan to switch was in place, but they weren't going to do it until c/o 2023, basically so that no students enrolled at the time the plan came about would be affected. But then COVID happened, they instituted it for my class (2020) and then just kept it.

 

[dcht90]

As someone who is currently on clinical rotations at MSU, I'd say that those stating they consistently are at the hospital 80-90 hours a week are over-exaggerating. I'm sure there are weeks where someone may get close, but that is not the norm. There is a policy in the hospital that if you work more than 16 hours in a day, you are sent home the next day after 8am treatments. This only happens if you are on call and get called in on a weekday. Students are also not allowed to take consecutive on-call shifts. So if I did a normal 12 hour day (7am to 7pm), then was called in 11pm for emergency surgeries and we finish surgeries at 5am - then I'm required to do 8am treatments on all my patients and then sent home for the rest of the day to sleep. When things like that happen, most classmates pitch in and help, so you don't have multiple patients to deal with in the am. You find classmates to be in charge of your patients for the day you are at home and you'll pick them back up the next day for 8am treatments. The house officers on the other hand, are consistently pulling 100 hour per week with little to no sleep and are at the hospital 7 days a week. The 16 hours per day policy is enforced and people are not labelled as having a 'bad attitude' for speaking up. But, you do have to speak up since clinicians are not stalking how many hours we had to put in. Most are aware of it and send you home without asking.

How you 'count' hours also varies. The school does not consider working on paperwork part of your time working at the hospital. That may sound harsh at face value, but there is plenty of time to get your paperwork done while at the hospital. When I leave the hospital, I'm not working on paperwork, but rather doing normal human things. I also usually have enough time to prep for the next day while at the hospital. Some days get crazy and that's OK, you just adapt and do your best. When I've been on crazy busy rotations, sure my workout schedule and cleaning my apartment suffer, but it is only for 3 weeks.