Rotations suck......not learn anything

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SpringDO

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Soo my third year sucks... I've been assigned to hospitals where the attendings dont care and they dont really teach and they let you go home early and dont even care if you show up.

I feel like my whole 3rd year was wasted. I complained about this but they cant place me anywhere else b/c spots are all filled up.

Does anyone have any similar experiences??? I try to be proactive but honestly I dont learn that much.

I am studying for step 2 on my own and everything I learn in from review books.

You will be shocked but I have not even written ONE SIGNLE NOTE TO DATE!!!

Am I going to be screwed come residency? I dont know what to do except study hard for step 2, but I feel like ill be a bad resident. I can try to rotate at better hospitals during fourth year and learn stuff then.

Anyone in my shoes can comment that would be helpful!

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To be honest, you will really be behind in residency. You are pretty much on your own during residency to manage your own patients with just little feedback from senior residents and attendings. Rotations during med school help you become more comfortable with managing pts and efficient with writing notes. If I were you I would sign up for sub internships and work really hard ur 4th yr. your school has a duty to prepare you for residency and I would not back down with them. Tell them that u have not written any notes. Good Luck.
 
Soo my third year sucks... I've been assigned to hospitals where the attendings dont care and they dont really teach and they let you go home early and dont even care if you show up.

I feel like my whole 3rd year was wasted. I complained about this but they cant place me anywhere else b/c spots are all filled up.

Does anyone have any similar experiences??? I try to be proactive but honestly I dont learn that much.

I am studying for step 2 on my own and everything I learn in from review books.

You will be shocked but I have not even written ONE SIGNLE NOTE TO DATE!!!

Am I going to be screwed come residency? I dont know what to do except study hard for step 2, but I feel like ill be a bad resident. I can try to rotate at better hospitals during fourth year and learn stuff then.

Anyone in my shoes can comment that would be helpful!

Not a single note all year? This is highly abnormal. You need to name the school.
 
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I definitely agree that your school is doing you a terrible disservice by not giving you a worthwhile 3rd year experience.
You can learn everything you need to know for Step 2 from review books, so I think you will do ok on that if you take it seriously and study hard, but I agree that it might be hard transitioning to residency unless you're able to get some really educational, solid 4th year rotations. I guess another option might be to see if one of your classmates would be open to voluntarily swapping spots with you? Maybe there is someone who is really lazy and wants an easier rotation schedule? :)

I think it is horrible that there are schools out there who do this to their students. :mad:
 
Have you done IM yet? If not, then you will probably have ample opportunity to write notes then. I didn't write any notes on my ob/gyn, peds, psych or FP rotations. But I did on IM and it's been no issue since.
 
I think this is somewhat endemic to osteopathic education in general. I go to one of the 'established' DO schools, and many of my rotations have been pretty weak. Granted, teaching is sometimes decent and we get to write a fair number of notes, but there have been just as many rotations where the teaching is dreadful and you basically just shadow the attendings.

Interestingly, our best 3rd year rotation was probably FM - I got to write all pt notes there. IM was probably our worst - half of it was spent at a hospital in which the attending wouldn't even let us touch patients because of 'liability concerns' (!?). I did write some notes on psych and surg but definitely nothing on peds, ob/gyn or other rotations.
 
Soo my third year sucks... I've been assigned to hospitals where the attendings dont care and they dont really teach and they let you go home early and dont even care if you show up.

I feel like my whole 3rd year was wasted. I complained about this but they cant place me anywhere else b/c spots are all filled up.

Does anyone have any similar experiences??? I try to be proactive but honestly I dont learn that much.

I am studying for step 2 on my own and everything I learn in from review books.

You will be shocked but I have not even written ONE SIGNLE NOTE TO DATE!!!

Am I going to be screwed come residency? I dont know what to do except study hard for step 2, but I feel like ill be a bad resident. I can try to rotate at better hospitals during fourth year and learn stuff then.

Anyone in my shoes can comment that would be helpful!

8 months into 3rd year without writing a single note is concerning. If you're not getting anything out of it then I'd do as little as possible, leave early and put all your energy into Step 2 and take it early.

You do need to see stuff and learn how to write a good note before you audition. I'd schedule a medicine month at a decent place if you don't get that experience before 4th year. All hope is not lost.

You do need to name your school though. Can't have applicants matriculating into a $50,000/year school where they spend 8/12 months with their dick in their hand.
 
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I experienced this on a few rotations but certainly not to the extent that you have. I agree that your school is doing a disservice. However, I think you are going to be alright. The mere fact that you are actually concerned about this speaks volumes toward your work ethic and attitude. There were all too many students in my class that would have loved to coast like it seems you are being forced to do.

Survivor DO
 
wow, thanks for all the replies people! I honestly dont want to name the school if thats ok?

I'm am studying like crazy for comlex step 2 so I feel like i'm learning at least something everyday.

I still have IM left so maybe ill ask another student if they want to swap.

For 4th year i'm going to request a more challenging hospital with residents so I am not lost intern year!!!

Thanks for all the replies and concern.
 
wow, thanks for all the replies people! I honestly dont want to name the school if thats ok?

I'm am studying like crazy for comlex step 2 so I feel like i'm learning at least something everyday.

I still have IM left so maybe ill ask another student if they want to swap.

For 4th year i'm going to request a more challenging hospital with residents so I am not lost intern year!!!

Thanks for all the replies and concern.

I wonder if it was you or the school that wasted your 3rd year.

It'd be great to tell your school's name. This way, you might not only get better response from your school's upperclassmen but also smooth the edges of this very issue of yours here before the general public. Otherwise, I might as well consider you as a troll. But, it's your choice.
 
No notes at all?! That's crazy. I go to a DO school and third year I wrote notes on all my rotations except outpatient FM.

Honestly, not a day goes by that I don't think COCA should spend more time improving the quality of our schools instead of approving every new school that applies. :mad:

OP, go do some sub-I's next year at institutions where you will be more involved in patient care or you will be really SOL come intern year.
 
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I wonder if it was you or the school that wasted your 3rd year.

It'd be great to tell your school's name. This way, you might not only get better response from your school's upperclassmen but also smooth the edges of this very issue of yours here before the general public. Otherwise, I might as well consider you as a troll. But, it's your choice.

UMMM i'm not a troll, maybe ure a troll. If I was complacent with this situation I wouldnt have posted it here in the first place, I would have kept my mouth shut and be happy doing nothing.

If I say the name of my school, they might figure out who it is because the school is fully aware of the situation and i've complained numerous times and they have not switched me out of the site that I am.
 
Shrug. I could easily name a few hospitals at my school that are like that. However we're generally spread around enough that time at those hospitals is at a minimum. However, I know Touro Mare Island has a rotation site in So. Cal. where they have 4 or 5 students for the entire year. The one major difference from this story is that they write up the subjective and objective section of the admission H&P. However there aren't any daily progress notes or anything. Also, they don't get to go home early.

On the other hand, I tried to make sure that as many of my rotations as possible were at the local county hospital, and I've had to write full notes on all of my rotations there... and most of them go in the chart (including clinic notes in peds and OB/Gyn and progress notes on inpatient family. Progess notes in IM were just for show, but the admissions H&P counted).
 
wow, thanks for all the replies people! I honestly dont want to name the school if thats ok?

I'm am studying like crazy for comlex step 2 so I feel like i'm learning at least something everyday.

I still have IM left so maybe ill ask another student if they want to swap.

For 4th year i'm going to request a more challenging hospital with residents so I am not lost intern year!!!

Thanks for all the replies and concern.

A word of advice. During your 4th year, the residents will expect you to function at a level of a 4th year student (whether it is an AI/subI or not). They will expect you to already know how to write notes and present on rounds. If you start a rotation with these skills lacking, it will severely impact their perception of you and ultimately your evaluation (and may harm your chance of doing residency there, and may weaken whatever letter of recommendations you get). However if you don't have to opportunity to do this as a third-year medical student then you have no other option but to do this as a Fourth year student. To not do this as a fourth-year would put you at a severe disadvantage when you become an intern and have to carry a full load of patient on Day 1.


Clinical education is the weakest link in an osteopathic medical education. It is highly variable. Some schools are better than others in regards to what they offer for clinical education. There are some school where it is possible to go through the entire third-year and fourth year without having any inpatient experience. A while ago there was a post made by osteopathic medical student asking if it was normal to have a OR nurse as his preceptor during his core surgical rotation. Unfortunately some of the more established schools have poor clinical rotation options, and some newer schools will have excellent clinical options. It is the biggest Achilles heel in the undergraduate osteopathic education.
 
A word of advice. During your 4th year, the residents will expect you to function at a level of a 4th year student (whether it is an AI/subI or not). They will expect you to already know how to write notes and present on rounds. If you start a rotation with these skills lacking, it will severely impact their perception of you and ultimately your evaluation (and may harm your chance of doing residency there, and may weaken whatever letter of recommendations you get). However if you don't have to opportunity to do this as a third-year medical student then you have no other option but to do this as a Fourth year student. To not do this as a fourth-year would put you at a severe disadvantage when you become an intern and have to carry a full load of patient on Day 1.


Clinical education is the weakest link in an osteopathic medical education. It is highly variable. Some schools are better than others in regards to what they offer for clinical education. There are some school where it is possible to go through the entire third-year and fourth year without having any inpatient experience. A while ago there was a post made by osteopathic medical student asking if it was normal to have a OR nurse as his preceptor during his core surgical rotation. Unfortunately some of the more established schools have poor clinical rotation options, and some newer schools will have excellent clinical options. It is the biggest Achilles heel in the undergraduate osteopathic education.

Thanks group therapy! I guess I will just have to learn everything 4th year, I have no choice they wont switch my hospitals.

Other students in my rotations love it because they can just take a day off and do whatever they dont complain.

I will just suck it up and probably get B's but I hope to learn as much as possible so I dont get screwed intern year.

At least I can make mistakes 4th year, intern year I will just get fired!!

thank you for your comment!
 
I wonder if it was you or the school that wasted your 3rd year.

It'd be great to tell your school's name. This way, you might not only get better response from your school's upperclassmen but also smooth the edges of this very issue of yours here before the general public. Otherwise, I might as well consider you as a troll. But, it's your choice.

Lol.. :thumbdown:

You think everyone who has anything bad to say about DO is a troll.

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Lol.. :thumbdown:

You think everyone who has anything bad to say about DO is a troll.

Sent from my SGH-T999 using SDN Mobile

I like how he tosses out, "I'm gonna consider you a troll!" as if it is a threat with some clout behind it.

BTW, you got a forecasted date to hit 100k posts? I'll send you a cake when you do. Maybe even an ice cream cake.
 
I'd consider writing your own notes for practice and your own a/p and see how it compares to the attending's. You can round on whoever you want. No one is going to stop you.
 
Lol.. :thumbdown:

You think everyone who has anything bad to say about DO is a troll.

Sent from my SGH-T999 using SDN Mobile

WOW. The Irony of you saying that about others is amazing :rolleyes:
 
OP, I feel your frustration. I signed up for third year rotations in a remote town, not knowing that my school didn't really have established rotations up here yet. There isn't a residency program for hundreds of miles. All the hospitals up here are in the process of shifting to a new EHR system, too, so everyone is 'too busy' to take med students. Basically this means that whoever can take me will take me, but they mostly don't teach much and don't necessarily feel comfortable letting me do much more than shadow. I do worry a lot about being ready for audition rotations.

Fortunately, I had a great IM preceptor who asked me to write extensive SOAP notes and email them to him, and we'd go over them the next day. I'm also finally writing some notes directly now that I'm on my surgery rotation. It feels awkward, but hopefully by the end of the rotation it will feel better.

Basically, ask your attendings if there are ways for you to practice. Even if they won't let you write in the chart for real, write your own note and ask them to give you feedback on it. It's not always going to go great, but just get the most out of each rotation that you can and make sure you visit some kick-ass hospitals for your sub-internships next year. ;)
 
I'm at a small community hospital where a number of docs aren't particularly academically oriented and I've had similar experiences on a number of rotations. Only on my IM and Gen surg rotations did I feel at allchallenged. I'm generally not a real aggressive person, but on some rotations I've had to be pushy just to get a worthwhile experience.

I'm on peds now, and have to continually ask just to look in kids ears and listen to hearts and lungs. No access to the charts, no presentations, and the doc gives very brief answers to medical questions. We get along and talk about cars, the state of healthcare and other stuff, but it seems like he has a very established flow and no interest in disrupting that in the name of medical education. I just take notes on every patient, work through differentials and workups in my head and compare that with what he actually does.

I don't know if this is an issue elsewhere, but on any outpatient rotation with a doc employed by the hospital we don't even have access to the EMR. They've promised a ghost account for students for a good while, but it's never materialized. Even if we did have an account though, nearly all of them use laptops and never have an extra for students.
 
OP, I feel your frustration. I signed up for third year rotations in a remote town, not knowing that my school didn't really have established rotations up here yet. There isn't a residency program for hundreds of miles. All the hospitals up here are in the process of shifting to a new EHR system, too, so everyone is 'too busy' to take med students. Basically this means that whoever can take me will take me, but they mostly don't teach much and don't necessarily feel comfortable letting me do much more than shadow. I do worry a lot about being ready for audition rotations.

Fortunately, I had a great IM preceptor who asked me to write extensive SOAP notes and email them to him, and we'd go over them the next day. I'm also finally writing some notes directly now that I'm on my surgery rotation. It feels awkward, but hopefully by the end of the rotation it will feel better.

Basically, ask your attendings if there are ways for you to practice. Even if they won't let you write in the chart for real, write your own note and ask them to give you feedback on it. It's not always going to go great, but just get the most out of each rotation that you can and make sure you visit some kick-ass hospitals for your sub-internships next year. ;)

You know what??/ This is a great idea! I am going to try to do that! I'll ask my attendings next week if I can write the note and have them look it over. Good call! Thanks!!!!!!!!!!!
 
I wonder if it was you or the school that wasted your 3rd year.

It'd be great to tell your school's name. This way, you might not only get better response from your school's upperclassmen but also smooth the edges of this very issue of yours here before the general public. Otherwise, I might as well consider you as a troll. But, it's your choice.

I had a nurse as a preceptor on surgery and did not follow patients before or after surgery. Care to call me a troll?
 
I'm at a small community hospital where a number of docs aren't particularly academically oriented and I've had similar experiences on a number of rotations. Only on my IM and Gen surg rotations did I feel at allchallenged. I'm generally not a real aggressive person, but on some rotations I've had to be pushy just to get a worthwhile experience.

I'm on peds now, and have to continually ask just to look in kids ears and listen to hearts and lungs. No access to the charts, no presentations, and the doc gives very brief answers to medical questions. We get along and talk about cars, the state of healthcare and other stuff, but it seems like he has a very established flow and no interest in disrupting that in the name of medical education. I just take notes on every patient, work through differentials and workups in my head and compare that with what he actually does.

I don't know if this is an issue elsewhere, but on any outpatient rotation with a doc employed by the hospital we don't even have access to the EMR. They've promised a ghost account for students for a good while, but it's never materialized. Even if we did have an account though, nearly all of them use laptops and never have an extra for students.

Wow I had the same experience on my peds rotation.

I remember I was on one family med rotation at a clinic and the doctor answered all my questions with one word answers. It was pathetic that my tuition is going to him. I was so pissed and I called our dean and he said he would take care of it but of course he didnt.

I can see the attendings write notes, some write longer notes than other but they never actually let me practice.

On my ob/gyn rotation I saw many c-sections but I was not allowed to help and with the gyn patients I was not allowed to perform pap smears. the only practice with gyn exams I had was in OSCE on rubber dolls.

I hope you get better experience next year!
 
Are situations like those noted above more hospital specific or school specific?
 
Threads like this seriously make me question whether or not I should just drop my DO acceptance and apply MD next year instead..
 
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You really need to name your school. This is a disservice to medical students and future patients.

I go to Kirksville and I can say they worked our ass off. The only "easy" rotation I had was inpatient Psych and that was an 8-3 rotation. Surgery I was routinely there 70+ hours a week and had 1 day of call on the weekend. Most other rotations required around 40 hours per week attendance and some at-home time with presentations/reading for shelf exams. The hospital I was at we were expected to be included in all aspects of patients care and frequently friendly/gently "pimped" by the residents and attendings. The UNECOM and KCUMB students at the hospital had the same expectations as us.
 
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Threads like this seriously make me question whether or not I should just drop my DO acceptance and apply MD next year instead..

Where will you be going? And yes all this makes me worried of getting a sour rotation in my last two years.
 
Are situations like those noted above more hospital specific or school specific?

Could be both. Almost all of the students at my school does OB/Gyn at one of two county hospitals that has the same residency program. The students are expected that if they need to do an exam (either routine maintenance or due to the chief complaint) to grab a LVN or nursing assistant and do them prior to presenting the patient to the attending. Outside of training during 2nd year (granted, those were on standardized patients, not a doll), I didn't have any supervised speculum exams. The only time an attending was present was if I saw something I was unsure of and asked the chaperone to buzz for one.

For the handful of students at the non-county hospital or the one preceptor we have, I'm not sure what their experience was.
 
strange and ridiculous.
people at my school don't have time to breathe most days.
is the same thing happening to other students on your rotation?
 
After reading some of these posts, I feel like I want to redo my 3rd year eek!
 
After reading some of these posts, I feel like I want to redo my 3rd year eek!

Can you give us a hint on which school it is? I think, as everyone else said, it'd be helpful for future students to try and avoid a situation like yours. It's really a shame if ALL your rotations were weak and doesn't seem to be the norm.
 
Can you give us a hint on which school it is? I think, as everyone else said, it'd be helpful for future students to try and avoid a situation like yours. It's really a shame if ALL your rotations were weak and doesn't seem to be the norm.

The reason I dont want to say is because our school does have some good rotations at big name hospitals. Its just that some people get super great rotations that are really structured with residents and some just get the total opposite like me.

The pre clinical years were amazing!! I think it is one of the strongest programs out there. I just got unlucky and placed in a hospital with no residents and the attendings just don't want to teach. I'm going to rectify this during 4th year though !!!

I dont want to say the name of the school because then they can narrow it down to like 20 of us from that rotation site. I'd rather keep it anonymous
 
Are situations like those noted above more hospital specific or school specific?

Threads like this seriously make me question whether or not I should just drop my DO acceptance and apply MD next year instead..

I can only speak to my experience and in this case it seems to be hospital specific but it's still a big problem. I L-O-V-E-D, loved the first 2 years at my school and think they did as a good a job as could possibly be expected from pre-clinical medical education today. Clinicals have been a HUGE disappointment, and I previously thought this would be the time when I would really shine and thrive.

I came to a smallish, non academic place mostly because my wife wanted to be close to family and I've never been less happy. Based on what I hear from friends at other sites, clinical experiences are great and more in line with what one would expect from 3rd year rotations.

I've given the matter a lot of consideration, due to my experience and also because I've seen some residents whose competence I question. Having gone through this, there's no way I could just trust that any DO graduate had appropriate clinical training. It's just far too variable, and there's no way to tell before hand where the good sites are. I have a young daughter who's expressed interest in medicine, and though it's a long way off, unless things change drastically, I don't think I could in good conscience recommend that she go to an osteopathic school if there are other options available.
 
...Having gone through this, there's no way I could just trust that any DO graduate had appropriate clinical training...

Before you go crapping on the Osteopathic profession, remember that DO graduates go through 3+ years of residency training after graduation.
 
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I can only speak to my experience and in this case it seems to be hospital specific but it's still a big problem. I L-O-V-E-D, loved the first 2 years at my school and think they did as a good a job as could possibly be expected from pre-clinical medical education today. Clinicals have been a HUGE disappointment, and I previously thought this would be the time when I would really shine and thrive.

I came to a smallish, non academic place mostly because my wife wanted to be close to family and I've never been less happy. Based on what I hear from friends at other sites, clinical experiences are great and more in line with what one would expect from 3rd year rotations.

I've given the matter a lot of consideration, due to my experience and also because I've seen some residents whose competence I question. Having gone through this, there's no way I could just trust that any DO graduate had appropriate clinical training. It's just far too variable, and there's no way to tell before hand where the good sites are. I have a young daughter who's expressed interest in medicine, and though it's a long way off, unless things change drastically, I don't think I could in good conscience recommend that she go to an osteopathic school if there are other options available.

You and spring go to the same school?
 
strange and ridiculous.
people at my school don't have time to breathe most days.
is the same thing happening to other students on your rotation?

What's the name of your school, oms2?
 
I like how he tosses out, "I'm gonna consider you a troll!" as if it is a threat with some clout behind it.

BTW, you got a forecasted date to hit 100k posts? I'll send you a cake when you do. Maybe even an ice cream cake.

If I get to 100k without getting banned I am doing something wrong.

WOW. The Irony of you saying that about others is amazing :rolleyes:

I don't think you know the the word irony means.
 
Ok I'll name it- AZCOM.

Heck I'm not afraid of my school's shortcomings- they suck at setting up good rotations. Every good one I had I set up myself. . Ive had tons of rotations where I did nothing but sit around. However that doesn't mean I didn't do anything. I took my own notes, then would ask to see the notes the attending writes and compare. I'd also talk with the nursing staff or ancillary staff as well to learn. Take charge of your own education. Find a resident and tag along asking good quality questions. Google and YouTube can be your best friend. Often a good quality question can bring out an attending's willingness to teach. But if not shoot your questions to your chair. Bug them since they get paid by your tuition dollars.

I feel for ya OP however you've got to realize that you can't leave your future in someone else's hands. Your should feel 100% comfortable writing notes and taking a history by your fourth year. Heck send me your SOAP notes and I'll critique ya. Just know you will need these dogged personality traits when dealing with sick patients, sitting back is not an option. Your going to feel uncomfortable and alone so take charge and save that patient's life!
 
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Ok I'll name it- AZCOM.

Heck I'm not afraid of my school's shortcomings- they suck at setting up good rotations. Every good one I had I set up myself. . Ive had tons of rotations where I did nothing but sit around. However that doesn't mean I didn't do anything. I took my own notes, then would ask to see the notes the attending writes and compare. I'd also talk with the nursing staff or ancillary staff as well to learn. Take charge of your own education. Find a resident and tag along asking good quality questions. Google and YouTube can be your best friend. Often a good quality question can bring out an attending's willingness to teach. But if not shoot your questions to your chair. Bug them since they get paid by your tuition dollars.

I feel for ya OP however you've got to realize that you can't leave your future in someone else's hands. Your should feel 100% comfortable writing notes and taking a history by your fourth year. Heck send me your SOAP notes and I'll critique ya. Just know you will need these dogged personality traits when dealing with sick patients, sitting back is not an option. Your going to feel uncomfortable and alone so take charge and save that patient's life!

Well crap.....
 
Ok I'll name it- AZCOM.

Heck I'm not afraid of my school's shortcomings- they suck at setting up good rotations. Every good one I had I set up myself. . Ive had tons of rotations where I did nothing but sit around. However that doesn't mean I didn't do anything. I took my own notes, then would ask to see the notes the attending writes and compare. I'd also talk with the nursing staff or ancillary staff as well to learn. Take charge of your own education. Find a resident and tag along asking good quality questions. Google and YouTube can be your best friend. Often a good quality question can bring out an attending's willingness to teach. But if not shoot your questions to your chair. Bug them since they get paid by your tuition dollars.

I feel for ya OP however you've got to realize that you can't leave your future in someone else's hands. Your should feel 100% comfortable writing notes and taking a history by your fourth year. Heck send me your SOAP notes and I'll critique ya. Just know you will need these dogged personality traits when dealing with sick patients, sitting back is not an option. Your going to feel uncomfortable and alone so take charge and save that patient's life!

how do you know that OP also goes to AZCOM or are you just guessing?
 
Yes, name the school so we as students can hold them accountable. Faculty do listen to these forums, and with a good proportion of prospective students reading here information has sway. Private schools are a business, and they will continue to do the minimum unless dragged into the light.



You really need to name your school. This is a disservice to medical students and future patients.

I go to Kirksville and I can say they worked our ass off. The only "easy" rotation I had was inpatient Psych and that was an 8-3 rotation. Surgery I was routinely there 70+ hours a week and had 1 day of call on the weekend. Most other rotations required around 40 hours per week attendance and some at-home time with presentations/reading for shelf exams. The hospital I was at we were expected to be included in all aspects of patients care and frequently friendly/gently "pimped" by the residents and attendings. The UNECOM and KCUMB students at the hospital had the same expectations as us.
 
Before you go crapping on the Osteopathic profession, remember that DO graduates go through 3+ years of residency training after graduation.

I don't mean to overgeneralize and crap on the whole profession. It's just that, like I said, there's extreme variability in regards to the quality of clinical education. This is unavoidable when schools depend on a force of community docs who aren't paid for serving as a preceptor and have basically no accountability to the school to actually educate. And yes, everyone goes through residency, but there are some pretty weak residencies out there as well.
 
basically if a school does not have it's own hospital then clinical training will be lacking. sure there might be a few rotation sites that a few students go to at each school that have decent or solid rotations but the majority won't be up to par. this is the case at all caribbean schools, most (almost all?) DO schools, and a handful of US MD schools. The caveat is that the LCME holds those schools that don't have their own hospital to a much higher standard than COCA. At the carib schools of course it's a free-for-all.

it is very easy for schools to get away with this because noone asks about this stuff at med school interviews. At US MD schools you can rest assured that there is sufficient oversight by the LCME so you don't necessarily need to do as much due diligence. It's not hard for a med school to build a nice anatomy lab and wired lecture halls that attract premeds during interviews but it's infinitely harder to train your clinical students.

finally, if you are wondering why residency programs "discriminate" against DO students you need not look any further than this thread. basically residency programs don't want to take a chance on someone that may have spent their whole third year of med school shadowing rather than gaining meaningful clinical experience because they simply won't be ready for residency. They typically can't tell the difference between rotation sites (or it's not mentioned on your transcript) so rather than taking the risk they choose not to deal with it
 
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