Thoughts: what is a major problem facing osteopathic medicine ?

[Seth Joo]

The lack of consistency and quality with DO clinical education is hardly a secret. The question I wonder about is whether that AOA/AACOM/COCA can fix it or even want to fix it...?

AOA wanting to fix things?? Are you kidding me?? They are all about the $$$$$.

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[j4pac]

AOA wanting to fix things?? Are you kidding me?? They are all about the $$$$$.

It's like Walmart. What is the bare minimum that we can offer before people stop coming to our store? Right now...they are "getting by" with inferior clinical rotations. They aren't getting dinged by accreditation boards, tons of people still are knocking down the doors to come, and generally, their students are still getting into residency programs.

But no question...if I am a PD at a program like Mayo or Hopkins...I'm skeptical of taking a DO. Why? Board scores don't always reflect clinical competency. DOs are at a significant disadvantage in regards to clinical education. If I have two applicants with similar scores (or even an MD with slightly worse scores) and I have not seen either of the candidates clinical competency first hand...I'm going with the MD. If the AOA ever wants to legitimately compete with MD programs...they absolutely have to improve clinical education. As of this time, many ACGME programs discriminate against DOs, but it is for a reason. Much of putting a rank list together is based on RISK. The risk of a DO is higher than an MD.

 

[Seth Joo]

It's like Walmart. What is the bare minimum that we can offer before people stop coming to our store? Right now...they are "getting by" with inferior clinical rotations. They aren't getting dinged by accreditation boards, tons of people still are knocking down the doors to come, and generally, their students are still getting into residency programs.

But no question...if I am a PD program at Mayo or Hopkins...I'm skeptical of taking a DO. Why? Board scores don't always reflect clinical competency. DOs are at a significant disadvantage in regards to clinical education. If I have two applicants with similar scores (or even an MD with slightly worse scores) and I have not seen either of the candidates clinical competency

Mayo took a student from AZCOM 5 years ago but hasn't taken any since, I think he was a token student. AZCOM has their act together better than many of the other less established DO schools but we all wind up being painted with the same brush because the other schools do not step up their game.

 

[asdf123g]

whats the importance of 3rd and 4th yr quality if DO's and MD's seem to show equal competence when they go out to practice?

 

[Seth Joo]

whats the importance of 3rd and 4th yr quality if DO's and MD's seem to show equal competence when they go out to practice?

You don't get it, Osteopathic students have to struggle in their third and fourth years to get a good quality clinical education while their counterparts in MD schools experience relatively smooth sailing. You should get to know some students at many of the DO schools around the country and the frustrations they deal with when they transition into the 3rd year, its not pretty. My school it was okay, but at many schools its not.

There are some schools where you might be literally living out of a suitcase in your third and fourth years.

 

[j4pac]

Mayo took a student from AZCOM 5 years ago but hasn't taken any since, I think he was a token student. AZCOM has their act together better than many of the other less established DO schools but we all wind up being painted with the same brush because the other schools do not step up their game.

I'm assuming you mean...Mayo Internal Medicine. Yeah...it's a huge uphill battle. It would take elite board scores...finding a way to do relevant research and audition rotations. Getting into clinical research is also NOT EASY as a DO student. The structure just isn't there. Getting an audition rotation at one of those types of places is like playing lotto.

I'm going to Mayo for PM&R...but also incredibly non-traditional and PM&R is the most DO friendly specialty. I highly doubt I would have had a chance at IM...and probably for good reason, they would have questioned my clinical education experience. No fault to them.

 

[asdf123g]

You don't get it, Osteopathic students have to struggle in their third and fourth years to get a good quality clinical education while their counterparts in MD schools experience relatively smooth sailing. You should get to know some students at many of the DO schools around the country and the frustrations they deal with when they transition into the 3rd year, its not pretty. My school it was okay, but at many schools its not.

There are some schools where you might be literally living out of a suitcase in your third and fourth years.

It sounds horrible, yes, i get that, and it should be better but at the end of the day if MD's and DO's all make it through to the end of the tunnel and largely come out the same, why do residency programs have such an issue with crappy rotations if it doesnt impact the kind of doctor they will be? thats my question!

 

[Seth Joo]

I'm assuming you mean...Mayo Internal Medicine. Yeah...it's a huge uphill battle. It would take elite board scores...finding a way to do relevant research and audition rotations. Getting into clinical research is also NOT EASY as a DO student. The structure just isn't there. Getting an audition rotation at one of those types of places is like playing lotto.

I'm going to Mayo for PM&R...but also incredibly non-traditional and PM&R is the most DO friendly specialty. I highly doubt I would have had a chance at IM...and probably for good reason, they would have questioned my clinical education experience. No fault to them.

He got into Mayo Dermatology!!! A Grand Slam for a DO. I have not heard of anyone going to Mayo for anything at my school since, some people have went to some of the UC community programs like UCSF Fresno but that ain't saying nothing because that program is low tier, if it was the real UCSF then it would saying volumes.

Even you got Goro telling people going on interviews telling students to ask schools questions about how clinical rotations work at the schools where they will interview, he also comments that some places got students running around like "vagabonds", I am not that blunt in my language, I prefer the term nomad instead, but yeah many schools have their students running around all over the place in year 3 and 4. Some people think its a good thing to travel and see the country, I don't think so. That's why the clinical program at so many schools is not so different from many Caribbean schools.

 

[Goro]

Agreed.

Although I do have to point out that DO schools have sent grads to Mayo and JHU.


They've taken people from KCUMB as well. That cracking sound you hear is the DO ceiling starting to give way. Stanford and NYU PM&R have taken DO as well, love 'em, actually.

Mayo took a student from AZCOM 5 years ago but hasn't taken any since, I think he was a token student. AZCOM has their act together better than many of the other less established DO schools but we all wind up being painted with the same brush because the other schools do not step up their game.

It's like Walmart. What is the bare minimum that we can offer before people stop coming to our store? Right now...they are "getting by" with inferior clinical rotations. They aren't getting dinged by accreditation boards, tons of people still are knocking down the doors to come, and generally, their students are still getting into residency programs.

But no question...if I am a PD at a program like Mayo or Hopkins...I'm skeptical of taking a DO. Why? Board scores don't always reflect clinical competency. DOs are at a significant disadvantage in regards to clinical education. If I have two applicants with similar scores (or even an MD with slightly worse scores) and I have not seen either of the candidates clinical competency first hand...I'm going with the MD. If the AOA ever wants to legitimately compete with MD programs...they absolutely have to improve clinical education. As of this time, many ACGME programs discriminate against DOs, but it is for a reason. Much of putting a rank list together is based on RISK. The risk of a DO is higher than an MD.

 

[bumblebee611]

It sounds horrible, yes, i get that, and it should be better but at the end of the day if MD's and DO's all make it through to the end of the tunnel and largely come out the same, why do residency programs have such an issue with crappy rotations if it doesnt impact the kind of doctor they will be? thats my question!

I am just a premed, too, so someone more knowledgeable please correct me if I am wrong, but I would assume that the program needs to rely on the residents to take care of actual, human patients, and there is a minimum standard that the interns should be meeting on day 1 ... and they just can't afford to waste a few months catching someone up who should have been able to meet that minimum standard upon graduation from medical school.

 

[meliora27]

I recently learned that every 5 years (I'm pretty sure this is the number), COCA has to go before the U.S. Dept of Education and make their case that they should continue to be the accrediting body for DO schools. In light of recent events, calling for a unified accreditation system for GRADUATE medical education (the 'merger'), this naturally begs the question, "why not have unified standards for the accredidation of UNDERGRADUATE medical education??

Perhaps the U.S. Dept of Education needs to be encouraged to consider this question, or at least due their due diligence in comparing COCA vs LCME standards when they decide if COCA will have another 5 years as the accrediting body for DO schools.

 

[StudyLater]

Perhaps the U.S. Dept of Education needs to be encouraged to consider this question

Encouraged = lobbied = $$$. And where you gonna get those $$$??? Why, open up a DO school of course.

The cycle continues. (oh **** that's actually a good pun)

 

[allantois]

It's like Walmart. What is the bare minimum that we can offer before people stop coming to our store? Right now...they are "getting by" with inferior clinical rotations. They aren't getting dinged by accreditation boards, tons of people still are knocking down the doors to come, and generally, their students are still getting into residency programs.

But no question...if I am a PD at a program like Mayo or Hopkins...I'm skeptical of taking a DO. Why? Board scores don't always reflect clinical competency. DOs are at a significant disadvantage in regards to clinical education. If I have two applicants with similar scores (or even an MD with slightly worse scores) and I have not seen either of the candidates clinical competency first hand...I'm going with the MD. If the AOA ever wants to legitimately compete with MD programs...they absolutely have to improve clinical education. As of this time, many ACGME programs discriminate against DOs, but it is for a reason. Much of putting a rank list together is based on RISK. The risk of a DO is higher than an MD.

We have a major shortage of physicians in this country. If we had less DO grads, we would just get more Caribbean and other foreign grads. U.S. MD schools alone cannot graduate enough students for reasons that their classes are too small due to more stringent requirements. Regardless, a good chunk of (low-tier) residency programs will have to take students with inferior clinical education. Whereas, that was previously reserved for FMGs and IMGs, now DOs are taking those spots.

Meanwhile, nurses are pushing for more clinical rights under pretense that physicians cannot fill all the need. However we try to improve DO education, the public will not receive better clinical care as they will either get more foreign grads (whose education not even COCA overseas), or they will get more DNPs (whose education is a total joke even when compared to medical education somewhere in Zimbabwe).

 

[Seth Joo]

We have a major shortage of physicians in this country. If we had less DO grads, we would just get more Caribbean and other foreign grads. U.S. MD schools alone cannot graduate enough students for reasons that their classes are too small due to more stringent requirements. Regardless, a good chunk of (low-tier) residency programs will have to take students with inferior clinical education. Whereas, that was previously reserved for FMGs and IMGs, now DOs are taking those spots.

Meanwhile, nurses are pushing for more clinical rights under pretense that physicians cannot fill all the need. However we try to improve DO education, the public will not receive better clinical care as they will either get more foreign grads (whose education not even COCA overseas), or they will get more DNPs (whose education is a total joke even when compared to medical education somewhere in Zimbabwe).

If you keep increasing the number of DO schools you will not increase influence, you will just get a saturation point where you get too many graduates, and not enough residency positions to train those graduates. The schools keep opening sure, but the AOA is not doing enough to make sure they have residency options for their graduates, they took the short cut of merging with the ACGME but that might actually backfire since DOs can already match into MD residencies anyway.

 

[meliora27]

Encouraged = lobbied = $$$. And where you gonna get those $$$??? Why, open up a DO school of course.

The cycle continues. (oh **** that's actually a good pun)

The LCME and it's stakeholders have a lot more power I'd venture to say than COCA. I'm sure the LCME wouldn't mind more power by making a play to become the sole accreditor of medical education in America.

It would seem like a pretty easy argument to make before the US Dept of Education to standardize the accreditation system of medical education... If it went to the public, I'm sure they could easily craft a message in support of "ensuring that the medical education of all doctors trained in America meets the same basic standards"

 

[Goro]

This is a very intriguing premise!

I could see it as part of the natural evolution of medical education in the US.

It would not surprise me that at some point in the near future COMLEX becomes an exit exam for the COMs, and USMLE becomes THE board certification exam for all med students.

I recently learned that every 5 years (I'm pretty sure this is the number), COCA has to go before the U.S. Dept of Education and make their case that they should continue to be the accrediting body for DO schools. In light of recent events, calling for a unified accreditation system for GRADUATE medical education (the 'merger'), this naturally begs the question, "why not have unified standards for the accredidation of UNDERGRADUATE medical education??

Perhaps the U.S. Dept of Education needs to be encouraged to consider this question, or at least due their due diligence in comparing COCA vs LCME standards when they decide if COCA will have another 5 years as the accrediting body for DO schools.

Not true, Allan. We have a problem in physician allocation, not numbers.

Once the Baby Boom era doctors retire, though, then there will be a shortage a doctor's.
We have a major shortage of physicians in this country.

 

[StudyLater]

Once the Baby Boom era doctors retire, though, then there will be a shortage a doctor's.

Until the BB patients are gone.

 

[asdf123g]

Until the BB patients are gone.

grim lol

 

[StudyLater]

grim lol

No I mean just....the f*ck? Everyone's trying to bring in this sage wisdom "....in 20 years this will happen. Therefore we should do this, this, and this now to prepare." Oh yeah? What about in 50 years?? Is your 20 year plan taking that into account? All of these people will die (not being morbid, just a fact that should be obvious enough). I'm waiting to hear about what we'll do then. You wanna fill a labor shortage that is entirely based upon a temporary surplus of consumers. But what does the labor do when the patient surplus is gone? The human capital you're generating has a shelf life of about 50-60 years, and you're generating it for a problem that will only exist for another 30-35 years.

But let's not think about that now.

 

[Goro]

Even with the eventual demise of the Baby Boomers, the US population is expected to rise over the next century; it may hit 400 million by mid century.

All of those Americans will need doctors.

It pays to be able to look beyond your nose.

The BBer's will be retiring over the next ten years, BTW.

No I mean just....the f*ck? Everyone's trying to bring in this sage wisdom "....in 20 years this will happen. Therefore we should do this, this, and this now to prepare." Oh yeah? What about in 50 years?? Is your 20 year plan taking that into account? All of these people will die (not being morbid, just a fact that should be obvious enough). I'm waiting to hear about what we'll do then. You wanna fill a labor shortage that is entirely based upon a temporary surplus of consumers. But what does the labor do when the patient surplus is gone? The human capital you're generating has a shelf life of about 50-60 years, and you're generating it for a problem that will only exist for another 30-35 years.

But let's not think about that now.

 

[StudyLater]

Even with the eventual demise of the Baby Boomers, the US population is expected to rise over the next century; it may hit 400 million by mid century.

All of those Americans will need doctors.

It pays to be able to look beyond your nose.

The BBer's will be retiring over the next ten years, BTW.

You think the same type of care will apply as does now? The same frequency of various types of procedures after the general population is no longer "aged?" There's definitely going to be a shift different from that simply projected within the next 30 years, once BBers have died. The population will increase; that's fair. But all this talk of an aged population will be a distant memory in 50-60yrs if we keep our fertility rate up. How "sick" the population is will change as a result, and will affect this wonderful business.

 

[Goro]

We'll always need doctors. In the 1950s/60s, it was a good time to be a pediatrician.

Now is a good time to be a gerontologist.

It's always a good time to be a doctor, period. Although I hear we seem to have a Pathologist glut. PM&R is heating up though.

You think the same type of care will apply as does now? The same frequency of various types of procedures after the general population is no longer "aged?" There's definitely going to be a shift different from that simply projected within the next 30 years, once BBers have died. The population will increase; that's fair. But all this talk of an aged population will be a distant memory in 50-60yrs if we keep our fertility rate up. How "sick" the population is will change as a result, and will affect this wonderful business.

 

[asdf123g]

We'll always need doctors. In the 1950s/60s, it was a good time to be a pediatrician.

Now is a good time to be a gerontologist.

It's always a good time to be a doctor, period. Although I hear we seem to have a Pathologist glut. PM&R is heating up though.

whats your opinion on what specialties may being to die due to advances in tech? Tech's come a long way. Just 15-20 years ago people were still using pagers, flip phones, and dial up internet. What would probably be 'protected' from advances in tech?

 

[Goro]

I don't think anything's going to die due to tech....if anything, tech will make MORE specialties, like genetic medicine, or interventionalists. Procedures may change, but the people doing the procedures will always be needed.

whats your opinion on what specialties may being to die due to advances in tech? Tech's come a long way. Just 15-20 years ago people were still using pagers, flip phones, and dial up internet. What would probably be 'protected' from advances in tech?

 

[Chimichica]

What is PD?

Sent from my SM-G900T using Tapatalk

 

[StudyLater]

What is PD?

Sent from my SM-G900T using Tapatalk

Program director. For a residency.

 

[Gandyy]

Man I have learned so much being on SDN for a year.

lol

 

[thepoopologist]

Thoughts: what is a major problem facing osteopathic medicine today ?

What is osteopathic medicine. Insurance doesn't cover for this specialty

 

[StudyLater]

Man I have learned so much being on SDN for a year.

lol

Seriously. Thank god for the internet. I'd probably literally be in the library like 24/7 trying to look up every little thing without it.

 

[Henry101]

Okay, I don't know if it's just me, but I'm kind of getting sick of the perpetuation of this myth that somehow all DO schools have poor rotation spots. Some might have questionable spots but I believe a majority of them have equal/comparable sites to MD schools.
CCOM students rotate with Rosalind Franklin and Rush students at Cook County
Nova students are in the same hospital as UofF students. Also, Nova students have exclusive dibs at Largo, one of the largest hospitals in western Florida.
WesternCOMP laid the educational foundation for UC Riverside's clinical site Riverside County Medical Center by starting a bunch of residencies in the region. Many DOs have joint appointments as adjunct clinical faculty for UC Riverside.
the list goes on...

If ya'll think MD schools are having an easy time with clinical sites, you're also misinformed. Just like Touro-NY, Columbia is fighting tooth and nail against St. George for rotation spots. Creighton is shrinking their Arizona program. etc. etc.

Also, one thing I appreciate about the clinical education of DO schools is that they give students the opportunity to set up their own rotations provided they meet certain standards/preceptors, etc. I know someone at LECOM-Bradenton that did a surgery rotation at the Hospital for Special Surgery in New York last year. I don't think that would be allowed if she was a student at Cornell or NYU. There was also a student from LECOM-B that matched ACGME Urology at University of South Florida. So this notion of poor clinical education is getting weaker and weaker and, unfortunately, it's DO students and pre-meds that continue to perpetuate it.

 

[StudyLater]

Okay, I don't know if it's just me, but I'm kind of getting sick of the perpetuation of this myth that somehow all DO schools have poor rotation spots. Some might have questionable spots but I believe a majority of them have equal/comparable sites to MD schools.
CCOM students rotate with Rosalind Franklin and Rush students at Cook County
Nova students are in the same hospital as UofF students. Also, Nova students have exclusive dibs at Largo, one of the largest hospitals in western Florida.
WesternCOMP laid the educational foundation for UC Riverside's clinical site Riverside County Medical Center by starting a bunch of residencies in the region. Many DOs have joint appointments as adjunct clinical faculty for UC Riverside.
the list goes on...

If ya'll think MD schools are having an easy time with clinical sites, you're also misinformed. Just like Touro-NY, Columbia is fighting tooth and nail against St. George for rotation spots. Creighton is shrinking their Arizona program. etc. etc.

Also, one thing I appreciate about the clinical education of DO schools is that they give students the opportunity to set up their own rotations provided they meet certain standards/preceptors, etc. I know someone at LECOM-Bradenton that did a surgery rotation at the Hospital for Special Surgery in New York last year. I don't think that would be allowed if she was a student at Cornell or NYU. There was also a student from LECOM-B that matched ACGME Urology at University of South Florida. So this notion of poor clinical education is getting weaker and weaker and, unfortunately, it's DO students and pre-meds that continue to perpetuate it.

Never met or heard of a DO student perpetuating this myth.

Oh well maybe @Seth Joo but I'm not sure. Maybe he can clarify his position.

 

[meliora27]

Never met or heard of a DO student perpetuating this myth.

Oh well maybe @Seth Joo but I'm not sure. Maybe he can clarify his position.

The above cited examples are the exceptions, not the rule. On the whole, DO clinical education is weaker than MD clinical education, for reasons that are clearly stated in many threads.

 

[StudyLater]

The above cited examples are the exceptions, not the rule. On the whole, DO clinical education is weaker than MD clinical education, for reasons that are clearly stated in many threads.

Please cite.

 

[allantois]

The above cited examples are the exceptions, not the rule. On the whole, DO clinical education is weaker than MD clinical education, for reasons that are clearly stated in many threads.

Weaker or not weaker, I will only touch on LECOM-B since it's in my state: they are a great school for students who are going to be proactive in their 3rd and 4th years. I actually see the fact that they can seek out their own rotations as a major advantage as they can use each and every of those rotations to market themselves at potential programs. Perhaps, that's why they have such great match lists. However, they tend to match into competitive residencies at AOA programs, which clearly presents a problem when all programs will merge since MD programs will still view DO grads as having inferior education.

 

[meliora27]

Please cite.

CCOM rotating with Rush and UIC students

Sure, CCOM has rotations at Cook County, Advocate Christ, and Advocate Lutheran General where they will rotate with UIC and/or Rush students, but again, you're kidding yourself if you think that all of the rotations at CCOM are in these hospitals. CCOM is amongst the best when it comes to quality of rotations, but there are still many other places that their students rotate at that are not of this caliber.

Nova students rotating with UF students

Again, how many students actually end up at this rotation site? Nova also has many sites that are at small community hospitals, or preceptor based. Like CCOM, you have to give Nova credit for at least trying their hardest to secure strong sites.

"Freedom to design your own fourth year"

This is because DO schools realize their limits and outsource the job of finding clinical rotations to their own students under the guise of 'freedom to design your own fourth year'.

This 'freedom' is important however as it is often what lets DO students match into competitive ACGME programs, as it gives them exposure to such programs, and the ability to get an LOR from these programs.

 

[StudyLater]

CCOM rotating with Rush and UIC students

Sure, CCOM has rotations at Cook County, Advocate Christ, and Advocate Lutheran General where they will rotate with UIC and/or Rush students, but again, you're kidding yourself if you think that all of the rotations at CCOM are in these hospitals. CCOM is amongst the best when it comes to quality of rotations, but there are still many other places that their students rotate at that are not of this caliber.

Nova students rotating with UF students

Again, how many students actually end up at this rotation site? Nova also has many sites that are at small community hospitals, or preceptor based. Like CCOM, you have to give Nova credit for at least trying their hardest to secure strong sites.

"Freedom to design your own fourth year"

This is because DO schools realize their limits and outsource the job of finding clinical rotations to their own students under the guise of 'freedom to design your own fourth year'.

This 'freedom' is important however as it is often what lets DO students match into competitive ACGME programs, as it gives them exposure to such programs, and the ability to get an LOR from these programs.

You said these were exceptions. Do you have examples of what a more "normal" DO rotation setup looks like? That's what I wanted to see.

 

[Seth Joo]

Never met or heard of a DO student perpetuating this myth.

Oh well maybe @Seth Joo but I'm not sure. Maybe he can clarify his position.

I did not say all DO schools have poor clinical rotations, but a good number them fall short in clinical education, many schools also keep changing their clinical sites, I won't give specific names because many schools outside of the more established DO schools do this, its a problem because it makes life difficult for students, it also means that the quality of clinical education that you get can vary from school to school.

Well established MD schools do not have this problem because they have what is known as "Clinical Schools" which are established clinical training departments that are responsible for the clinical training of a school's medical students, you do not find these at Osteopathic medical schools, medical students at such institutions will have a clearer idea of where they will get their clinical education than at many DO schools.

The AOA and COCA are eager to expand and open up new school without an eye on quality which I think is wrong.

 

[StudyLater]

I did not say all DO schools have poor clinical rotations, but a good number them fall short in clinical education, many schools also keep changing their clinical sites, I won't give specific names because many schools outside of the more established DO schools do this, its a problem because it makes life difficult for students, it also means that the quality of clinical education that you get can vary from school to school.

Well established MD schools do not have this problem because they have what is known as "Clinical Schools" which are established clinical training departments that are responsible for the clinical training of a school's medical students, you do not find these at Osteopathic medical schools, medical students at such institutions will have a clearer idea of where they will get their clinical education than at many DO schools.

The AOA and COCA are eager to expand and open up new school without an eye on quality which I think is wrong.

That's fair enough but I mean.....they get rotations, do they not?

Is the idea that they may get rotations with some attendings that don't give a **** about educating them, but are just forced by the department to do so? I just don't see how education would be subpar. You're a student doc, learning from a doc. All he has to do is show you what he's been doing on a daily basis for years and have you practice doing some of what he does (the parts you're allowed to practice). Even if the doc isn't really a "teacher" type, he still probably knows what's important to know as a physician and can hopefully communicate that to you.

 

[Seth Joo]

That's fair enough but I mean.....they get rotations, do they not?

Is the idea that they may get rotations with some attendings that don't give a **** about educating them, but are just forced by the department to do so? I just don't see how education would be subpar. You're a student doc, learning from a doc. All he has to do is show you what he's been doing on a daily basis for years and have you practice doing some of what he does (the parts you're allowed to practice).

Of course they get rotations, but the quality at many schools is variable, and where you go depends, sometimes many of the experiences are nothing more than watching your preceptor, which I think is unacceptable. Students at more well known MD schools never really have to think about these things because the MD schools usually own teaching hospitals where they will train students. At some schools you might have your rotation at a doctor's office rather than a full fledged teaching hospital.

 

[StudyLater]

Of course they get rotations, but the quality at many schools is variable, and where you go depends, sometimes many of the experiences are nothing more than watching your preceptor, which I think is unacceptable. Students at more well known MD schools never really have to think about these things because the MD schools usually own teaching hospitals where they will train students. At some schools you might have your rotation at a doctor's office rather than a full fledged teaching hospital.

Is there any way this can be mitigated? Can I, as a student, just be proactive and always ask to be able to do whatever it is I need to learn how to do? It seems the quality is simply tied to students not being engaged enough. If I, as a student, take it upon myself to ensure I'm engaged, would that solve the problem?

 

[allantois]

Whatever, cut down DO programs, all you'll get is more mediocre DNP schools opening up in their place.

 

[Seth Joo]

Is there any way this can be mitigated? Can I, as a student, just be proactive and always ask to be able to do whatever it is I need to learn how to do? It seems the quality is simply tied to students not being engaged enough. If I, as a student, take it upon myself to ensure I'm engaged, would that solve the problem?

There is not much you can do, because even many of the programs with poor clinical education get thousands of applications mostly because students these days are not very discriminating when it comes to getting value for their education dollars, also because its still better than going to a foreign country for an MD. There was a time when DO schools used to have nearly open admissions standards, as recently as the 1990s it was pretty easy to get admission into a DO program. Today that is no longer the case, the best DO schools are as tough to get into as mid tier MD schools were maybe 10-15 years ago.

Things changed because DOs today have full practice rights as MDs and can train in MD residencies so applications have increased and so have admissions standards.

The AOA and COCA will keep opening more schools.