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What you wish you knew day 1
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Yea I interviewed there and the students were all talking about this.I think it is WesternU, the place where I'm heading
I also perceived the administration to have a DGAF attitude as well. But that's just me. Also it's SoCal.
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But isn't that the case at many other med schools? I've read similar complaints from people who attend TouroCA and LMU.
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Maybe. I didn't interview at either of those places but I think there's always changes in curriculums/schedules. Adapt and overcome
Changes to curriculum? Sure. However the school should be upfront with major changes during interview season instead of performing what is tantamount to a bait and switch.
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Yeah LMU
Yeah TouroCA and LMU I have heard have really bad rotations....idk....I think these schools should really start trying to invest on better clinical rotations. I mean SGU has pretty solid rotations in the northeast for a Carib school. This is embarassing. Anyone can learn basic sciences. Just give me a book, tell me what to read and test me on it. But once I'm in the hospital dealing with real people, what book is going to help me then? We need solid rotations so that program directors stop thinking osteopathic students are undertrained.
Yeah TouroCA and LMU I have heard have really bad rotations....idk....I think these schools should really start trying to invest on better clinical rotations. I mean SGU has pretty solid rotations in the northeast for a Carib school. This is embarassing. Anyone can learn basic sciences. Just give me a book, tell me what to read and test me on it. But once I'm in the hospital dealing with real people, what book is going to help me then? We need solid rotations so that program directors stop thinking osteopathic students are undertrained.
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Yeah, from what I hear, UNECOM did some crazy overhaul a few years back that students were not happy about as well. Unfortunately there's not much people can do about it. Just gotta fill out course eval or talk to coordinator and hope people after you have an easier time.
Also, as for rank, it matters, but not as much as boards. It definitely does matter a lot more on the MD side because of AOA, but I don't know if Sigma Sigma Phi really carries the same weight at ACGME programs.
Anyways, rank is one of the criteria, but as I said before different schools calculate rank differently and in some schools clinical gradess are worth much more than preclinical, while at other schools its the opposite. Know what your school does.
One thing is for sure regardless of any of this: Level I/Step I grades >>>> preclinical grades in most cases. And usually (but depending on the residency you want) clinical grades >> preclinical grades.
Also, as for rank, it matters, but not as much as boards. It definitely does matter a lot more on the MD side because of AOA, but I don't know if Sigma Sigma Phi really carries the same weight at ACGME programs.
Anyways, rank is one of the criteria, but as I said before different schools calculate rank differently and in some schools clinical gradess are worth much more than preclinical, while at other schools its the opposite. Know what your school does.
One thing is for sure regardless of any of this: Level I/Step I grades >>>> preclinical grades in most cases. And usually (but depending on the residency you want) clinical grades >> preclinical grades.
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Yeah I hear you. That's why I'm not gonna neglect my pre-clinical grades or rank. Nobody really know's who's gonna be the PD looking at their application and what he/she will favor and what minor thing will cause him/her to pass up on your application. Better to cover all your bases.
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The word "gunner" used to mean something, but lately has evolved to mean "anyone who I think studies more than me, tries harder than me, and/or gets better grades than me". Nothing wrong with being a "gunner" by today's definition.
Pre-clinical grades don't necessarily matter if your school doesn't report percentiles or if you aren't in the running for AOA. In other words, if you attend a school that doesn't report rankings to residency programs, then being #26 in the class is no better than being #200. With that said, pre-clinical grades are a good way to judge your level of understanding of the material. Most upperclassmen have told me that the best thing to do during MS1/early-MS2 in regard to boards prep is to study and do well in classes.
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I agree with everything @dyspareunia has said so far.
Someone mentioned it above I think, but the AOA equivalent for DOs is SSP (Sigma Sigma Phi). Having solid grades helps for that, in addition to other things depending on how your school selects students.
Another thing I would like to point out is that the general tone of "grades don't matter" is often taken from the Allo forum and applied here. Most DO schools are not P/F and are ranked. There are shades of gray within MD pre-clinical grading systems that isn't seen to the same degree in DO programs and reputation of the schools matters to a larger degree. In other words, at a school recruiting the highest caliber students with an awesome average board score, rank doesn't matter as much if the school even has it. I don't think this can be applied to DO schools to the same degree. It behooves you to have a solid class rank, especially if you want one of the incredibly limited competitive DO residency spots.
Someone mentioned it above I think, but the AOA equivalent for DOs is SSP (Sigma Sigma Phi). Having solid grades helps for that, in addition to other things depending on how your school selects students.
Another thing I would like to point out is that the general tone of "grades don't matter" is often taken from the Allo forum and applied here. Most DO schools are not P/F and are ranked. There are shades of gray within MD pre-clinical grading systems that isn't seen to the same degree in DO programs and reputation of the schools matters to a larger degree. In other words, at a school recruiting the highest caliber students with an awesome average board score, rank doesn't matter as much if the school even has it. I don't think this can be applied to DO schools to the same degree. It behooves you to have a solid class rank, especially if you want one of the incredibly limited competitive DO residency spots.
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I skipped a lot of posts, so maybe its already been said, but let me comment in case it hasnt been.
A lot of people seem tio echo the statement that they wish they had spent more time with the family or took it less intensely or whatever. What I wish I knew before medical school is how to sacrifice *even more* for it. I am a resident now and I was blessed enough to do an intern year at a hospital where there are aton of residency programs of DRASTICALLY different quality. We have some residencies that are pulling in high ranked students from top MD schools, we have programs that are pulling in students who clearly slacked, and one program that seemed to value personality over qualification so you get some incredibly dedicated people and some less dedicated people (unfairly I am lumping-family centric in there), that all have a certain characteristic unrelated to work ethic in common. I even work with some prior classmates, whose study habits I know very well.
As a single male (and I dated plenty, and had time to, I just mean I wasnt married or otherwise attached) I was shocked with how much time I could study in a given day. I would LIVE at the school. My fellow classmates were my family and as my genetic family became secondary. I lived and died by them. I knew them greater than I had ever known anyone else. We got each other through the hardest times of our lives and we did it together. And looking back at it.... I wish I studied with them and secluded myself from everyone else EVEN MORE. I wished I spent less time dating around ad watching Sunday football. I wish I spent less time hosting people at my apartment and watching shows on netflix. Because I know the people who had families and left to be with them. I work with some of them and im good friends with tons of them. I know the people who found their love on weekends away from the classroom and the books. I know the people who left at 8 instead of staying until 10 or 11 for that extra power cram session. Many of them are happy where they are, some are not. But extremely few of them are anywhere I'd be happy to be. And more nerve-wracking, the people I work with who definitely (by witnessing it, or by their own admission) fell into any category less intense than my study regiment are the poeple I'm constantly covering for when they give inappropriate medicine, or dont know how to handle acutely ill patients who are actively changing hemodynamically on the floor. They are the people who make mistakes that "matter statistically". They are competent enough to get the patient healthy, but not competent enough to avoid morbidity by suggesting the right medicine for the patients unique needs rather than the 'close enough' medication, or missing the physical exam sign or lab finding that changes how to interpret the disease. These are the people who see a patient in the ED and send them home, so that when I see the patiet bounce-back the next day and they have an undiagnosed aortic anyuerism being treated with a muscle relaxant I flip out.
A lot of attendings rely on you to give the right picture of the patient. Ive seen plenty who really look into the patient and examine themselves, but the large majority put their faith that you did it right. If you are not catching the small details, the attending wont strip them down and look for the tiny pathopneumonic bruise or notice the strange lumps on the nose that signal lupus pernio and tell you that thye dont have a pulomary infection, but they have sarcoidosis. The attendings will miss it because they expect you to break your back and catch it. I know I dont always do it right and patients sometimes suffer because of it. But I am sickened by how much a lot of my co-residents do it wrong and dont realize that it is peoples lives that they are screwing with by not being prepared enough. And while its not fair to dump it all on the medical school traning, as a huge part of this is continued learning for life.... I know people who were gung-ho like me all medical school and got married and became family me with children right at the end before residency. They function like I do... they never lost their willngness to sacrifice a bit from their lives to imporve hundreds or thousands of patients lives. They just have much more demands of their free time than I (still legally single) do. But their work time, which is often much longer than their work hours suggest, is dedicated to being ready to save every life as flawlessly as possible.
So yes. I wish I knew to study MORE. To sacrifice MORE. And to realize that my amily will forgive me and still send me frozen leftovers even if I dont make time to call tonight if I still have a few more pages in the textbook to read. When I realize how much I dont know, and how much others who were more anal than me do know... im blown away. Just as blown away as I am with how ridiculously unaware of vital things I feel others are, who may have even scored similarly to me on the boards, but never put that same effort in to really "doing it for the patients I will have in the future".
Do it for the patients. Sacrifice four years (really 3.5) of your life to make them better.
A lot of people seem tio echo the statement that they wish they had spent more time with the family or took it less intensely or whatever. What I wish I knew before medical school is how to sacrifice *even more* for it. I am a resident now and I was blessed enough to do an intern year at a hospital where there are aton of residency programs of DRASTICALLY different quality. We have some residencies that are pulling in high ranked students from top MD schools, we have programs that are pulling in students who clearly slacked, and one program that seemed to value personality over qualification so you get some incredibly dedicated people and some less dedicated people (unfairly I am lumping-family centric in there), that all have a certain characteristic unrelated to work ethic in common. I even work with some prior classmates, whose study habits I know very well.
As a single male (and I dated plenty, and had time to, I just mean I wasnt married or otherwise attached) I was shocked with how much time I could study in a given day. I would LIVE at the school. My fellow classmates were my family and as my genetic family became secondary. I lived and died by them. I knew them greater than I had ever known anyone else. We got each other through the hardest times of our lives and we did it together. And looking back at it.... I wish I studied with them and secluded myself from everyone else EVEN MORE. I wished I spent less time dating around ad watching Sunday football. I wish I spent less time hosting people at my apartment and watching shows on netflix. Because I know the people who had families and left to be with them. I work with some of them and im good friends with tons of them. I know the people who found their love on weekends away from the classroom and the books. I know the people who left at 8 instead of staying until 10 or 11 for that extra power cram session. Many of them are happy where they are, some are not. But extremely few of them are anywhere I'd be happy to be. And more nerve-wracking, the people I work with who definitely (by witnessing it, or by their own admission) fell into any category less intense than my study regiment are the poeple I'm constantly covering for when they give inappropriate medicine, or dont know how to handle acutely ill patients who are actively changing hemodynamically on the floor. They are the people who make mistakes that "matter statistically". They are competent enough to get the patient healthy, but not competent enough to avoid morbidity by suggesting the right medicine for the patients unique needs rather than the 'close enough' medication, or missing the physical exam sign or lab finding that changes how to interpret the disease. These are the people who see a patient in the ED and send them home, so that when I see the patiet bounce-back the next day and they have an undiagnosed aortic anyuerism being treated with a muscle relaxant I flip out.
A lot of attendings rely on you to give the right picture of the patient. Ive seen plenty who really look into the patient and examine themselves, but the large majority put their faith that you did it right. If you are not catching the small details, the attending wont strip them down and look for the tiny pathopneumonic bruise or notice the strange lumps on the nose that signal lupus pernio and tell you that thye dont have a pulomary infection, but they have sarcoidosis. The attendings will miss it because they expect you to break your back and catch it. I know I dont always do it right and patients sometimes suffer because of it. But I am sickened by how much a lot of my co-residents do it wrong and dont realize that it is peoples lives that they are screwing with by not being prepared enough. And while its not fair to dump it all on the medical school traning, as a huge part of this is continued learning for life.... I know people who were gung-ho like me all medical school and got married and became family me with children right at the end before residency. They function like I do... they never lost their willngness to sacrifice a bit from their lives to imporve hundreds or thousands of patients lives. They just have much more demands of their free time than I (still legally single) do. But their work time, which is often much longer than their work hours suggest, is dedicated to being ready to save every life as flawlessly as possible.
So yes. I wish I knew to study MORE. To sacrifice MORE. And to realize that my amily will forgive me and still send me frozen leftovers even if I dont make time to call tonight if I still have a few more pages in the textbook to read. When I realize how much I dont know, and how much others who were more anal than me do know... im blown away. Just as blown away as I am with how ridiculously unaware of vital things I feel others are, who may have even scored similarly to me on the boards, but never put that same effort in to really "doing it for the patients I will have in the future".
Do it for the patients. Sacrifice four years (really 3.5) of your life to make them better.
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FA is never too early. Supplement it with your classes from day 1.
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Emergency Medicine. Gonna be residency-ing at a pretty damn baller hospital in Manhattan.
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Dude that is a-w-e-s-o-m-e.
What were your board scores? Were you unmatched that you did an intern year?
I'd love to hear your success story.
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While I agree with DocEspana, that these are people's lives, so you better work your butt off regardless, I disagree with the parts that make it seem like spending time with, excuse my wording, your "real family" can wait. For one thing, sometimes they can't. We all should know that sometimes stuff happens. You don't always have the time you thought you would. To be honest, I've seen too many of my friends blow off calling their parents, and then hate themselves for it when their dad has an MI or their mom is diagnosed with stage 4 lung cancer. Time isn't always on your side. Fortunately, I learned this early enough, but not everyone is so lucky. Sure, you may not be able to drive home every weekend to see them, but that doesn't mean you can't talk to them, you can skype with them, etc. The same goes for your wife or your children.
There is a difference between managing your time well with high quality studying, and sitting in front of a book at the library all day, reading something over and over that you know you're going to forget tomorrow because you're not focused.
The people who are slacking to the extent of not knowing the material and not learning it for their patient aren't doing that because they're too busy spending time with their family or talking to their parents, they're doing it because they are (big surprise) lazy, not focused enough, or not getting that what they learn today will affect people's lives tomorrow. Don't be that guy, but that doesn't mean you need to cut off from your family or sacrifice your marriage to be a good (or even great) doc.
There is a difference between managing your time well with high quality studying, and sitting in front of a book at the library all day, reading something over and over that you know you're going to forget tomorrow because you're not focused.
The people who are slacking to the extent of not knowing the material and not learning it for their patient aren't doing that because they're too busy spending time with their family or talking to their parents, they're doing it because they are (big surprise) lazy, not focused enough, or not getting that what they learn today will affect people's lives tomorrow. Don't be that guy, but that doesn't mean you need to cut off from your family or sacrifice your marriage to be a good (or even great) doc.
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What's FA?
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First Aid (for the USMLE 2014 - right now).
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242, 232
585, 555.
I didnt go unmatched as much as I set my match list to give me a shot at an unlikely field and give myself TRIs as the next landing spot. So I was at a TRI and did A LOT of stuff right. I'll write about it at some point when Im not cramming for Step 3 (as I am right now). But came out of the TRI and got only a handful of interviews, but all with really good programs. Then matched #1.
585, 555.
I didnt go unmatched as much as I set my match list to give me a shot at an unlikely field and give myself TRIs as the next landing spot. So I was at a TRI and did A LOT of stuff right. I'll write about it at some point when Im not cramming for Step 3 (as I am right now). But came out of the TRI and got only a handful of interviews, but all with really good programs. Then matched #1.
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Did you match as a pgy-2, or did you lose a year by dong a TRI year first?
I know an EM resident at my school's home hospital who was able to slide into a slot that opened up at the hospital while he was a TRI. Also I interviewed at one of the new residencies this year and they stated that they were considering taking a few interns as PGY2s. It's rare, but it happens.
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Went PGY-1, but its a 3 year program... so its not like i lost time. All the AOA ones are 4 years, I'm doing it on an AOA time-line haha.
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Do think doing a TRI for a year hurt your chances for interviews? Obviously it worked out for you in the end.
Personally, I feel like a TRI would really improve your skills and ability as a doc, regardless of what you go into, because you'll at very least have a more solid base in general/different fields of medicine, but doing it seems risky since its usually easier to match as a senior than as an intern. Every doc that I've met that seemed (at least to me at the time) to have a good grasp of medicine did a TRI or TY beforehand (whether it was because it was required for all docs at the time or whether their residency was an advanced position after a rotational internship).
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There was a weird dichotomy, and a LOT of people felt the same way as me.
I got a lot less interviews, and ironically, AOA programs avoided me like the plague with tons of them saying they wanted nothing to do with an intern. It got so freakishly bad with AOA programs that I was calling them up and asking if there was something wrong with my ERAS application. There wasnt, they just only wanted graduating seniors for the fields I applied in. And plenty of ACGME programs felt the same way. But the interviews I did get were from *so much better* hospitals than I got the first time around. And every interview except one had the program director telling me how s/he has never had any problems with taking people who did intern years and how their skills and clinical judgement were very strong and 'positive qualities'.
So yea. Went down from like 14 interviews and 6 or 7 more interviews I declined going to.... to 8 and I went to all 8. But those 8 were all at pretty big name hospitals that didnt bother with me last year.
I have friends who went from 10/12/14 or so interviews to 3 or 4. And they were prominent places, but they didnt match and had to soap. Two didnt Soap either :-/
Except for the two who didnt even find a spot in the SOAP who ended up in regrettable places, everyone who did a TRI ended up going to really damn good places (Montefiore, Mt. Sinai NYC, University of Florida, NYU, University of South Carolina, Cook County Hospital, University of Kentucky Scripps San Diego, A John's Hopkin Affiliated Hospital whose name escapes me*, North Shore Long Island Jewish, and Myself in Manhattan) and in good fields (Anesthesia, EM, Urology!, Neurology, Pediatric Neurology, ObGyn, and a crap ton of PM&R people getting PGY2's they could roll right into, for the above hospitals).
*When I say these, I dont mean "a hospital under UofF's name... I mean the damn UofF main hospital. Except for the one Hopkin's affiliated hospital, which i documented as such
I got a lot less interviews, and ironically, AOA programs avoided me like the plague with tons of them saying they wanted nothing to do with an intern. It got so freakishly bad with AOA programs that I was calling them up and asking if there was something wrong with my ERAS application. There wasnt, they just only wanted graduating seniors for the fields I applied in. And plenty of ACGME programs felt the same way. But the interviews I did get were from *so much better* hospitals than I got the first time around. And every interview except one had the program director telling me how s/he has never had any problems with taking people who did intern years and how their skills and clinical judgement were very strong and 'positive qualities'.
So yea. Went down from like 14 interviews and 6 or 7 more interviews I declined going to.... to 8 and I went to all 8. But those 8 were all at pretty big name hospitals that didnt bother with me last year.
I have friends who went from 10/12/14 or so interviews to 3 or 4. And they were prominent places, but they didnt match and had to soap. Two didnt Soap either :-/
Except for the two who didnt even find a spot in the SOAP who ended up in regrettable places, everyone who did a TRI ended up going to really damn good places (Montefiore, Mt. Sinai NYC, University of Florida, NYU, University of South Carolina, Cook County Hospital, University of Kentucky Scripps San Diego, A John's Hopkin Affiliated Hospital whose name escapes me*, North Shore Long Island Jewish, and Myself in Manhattan) and in good fields (Anesthesia, EM, Urology!, Neurology, Pediatric Neurology, ObGyn, and a crap ton of PM&R people getting PGY2's they could roll right into, for the above hospitals).
*When I say these, I dont mean "a hospital under UofF's name... I mean the damn UofF main hospital. Except for the one Hopkin's affiliated hospital, which i documented as such
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The AOA is just ridiculous. They are the ones promoting the benefits of the TRI year, and yet a lot of residency programs look down on the interns. When AOA adds more residency, they open a bunch of TRI spots with subpar standards to take advantage of the desperate medical graduates. AOA TRI is nowhere near as good as TY on the ACGME side.
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I'll say this... most ACGME programs that talked to me didnt see a difference and LOVED that I did it.
As with everything, there are exceptions. The hospital I matched into as a TRI also has a TY and a mix of AOA and ACGME residencies (they just opened up a ACGME IM program this year and their Gen Sx has been transitioning from AOA to ACGME).
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Personally I've been told this repeatedly by REAL LIFE practicing physicians and PDs...it doesn't mean fail all your classes and do the bare minimum in your preclinical years. It means don't be a douche about grades. I've always taken it as: Do what you gotta do and learn the material...just don't be obsessed with a letter grade while your doing it. You have enough on your plate as is.
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oh yea I agree. It's like, if you try your best and you end up with a C for the class, don't beat yourself up over it. But if you're purposely giving the minimum because you know a C will still make you a doctor, I feel that I could not agree with this mindset. I say try your best, and whatever your honest efforts earns you, be happy with it.
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Congrats on your step scores. They are the kind of scores I hope to achieve.
Secondly, thank you for sharing your story. I'm really glad when things got tough for you, you didn't get discouraged. As they always say, when one door closes, another one opens.
Lastly, I find it kind of insulting that residencies would prefer a medical graduate who ONLY has rotation experiences over an intern who's actually in the field working as a resident would. It's like, why would all those real-world hours be held against you? This is ridiculous. It makes TRI seem like a death trap.
Was your TRI ACGME or AOA?
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Do you think your lower CK score hurt you?
There's a couple of reasons. First, you've already burned a year of funding from my understanding. The only advantage of an intern year (TRI/TY/Prelim) vs other residents is that the intern hasn't set their clock yet. Granted, this is a bigger problem with the surgical residencies that takes 6 or 7 years to complete than for EM.
Traditional Rotating Internships (TRIs) are only AOA. ACGME intern years are prelim years or transitional years.
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By definition, TRI is AOA (though not for long!). The ACGME equivalent is the TY. And the issue, from what Ive seen, comes from a two pronged issue:
1) all programs need screening mechanisms. If a program doesnt have a good exposure with high quality PGY-1 applicants, they may set their screening parameters to screen out all PGY-1s just because there are enough low quality interns in the larger pool of TRIs that they will do themselves a favor more often than not. I happen to be a very good candidate and be from a TRI program known for placing their people in spectacular programs (see all the places I referenced in my previous post)... but I can see why a program might just set that as a filter if they expect to get enough graduate applications
2) funding gets a bit dicey. If you start a program your funding becomes "the length of that program" and not a year longer. So anyone who initially matched IM has 3 years of full payment from the government and anything after that is only half funded. (fun fact: nearly every fellow in the US is only 50% funded for this reason, the other 50% is from the hospital. This is why fellows are worked absolutely to death. The hospital partially pays their salary). If you initially match surgery you have 5 years of funding. Neurosurgery? 7 years of funding. There is some theoretical tricks possible if someone matches surgery then changes to a 3 year field... they could have 1 or 2 extra years of funding to make them SUPER desirable for fellowship. The funding is tied to you, so you can bring extra funding with you, though IDK if anyone has ever tried this. Anyway, TRI and TY have unique rules. Its based on what you go into. Both TRI and TY are considered "a year off the total", but only if its not historically part of the training to begin with. So if you do a TRI or a TY and want to go into IM or FM you will receive funding for only 2 additional years because you are expected to go right into PGY-2. Same thing with surgery, only get 4 additional years of funding as its expected that you go into PGY-2 year. Programs will be very unhappy to take you if they only have PGY-1 spots to offer, as they have to then tell the hospital that they accepted someone who is only half funded during their PGY-3 year. A lot of programs know about this, but dont know that it doesnt effect your funding if the program historically does use intern years. So if you go into neurology (which is 50-50 on if they require an intern year) you'll get 100% of your years funded wether you match to a program requiring that extra year or not. Same thing with EM: most EM programs are 3 years, but since they were all historically 4 years (be it 1 + 3 or just a combined single-site 4 years) the funding says it is a known route into ED to take an intern year and then 3 additional years. Obviously radiology, derm, PM&R, anesthesia are all fine too since they are all overwhelmingly programs that require this intern year.
But yea... a lot of programs get nervous because they either dont have a PGY-2 to offer or dont want to pay you extra, something seen more at the AOA programs which are, if i am to generalize, poorer off then many of their ACGME cousins. They dont want to have the hospital pay half your salary your cheif year, so they dont offer you PGY-1 spots. Perhaps worse are the programs that would get full funding for you, but dont offer it because they are just plain unaware of how it works.
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I dont think anyone cared. All my interviews everyone was complimenting my scores, or said "they are fine scores". They would have cared if it was some dramatic difference. But instead it was just something at-or-near the standard deviation mark. So I'm within my own margin of error.
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I should clarify before someone yells at me for being lazy with my facts... its only a 50% cut to your directGME funding. There is also indirect GME funding which can make up anywhere from 25% to 75% of your total funding based on how many medicare patients your hospital sees.* A more realistic estimate of what "half funding" actually is would be about 70% funding in most cases, as there is still full "indirect" GME funding. But still, hospitals are loathe to pay even 30% of your salary.
* Every resident in the country has the same direct GME funding. I forget the amount. The calculation for the indirect GME funding is some arcane secret formula that neither the government nor any hospital will ever disclose even if you held them at gunpoint. So its all based on word of mouth and a leaked breakdown of how it works that make it to the internet every once in a while and only establishes that different hospitals pull in drastically different amounts of money per resident. Im sure the formula is out there, but I've never seen it.
* Every resident in the country has the same direct GME funding. I forget the amount. The calculation for the indirect GME funding is some arcane secret formula that neither the government nor any hospital will ever disclose even if you held them at gunpoint. So its all based on word of mouth and a leaked breakdown of how it works that make it to the internet every once in a while and only establishes that different hospitals pull in drastically different amounts of money per resident. Im sure the formula is out there, but I've never seen it.
I think it's really important that if you want to reapply next year and are at risk for not matching, APPLY FOR INTERN YEAR. I know other students who didn't match, didn't get anything in a SOAP, and now are trying to pick over the left overs. At least with the match you have some choice over where you match for an internship and can guide it towards hospitals that have EM programs and have some control over the quality of program you end up in.
As a side note, I got this funny little alert that was just "Dr. Zombie: *". I guess that's what we get when someone does the @___ posts.
When I went to turn in my contract (I live like 10 minutes from the hospital), I brought this up with the residency coordinator. She laughed and then said that they receive very little Medicare money because the patient population is more Medicade/MediCal than anything else, so funding doesn't normally make too much of a difference.
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Know these things, and you'll be solid.
M1 and M2:
**The trick to doing well starts in the mind. Tons of med students freak out and cause themselves unnecessary stress. I've seen this over and over again. This is self sabotage. Med school is hard but honestly, it's not extremely difficult. Create a strategy, keep cool and focus, and adapt.
***Also, LEARN FOR THE SAKE OF LEARNING. Don't do it just for the grade. Find something interesting and fascinating in every class. Don't become a slave to grades. It makes your life a lot easier, and you'll probably do better in school because of it.***
1. Boards, boards, boards. - Boards are the first step to get you in the door for residency. It's not everything, but it's a very important factor.
Buy first aid and annotate the crap out of it from day one along side your classes. I wish I started First Aid earlier. The more familiar you get with it, the better. Class rank matters to an extent, but boards matter way more. Plus, studying for boards should help with your classes too, if you do it right.
**Again, the trick to studying for boards (besides strategy) is mindset. Look at boards as an opportunity to synthesize everything you've learned in the first 2 years into one package. Once I adopted this mentality, I actually enjoyed studying for boards! (Yes, people thought I was crazy, but I was having fun so who cares?)**
2. Once you reach M2 year, start studying hardcore for boards in January. Align your study schedule for boards with you classes. Create a strategy. Studying smart >>> Studying hard, although ideally you should study smart and hard. Minimize your resources for studying.
First aid + Pathoma + USMLE World Qbank = SUCCESS (disclaimer - this is for the USMLE. I chose to focus on the USMLE vs the COMLEX)
***Study well for boards - as in understand the concepts and DON'T just memorize random stuff. This paid off big time in rotations. For me, it made 3rd year sooooo much easier. You'll be surprised with how much you can retain, and attendings/residents/interns will be impressed***
3. Don't ignore your physical and social needs. Nothing is worth sacrificing for your health, even med school. Exercise and eat healthy. Take time to talk/spend time with the people that matter in your life. Keep up your hobbies outside of med school. Have fun! There is always enough time.
M3
1. ***LEARN HOW TO PRESENT PATIENTS WELL*** Besides being pimped (which shouldn't be too bad if you studied well your first two years and have a good knowledge base), attendings will gauge your intelligence by how well you present patients. With a good knowledge base and patient presentations alone, attendings offered to write me letters of rec and tried to persuade me to go to their residency programs!
2. Be thoughtful and genuine in rotations. Be willing to help people out, even when it comes to non-physician staff. If you're a decent person, this should come naturally.
3. Be passionate and willing to learn. If you bring good energy to the team and learn, attendings may look past your lack of knowledge (if that's a problem). If you're in touch with why you want to be a doctor, this should come naturally.
4. Again, don't ignore your personal needs!
**It's a privilege to aid patients in their time of need. The amount of trust and respect patients place on you - even as a med student - is humbling.**
Hope this helps!
M1 and M2:
**The trick to doing well starts in the mind. Tons of med students freak out and cause themselves unnecessary stress. I've seen this over and over again. This is self sabotage. Med school is hard but honestly, it's not extremely difficult. Create a strategy, keep cool and focus, and adapt.
***Also, LEARN FOR THE SAKE OF LEARNING. Don't do it just for the grade. Find something interesting and fascinating in every class. Don't become a slave to grades. It makes your life a lot easier, and you'll probably do better in school because of it.***
1. Boards, boards, boards. - Boards are the first step to get you in the door for residency. It's not everything, but it's a very important factor.
Buy first aid and annotate the crap out of it from day one along side your classes. I wish I started First Aid earlier. The more familiar you get with it, the better. Class rank matters to an extent, but boards matter way more. Plus, studying for boards should help with your classes too, if you do it right.
**Again, the trick to studying for boards (besides strategy) is mindset. Look at boards as an opportunity to synthesize everything you've learned in the first 2 years into one package. Once I adopted this mentality, I actually enjoyed studying for boards! (Yes, people thought I was crazy, but I was having fun so who cares?)**
2. Once you reach M2 year, start studying hardcore for boards in January. Align your study schedule for boards with you classes. Create a strategy. Studying smart >>> Studying hard, although ideally you should study smart and hard. Minimize your resources for studying.
First aid + Pathoma + USMLE World Qbank = SUCCESS (disclaimer - this is for the USMLE. I chose to focus on the USMLE vs the COMLEX)
***Study well for boards - as in understand the concepts and DON'T just memorize random stuff. This paid off big time in rotations. For me, it made 3rd year sooooo much easier. You'll be surprised with how much you can retain, and attendings/residents/interns will be impressed***
3. Don't ignore your physical and social needs. Nothing is worth sacrificing for your health, even med school. Exercise and eat healthy. Take time to talk/spend time with the people that matter in your life. Keep up your hobbies outside of med school. Have fun! There is always enough time.
M3
1. ***LEARN HOW TO PRESENT PATIENTS WELL*** Besides being pimped (which shouldn't be too bad if you studied well your first two years and have a good knowledge base), attendings will gauge your intelligence by how well you present patients. With a good knowledge base and patient presentations alone, attendings offered to write me letters of rec and tried to persuade me to go to their residency programs!
2. Be thoughtful and genuine in rotations. Be willing to help people out, even when it comes to non-physician staff. If you're a decent person, this should come naturally.
3. Be passionate and willing to learn. If you bring good energy to the team and learn, attendings may look past your lack of knowledge (if that's a problem). If you're in touch with why you want to be a doctor, this should come naturally.
4. Again, don't ignore your personal needs!
**It's a privilege to aid patients in their time of need. The amount of trust and respect patients place on you - even as a med student - is humbling.**
Hope this helps!
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Your situation is the anomaly. Definitely. Been in enough discussions of this sort of stuff to know that most hospitals usually make more in indirect than they do in direct funding. Usually you make almost twice as much in indirect payments.Yet, some hospitals simply dont have the right population mix to cash in. Thus why there is a minimum "direct" amount.
From healthaffairs.org:
I don't doubt that it is, I just found it interesting that that was what she said. I wonder how much money it actually costs on average, and if any of it is made up by increased efficiency since the intern had already completed an intern year. Also, in my case, my program gives us $1000 for "educational expenses." This includes Step III as well as a tablet (which is basically necessary since we went to electronic order entry last year. Also, obviously tablet + step III >$1000).
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Sooo is the consensus to buy FA right away or no?
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Thanks everyone for the useful advice and information!
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Yes, buy it now and pre read it cover to cover before med school start.
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Honestly, I bought it at the end of first semester-first year and haven't opened it yet as I approach the end of second semester. Haven't had time really. I am sure if I decided to forgo my personal time/time with wife I could probably get into it. Don't really want to do that tho. I'll probably play around with it over summer and check out the sections that cover the systems I have completed through first year. With that said, no harm in buying it and if you have time to get into it then awesome. If you don't, then you have it for when you do get the time. I know for a fact there are people in my class that are getting down with their FA already.
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I agree.
I feel that FA is good beginning second year once you get into the organ systems. Simply read the chapter for whatever system you're on at the time. When you begin dedicated board prep you will have seen the material before and it will go faster in terms of refreshing your memory.
At my school the first year curriculum has little/nothing to do with system pathology so FA or another review book would be of little use. If you want a book for first year the BRS physiology by Costanzo would be good to use as you go through each system.
