Let me put it this way: No residency will ever care in the least how many gall bladders you've pulled out yourself compared to how many you've seen pulled out. No residency will ever care how many rare and obscure diagnosis you can make when you can't write an amazing H&P or can't manage >5 patients while still going to all those require meetings.
Complaining about required meetings ruining the rotation is like a pre-clinical student complaining about pharmacology ruining the first two years of med school. It's going to be a crux of your future whether you like it or not. Feel free to complain about it and ignore it and thus be grossly unprepared for a future that will be full of it no matter what you do.
There are great opportunities to be had at community hospitals. Of that there is *NO DOUBT*. But those opportunities will be much less frequent than the same great opportunities at academic centers, and its hard as hell to get enough word of mouth beforehand to know if the rotation youre walking into is crappy or excellent. If you have no information ahead of time to educate your decision, you have to pick the academic center 9 times out of 10 just because the odds of a great educational experience are higher there. Plus every month at a community center is time away from "learning how to be an intern" which is... really... what we're doing in our clinical years you don't need every month to be dedicated to academic hospitals, but for the sake of learning how to be a proficient intern it definitely helps if most of them are there.
Being a proficient intern means being able to take care of **** by oneself. This involves everything from forming the dx to finding out where the marker is in the supply room.
IME, rotations at academic centers tend to be highly structured, so that students never learn how to do stuff for themselves... because guess what, they have no real responsibility, so they don't have to figure out how to do things.
In contrast, at the community hospital, students have more liberty & function more autonomously. So they gain more practical skills. I'm not talking about pulling out the gallbladder... I'm talking about simple things like figuring out that EMR by yourself. In contrast to the 2-hr formal tutorial you're liable to get at a university hospital.
My main point isn't about doing more *procedures*. It's just the simple fact that the more you DO, the more you learn. At an academic center, students are often treated exactly like students- coddled, shadowing, and never learning how to do stuff on their own. Internship, as we all know is about figuring out how to do ****, much of which is scut work. Everything from how to enter that weird order, to calling that consult, to doing that quick exam.
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Btw, I loved pharm, so I don't know what you're talking about lol... required meetings as an attending would be just fine. After I'm comfortable working up bread & butter, it would be quite useful & interesting to spend hours discussing more obscure cases. I just don't think it's that helpful at the student level, when we're still honing our basic skills.
As for your idea "get used to it"... well, not all residencies are at academic centers. I mean, so far I've really disliked many aspects of the academic experience-- everything from hierarchy, red tape, required meetings, to decreased time with the patient.
Personally, I would NOT choose to be seen or have my family be seen at an academic teaching hospital in the future... unless it's some obscure disease or complicated procedure, of course.
Things don't get done at the teaching hospital! I mean, that morning labs/morning meeting example is just one... where a patient at a private hospital would've been d/ced by noon after a simple chole, he could be staying til 5pm for no good reason at a teaching hospital.
Exception: the meetings I DON'T mind are the "patient panel" meetings. They have been uniformly memorable & interesting. I can still remember a sickle cell patient talking about the excruciating pain & how people didn't believe he was in that much pain so they wouldn't give him painkillers. Stuff like that- directly applicable to our clinician work. Makes an impact.
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So yeah. I think for residency, I won't pick one that is largely centered at a academic institution. A large part of learning is VOLUME of bread & butter cases. Learning how to deal with all the manifestations of the common stuff, including complications, etc. Learning how something common like pancreatitis manifests in some woman with 2 transplants & some rare immune disorder ? I don't know how helpful that is. I think it's more helpful to learn the uncommon *presentations* of the common stuff.
I think ideally for residency, there would be several institutions- university, VA, community, to rotate through. Come fellowship time? Yeah, of course the university hospital with the renowned specialist is obviously the only place to be. And by that time, all those Grand Rounds & required meetings will actually be useful & meaningful.
