Thank you for your comments and answers.
When you say EC-heavy, besides research, what are the things does Columbia look for in particular, if any? Or is it fine so long as there is just lots of "something" that an applicant is passionate in?
anything is fine, just passion in general
How many students do you know who conducted research as a MS1? In other words, how easy is it to get involved in research as a MS1?
Honestly i've never heard a school say it wasn't easy, but yes it is easy. I started a week in and anyone who was interested had no trouble finding a lab. Remember, academic physicians want you to be interested in their work. If they weren't passionate about it they probably wouldn't take the pay cut to be in academia
Can you explicate your clinical experiences as a MS3? To what extent can you involve, as opposed to doing clinically meaningless work?
When you are thinking of the pros and cons of medical schools as far as the clinical years go, I strongly recommend that you focus on two points: diversity of patients and volume of patients. As far as diversity goes, I think you will agree that New York and Columbia offer essentially the widest array of patients around. We are at the heart of enormous amounts of immigration and travel all over the world, and our patient population (and their medical problems) reflects a diverse array of ethnicities, cultures, and socioeconomic backgrounds. This patient diversity is coupled by our wide array of hospital affiliates both within the city (Harlem, Saint Luke's-Roosevelt, Bronx VA, Allen Pavilion, etc), as well as in more rural parts of the country such as Indian reservations in the southwest, the Bassett hospital is Cooperstown, and the Stamford Hospital in CT. At the same time, while it is nice to see some of the rarest conditions in medicine, our volume of patients assures us that we will also see all of the bread and butter health problems that are also crucial to one's education during the clinical years.
Columbia has 8 major clinical rotations during clinical year- Medicine x2, surgery, OBGYN, Neurology, Psychiatry, Family Medicine, and Pediatrics. You will do no more than two of these outside of the CUMC unless desired, and people with a need to stay on campus are allowed to. We also rotate through many of the smaller specialties such as dermatology, radiology, emergency medicine, and the surgical subspecialties. The reason for this is because they want to expose you to all the possibilities, because how else would you want to know you want to be a urologist, etc? They also require you to learn valuable clinical skills that will make you a better intern such as intubation, placing catheters, etc. This allows you to learn from the masters of each skill.
Each location provides different experiences. For example, your day and your responsibilities at a small hospital without residents vs the main hospital. Columbia has an all volunteer teaching staff, which means they want to be there and are interested in your improvement. You don't really do any scut, but it does depend on your definition I suppose. Some people think that drawing blood on your patients is scut, but I always volunteered to do it when a stat draw was required because its a reasonable skill to have in your back pocket. You won't be doing anything that isn't involved in improving the care of your assigned patients.
How were your schedules like for MS1 and 2? Are your afternoons completely open, like the schedules at Case?
we have a three semester curriculum instead of four. Most days are from about 9-12 or 9-1, with one to three afternoons a week with afternoon classes for about 4 hours depending on the part of curriculum you are in. The first semester consists of 3 major courses: Molecular Mechanisms, which is an umbrella course for essentially all basic medical sciences, Anatomy, and Foundations of Clinical medicine. FCM is on Wednesday mornings instead of MM and is a combination of bioethics and clinical skills. For example, you may have a lecture on how one appropriately ascertains a patient's sexual history and then move on to small groups to discuss and practice this interview with a standardized patient (which is an actor). You then will move onto real patient interviews at an afternoon clerkship on either Monday, Wednesday, or Friday. In the clerkship, you are paired with a health care practitioner at a wide variety of sites (such as The Door, Calvary Hospital, Young Mens Clinic, Neurosurgeons, Physical Therapists, offer examples as needed, preferably your own experiences) and get to interview patients in a very diverse array of situations. You do two clerkships in the first semester, and you do have some say in selection when possible. After the first semester you switch over from history taking to physical examinations in the second semester and then finally to how one efficiently conveys information from histories and physicals to an attending during presentations and in the form of write ups.
Anatomy consists of basically two full afternoons, one in the dissection lab and the other in small groups. Small groups consist of four students per cadaver, with 2 groups dissecting the same cadaver on alternative days. Now some of you may be thinking "ah man I want to dissect the whole cadaver myself", but I promise by the second day you will be thinking "I'm so glad it isn't my turn to dissect today." Don't get me wrong, I love to dissect, I still go in on occasion and do so. HOWEVER, dissection itself has a very low benefit to cost ratio and consists mostly of cleaning up things so that you can actually decide what everything is. The reason why we only dissect half is to save everyone time, you still get to see and learn everything. Now, the non-dissecting group consists of osteology- the study of bones-, radiology, and applied clinical skills. For example, guy walks in with knife in arm, what nerve was cut, what finger can't he move? This is great practice because both our exams and the step 1 test anatomy in this format.
Now for some general things about our courses. All classes are recorded, and what is especially nice is the slides are synched to the lectures. So if you fell asleep during slide 33 you can click it and just watch that part of the lectures. This makes it a great study and review tool as well. In addition, we are a pass fail unranked school during the pre-clinical years. The unranked part is the most important part, as a lot of schools say they are pass fail but have an internal system of rankings. Unless everyone who passes is ranked first, then clearly they used grades to determine your grades. Our system is not about slacking off and just breezing by, everyone works hard and the average grades have not changed since before the system was instituted. What it does is take as much of the anxiety out of medical education as possible and gives you the confidence to take advantage of the free time that is naturally built into the pre-clinical curriculum. So you can do volunteering, do fun things, do research, do shadowing, or just figure out what you want to do with yourself after medical school without a nagging voice in the back of your head eating away at you because you are terrified of getting a 99 and not a 100. Pre-clinical grades and rankings are ultimately not highly valued by residency directors, so you aren't losing out on anything when compared to the confidence to build your resume in other ways.
My favorite part of the university feel of P&S is that we are allowed to take up to 2 free classes per semester at an school or department at Columbia (other than Law). Given the low stress environment, it is definitely possible to do so and many people take advantage of it. In fact, there is an optional narrative medicine class during pre-clinicals that students can waive if they have a class that they would prefer to take.
What would you have done differently if you could do the whole medical school again?
Nothing, I've been quite happy with my experience
What were the things you wish you would have known?
Well, I discovered this during interviews for med school but I'm glad to have realized that the 3rd and 4th year experience are more important than the pre-clinicals, in terms of assessing a school IMO. Also, go somewhere that makes you happy. You don't get a coupon after residency to relive your life.
Thank you in advance for your time. Your comments will be very helpful in writing secondaries!