sozme

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At our school, we pay something like 20k for the summer semester (~10 weeks of rotation). What we get for that is an all-volunteer faculty (they get paid nothing by our school). As such, our IM rotation is basically 3 students following one hospitalist around while 90% of the time we just watch him do notes (not his fault, he is just really busy and ain't being paid a dime by our school).

This is really depressing because I feel that we deserve higher quality teaching for the astronomically high tuition rates and shouldn't be just shadowing or seeing 1 patient a day (who has already been seen by the hospitalist and 3 other specialists) with no critique of our presentation skills or anything.

I try to keep telling myself that I am paying for the degree, not the quality of the education, but it is extremely frustrating/depressing some days. Are any of your core rotations like this?
 

Mad Jack

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You're really paying for first and second year mostly, but diluted over four years. Medical school is a package that you are paying for in a glorified installment plan, basically, not a thing you are paying for in proportion to resources utilized during a given semester. If they did it that way you'd probably be paying 85% of your total tuition over years one and two, which would be brutal for those that fall out or repeat.
 

witzelsucht

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oh yeah paying 100k for those ****ty ass first year ppts. bring back the ****ing apothecary test. acutally, it already exists, just dont make med school a requirement for step 1. biochem = easy, self study. physio = costanzo and kaplan/khan academy. 2nd year? sketchy micro, self-study some immuno. Read big robbins and do pathoma/uworld for second year. boom. no more med school necessary. maybe you need a med school for anatomy, and some H&P class. that's it. make an option to just self study and pass step 1.
 

Mad Jack

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oh yeah paying 100k for those ****ty ass first year ppts. bring back the ****ing apothecary test. acutally, it already exists, just dont make med school a requirement for step 1. biochem = easy, self study. physio = costanzo and kaplan/khan academy. 2nd year? sketchy micro, self-study some immuno. Read big robbins and do pathoma/uworld for second year. boom. no more med school necessary. maybe you need a med school for anatomy, and some H&P class. that's it. make an option to just self study and pass step 1.
I'm sure quality control of physicians would be excellent in such a scenario...
 

witzelsucht

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I'm sure quality control of physicians would be excellent in such a scenario...

it would be no different. what makes a good surgeon? the ability to cut and sew. which is learned in residency. 1st and 2nd year dont matter, you can learn it from a book just as well. what makes a good internist? managing complex dieseases. learned in 3rd year (a tad), and RESIDENCY. what makes a good psychiatrist? well, I don't know, but it sure as **** aint the krebs cycle. psychiatry is probably more a function of intrinsic personality...and residency training.

I think if you got a handful of bright ass people, 35 mcats, volunteer EMT, research experience types. real go-getters. and you took 20 of them and put them in med school, and you gave 20 of them a subscription to SDN and a stack of robbins/pathoma/uworld/costanzo books, and some kaplan ****, and you said hey guys meet back here in 2 years we're gonna take "step 1", I bet the scores would be even. and if you said ok now go do 2 years of clinical rotations, there would be no difference in 4 years when they become interns.
 
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Mad Jack

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it would be no different. what makes a good surgeon? the ability to cut and sew. which is learned in residency. 1st and 2nd year dont matter, you can learn it from a book just as well. what makes a good internist? managing complex dieseases. learned in 3rd year (a tad), and RESIDENCY. what makes a good psychiatrist? well, I don't know, but it sure as **** aint the krebs cycle. psychiatry is probably more a function of intrinsic personality...and residency training.

I think if you got a handful of bright ass people, 35 mcats, volunteer EMT, research experience types. real go-getters. and you took 20 of them and put them in med school, and you gave 20 of them a subscription to SDN and a stack of robbins/pathoma/uworld/costanzo books, and some kaplan ****, and you said hey guys meet back here in 2 years we're gonna take "step 1", I bet the scores would be even. and if you said ok now go do 2 years of clinical rotations, there would be no difference in 4 years when they become interns.
There's much more to being a doctor than passing a test, and, at least at my school, we get a lot of practice in clinical skills, physical assessment, and other such things you can't just master in a book. You're being socialized to become a physician in the first two years, not just learning facts. The stress and coping mechanisms you have to develop are a big part of that. And the strict entry criteria of medical school ensure a high level of quality control that merely having people take a test would not provide.

The first two years sick, but our broad knowledge base and extensive training are a large part of what separates us from midlevels. If we give that up, we give up our identity, as well as many of our claims to superiority. That training is expensive, and thus ends up being spread out evenly over our for years of tuition, which grinds the gears of people like OP, but is fundamentally sound.
 

Wordead

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You're really paying for first and second year mostly, but diluted over four years. Medical school is a package that you are paying for in a glorified installment plan, basically, not a thing you are paying for in proportion to resources utilized during a given semester. If they did it that way you'd probably be paying 85% of your total tuition over years one and two, which would be brutal for those that fall out or repeat.
I'd disagree....you should feel like you're paying for the clinical years. I used to think M3 was universally a waste of time, but seeing the difference in quality of rotations between my med school (middle of the road) and my residency program (a top one) made me revise that opinion. The difference between situations like the OP, where you have random ass volunteer faculty (i rotated at a few of those M3) vs programs where you have dedicated teaching faculty plus quality residents (not to toot my own horn) who can/will teach and aren't dying and overwhelmed by intern year? It's a vast, vast gulf. It really makes me rather bitter towards my med school.
 

Wordead

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it would be no different. what makes a good surgeon? the ability to cut and sew. which is learned in residency. 1st and 2nd year dont matter, you can learn it from a book just as well. what makes a good internist? managing complex dieseases. learned in 3rd year (a tad), and RESIDENCY. what makes a good psychiatrist? well, I don't know, but it sure as **** aint the krebs cycle. psychiatry is probably more a function of intrinsic personality...and residency training.

I think if you got a handful of bright ass people, 35 mcats, volunteer EMT, research experience types. real go-getters. and you took 20 of them and put them in med school, and you gave 20 of them a subscription to SDN and a stack of robbins/pathoma/uworld/costanzo books, and some kaplan ****, and you said hey guys meet back here in 2 years we're gonna take "step 1", I bet the scores would be even. and if you said ok now go do 2 years of clinical rotations, there would be no difference in 4 years when they become interns.
If you ask any attending they'll tell you the ability to cut and sew does not make a good surgeon; they can teach a monkey to do that.

Nor is "managing complex diseases" the sign of a good internist.
 

Psai

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I'd disagree....you should feel like you're paying for the clinical years. I used to think M3 was universally a waste of time, but seeing the difference in quality of rotations between my med school (middle of the road) and my residency program (a top one) made me revise that opinion. The difference between situations like the OP, where you have random ass volunteer faculty (i rotated at a few of those M3) vs programs where you have dedicated teaching faculty plus quality residents (not to toot my own horn) who can/will teach and aren't dying and overwhelmed by intern year? It's a vast, vast gulf. It really makes me rather bitter towards my med school.
Yes. The attendings here are so busy teaching residents things that they should have learned in medical school that our students fall by the wayside. It's really a shame because we out class the residents by far. Quality teachers are few and far between. It seems that all they care about is cranking through patients. It was a struggle to get students to even have access to the emr (wtf?) but it doesn't matter when everyone's so busy writing their own notes that they don't look at yours.
 

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I hate to say that, but things will never change because even new med students who suppose to try to change the system are defending it... There is no reason for someone to go to school for 11 years to become a PCP when every physician you talk to tell you 90% of the stuff you learn to be a good physician is during residency... The Flexner Report is outdated... It's time for med school to be 3 years of prereq, 3 years of med school and 3+ years residency... It's not the # of years that differentiate us from MLP; it's what we learn...
 
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Psai

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it would be no different. what makes a good surgeon? the ability to cut and sew. which is learned in residency. 1st and 2nd year dont matter, you can learn it from a book just as well. what makes a good internist? managing complex dieseases. learned in 3rd year (a tad), and RESIDENCY. what makes a good psychiatrist? well, I don't know, but it sure as **** aint the krebs cycle. psychiatry is probably more a function of intrinsic personality...and residency training.

I think if you got a handful of bright ass people, 35 mcats, volunteer EMT, research experience types. real go-getters. and you took 20 of them and put them in med school, and you gave 20 of them a subscription to SDN and a stack of robbins/pathoma/uworld/costanzo books, and some kaplan ****, and you said hey guys meet back here in 2 years we're gonna take "step 1", I bet the scores would be even. and if you said ok now go do 2 years of clinical rotations, there would be no difference in 4 years when they become interns.
Bro i won't cut you up because i remember having the same thoughts but you're dead wrong. Cutting and sewing is the least important thing for a surgeon. Really the most important thing is whether the problem is surgical and if so, how should it be done. A good internist is one who knows how to rule out life threatening disease and dispo well. The preclinical years give you a framework of how and what to study. You would never push yourself at that rate by yourself. As you go on, you have less time to get through more material. You build stamina and the ability to retain snippets of information that can help your patient
 

cbrons

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There's much more to being a doctor than passing a test, and, at least at my school, we get a lot of practice in clinical skills, physical assessment, and other such things you can't just master in a book.
I agree with everything you said insofar as the school actually DOES teach clinical skills, etc. At my school they don't teach these things and they also have all volunteer clinical faculty (or at least 95% volunteer clinical faculty).

I'd disagree....you should feel like you're paying for the clinical years. I used to think M3 was universally a waste of time, but seeing the difference in quality of rotations between my med school (middle of the road) and my residency program (a top one) made me revise that opinion. The difference between situations like the OP, where you have random ass volunteer faculty (i rotated at a few of those M3) vs programs where you have dedicated teaching faculty plus quality residents (not to toot my own horn) who can/will teach and aren't dying and overwhelmed by intern year? It's a vast, vast gulf. It really makes me rather bitter towards my med school.
Yep. There is definitely a difference in QUALITY between American M.D. programs. NEVER let any of the pre-allo fools get you thinking that all American MD schools are more or less equal. There is in fact a VAST gulf between the quality of some programs (and by the way, the best schools are not necessarily the "top tier" schools in terms of applicant competitiveness). In fact I will go a step further and tell you that certain D.O. schools are a lot better than some MD schools.
 

Mad Jack

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I agree with everything you said insofar as the school actually DOES teach clinical skills, etc. At my school they don't teach these things and they also have all volunteer clinical faculty (or at least 95% volunteer clinical faculty).
I actually really like the clinical skills we get in first and second year here. We're trained and expected to be able to do a full H&P, ROS, and physical for every system (excluding ophtho and ob/gyn) within 22 minutes by the start of year 2, and we're tested on our clinical skills six times a year to make sure we're meeting the marks set for us. We've got a split of perhaps 60/40 volunteer and paid faculty (we've got a lot of part-time faculty for clinical stuff). I'd consider most of my money well spent thusfar.
 
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I hate to say that, but things will never change because even new med students who suppose to try to change the system are defending it... There is no reason for someone to go to school for 11 years to become a PCP when every physician you talk to tell you 90% of the stuff you learn to be a good physician is during residency... The Flexner Report is outdated... It's time for med school to be 3 years of prereq, 3 years of med school and 3+ years residency... It's not the # of years that differentiate us from MLP; it's what we learn...
At almost every undergrad, you can graduate in 3 years if you really want to do so. Personally, I wouldn't trade a week of my undergrad experience because I'll always look back on those 4 years as the best of my life because of the ratio of fun:responsibility compared to any other years. As far as cutting medical school to 3 years, I can't think of a scenario where this would benefit the majority of students. For every student that comes out of med school in the same specialty he/she wanted going into it, I'd imagine there's at least 3 that changed their minds multiple times and needed all 4 years to decide. I'd consider shortening preclinical to 1.5 years as some schools have in favor of more clinical electives and/or dedicated research time, but I can't justify shortening the overall 4 years just for the sake of shortening them.
 
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Entadus

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I'm having better clinical experience than OP describes and I'm only an M2..... I would be pissed to have that issue during 3rd year :mad:
 
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Petypet

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Enjoy the slow rotations, learn what you like and don't like, and move on. Things will get ALOT busier!