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Please reference the ACGME faq above.
Show us where in the FAQ it says AOA grads were not adequately trained, and this being the driving force behind the merger.
Please reference the ACGME faq above.
http://www.acgme.org/Portals/0/PDFs/Nasca-Community/FAQs.pdf
Under page 16. Appendix 1, question: Will individuals who are currently enrolled in AOA approved residency program be eligible for entry into ACGME accredited fellowships
Answer: effective july 1, 2016, eligiblity requirement for all fellowship positions require completion of prerequest training in a program accredited by ACGME, the RCPSC (candian) or CFPC (canadian).
Mind you, this isn’t from me. This is from the ACGME. Many fellowships are not ACGME accredited, perhaps explaining the source of your confusion.
Please reference the ACGME faq above.
At my one of my required (not elective) rotations, at a site with ACGME residents and fellows, I got told to come ever other day because there were too many students. Same thing happened to the MD students. This obviously isn't representative of every (or even most) rotations, but it goes to show that there is variable quality at MD and DO programs alike.
Now, I've met DO students who got precious little experience with writing H&Ps, progress notes, etc. But the MD students from my program's med school don't get to write notes that count either. Sometimes they write notes for practice, but since they don't count there usually not emphasized much.
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I'm curious about the whole 'notes don't count' thing. On my rotations, my notes are either co-signed (where they 'count' as part of the record), or they are filed under my name with a 'medical student' identifier front and center. Either way, they should count from the standpoint that these are real patients that need progress notes, H&Ps, etc. and as students, there's definite utility in writing these up. That being said, when I had rotations where my notes entered the record under 'medical student,' no one gave af about them and even though they were available to everyone, no one actually read them.
I'm sure we could all argue about the value of note-writing throughout 3rd and 4th year, but I don't think I've ever said to myself: "dang, I sure wish I could write more notes." I had one rotation where my attending told me not to write notes because it was mostly busy work and I should be focused on seeing patients and learning management. His point was twofold: (1) if you've gotten to this point in your medical career and don't know how to write notes, you're a pitiful excuse for a med student and I won't be the one that tries to spray perfume on the piece of garbage that you are and (2) you will write more notes during the first 2 months of your intern year than you did during your entire 4 years of medical school, so just chill and learn.
This. I actually had mostly solid to great rotations. To be fair virtually all were with residents, and there were some people at my school that had terrible experiences.
The real problem isn't that all DO rotations are terrible, its that at even the same school you could have a wildly different rotation experience. This is true from the "top" DO schools to the bottom.
Yeah, you had a horrible rotation. I saw a ton of deliveries and C-sections on my OB rotation. Plenty of NOB/ROB visits, some pelvics, some gyn surgeries (not a lot, but some).
Again, never had a remotely similar experience on my rotations.
3rd years start at 2 and ramp up to 4 by the end if the first week. Depending on how busy the service was and how many students were on, I might have gone up to 6, but officially we didn't "need" to see more than 4. 4th years usually started at 4.
Yeah, as long as you are interviewing patients in an outpatient setting and you actually practice/study for the PE, you'll be fine. Its not that heavy on the actual knowledge. Its more about going through the motions.
It can literally happen anywhere. Med school (MD and DO) rotations are highly variable, and dependent upon your site, residents/attendings, the service, and even the time of year. At MD schools there is less variability because there's usually enough room for people to rotate through the same handful of sites. At DO schools its more variable because we often go to smaller (not necessarily small) and a greater number of different sites. On top of that, you have the preceptor rotations which are wildly variable from amazing to terrible.
I've heard a lot from MD students about what they've done on rotations before intern year. It varied widely from virtually unchecked autonomy and a sink or swim attitude to glorified shadowing and just overall coddling. It was also not consistent from service to service. That said, the individuals from the same schools had pretty consistent experiences across the board.
The variability within the same DO school is something that really needs to be fixed, because it always makes us more of a gamble for residency programs.
Yeah, I can tell you that plenty of the MDs I know didn't have your same experience.
Mine didn't officially, but they'd pay the hospital system in other ways.
This.
This is true.
I don't know, most people seem relatively unprepared for intern year. It wasn't just this lowly DO intern.
You could fix most deficits with a single ACGME rotation with residents. I used some selective and elective time to do that in 3rd and early 4th year, and it was fine.
Virtually all of my rotations were resident based ones, in a hospital with that type of training program. Not all DO schools have preceptor only rotations.
Clinical grades are definitely watered down. That said, the same thing is happening for students at the MD program where I'm in residency. I see some rotations with limited structure where you basically pick the nicest person to do your evals, and then I see other rotations where you basically have to walk on water to get Honors. Its unfortunate but subjective evaluations by residents and attendings really do dilute clinical grades.
It's hard to make blanket statements because it really does vary school to school, and doesn't necessarily follow the tiers. There are some low tier MD schools that have way better clinical rotations than midtiers.
As a matter of policy my school didn't allow you to see your MSPE. Basically, the only way to see it would be to have all the quotes taken out, and to turn it into a really generic sounding one. Most opted not to do that, and just hope for the best.
It might help some, but you'd be better off doing one in the same field you plan to do aways and auditions in. E.g. if you're going to apply EM, do an EM rotation at an ACGME program that you think will be low on your list or completely out of your league, so you don't lose much. Get some SLOEs and based on feedback and how many other SLOEs you get, then decide if you want to send that first one to residency programs.
Dude, literally everyone is unprepared for intern year. Everyone. There are just some parts of it that you are less unprepared for.
Don't do ICU post match 4th year... I mean unless you really want to. Intern year is going to kick your butt either way, so no point burning out before you even get there.
I've interviewed patients in an outpatient setting for 2 weeks out of the last 5 months of rotations. My site is really lacking. If PE were job shadowing I'd handle it well. I literally plan on OLDCARTS for every encounter of PE because that's all I know to go on. I haven't developed any natural flow. I've already got it in my head that I won't be passing PE on the first attempt. It's a horrible feeling. I did well in the first two years too and am passing/high passing rotations purely based on COMAT scores, but I can't get that idea out of my head.
It is what it is man. I'm just ready to get out of here in 5 more months. I really appreciate the resource tips. I'll look into these if I can find some of them.Get the COMLEX PE book by JBReview and watch the Kauffman videos associated with it. You'll be fine. OLDCARTS is fine. I used CODIERS-SMASH-FM myself. The whole exam is a checklist. If you can get your hands on a used copy of the First Aid for the CS with the clinical cases, that's also helpful because it lays out a lot of things you could say. I'm sure a PDF is floating around your school somewhere.
Sorry for your rotation experiences. Its ridiculous for you to have to deal with that.
After seeing the mixed bag, like what has already been said on sdn, I think applicants should Pick their school on rotation based merits and not just location. And like others said earlier people should be calling out their school on here so that applicants know what to avoid.
I’d agree, but it seems like it’s highly variable within every school and even between each school’s rotation sites. I could call out which rotations at my school have been awesome and which are crappy, but my classmates at a different hospital might have the opposite experience, and I think that’s probably the case everywhere.After seeing the mixed bag, like what has already been said on sdn, I think applicants should Pick their school on rotation based merits and not just location. And like others said earlier people should be calling out their school on here so that applicants know what to avoid.
I'm sure we could all argue about the value of note-writing throughout 3rd and 4th year, but I don't think I've ever said to myself: "dang, I sure wish I could write more notes." I had one rotation where my attending told me not to write notes because it was mostly busy work and I should be focused on seeing patients and learning management. His point was twofold: (1) if you've gotten to this point in your medical career and don't know how to write notes, you're a pitiful excuse for a med student and I won't be the one that tries to spray perfume on the piece of garbage that you are and (2) you will write more notes during the first 2 months of your intern year than you did during your entire 4 years of medical school, so just chill and learn.
MS-III here and I find that it's pretty evident most DO rotations aren't so great....
Attending physician here and that's a pretty good generalization, considering you couldn't have possibly seen "most" DO rotations that are available.
Mine were all great, because I made them that way. I even picked most of my own by myself. I wasn't willing to let my school make the choices for me. During 3rd year I delivered 9 babies by myself. Usually the attending was in the room but once he was next door as two were coming at the same time. In 4th year I performed a surgery from start to finish by myself. Yes, it was simple, but I made all the decisions and did all the work. I put in chest tubes, intubated patients, performed liposuction, sewed for hours on multiple cases. In 4th year I saw all the patients in one outpatient rotation for a couple days by myself. The attending was sick and she stayed in the back room on a cot in case of emergency and signed all the prescriptions... but again, I did all the work. I removed more suspicious moles and did more I&D's than I can remember. Closed every surgery in one rotation 4th year. Can't even remember how many codes I ran.
The funny thing is that some of my classmates claimed they had crappy rotations at the same hospital, with the same attending physicians. They never got to do anything. Why do you think that is?
Why do you think that is?
Because they're not as amazing as you are, obviously.
Let me just clarify for anybody who didn't already know that your whole post is a load of bull****. Most med students in the year of 2018 wouldn't get to do 99% of what you listed under any circumstances. Running a code? **** off.
Because they're not as amazing as you are, obviously.
Let me just clarify for anybody who didn't already know that your whole post is a load of bull****. Most med students in the year of 2018 wouldn't get to do 99% of what you listed under any circumstances. Running a code? **** off.
I am convinced it is a troll post.
He's not a troll. He used to post on here a lot when he was in school/residency. He's been out of school for some time though.
Most hospitals and docs don't let students work like that anymore. Even a decade ago things were different. A lot has changed in the last 10-20-30 years. Most attendings and hospitals won't let med students do the majority of the stuff he mentioned on their own anymore, with the exception of running a code until someone better showed up, that definitely happened at some of the sites I rotated at, but they were usually the smaller places with only an FM residency - almost anyone ran the code until someone better showed up.
Under supervision, I also did some intubating, knew someone else that put in a chest tube, multiple I&Ds, staple closed a few surgeries (didn't do a ton of suturing on my surgery rotations - but I sure did on EM), and definitely in some of my outpatient rotations I saw most of the patients myself, made a plan, 95%+ of the time the attending didn't change it, and just stepped in for a few minutes to chat with the patient.
To be completely honest, not too long ago (we're talking in the 90s) 3rd year med students used to do far more than that on their own. Its sad that his statements sound unbelievable, but its not surprising given the way things have changes.
Personally, I don't necessarily think these experiences are particularly essential as a med student, although they can be reassuring and make intern year a bit easier. I know plenty of MD students at my current institution that don't do the majority of them. When you come in as an intern, everyone assumes that you have very little experience, because there is such a range of experience at different med schools. Intern year, the learning curve is steep, and you really do have to be ready to do a lot of things you have no experience with. You watch a Youtube video, ask for help/supervision if its available, and then you do it.
Attending physician here and that's a pretty good generalization, considering you couldn't have possibly seen "most" DO rotations that are available.
Mine were all great, because I made them that way. I even picked most of my own by myself. I wasn't willing to let my school make the choices for me. During 3rd year I delivered 9 babies by myself. Usually the attending was in the room but once he was next door as two were coming at the same time. In 4th year I performed a surgery from start to finish by myself. Yes, it was simple, but I made all the decisions and did all the work. I put in chest tubes, intubated patients, performed liposuction, sewed for hours on multiple cases. In 4th year I saw all the patients in one outpatient rotation for a couple days by myself. The attending was sick and she stayed in the back room on a cot in case of emergency and signed all the prescriptions... but again, I did all the work. I removed more suspicious moles and did more I&D's than I can remember. Closed every surgery in one rotation 4th year. Can't even remember how many codes I ran.
The funny thing is that some of my classmates claimed they had crappy rotations at the same hospital, with the same attending physicians. They never got to do anything. Why do you think that is?
Absolutely full of ****
Things aren't different in the MD world. Some rotations are good and others are glorified shadowing...
I think what's most disturbing to me is how varied the experiences are.
I felt like my experiences were solid, and thought it was basically representative of what many people at my school experienced, until I met up with my friends from different sites at the end of 3rd year, and then again at the end of 4th. The truth is it varies a lot.
Pure facts. I've heard LECOM students who did practically zilch on their OB/GYN rotations except for holding retractors during surgery and maybe practice some fetal Dopplers. They barely knew how to write an OB progress note after 4 weeks and never had to take an overnight shift. Others were first assist on 20+ C-sections, closing episiotomies, etc.
This isn't not true, but it's unfair to specifically call out LECOM when the quality is all over the map at virtually all DO schools.
Someone drop some more knowledge on LMU-DCOM rotations.
Look at TouroNY Harlem they dont even have enough rotation spots for their current second year class. At least the other schools I seestudents post about in this thread have nough spots.
osteopathicmedstudent is actually a disgruntled 3rd year Medical student who posts the same thing every week.
Can someone from Harlem 2020 DO class confirm this? Otherwise this is just more fake news...
The quality is definitely all over the map. The DO schools aren't the problem it's the low quality sites they use because they admit far too many students. I've written 2 soap notes in my first rotation and haven't done anything since then. I'm now into my 8th rotation of the year. Scares the **** out of me for the PE exam coming. I've learned to let the disappointment pass me and just roll with it. Others at my school are having the complete opposite experience at other sites. These docs tell me that I'll be great though; I'm glad they can tell that by having me stand in a corner.This isn't not true, but it's unfair to specifically call out LECOM when the quality is all over the map at virtually all DO schools.
Peds is the one rotation that I wish DO sites did better with across the board. I have literally never heard of any DO student having an inpatient pediatric experience that wasn't pathetic, even at otherwise good rotation sites. I wasn't even interested in the field, but it bothers me because the DO world purportedly advocates for primary care and yet peds is so neglected.
My third year DO experience in all specialties was amazing, including peds. Inpatient and outpatient experience top notch, of the patients I followed, we diagnosed one with scurvy, another with kawasaki, another with bilateral wilms tumor...etc. One of the few redeeming qualities of my school were quality 3rd year rotations.
I am shocked reading some of the people's experiences with rotations. Rotation sites should be closed if students can't follow patients and write soaps/present.
Yeah. Cause our schools want us to enter FM or IM. Looking at our 3rd year rotations... I am pretty much screwed and STEP 1 will be my only saving grace (I hope and pray).
Assuming your rotations were actually "amazing" (keep in mind you may be living in the DO rotations bubble and don't know how real quality rotations are like), that doesn't change the fact that vast majority of DO rotations seem to be at trash hospitals with trash faculty, such as physicians who have never taught residents or fellows. Until that changes, the entire medical world is going to generalize and look at DO clinical training as absolutely trash.
At this point, FM in Alaska is even a reach. I've heard that they're only look at Harvard grads with 250+ Step scores.
Lol how? Alaska sounds more like the place you would scramble into rather than fight over.
Only @QueenJames and I understand this thing about FM in Alaska.
Lol how? Alaska sounds more like the place you would scramble into rather than fight over.
Yeah right. Neither of you two looosers are gonna Still (AT) my categorical spot. I gun you down like that polarbear up in the wilderness. Rural Alaska FM is my jam, I'll outgun anyone and cranial manipulate the rest!Only @QueenJames and I understand this thing about FM in Alaska.
They were amazing, thanks for the "reality check". We were lucky to join the major rotation site for an MD school and we plugged into their curriculum. Your last sentence is true for competitive specialties/top IM programs. That is partially overcome by excellent board scores and research. You will never wear down the DO tag by top programs, however.
That's awesome that you guys were able to do that. But I don't think the point of this thread is about the rare opportunity to join an MD program's rotation site... to be fair, the vast majority of DO rotation sites are complete trash. I don't think a major rotation hospital of an MD program really counts here. Do you guys still have that site?