A lot of DO rotations aren't so good...

[ortnakas]

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.

Aren't you still in the pre-clinical years? I'm not going to put AT Still on a pedestal and tell you all of my rotations have been incredible. But now that I'm almost done with fourth year and have compared experiences with MD students when we've rotated together, our rotations haven't been all that different. If you haven't gone through it yourself yet, it's a little insulting and more than a little presumptive to classify everywhere and everyone you'll work with as trash.

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[Chibucks15]

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?

my question is how do you know that every site everywhere is trash? You go on and on about things you have no direct experience with and expect people to take your advice like some sage. You're the same year as me and I'm 99.99% sure perusing the optho forums on here and talking to your research team doesn't constitute anywhere near statistically significant evidence to back up your blanket statements about how terrible the advice is on here. Provide that and I'll follow every word you say bud

 

[sab3156]

my question is how do you know that every site everywhere is trash?

You don't need much experience to realize that rotating through hospitals with zero residency training programs isn't exactly going to be an incredible experience.

 

[Chibucks15]

You don't need much experience to realize that rotating through hospitals with zero residency training programs isn't exactly going to be an incredible experience.

But from everyone's posting that has actually gone through it they've said for the vast majority of the time it isn't all that different...you've come at me for anecdotal statements and have yet to back up your own

 

[IsWhat]

Find yourself a few good inpatient medicine, inpatient Peds, and ICU rotations by the time you hit residency and you most likely won’t be behind anyone. Just don’t let yourself be that DO student who went through all of 3rd and 4th year without rounding in a teaching hospital. It’s not ideal, but if your 3rd year rotations are terrible then schedule rotations at academic centers during your 4th year. Many of the students at my program do this and it works out just fine.

 

[DO2015CA]

You don't need much experience to realize that rotating through hospitals with zero residency training programs isn't exactly going to be an incredible experience.

My biggest gripe is the lack of rotations with in house residency programs. Saying that, as a third year you are learning the basics and this can be learned at a preceptor based rotation. You aren’t some fully functioning resident that should have it all down. The problem is that you don’t learn how to function as a part of a medical team and so your first “audition” rotation you will be awkward while learning the ropes, but after that you are up to speed for auditions. Training at a place with a residency program doesn’t instantly make it a good learning experience. There needs to be engaged faculty and motivated students. There can be poor rotations and there most likely will be one of two but to automatically assume they are all crap is off base.

 

[IslandStyle808]

Find yourself a few good inpatient medicine, inpatient Peds, and ICU rotations by the time you hit residency and you most likely won’t be behind anyone. Just don’t let yourself be that DO student who went through all of 3rd and 4th year without rounding in a teaching hospital. It’s not ideal, but if your 3rd year rotations are terrible then schedule rotations at academic centers during your 4th year. Many of the students at my program do this and it works out just fine.

Did they do rotations that were not in their field of interest during 4th year, so they can get used to the academic hospital setting? Or did they jump right into the field they wanted to go into?

 

[IsWhat]

Did they do rotations that were not in their field of interest during 4th year, so they can get used to the academic hospital setting? Or did they jump right into the field they wanted to go into?

The people I have talked to were able to have a little bit of both, but it makes for a much harder year. Being forced to do in 4th year what should have been done in 3rd year is an unfortunate reality for many DO students.

 

[sab3156]

My biggest gripe is the lack of rotations with in house residency programs.

That's a major issue that PDs seem to be aware of, and for example, from what I have been told it makes it difficult for them to take DO rotation letters at face value (even according to some PDs on this site).

 

[DO2015CA]

That's a major issue that PDs seem to be aware of, and for example, from what I have been told it makes it difficult for them to take DO rotation letters at face value (even according to some PDs on this site).

That’s why you don’t use 3rd year letters. Yes it puts more stress on audition rotations because not only do you need to impress them but also get a good letter to send to other programs. You do an audition rotation at a university ACGME program then get a letter. Other programs will hold that letter with weight because it will be a residency program. Solved the problem you posed.

 

[NontradCA]

My biggest gripe is the lack of rotations with in house residency programs. Saying that, as a third year you are learning the basics and this can be learned at a preceptor based rotation. You aren’t some fully functioning resident that should have it all down. The problem is that you don’t learn how to function as a part of a medical team and so your first “audition” rotation you will be awkward while learning the ropes, but after that you are up to speed for auditions. Training at a place with a residency program doesn’t instantly make it a good learning experience. There needs to be engaged faculty and motivated students. There can be poor rotations and there most likely will be one of two but to automatically assume they are all crap is off base.

From my experience doing rotations at “DO hospitals” with residencies I’d say the quality of education between attending only rotations and DO residents is huge. I think this is largely due to the fact that many DO residencies have little in the way of actual teaching, and the residencies are busy doing. I would much rather be with an attending than at these sites.

Couple this with the fact that many of these programs are malignant. And this is from one of the supposedly better DO places to do residency. It’s no wonder that half of their programs are being shut down by the merger. I don’t mean to offend anyone, only to offer an opinion.

 

[sab3156]

That’s why you don’t use 3rd year letters. Yes it puts more stress on audition rotations because not only do you need to impress them but also get a good letter to send to other programs. You do an audition rotation at a university ACGME program then get a letter. Other programs will hold that letter with weight because it will be a residency program. Solved the problem you posed.

Of course... but the fact that obstacles exist is far from ideal. Issues like these are the entire point of this thread. Saying "go get letters at an ACGME program" is hardly addressing the problem.

 

[NontradCA]

Of course... but the fact that obstacles exist is far from ideal.

It is unfortunate, which is why students should also try to find mentors at academic centers during 1st and 2nd year as well.

 

[DO2015CA]

Of course... but the fact that obstacles exist is far from ideal. Issues like these are the entire point of this thread. Saying "go get letters at an ACGME program" is hardly addressing the problem.

No. That is using one argument to offer it as proof for another. DO students can’t help that an ACGME programs don’t value their preceptors opinion, but that doesn’t discount the DO students experience. Sure it’s not ideal, nothing about DO is, but a residency program not being receptive of your preceptor’s letter doesn’t negate the skills you will have learned. An audition is to show the skills and knowledge you have. Guess where you learned that?

 

[ortnakas]

You don't need much experience to realize that rotating through hospitals with zero residency training programs isn't exactly going to be an incredible experience.

My issue is that you don't seem to understand that there's a LOT of gray area between "an incredible experience" and "complete trash."

I've met with MD students who have rotated at Big Name Academic Hospitals who didn't get to see or do much because they were so far down in the pecking order... being in the general vicinity of Big Name Attendings doesn't actually guarantee you access to them.
I've met with DO students who rotated without residents and never got the full rounding experience on the floors or who never saw surgeries more exciting than a lap chole.

But the vast majority of students I've met have had experiences that fall somewhere in the middle. I'm not going to argue that we have an absolutely equivalent experience to MD students because that's not the case. But it's equally not true that our educations are all trash because we're not at Best Medical School rotating at House of God.

 

[IslandStyle808]

It is unfortunate, which is why students should also try to find mentors at academic centers during 1st and 2nd year as well.

Tried and failed. Which is also unfortunate.

 

[IslandStyle808]

The people I have talked to were able to have a little bit of both, but it makes for a much harder year. Being forced to do in 4th year what should have been done in 3rd year is an unfortunate reality for many DO students.

Yeah, I've prepare myself for this scenario before medical school. I will probably have to do a rotation in a field I'm not going into first. Otherwise, it will affect how I do in the fields I want (yes, fourth year grades are given for interviews at my school).

 

[sab3156]

My issue is that you don't seem to understand that there's a LOT of gray area between "an incredible experience" and "complete trash."

Sure, I agree there is gray area. But I don't think hospitals with zero residency programs have any business teaching 3rd year rotating students. Many DO rotation sites lack residency programs and any experience with formal medical training. Not being able to see any residents work and having to basically be stuck with a single preceptor for your rotation isn't exactly a great experience. Sure, you might do some cool stuff (maybe - since this is varied), but that doesn't mean you're getting a great education. You just won't have any structure or system for formal instruction so that you learn things from ground up.

And I know people keep saying "I got to do a lot of cool stuff on my rotation", but delivering a million babies is not a standard measure of clinical education. No ACGME PD is going to say "WOW you delivered X number of babies in 4 weeks and saw Y number of patients on your own? DO rotation sites sound awesome, you sound like you'd make a really reliable addition to our residency program." They are going to want to know if you will be able to hit the ground running. The fact that DOs basically HAVE to go to an ACGME program to see how a resident is supposed to work is just silly, and hence my usage of the terminology "trash" for describing rotation sites that don't have residency programs.

Hey, I might be completely wrong, but we can tag some PDs in here and see if they can offer some insight on this issue.

It is unfortunate, which is why students should also try to find mentors at academic centers during 1st and 2nd year as well.

10000% agree with you on this.

But from everyone's posting that has actually gone through it they've said for the vast majority of the time it isn't all that different...you've come at me for anecdotal statements and have yet to back up your own

Well, people are also here saying that you actually have to go out of your way to get some real training so that you aren't behind during residency. Not sure why you are so selective in your reading of this thread.

An audition is to show the skills and knowledge you have. Guess where you learned that?

Right, because 3rd year training at DO sites with no residency training programs is going to put you in a great position to impress the faculty who are responsible for formal didactics and training of residents and resident selection at ACGME academic centers. Seems legit.

 

[DO2015CA]

Sure, I agree there is gray area. But I don't think hospitals with zero residency programs should have any business teaching 3rd year rotating students. Many DO rotation sites lack residency programs and any experience with formal medical training. Not being able to see any residents work and having to basically be stuck with a single preceptor for your rotation isn't exactly a great experience. Sure, you might do some cool stuff (maybe - since this is varied), but that doesn't mean you're getting a great education. You just won't have any structure or system for formal instruction so that you learn things from ground up.

And I know people keep saying "I got to do a lot of cool stuff on my rotation", but delivering a million babies is not a standard measure of clinical education. No ACGME PD is going to say "WOW you delivered X number of babies in 4 weeks and saw Y number of patients on your own? DO rotation sites sound awesome, you sound like you'd make a really reliable addition to our residency program." They are going to want to know if you will be able to hit the ground running. The fact that DOs basically HAVE to go to an ACGME program to see how a resident is supposed to work is just silly, and hence my usage of the terminology "trash" for describing rotation sites that don't have residency programs.

Hey, I might be completely wrong, but we can tag some PDs in here and see if they can offer some insight on this issue.



10000% agree with you on this.



Well, people are also here saying that you actually have to go out of your way to get some real training so that you aren't behind during residency. Not sure why you are so selective in your reading of this thread.



Right, because 3rd year training at DO sites with no residency training programs is going to put you in a great position to impress the faculty who are responsible for formal didactics and training of residents and resident selection at ACGME academic centers. Seems legit.

Lol. I’m done listening to your ignorance. You are believing anecdotal evidence that fits your narrative from a site where people go to unload their frustrations. Some of their frustrations valid, but some very overblown. It’s boardering delusions where no counter evidence can sway your position. There has been multiple students that have given you their first hand experience and you choose to ignore it. It’s the same anecdotal evidence but against your narrative so it couldn’t possibly be true. So be it. Be jaded. It won’t change the position you are in or will be in for the next four years.

 

[sab3156]

Lol. I’m done listening to your ignorance. You are believing anecdotal evidence that fits your narrative from a site where people go to unload their frustrations. Some of their frustrations valid, but some very overblown. It’s boardering delusions where no counter evidence can sway your position. There has been multiple students that have given you their first hand experience and you choose to ignore it. It’s the same anecdotal evidence but against your narrative so it couldn’t possibly be true. So be it. Be jaded. It won’t change the position you are in or will be in for the next four years.

No one is talking about anecdotes... try and relax.

 

[IslandStyle808]

No one is talking about anecdotes... try and relax.

The big question is what are you going to do if it happens to you?

 

[sab3156]

The big question is what are you going to do if it happens to you?

You mean if I get stuck in a trash rotation site (which is inevitable)? I will just have to do what everyone does - suck it up and immediately hit the ACGME academic centers as soon as 4th year starts for real education.

 

[FistLength]

You mean if I get stuck in a trash rotation site (which is inevitable)? I will just have to do what everyone does - suck it up and immediately hit the ACGME academic centers as soon as 4th year starts for real education.

your school doesn't do rotations at hospitals with residency programs?

 

[sab3156]

your school doesn't do rotations at hospitals with residency programs?

Some are (AOA residencies), but most aren't.

 

[AnatomyGrey12]

Sure, I agree there is gray area. But I don't think hospitals with zero residency programs have any business teaching 3rd year rotating students.

You realize that with the growth in MD schools that not every MD student rotates at a major academic center with residents right? Some schools, like the new WSU, openly state on their website that their rotations are largely preceptor based at community hospitals. Let’s not pretend that every MD student rotates at Man’s Greatest Hospital.

Some are (AOA residencies), but most aren't.

So you mean they are all ACGME... because by the time we get to rotations they will essentially either be ACGME or non-existent.

I’ll remember that my rotations will be trash as I rotate through a teaching hospital with multiple ACGME residency programs.

 

[Chibucks15]

Sure, I agree there is gray area. But I don't think hospitals with zero residency programs have any business teaching 3rd year rotating students. Many DO rotation sites lack residency programs and any experience with formal medical training. Not being able to see any residents work and having to basically be stuck with a single preceptor for your rotation isn't exactly a great experience. Sure, you might do some cool stuff (maybe - since this is varied), but that doesn't mean you're getting a great education. You just won't have any structure or system for formal instruction so that you learn things from ground up.

And I know people keep saying "I got to do a lot of cool stuff on my rotation", but delivering a million babies is not a standard measure of clinical education. No ACGME PD is going to say "WOW you delivered X number of babies in 4 weeks and saw Y number of patients on your own? DO rotation sites sound awesome, you sound like you'd make a really reliable addition to our residency program." They are going to want to know if you will be able to hit the ground running. The fact that DOs basically HAVE to go to an ACGME program to see how a resident is supposed to work is just silly, and hence my usage of the terminology "trash" for describing rotation sites that don't have residency programs.

Hey, I might be completely wrong, but we can tag some PDs in here and see if they can offer some insight on this issue.



10000% agree with you on this.



Well, people are also here saying that you actually have to go out of your way to get some real training so that you aren't behind during residency. Not sure why you are so selective in your reading of this thread.



Right, because 3rd year training at DO sites with no residency training programs is going to put you in a great position to impress the faculty who are responsible for formal didactics and training of residents and resident selection at ACGME academic centers. Seems legit.

No I really don't think I'm selectively reading. Where have you gotten this information? How many PDs have you personally talked to, in addition to sample students from each school to decide if all their rotations are "complete trash"? There is zero chance you've found enough data points to support your argument, as most on here have pointed out. Yet you continue to come after my reading comprehension...hmm...

EDIT: I, along with most on here, have never gone out of our way to say its the greatest clinical experiences you can ever have, but I still see DOs being trained pretty well and in a variety of scenarios so it can't be THAT bad...

 

[FistLength]

No I really don't think I'm selectively reading. Where have you gotten this information? How many PDs have you personally talked to, in addition to sample students from each school to decide if all their rotations are "complete trash"? There is zero chance you've found enough data points to support your argument, as most on here have pointed out. Yet you continue to come after my reading comprehension...hmm...

EDIT: I, along with most on here, have never gone out of our way to say its the greatest clinical experiences you can ever have, but I still see DOs being trained pretty well and in a variety of scenarios so it can't be THAT bad...

To echo what he is saying, I spoke to a PD (although it is a very competitive ACGME residency), he was candid about 3rd year DO grades because of where they train. When I mentioned where I will be doing my 3rd year (large hospital that is the rotation site of MD school) he raised his eyebrows and said "oh ok good." N=1 but the idea holds for competitive specialties, certain PD's.

 

[sab3156]

To echo what he is saying, I spoke to a PD (although it is a very competitive ACGME residency), he was candid about 3rd year DO grades because of where they train.

Yep, heard it from numerous faculty and a couple of PDs myself. Never heard anyone say "DO clinical training is reliable, so I will assume the DO applicant to my program has great training." Quite the opposite.

 

[Shinken]

These threads always remind me of the superior clinical education we get at OU-HCOM.

To make blanket statements that all DO clinical education is trash, is actually a trash comment. But then again, this is SDN, so what do we expect? Not reasonable, mature comments based on real life, that's for sure.

OK, I'm done, I'm back to work with my trash education (funny my employer and colleagues don't think so...guess they don't know about SDN). Carry on.

 

[sab3156]

To make blanket statements that all DO clinical education is trash, is actually a trash comment.

OK, I'm done, I'm back to work with my trash education (funny my employer and colleagues don't think so...guess they don't know about SDN). Carry on.

I think reading skills would be beneficial here. We are mainly talking about rotation sites with zero residency programs who don't have any experience in real medical education.

Also, seems like you're in FM. A lot of other more competitive specialties will look down on DO clinical training and think it is subpar for various reasons. Maybe you didn't experience it, but it is quite common for PDs in competitive specialties to question the quality of your education, including your clinical education at sites with no residencies.

 

[Chibucks15]

I think reading skills would be beneficial here. We are mainly talking about rotation sites with zero residency programs who don't have any experience in real medical education.

Also, seems like you're in FM. A lot of other more competitive specialties will look down on DO clinical training and think it is subpar for various reasons. Maybe you didn't experience it, but it is quite common for PDs in competitive specialties to question the quality of your education, including your clinical education at sites with no residencies.

What is your obsession with reading comprehension when you aren't showing any yourself?...no one has said that there aren't competitive residencies that look down upon DOs. That's a stated fact. Obviously the top-tier residencies look down upon everyone because they can. That's the luxury of being the best of the best. No one has said every clinical site is perfect...its that way with MDs too (albeit to a lesser extent due to affiliated hospitals). It's much more about whos teaching you. Obviously clinical education is more an issue for newer schools but to say that all DO education is trash (while being one yourself) is disingenuous and in no way helpful to the people who may just cruise these forums. There are plenty of pretty damn good physicians that come out of this "garbage" education and maybe when you're in a hospital setting you'll realize nobody cares at all where you went, as long as you're competent. Nice dig at the lowly FM attending by the way...really good look for you

 

[sab3156]

Jeez. The sensitivity is off the charts. My post was addressed specifically to one person. He said no one thinks anything negative of his DO clinical training. Best to put the specialty in perspective, because we were talking earlier about what PDs have said to people in competitive specialties.

 

[Chibucks15]

Jeez. The sensitivity is off the charts. My post was addressed specifically to one person. He said no one thinks anything negative of his DO clinical training. Best to put the specialty in perspective, because we were talking earlier about what PDs have said to people in competitive specialties.

It isn't sensitivity...your statements are talking about the entire clinical education. You never once quantify it with a "for competitive specialties", until someone questions you which causes you to respond with that optho research you did and the random people on the other forums you talked to (which doesn't mean jack). Everyone already knows the top of the top specialties are much harder to get into, especially as a DO. You just repeatedly bash DO education vaguely as a whole. I'm obviously not the only one who thinks it, I'm just the one that calls you out on it.

 

[DrMcCoyDO]

You don't need much experience to realize that rotating through hospitals with zero residency training programs isn't exactly going to be an incredible experience.

I’m just going to put this out there; obviously n=1. Fourth year about to graduate here, and I’ve been about 50/50 for rotations with a residency vs without, and about 2/3 of those rotations were with a major academic center. I’ve had a couple crap rotations, but for the most part, even rotations I wasn’t a fan of were good learning opportunities, both residency and preceptor based. On preceptor based ones, I got a better chance to hone my understanding of common pathologies (with a few off the wall ones); in residency based ones, I was able to learn how to better work as part of a team. Both types gave me good opportunities to learn how to present and do a thorough H&P; honestly, some of the preceptor based rotations forced me to learn without the safety net of my residents.

Again, I’m obviously just one person, but I did not put massive amounts of effort into getting these rotations aside from taking the time to research the sites before I requested them, and my experience has been overall a good one in my clinical years.

Seriously, dude, you are a first year; you really shouldn’t be this cynical yet.

 

[sab3156]

It isn't sensitivity...your statements are talking about the entire clinical education. You never once quantify it with a "for competitive specialties", until someone questions you which causes you to respond with that optho research you did and the random people on the other forums you talked to (which doesn't mean jack). Everyone already knows the top of the top specialties are much harder to get into, especially as a DO. You just repeatedly bash DO education vaguely as a whole. I'm obviously not the only one who thinks it, I'm just the one that calls you out on it.

Go read the post I was replying to. We were talking in the context of competitive specialties. And no one is making purely generalized statements. I said "most" for a lot of what I posted.

Even so, I mean, just go talk to ACGME PDs and see why so many have trouble taking DO rotation sites too seriously.

 

[Chibucks15]

Go read the post I was replying to. We were talking in the context of competitive specialties. And no one is making purely generalized statements. I said "most" for a lot of what I posted.

Even so, I mean, just go talk to ACGME PDs and see why so many have trouble taking DO rotation sites too seriously.

I mean I'll just go ahead and bust my butt working with the situation I chose to be in rather than complaining about how bad it is on an online forum, as a pre-clinical student telling upperclassmen how bad their education is. But that's just me

 

[sab3156]

I mean I'll just go ahead and bust my butt working with the situation I chose to be in rather than complaining about how bad it is on an online forum, as a pre-clinical student telling upperclassmen how bad their education is. But that's just me

If you want to ignore it, that's fine. But it doesn't mean no one else can talk about it. This thread is about these issues, and if you don't like it, don't post here. Just a thought.

 

[FistLength]

As one of our esteemed members, @aProgDirector has recently said regarding advice if a DO student should do aways

I'm going to disagree. I get lots of apps from DO's. The one's that have an LOR from an MD school, especially a subI, telling me that the student did just as well as the MD students, is gold in my book. One of the problems with DO schools is the variation in quality of rotations. It's often very difficult for me to determine what your medicine experiences were like.
So:
1. Doing an away rotation at a program that doesn't take DO's is not going to get you a spot there.
2. Doing an away rotation early enough such that you get an LOR might open doors at some residency programs.
3. Many DO's can match into allo programs without it, so it's more of an app booster than a requirement.
4. This all assumes you do well -- although if you run into trouble, probably better to know that, improve your skills, and be prepared for internship.



Take from that what you will.
The point is that we should proactively seek out bigger hospital systems to rotate at to cover our bases, even if we get great education from our rotations.

 

[NontradCA]

These threads always remind me of the superior clinical education we get at OU-HCOM.

 

[NontradCA]

Oh the superiority of driving an hour each way, through cornfields, to see an attending who’s there just to make more money, practice medicine.