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any DO schools with rotations primarily at university hospitals?

Discussion in 'Pre-Medical - DO' started by rkaz, Jan 3, 2009.

  1. rkaz

    10+ Year Member

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    Hi all,
    I was wondering if there are any DO schools with rotations primarily at university-based teaching hospitals? I know many schools may have the option of a few rotations at university-based hospitals, but most of the rotations seem to be at community-based hospitals. I understand the reason for this, since osteopathic medicine has a greater focus on primary care, which I am assuming would be the focus at community hospitals while specialty medicine would be more likely to be found at university hospitals (this I assume). However, in general, I've heard that the quality of teaching at university hospitals seems to be better (yes, I know there are notable exceptions like Mayo or Cleveland Clinic, but these are only a few).

    Thus, I was wondering if any of the DO programs has nearly ALL rotations (or at least students can have the option of rotating at all) university teaching hospital sites.

    I realize there are lots of assumptions in my post here, but I am writing from my limited knowledge. I assumed all teaching-hospitals are university based, though I don't know if this is necessarily the case. Since this is on the topic of 3rd/4th year rotations, maybe this post would be better in the 'osteopathic' section, but I figured there is more traffic here in pre-osteo.

    Any information is appreciated. Thanks!
     
  2. rkaz

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    anyone? Do none of the DO schools have their own teaching hospital?
     
  3. Chocolate Bear

    Chocolate Bear Moderizzle Fo'Shizzle!
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    Hospitals that are affiliated/attached are hard to find. You'll have more luck with this at the few public DO schools, as they had more backing/infrastructure.

    However, just b/c it's not attached/affiliated doesn't mean that your clinical education will necessarily be of diminished quality or significantly more inconvenient (drive time, etc.).

    This is an often-asked question, but it's hard to answer. Clinical affiliations are changing each year, especially at the newer schools. I recommend looking through this thread for some details on individual schools. Sorry I can't be of more help.
     
  4. dozitgetchahi

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    OSU-COM still has its own teaching hospital, although it's in the midst of some financial trouble. UMDNJ-SOM is very closely associated with a modest hosptial (they essentially share a campus), but I've been told that not very many students rotate there.

    On the other hand, CCOM and PCOM are known for giving their students the opportunity to rotate at the many of the superb teaching hospitals located in Chicago and Philadelphia (respectively). This may be closer to what you had in mind.
     
  5. cliquesh

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    Also, just so you know, most MD schools pimp you out to local community hospitals for certain rotations. Like Abington Memorial Hospital in Philly hosts PCOM, U Penn, and Jefferson students for general sugery.
     
  6. CoachPutMeIn

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    Doesn't LMU do a hefty amount at Tennessee?
     
  7. prefontaine

    prefontaine Senior Member
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    As a student, you will likely get to do much more at a community hospital than at a larger academic center. At the latter, you will be far down the pecking order and will spend much of your time observing.

    I probably did more as an MS 3 and 4 at the smaller hospitals than during my time as a resident.

    Your motivation and interest as a student will partially play a role, but if there are fellows and residents wanting to practice procedures, your exposure may be limited to observation.
     
  8. MossPoh

    MossPoh Textures intrigue me
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  9. predodoc

    predodoc Junior Member
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    Here is my experience as a 4th year at one of the newer (branch) schools. After going through it Ive realized there are 3 different kinds of hospitals(most with a little overlap).

    1. The community hospital with little to no teaching.- This means they usually have no residency programs in place and if a medical student rotates through, they are usually paired up with an attending (doc that works at the hospital). Usually what you can do depends on what the physician will let you do. This can be alottt and a very good experience. Or this can be just a shadowing experience. Ive found that they are usually more on the shaddowing side but really depends on the doc and the hospital. There are good things about doing this: call is usually lighter than you would have at teaching hospitals and many times they dont make you do it. Hours are usually what the doc wants you to do, which are usually what he/she works( more 8-5 jobs). Also, you can get some really great direct teaching as you see patients during the day.

    2. Community hospital with teaching- Teaching, usually means they have residents based at the hospital. This usually also means they have students rotate with the residency programs. Most community hospitials dont have thier "own" medical school and will have "affiliations" with schools. There can be more than one school that rotates through. One hospital I had a few rotations with had us and also had students from a nearby state MD school. These residency program sizes vary alot. Some hospitals only have Family medicine with about 30 residents. Others will have 15 specialties each with tons of residents and with some subspecialty fellowships. I think the education is usually good at these places because you work with the residents and get the feel. Also, these residents usually get to do a little more since many of these hospitals dont have subspecialty fellowships. This means that if you are rotating with internal medicne and there is no Cardiology sub- specialty fellowships, you are more likly to take care of cardiac cases than you would at places with fellows. As a medical student I dont think there is much less of an advantage going to a community hospital over a university one. Besides maybe the face time you would get with the university hospital if you wanted to do residency there.

    3 University hospitals- Have a medical school "belonging" to itself. Their own students are usually the only students rotating through (except for away elective rotations from other schools-usually done in 4th year to check out the program). Good teaching, with many specialties and subspecialties and more focus on research.


    Why is having a university hospital good? Because you can do many of your rotations at the hospital and get to know the system. You can make connections with big name people and get a leg up on the specialty you want. Also, you will probably be considered higher for a residency spot a the hospital if you want to go there.
    But just because you get into a med school with a university hospital doesnt mean you have all rotations there, and you may have many of your rotations in the teaching community programs.

    Most D.O. schools dont have a University hospital, although Im sure some do. Many DO schools have the communty affiliation hospitals, which can be a strong affiliation where many of the students rotate through and can be very good hospitals. Or can be loose affiliations where only like 1-2 students rotate through each rotation. These loose affiliations can also easily be lost if there is a disagreement with money or whatever and has happend several times in my schools short history.

    Big questions to ask schools is if the rotations are affiliatied with hospitals with residency programs and about what percentage of the rotations you will do can be done at a afiliated hospital with residency programs.
     
  10. rajaholick

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    MSUCOM has strong ties with the Detroit Medical Centers hospitals (a network of 6 different metro detroit hospitals, also used by wayne state university) as well as Henry Ford health systems.
    MSUCOM's new expansion in Detroit is built on the Detroit medical Center campus.
     
  11. EMT2ER-DOC

    EMT2ER-DOC Why so Serious?????
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    UMDNJ-SOM has its own affiliate hospital, the Kennedy Health System. The system is made up of 3 sites (Stratford, Cherry Hill, and Washington Township). In addition, we rotate through Our Lady of Lourdes in Camden.

    If you would prefer to do the North Jersey Tract, you can do it at Christ Hospital in Jersey City.

    98% of our students rotate through these hospitals. You have no choice where to rotate during your 3rd year. If you would like to go out of system for 4th year, you can. In addition, we have our own Doctor Group known as the University Doctors which are located on Campus. You will be rotating through them as well.
     
  12. Deepa100

    Deepa100 Junior Member
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    EMT2ER-DOC,
    Thanks for taking time to answer Q's.
    Are these sites within an hour of driving distance from the school?
     
  13. rkaz

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    Hi all, thank you so much for all the helpful replies!

    Predodoc, I think you have addressed the heart of my concerns. That was exact what I was trying to figure out. My issue is that my current top choice DO school has issues with 3rd/4th year students getting rotations at teaching hospitals. One of the main concerns of students in their clinical years is doing preceptor-based rotations at non-teaching hospitals, which results in varied quality of experiences. That's why I wanted to know if other schools have options for their students to attend rotations either completely through a combination of community teaching hospital or university hospital... as I wanted to avoid those community based NON-teaching hospitals (unless I happened to know that the preceptor/rotation was of excellent quality).

    From what I've gotten out of this thread is that it seems one of the most hands-on experience can be gained in the primary care areas in community based teaching hospitals, while the specialty rotations will naturally be done at affiliated university hospitals. I am glad to hear this perspective as I didn't realize primary care rotations at community hospitals could be more hands on than at university hospitals (though I don't want to completely generalize). Now I am just trying to find out which schools would allow me to rotate all through affiliated hospitals, so that I hope I can get the best education possible.

    I will ensure to ask this question. This is what really matters to me. Thanks!
     
  14. EMT2ER-DOC

    EMT2ER-DOC Why so Serious?????
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    20 minutes
     
  15. predodoc

    predodoc Junior Member
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    And just like the previous post, ask about distances. My school can place about 60-70% of their students in hospitals with residency programs if they wanted but most would be located far from campus (1-7 hours). These rotations are usually covered for housing by the school but just having to live somewhere else sucks, esp if you have a sig. other.

    b/c students select their own rotations from a list at my school and most students want to stay near the school, we end up fighting over local preceptors who work in community non-teaching hospitals or not in hospitals at all. So distance is another important question.

    You know... most premeds go on interviews and look at the campus, the class room, see the library meet some professors and go home. This is only 1/2 of medical school. And from my experience by talking to students at other DO and MD schools is that the education is pretty standard at all these places and how well you do largly depends on YOU! For my first 2 years we used 90% of the same books that the state MD school did. Did our lectures in almost the same order, Had a primary care class, Cadavers, models, suture labs ect, ect,ect. The only thing we had that they didnt was OMM. And how well you did depended on you. I did better then all my friends on USMLE 1 that went to the state MD school mostly because I had a chip on my shoulder and worked hard.
    Now, 3rd and 4th year rotations are a different story and this is were I believe most students should make their focus of the decision. Although more difficult, doing rotations with residency programs is usually better for your preparation for residency than doing rotations with a preceptor physician. Since residency is you next step, you should focus on this. Plus, its usually better to get letters of rec from Program directors of residency programs than private docs who have been out of residency for 15 yrs. When interviews for residency come around your 4th year, it helps alot to have Program director letters. And most program directors know eachother, even the ones from community hospitals, so having a university hospital letter over a community hospital letter doesnt really matter.

    So, you are probably thinking, how did your students manage to get good letters and experience if most of your rotations were at non- teaching hospitals?? Because we have 5 electives our 4th year and 3-4 of them are early in 4th year. We are strongly recommended to sign up for away electives at residency programs we would like to go to and work our butts off to impress, and try to get at least 1 letter in the specialty you want. Lots of schools do this, even schools with university hospitals, but they make doing away rotations more of an option than a strong recommendation.

    Anyway, Im just trying to spread some light on how everything works. The stuff I didnt know or think about when applying to school 4 yrs ago.
     
  16. scpod

    Physician Moderator Emeritus 10+ Year Member

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    Another take on the situation....

    The three "types" of hospitals that the other user mentioned are just about right...except, not all community hospitals are the same. The one where I spend most of my time is very, very used to having students (medical students, PA, Nursing, Nurse Midwife, NP, etc.) and they do a great job. In IM I rounded on all of my attendings patients, but I also carried some of my own. I did the H&P, admitted them, wrote the orders, and discharged them. It was just like a sub-I. I was given assignments every night and learned a lot. I did awesome on the Medicine shelf. OTOH, while I was doing an EM rotation at an 800+ bed level one trauma center with 13 different residencies, I shared a house with a couple of students doing IM. They complained constantly about the amount of time spent in lectures, rather than patient care, and they saw the attending maybe once a day during rounds. The best way to learn this stuff, IMHO, is by doing it-- not by being lectured to. On OB/Gyn rotations I delievered babies myself, sewed up the episiotomies, and first-assisted in C-sections and Gyn surgeries. You're not likely to do that if you have a resident. In surgery, I first-assisted and closed tons of patients. Again, not likely to do that with a resident around. At my little community hospital I eat breakfast and lunch with the attendings and I've been invited to their houses and to the beach during off hours. Who you know has a big say come residency time. A bunch of the attendings I mingle with were chief residents when they trained and still pull some weight. Getting good LOR's is not a problem there. That said, it will not be the same way at every community hospital. That's why it's so important to talk to your upperclassmen first when you are thinking about rotations.

    Those hospitals with a single residency, often family practice, are not too bad either sometimes. They very often love to have students and love to get them involved because they want to have students apply for their residency. You'll very often get free room and board as well. You may be paired with a resident who is rotating through the same service, though, so you might not get as much "hands-on" experience. If you are in OB/Gyn, for instance, the resident is likely to do deliveries while you watch. But you still might get to be involved. You'll probably have a noon conference or something didactic at least once a day. I actually learned a few things from some of them.

    Even within those big university teaching hospitals you can get varying experiences. It all depends on the intern or resident you are teamed up with. Unless you are doing a sub-I you are the bottom man (or woman) on the totem pole. The place where I recently rotated for EM had different exeriences on different services. The IM and Surgery guys spent a lot of time watching. They also had to present little topics at lunch and sit through lectures. EM, though, was great because you worked with an attending. Most of them just said, "Grab some charts and go see some patients. Find me when you're finished." I got to do lots of hands-on stuff.

    The besy part about those big hospitals, though, is that you'll never have patients who don't want a student in the room. It isn't their choice. When they consent to be treated there, they also consent to have students take care of them, and you'll never have a problem writing in the chart there. If you really want to sit through the lectures and stuff it's available. I do better studying on my own. I don't need to hear someone tell me how to manage diabetes again every month. And, I certainly don't need to hear my clasmates present a topic that they read up on for an hour the night before. Big hospitals like that, though, do attend to attract some top-notch people. You may have an opportunity to rotate with some of the well-known experts in the field or at least listen to them speak. It can be really good from the aspect that you get to meet a lot of residents and they can be valuable sources sometimes. You can learn a lot from them about the different programs that they applied to.

    I guess my opinion is that a good mix of these types of hospitals can be good for you. If you stay at one place the whole time, you learn the way that they do things, but it's far from universal. Plus, most people don't end up working at a big university teaching hospital for he rest of their lives. A little exposure to other resources is probably beneficial. Use your upperclassmen as a guide in your choices because every situation is different. Your educaton is what you make it out to be.
     
  17. dannyboy1

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    NYCOM has many big hospitals as affiliates like LIJ, brookdale university hospital, st barnabas ect.
     
  18. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
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    In answer to the OP's post from the residency forum:

    First off, it's great that you're thinking about these things now, because most premeds don't. In all honesty, some of the questions I'd want to have answers for are probably things you shouldn't even ask students, let alone administration or interviewers, so use your discretion. :p

    But here are some things that I think are important to think about even if you don't actually ask these questions:

    1) Ideally, you will have opportunities to rotate and/or do electives in many specialties. A lot of people come to med school planning to go into one field, and then end up doing something completely different. So if you come in planning to be an OB/gyn and then decide you want to learn more about ENT based on one surgery you scrubbed for during your surgery rotation, it's going to be tough if your school doesn't offer an ENT rotation. You can still do an away, or maybe talk the administration into setting up an elective for you. But it's a lot easier if the school offers lots of options. They call med school an "undergrad" education for a reason.

    2) If you get the chance to meet any MS3/4s, I would definitely ask them how the clinical training works. How much do they get to do? How many hospitals can they rotate at for required rotations? What are the different hospitals like? How willing are the attendings and residents overall to teach med students? Do evals (which are mostly subjective) form the basis of their rotation grade, or do shelf exams (which are more objective but tend to favor students who are good test-takers) matter most? Clinical grades are much more important to residency PDs than preclinical grades, so you really want to know how you'll be graded during third year.

    3) What resources are in place to help students with residency placement? Is there good advising in terms of determining your competitiveness for your chosen specialty and how to go about picking a specialty? How many students does each advisor have? Do the advisors really get to know their students? Will they help you figure out what you need to do to be competitive for the specialty (ex. research, high Step 1 score) that you want? Will someone be willing to make a few phone calls on your behalf if you aren't getting enough interviews?

    4) How accessible is the administration to student concerns? This is important for all four years, really, but especially in the clinical years. If you have a problem with one of your rotations, will your feedback be taken seriously? Do students get to give any input into the clinical curriculum? (The answer will probably be no at many schools, but it's good to know that up front.)

    Hope this is helpful. Best of luck w/ your interviews. :)
     
  19. boggvir

    boggvir Sunny California
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    This is awesome information, thank you very much.
     

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