Any School vs. DUKE

[MrBurns10]

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As more and more versus threads pop up daily, I thought I'd make a post about my experiences at Duke so people could refer to it when deciding between it and another school (especially because Duke's decisions should be coming out in the next few weeks). Anything so I don't have to write this multiple times...I'm lazy. I'm currently a 3rd year so I can't comment yet on residency applications, so I'll just talk about the first three years.

First year
Curriculum
As I'm sure you know by now if you've applied there, Duke has an 11-month first year that encompasses all of the basic sciences. Some people say "that's insane! It must be crazy busy!" Well, the answer is yes and no. Yes, it's a busy year. Typical schedule is lectures 9-4 everyday, usually with one or two half days off per week. The beautiful thing is that lectures are streamed online, so you only have to come for whatever mandatory sessions (mainly in the 2nd semester). My class had a notes group, where one person was assigned a lecture and that person streamed the lecture and took very detailed notes, then sent them out to everyone. This averaged out to doing one lecture every 5 weeks or so, making studying tremendously efficient because you could stay at home and study on your own just from the notes others had written. But some people still went to class, and if that's what works for you that's great. I personally had a ton more free time to do whatever I wanted when I realized going to class wasn't working for me. I got involved in volunteering, worked out regularly, and hung out with friends. Not bad if you ask me.

Grading and Teaching
Grading is P/F for the first block and H/P/F for the remaining 3 blocks. You may wonder if that makes for a competitive student body, but that's not remotely the case. It's not graded on a curve, meaning that everyone in the class could get honors if they achieved the necessary grades. Study guides were passed around all the time as a result. The teaching was great for the most part. Faculty were very open to helping students out, and there's a free tutoring service through the medical school.

Advisory Deans
This is one of the best parts about Duke. Your class of 100 is divided into 4 groups of 25 and you're assigned one advisory dean (the dean that will advise you and ultimately write your dean's letter). During first year, you will have weekly lunches with your advisory dean in groups of about 10 students. This is a place where you can air your grievances, get some informal advising about 2nd/3rd year, and allow your dean to get to know you on a personal level. The advisory deans are fantastic and want you to be as successful as you can be.

Practice Course
A half day per week throughout first year, then 4 weeks on, 4 weeks off during your second year. This is where you learn how to interview patients on all sorts of topics, how to give bad news, etc. Through practice course you'll also spend a half day in a clinic of your choice during 2nd semester.

Second year
This is the rotation year, exactly the same as the 3rd year in other schools. Rotations are: Surgery (8 weeks), Internal Medicine (8 weeks), Peds (6 weeks), Ob/gyn (6 weeks), Family Med (4 weeks), Psych (4 weeks), and 3 elective periods (two 2-weeks and one 4-week).

One of the biggest assets of Duke's 2nd year is that you not only go through your rotations early, avoiding the stress of being at the end of your 3rd year and still not knowing what you want to go into, but you also get 3 electives. This is awesome because it allows you to explore fields outside of the traditional clerkship fields. A lot of other schools don't even give electives to 3rd years. No matter what school you go to, make sure you ask about elective rotations prior to 4th year.

Clerkship Directors
Another of Duke's biggest assets are its clerkship directors. They're all super nice and responsive to feedback. They take student input and actually make changes to subsequent rotations based on that feedback. And this change is quick (from the first rotation group to the second). It's nice knowing that they actually care about what we think.

Third year
In a word: awesome. Let's just say I could have easily written this dissertation of a post on a weekday than on a Saturday night, but I'm just killing time before I go out.

Research vs. Dual Degree
You have the option of doing a dual degree (MPH, MBA with an extra year, MPP, pretty much anything really) or doing research. The research can be basic, clinic, translational, epidemiological, really anything that can relate to medicine. There are several research scholarships available whose stipends range from $20-40ishK, helping cut costs. Some students choose to go abroad; I have 3 classmates in Africa, 1 in India, 1 in Singapore, etc.

Mentoring
The strongest aspect of the Duke curriculum. The mentoring is fantastic here, and while there are some bad ones (like at every school), I'd say the vast majority are really good. In case you can't tell, I absolutely love my mentor, as well as my project. A lot of people publish in their 3rd year; for some it's a conference abstract, for others it's a first author paper. The 3rd year allows you to get research experience (important for you and also looks good on the residency app), possibly publish, and get to know a mentor really well who can write a strong LOR and possibly make helpful phone calls to residency programs for you. The first two years are hands down worth the third year.

Step 1
You take step 1 anytime during the year. Some people take time off right after rotations to study and take it in September/October, others wait until before or after Christmas, others will take it this summer. You can spend a couple months studying a few hours a day, then take 3-4 weeks off from your research to study hardcore. It's very self-directed, and the great thing is that if you're not ready to take it, you can just push it back until you are. People ask if it's harder to relearn the material, and I would say yes and no. Your clinical year does help you remember and put into a clinical context diseases, meds, etc. It will take you longer to go back and relearn subjects like biochem and cell bio, but the good news is that there is time to do that.

Continuity Clinic
You will spend a half day per week in a continuity clinic of your choice. Some use their clinic to explore a particular field, while others (like me) chose it because they like their preceptor. It's a good way to keep in contact with patients and keep up your history-taking and physical exam skills.

Location
Durham is not for everyone, but I personally love it. I've been here 8 years now (did my undergrad here too) and I'd love to stay even longer and maybe even settle down here. Housing is cheap, lots of outdoor stuff to do, mountains and beaches are a few hours away, and traffic isn't bad. Great restaurants, too.

Well, I think that's enough writing for about a year. Sorry for the long post. In case you can't tell, I really love my school, and while there are always going to be some negatives, I don't think I could have chosen a better school for me. I'd be happy to answer any questions you all have, and good luck wherever you end up.

 

[chiz2kul]

Excellent post.
But could you highlight any negatives?

 

[diosa428]

I mostly agree with Burns. Duke is great.

Negatives for me:
#1 - The south isn't for everyone (although the weather is nice). I personally can't wait to return to the north, although I will miss chilling by the pool from April to Oct.
#2 - For those of us away for third year, doing research not at Duke, our programs do not necessarily give us 3-4 weeks off to study for step 1. So your choice is to either try to study on nights/weekends, or wait until the end of third year, when you are totally removed from all of medicine, and take a month off before starting fourth year to study. Not fun.
#3 - This one is a potential negative for some people, I personally liked it - At other schools, when you take the shelf exams (exams at the end of every rotation), you've already taken Step 1 so you already know a lot of the material... at Duke, you take the shelf exams before Step 1, so historically Duke students don't do particularly well on them. However, the course directors are used to this and the shelf exams aren't worth a lot towards your grade. This can be an advantage if you are one of those people who doesn't test well but makes a good impression and gets good evals, and a disadvantage if you suck in person and your evals are crappy but you test well.
On a related note to the above - I think sometimes our residents think we're dumb b/c we don't take Step 1 before our rotations so we haven't consolidated the information the same way that kids at other schools have. But everyone at Duke is on the same page, so it doesn't necessarily make you look any worse than your classmates. Or maybe I should have just studied more as a first year....

 

[MrBurns10]

Sure. I didn't want to make the post even longer than it already was and I figured someone would ask. These are what I personally see as Duke's negatives. Just keep in mind that everyone's experiences differ.

1. Curriculum-one of Duke's greatest strengths is the curriculum, but it's also a point of weakness (I sound like a premed). Compared to my friends at other med schools, I was not nearly as well prepared for rotations. They had just taken step 1 and had all this knowledge ready to put on display. But what diosa said was right...the residents and attendings at Duke know that we're not as well prepared knowledge-wise, and your grade is not really affected by it (plenty of people honor their first rotation). Besides, I personally remember better by doing than just reading something in a book.

2. Step 1- I think it is harder to take it after being removed from the basic sciences for a year. While there is time to catch up, it does make the review process more difficult. People still generally do fine to well, however...it's very individualized.

3. Third-Fourth year transition- if you do a 10 month 3rd year, then you'll start your 4th year at the end of June and be able to have 2 months during the year. If you do a 12 month 4th year (for example, it's required if you do a Howard Hughes fellowship), then you start your 4th year in August and don't have as much free time. But again, that's dependent on your project and whatever scholarship you get.

4. diosa428

That's all I can think of for now. If I can think of anymore, I'll post about them.

 

[Dral]

Let's say you don't get an opportunity to narrow down exactly what you want to do in your 2nd yr electives. Can you take some clinical time 3rd year, or would you have to wait until 4th year?...meaning if you had a 12 month 3rd year, you wouldn't be able to explore until Aug. of 4th year. Yikes.

I'm at an accelerated schedule school and I'm one of those 'unsure what I want to be when I grow up' types. I have 2 days left of third year clerkship days (woo!). Luckily, I front loaded my 4th year schedule with things I think I may want to do, so that I'll have gone through 8 different electives between now and August of this year. I hope I'll know by the end of that. haha.

If I was pretty sure of what I wanted to do, the Duke program sounds like it would really rock though.

 

[MrBurns10]

Let's say you don't get an opportunity to narrow down exactly what you want to do in your 2nd yr electives. Can you take some clinical time 3rd year, or would you have to wait until 4th year?...meaning if you had a 12 month 3rd year, you wouldn't be able to explore until Aug. of 4th year. Yikes.

So I believe there is the option to do a rotation during 3rd year and break up your research, but it's rarely used. A lot of times people use continuity clinic to explore a field or, since there's a lot of free time in 3rd year, students can "shadow" in whatever they want (like, if I wasn't sure if I was interested in ophtho and didn't do a rotation in it 2nd year, I could ask someone in the ophtho dept to see if I could work with them for a few days and observe some surgeries). That can help.

I have plenty of classmates who are still deciding between a few different specialties, so it's pretty common. Anyway, I wouldn't sweat it if I were you...it sounds like you have a really good schedule to try to figure out what you like. Good luck on your decision!

 

[scarletgirl777]

Sure. I didn't want to make the post even longer than it already was and I figured someone would ask. These are what I personally see as Duke's negatives. Just keep in mind that everyone's experiences differ.

1. Curriculum-one of Duke's greatest strengths is the curriculum, but it's also a point of weakness (I sound like a premed). Compared to my friends at other med schools, I was not nearly as well prepared for rotations. They had just taken step 1 and had all this knowledge ready to put on display. But what diosa said was right...the residents and attendings at Duke know that we're not as well prepared knowledge-wise, and your grade is not really affected by it (plenty of people honor their first rotation). Besides, I personally remember better by doing than just reading something in a book.

2. Step 1- I think it is harder to take it after being removed from the basic sciences for a year. While there is time to catch up, it does make the review process more difficult. People still generally do fine to well, however...it's very individualized.

3. Third-Fourth year transition- if you do a 10 month 3rd year, then you'll start your 4th year at the end of June and be able to have 2 months during the year. If you do a 12 month 4th year (for example, it's required if you do a Howard Hughes fellowship), then you start your 4th year in August and don't have as much free time. But again, that's dependent on your project and whatever scholarship you get.

4. diosa428

That's all I can think of for now. If I can think of anymore, I'll post about them.

So, on balance would you say that it was harder to study for the boards? Schools where students take Step 1 after clinical time insist they arranged it that way because it's easier for students to do well...

 

[MrBurns10]

So, on balance would you say that it was harder to study for the boards? Schools where students take Step 1 after clinical time insist they arranged it that way because it's easier for students to do well...

So it's really hard to say because I've only taken it after rotations, so it's the only thing I know. Rotations helped a lot in certain ways and hindered me in others. For example, I didn't remember anything about biochem so I had to go back and review it all. But then again, that's usually one of the first blocks at other med schools, so you're still going more than a year without touching the subject. Another way that it hindered me was that I was so used to thinking in a clinical way that when I started studying it was like I was preparing myself for step 2 (e.g. thinking about the next step in management as opposed to the basis behind a disease). I don't think that was a big deal, though...it just took some getting used to.

It helped in that when I read a clinical vignette (all the questions are vignettes), I could easily frame it into a patient that I had either seen or talked about on rotations. Even if I hadn't seen the disease, I could easily put the symptoms into a particular disease category, I think probably a little more easily than students at other schools.

What's interesting is that the NBME is moving in the direction to where step 1 and step 2 will form one combined test that will be administered after 3rd year. So clearly most everyone thinks positively of the way Duke does it.

 

[diosa428]

Let's say you don't get an opportunity to narrow down exactly what you want to do in your 2nd yr electives. Can you take some clinical time 3rd year, or would you have to wait until 4th year?...meaning if you had a 12 month 3rd year, you wouldn't be able to explore until Aug. of 4th year. Yikes.

It's not really that different than other schools who have a "normal" curriculum... if you don't figure out what you like 3rd year, you have to figure it out 4th year... at least Duke offers 3 elective blocks during 2nd year to help with that. I guess your point is that other schools start 4th year earlier than August? B/c we have the option of starting as early as June if we want, you'd just do a shorter research year. That's a decision every individual student has to make based on how they feel about their own career paths.

As far as clinical work as a third year, you are supposed to do practice course (aka work in clinic as Mr. Burns mentioned) throughout the year, so you could arrange to work in a clinic that was in a specialty that you were interested in. You can also shadow, as mentioned. You can take a month off and do a rotation if you want, but that's something you have to arrange with your mentor, and some funded research programs won't allow it.

 

[waytooez]

Sure. I didn't want to make the post even longer than it already was and I figured someone would ask. These are what I personally see as Duke's negatives. Just keep in mind that everyone's experiences differ.

1. Curriculum-one of Duke's greatest strengths is the curriculum, but it's also a point of weakness (I sound like a premed). Compared to my friends at other med schools, I was not nearly as well prepared for rotations. They had just taken step 1 and had all this knowledge ready to put on display. But what diosa said was right...the residents and attendings at Duke know that we're not as well prepared knowledge-wise, and your grade is not really affected by it (plenty of people honor their first rotation). Besides, I personally remember better by doing than just reading something in a book.

2. Step 1- I think it is harder to take it after being removed from the basic sciences for a year. While there is time to catch up, it does make the review process more difficult. People still generally do fine to well, however...it's very individualized.

3. Third-Fourth year transition- if you do a 10 month 3rd year, then you'll start your 4th year at the end of June and be able to have 2 months during the year. If you do a 12 month 4th year (for example, it's required if you do a Howard Hughes fellowship), then you start your 4th year in August and don't have as much free time. But again, that's dependent on your project and whatever scholarship you get.

4. diosa428

That's all I can think of for now. If I can think of anymore, I'll post about them.

am i missing something or did u just say that your classmate was a negative about duke?

 

[MrBurns10]

am i missing something or did u just say that your classmate was a negative about duke?

Yeah, worst roommate ever.





I hope you know I'm just messing around.

 

[diosa428]

Also, I would like to mention the global health opportunities at Duke, since that's something that more and more pre-meds are becoming interested in:
1.) First year - Duke offers a global health course for first years that is essentially a lecture on a current global health topic once per week for about an hour and a half (fall semester). There is another global health course focusing on culture and health in latin america that is offered in the spring semester and includes an optional 10 day trip to Honduras (this can actually be taken in any year). Duke also offers Medical Spanish, which is a classroom course for beginners, or an individual online tutorial with a native speaker via webcam (basically you talk to someone from Guatemala for an hour a week for like 10 weeks, and Duke pays for it). Some students are also trying to start up a Medical Chinese course.
2.) Second year - you can do your 4 week elective abroad if you want, and you could prob do your 2 week electives abroad too, but it would be expensive/hard to arrange.
3.) Third year - you can do all of 3rd year abroad if you want. Of course, funded programs like the Fullbright and the Fogarty are options. Duke sends 2 students per year to do research at Duke's school in Singapore (fully funded). Duke also sends 2 students per year to Moshi, Tanzania to do HIV research. I know of other students who decided to do work abroad through Duke mentors who got funding from various sources.
4.) Fourth year - you can do up to 8 weeks abroad, and more if you can convince the administration that you have a good reason to.

For Duke's other global health opportunities, check out:

http://globalhealth.duke.edu/

 

[diosa428]

So it's really hard to say because I've only taken it after rotations, so it's the only thing I know. Rotations helped a lot in certain ways and hindered me in others. For example, I didn't remember anything about biochem so I had to go back and review it all. But then again, that's usually one of the first blocks at other med schools, so you're still going more than a year without touching the subject. Another way that it hindered me was that I was so used to thinking in a clinical way that when I started studying it was like I was preparing myself for step 2 (e.g. thinking about the next step in management as opposed to the basis behind a disease). I don't think that was a big deal, though...it just took some getting used to.

It helped in that when I read a clinical vignette (all the questions are vignettes), I could easily frame it into a patient that I had either seen or talked about on rotations. Even if I hadn't seen the disease, I could easily put the symptoms into a particular disease category, I think probably a little more easily than students at other schools.

What's interesting is that the NBME is moving in the direction to where step 1 and step 2 will form one combined test that will be administered after 3rd year. So clearly most everyone thinks positively of the way Duke does it.

Agree with above.

 

[diosa428]

am i missing something or did u just say that your classmate was a negative about duke?

Don't worry, I only have one more year. You guys won't have to attend Duke with me there.

 

[MrBurns10]

Don't worry, I only have one more year. You guys won't have to attend Duke with me there.

Not if I have anything to do with it. I'm going to submit a letter to Duke Psych telling them they're your #1 choice and that you plan on ranking them as such.

Durham for another 4 years!

 

[Bearferret]

This thread is awesome - lots of good information. The problem is, I pretty much already know that I want to go to Duke more than any other place out there. The only question is if it's worth all that money. I'm in that particularly sucky situation where my parents make a lot of money, but I don't expect to see any of it for med school, meaning that I will get basically nothing in the way of financial aid, and I'll have to cover basically the entire cost of attending school with loans.

In a way, it's a good thing that I have such a small chance of getting accepted. I may not have to make such a tough decision at all.

Now for an actual question: how difficult is it to get substantial funding for your research during 3rd year? If I'm willing to be flexible with what research I do (i.e., pick a research topic likely to get funding), could I be reasonably assured of a good grant, even if I don't have prior research experience?

 

[MrBurns10]

Now for an actual question: how difficult is it to get substantial funding for your research during 3rd year? If I'm willing to be flexible with what research I do (i.e., pick a research topic likely to get funding), could I be reasonably assured of a good grant, even if I don't have prior research experience?

It's actually not that hard. We have 100 people in our class, 94 of whom are MD only. I believe 7 are doing dual degrees. So of the remaining 87:

13 are in the CTSA scholarship program through the NIH funding clinical/translational research at Duke
10 are in the Howard Hughes fellowship (basic science)
10ish at the NIH doing clinical research (diosa could give more exact numbers than I could since she's in this program)
1 is doing a Sarnoff scholarship at Stanford (cardio research)
1 is doing the scholarship in Singapore
2 are doing funded research in Tanzania

I'm sure I'm missing people (I know some applied for Doris Duke scholarships). Some students were not eligible for 3rd year scholarships since they already receive scholarship money to Duke Med. I believe a few were able to get a little funding outside of scholarship programs, and some students did not apply to any programs. Hope that helps!

 

[Depakote]

duke would win... if it had a knife.

 

[diosa428]

It's actually not that hard. We have 100 people in our class, 94 of whom are MD only. I believe 7 are doing dual degrees. So of the remaining 87:

13 are in the CTSA scholarship program through the NIH funding clinical/translational research at Duke
10 are in the Howard Hughes fellowship (basic science)
10ish at the NIH doing clinical research (diosa could give more exact numbers than I could since she's in this program)
1 is doing a Sarnoff scholarship at Stanford (cardio research)
1 is doing the scholarship in Singapore
2 are doing funded research in Tanzania

I'm sure I'm missing people (I know some applied for Doris Duke scholarships). Some students were not eligible for 3rd year scholarships since they already receive scholarship money to Duke Med. I believe a few were able to get a little funding outside of scholarship programs, and some students did not apply to any programs. Hope that helps!

There are actually 5 doing clinical research through the NIH-CRTP, 2 doing Cloisters (also NIH) and one doing the NIH's year off program for medical/graduate students.
There are 2 kids from our class doing the Doris Duke and another guy from the class above us taking a second third year doing the Doris Duke. I know of a few more that got offered positions but declined them for something else.
There are 4 kids who have National Center for Research Resources Clinical and Translational Science awards (different than the NIH-funded ones, it appears).
There are also internal Duke scholarships specific to medicine research and surgery research, although I can't remember the names of the scholarships.

Basically, if you really want money, you can get it. I think everyone that I know of that was trying for money and flexible about where they would go got something. A lot of kids that weren't flexible about what they wanted to do (ie, applied for Howard Hughes, wanted a specific lab in a specific location) also got money.

 

[Upgrayedd]

Make a detailed list of pro's and con's:

pro's: good medical school

con's: everyone will sneer at you for the rest of your life when you tell them where you went to medical school. get used to hearing "duke basketball sucks". you might even lose patients over this. infact, i'd probably walk right out, even if I was having a stemi

There's no right or wrong answer here, just food for thought

 

[MrBurns10]

Just wanted to bump this post-second look. What did you guys think? I was one of the 2348091230 panelists on Friday. Let me know if you have any more questions!

 

[searun]

Well, sure, Duke is a fantastic school, no doubt. Although I do not think that I would want to do undergrad and med school at the same school. But, sure, Duke is sweet.

Did you watch North Carolina last night? I know, your boyfriend, fiance, goes to North Carolina, but Duke is getting dominated. Not in med school, but on the court. The balance of power had shifted with that Kansas guy, I think he is a better college coach. Duke is going to be second fiddle for awhile.

 

[MrBurns10]

Well, sure, Duke is a fantastic school, no doubt. Although I do not think that I would want to do undergrad and med school at the same school. But, sure, Duke is sweet.

Did you watch North Carolina last night? I know, your boyfriend, fiance, goes to North Carolina, but Duke is getting dominated. Not in med school, but on the court. The balance of power had shifted with that Kansas guy, I think he is a better college coach. Duke is going to be second fiddle for awhile.

Fortunately, my fiance is a Duke fan, thus preventing the need for a breakup. You know, it's not so bad doing undergrad and med school at the same place. There are 10-15 of us every year that do that!

Yeah, UNC has had our number for a few years now. Roy Williams has done a great job getting premier recruits and keeping them around. The Duke-UNC rivalry is cyclical...we had our way with them in the late 90s/early 00s, and they're doing the same to us now. We've got some great recruits coming in 2010 (2009 is okay, too), so hopefully we can tip the balance of power our way 🙂

 

[Evergrey]

Duke sounds like an awesome program, the research year really appeals to me since I've been getting into research during my last year of college and I absolutely love it. I'm going to try applying to it I think, even though my numbers indicate I have significantly less than a stone's throw chance of getting it (3.72 cGPA/3.78sGPA, hoping to bump them both .03 this last semester).

 

[searun]

Fortunately, my fiance is a Duke fan, thus preventing the need for a breakup. You know, it's not so bad doing undergrad and med school at the same place. There are 10-15 of us every year that do that!

Yeah, UNC has had our number for a few years now. Roy Williams has done a great job getting premier recruits and keeping them around. The Duke-UNC rivalry is cyclical...we had our way with them in the late 90s/early 00s, and they're doing the same to us now. We've got some great recruits coming in 2010 (2009 is okay, too), so hopefully we can tip the balance of power our way 🙂

From the posts above you, Burnsie, I love hearing about the Doris Duke Scholarships and the Howard Hughes Scholarships, both Howard and Doris were crazier than fruit flies on LSD, or perhaps LDS. But they sure had alot of money. Pretty crappy ending of life for both, Howard, paranoid in his hotel room in Las Vegas, and Doris, carrying on with the gardner or butler, or whoever he was. And Tobacco Road funding med school, you have to love the irony of that. But, yeah, basketball is cyclical, but that Roy guy is pretty good.

 

[whatthe]

a