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Finally, true wisdom that comes from experience!!!
Application process: Looking back as a 4th year
- Thread starter MikeS 78
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I subscribe
E
ehd327
great post. bump.
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Thanks for taking the time to write this info...I'll take it to heart when I'm interviewing...I love it when people tell you the 'nitty gritty' and quite beating around the bush.
What is not important:
1) Impression of students: this is bogus, totally bogus. Every school has a fairly similar mix of a few types and if you think you can tell what students are like by meeting the tour guide and 3 other people you are fooling yourself.
A) Gunners- Every american medical school has gunners. Furthermore, your interview process will not allow you to prove or disprove my theory, as these people generally aren't doing interviews. Also don't let anyone tell you that theres no competition at their school because there is always someone who wants to do ortho at the hosp for special surgery, even at DO schools.
Moreover if you are really worried about dodging the "Gunners" then 90% chance that you are one....my observational experience
B) Slackers- These are the real people I'd be worried about: they tend not to show up to stuff and make everyone look bad.
C) Superstars- Every school has these, good schools have a few more.
D) Everyone else (prob 45-60% of a class)
2) Curriculum- Guys I hear this alot and read this on this board alot....looking back I thought this was a big deal, now I say "who really cares." Here's my breakdown of the issue
A) PBL- you have no background to base your case based learning on...and will not have it until year 2 and probably 1/2 through that (when you start organ system pathology/pathophys). Really how can you expect someone to understand CHF related fluid retention with no prior knowledge of renin-angiotensin and the kidneys...silly
B) lectures vs no lectures- For all practical purposes, you are going to teach your damn selves 90% of the first 2 years.
The reason for this is that most of the first two years really is vocab and getting your mind around a few key concepts so that third year you can actually understand what your residents and attendings are saying. So despite all the hype about new novel ways of learning it boils down to you hanging out with Robbins pathology, a microscope/online slides and a cadaver and figuring it out.
As far as clinical relevant knowledge year 1-2 is more or less the about the same, deal with it. I say this coming from an Ivy so trust me.
3) Quality of facilities- Theres three reasons why this is pretty irrelevant
A) they never show you all the facilities-
B) Does learning in an old building really impact your education
C) When you're trudging in the snow at 4 am to rounds on surgery are you really going to notice or care what the outside of the hospital looks like......highly doubtful
4) extracurricular/social stuff- This is +/-. If you have a passion for playing the violin...can't live without it and are willing to do it despite significant other time committments..this can be a plus
however, do not get the false impression that a medical school class remains this cohesive bunch of social butterflies for 4 years. Generally, everyone is very busy and alot of people are overwhelmed. The attendance at class events dropped preciptiously year 2.
5) early patient contact- I think this is a total sales pitch: To provide an anecdote: It was january of my second year. we were in our physical diagnosis class, having our first group interview with a patient with renal failure and volume overload causing CHF.
so the encounter goes like this.....
A classmate "so what brings you to the hospital today"
patient: "I am having a tough time breathing, it feels like im drowning when I lie flat"
Classmate "that sounds bad"
long silence.
This classmate was a smart guy and ended up being AOA and this was 1 1/2 years into medical school.....
so if thats 2nd year what are you really going to do interviewing patients 1st year.......basically acquire bad habits that you will need to fix later in life. Is it a total waste? no. However do not make this any more than a minor consideration.
Things that are important
1) What is the 3rd year like and how is it structured?:
I almost never hear any real questions or comment from applicants regarding this topic. In the end this is the only real difference between schools, and probably could be the only real question to ask? more specific questions?
a) How are the rotations structured? What is your role on the wards? Do you have a clear role Do you get your "hands dirty" alot, or is it alot of shadowing? This is very important. You really don't learn much by watching people do stuff and if they work you down to a minimal role you will not gain much experience and will suck for several months into internship.
Now I'm not saying you demand the right to cross clamp the aorta during a CABG, but medicine is not a spectator sport and if the school doesn't have a culture of teaching (i.e. alot of patients are private patients, medical students aren't allowed to do anything) it will be a long, boring 3rd year.
2) Where do 3rd year evaluations come from?
Alot of people go in with this attitude "I am here to learn not to get grades." I agree with this attitude 85%. However, using that attitude indiscriminantly is impractical and can lead to some evaulations that you are not too happy with, it happens
You probably can't please everyone equally. This is especially true on surgery and medicine where there is not enough hours in the day.
Thus, the recommendation I make to everyone is to figure out roughly who writes the evaluation and what they expect and make sure you do a really good job on that. I do not recommend kissing up....However, it is really easy at times to get caught up in "which 5 minute presentation do I spend preparing for tomorrow. " This is why if you know who is grading you you can prioritize which person you pull the NEJM articles out for, and who gets the 15 minute before cram session off up-to-date.
Understand however while this happens at all schools (its how the beast works) not all schools do a reasonable job at making this fair or letting you know who is grading you or what you are supposed to do. Thus you should really make an effort to ask questions such as for every rotation do you have an attending directly responsible for evaluating you, or a preceptor (someone not taking care of patients that you are caring for who evaluates your academic abilities and analytic abilities? ideally your grade should come roughly equally from both.
3) Where do the students end up? If you dont want to do primary care, and 75% of school X does. Guess what, you are signing up for 15 weeks of primary care rotations at that school. Conversely, if you want to do general internal medicine or family medicine....and you come to a school that puts out 25 orthopods and 10 neurosurgeons a year.....you will spend alot of time learning about surgeries that you will never perform in your life.
4) How are medical students protected from scut?
If they cannot give you a real answer to this question expect to learn alot about running bloods to the lab and wheeling patients to the CT scanner and very little about managing an MI.
Some schools do a good job of setting up systems to prevent this, however I have also met interns who told me that they failed the surgery shelf because their school was rampant with scut and they didn't learn anything. I think my school did a very good job at scut control, however I have wheeled my share of patients to CT at 2 am.
5) How receptive is the administation to fixing problems and/or disciplining out of line behavior, espcially from residents?
trust me when you have an ID class where the course director is terrible, you will really appreciate it when a new course director is hired the next year.
6) how is the research opportunities at this school?
If you want to end up at an academic program, there will come a time when you will seek papers and if they are not there to be written then you will understand the meaning of this question. If not then forget I mentioned this.
7) how good is this school at focusing on the bread and butter?
This is especially relevant if you are looking at an academic powerhouse type place. Typically alot of times you will find that big tertiary centers tend to be filled with people who A) study esoteric diseases, B) specialize in highly uncommon or speciallized surgeries or diagnostic tests, or C) only doing big commando surgeries on cases people in the community looked at and said no way im touching that.
This is something you may be interested in as an attending or at the end of your residency. However in medical school most of these areas will not be your field and learning the literature on steroid tapers for patients with the CREST syndrome, the signs and symptoms of spinocerebellar ataxia 8 or how to resect a pseudomyxoma peritonei is probably not the best use of time in your only exposure to the area. Its easy to get caught up in that stuff, however good schools recognize the nature of the academic beast and try to make sure that you leave knowing the stages of active labor, how to read an EKG and how to manage childhood asthma.
I hope this helps
mike[/QUOTE]
What is not important:
1) Impression of students: this is bogus, totally bogus. Every school has a fairly similar mix of a few types and if you think you can tell what students are like by meeting the tour guide and 3 other people you are fooling yourself.
A) Gunners- Every american medical school has gunners. Furthermore, your interview process will not allow you to prove or disprove my theory, as these people generally aren't doing interviews. Also don't let anyone tell you that theres no competition at their school because there is always someone who wants to do ortho at the hosp for special surgery, even at DO schools.
Moreover if you are really worried about dodging the "Gunners" then 90% chance that you are one....my observational experience
B) Slackers- These are the real people I'd be worried about: they tend not to show up to stuff and make everyone look bad.
C) Superstars- Every school has these, good schools have a few more.
D) Everyone else (prob 45-60% of a class)
2) Curriculum- Guys I hear this alot and read this on this board alot....looking back I thought this was a big deal, now I say "who really cares." Here's my breakdown of the issue
A) PBL- you have no background to base your case based learning on...and will not have it until year 2 and probably 1/2 through that (when you start organ system pathology/pathophys). Really how can you expect someone to understand CHF related fluid retention with no prior knowledge of renin-angiotensin and the kidneys...silly
B) lectures vs no lectures- For all practical purposes, you are going to teach your damn selves 90% of the first 2 years.
The reason for this is that most of the first two years really is vocab and getting your mind around a few key concepts so that third year you can actually understand what your residents and attendings are saying. So despite all the hype about new novel ways of learning it boils down to you hanging out with Robbins pathology, a microscope/online slides and a cadaver and figuring it out.
As far as clinical relevant knowledge year 1-2 is more or less the about the same, deal with it. I say this coming from an Ivy so trust me.
3) Quality of facilities- Theres three reasons why this is pretty irrelevant
A) they never show you all the facilities-
B) Does learning in an old building really impact your education
C) When you're trudging in the snow at 4 am to rounds on surgery are you really going to notice or care what the outside of the hospital looks like......highly doubtful
4) extracurricular/social stuff- This is +/-. If you have a passion for playing the violin...can't live without it and are willing to do it despite significant other time committments..this can be a plus
however, do not get the false impression that a medical school class remains this cohesive bunch of social butterflies for 4 years. Generally, everyone is very busy and alot of people are overwhelmed. The attendance at class events dropped preciptiously year 2.
5) early patient contact- I think this is a total sales pitch: To provide an anecdote: It was january of my second year. we were in our physical diagnosis class, having our first group interview with a patient with renal failure and volume overload causing CHF.
so the encounter goes like this.....
A classmate "so what brings you to the hospital today"
patient: "I am having a tough time breathing, it feels like im drowning when I lie flat"
Classmate "that sounds bad"
long silence.
This classmate was a smart guy and ended up being AOA and this was 1 1/2 years into medical school.....
so if thats 2nd year what are you really going to do interviewing patients 1st year.......basically acquire bad habits that you will need to fix later in life. Is it a total waste? no. However do not make this any more than a minor consideration.
Things that are important
1) What is the 3rd year like and how is it structured?:
I almost never hear any real questions or comment from applicants regarding this topic. In the end this is the only real difference between schools, and probably could be the only real question to ask? more specific questions?
a) How are the rotations structured? What is your role on the wards? Do you have a clear role Do you get your "hands dirty" alot, or is it alot of shadowing? This is very important. You really don't learn much by watching people do stuff and if they work you down to a minimal role you will not gain much experience and will suck for several months into internship.
Now I'm not saying you demand the right to cross clamp the aorta during a CABG, but medicine is not a spectator sport and if the school doesn't have a culture of teaching (i.e. alot of patients are private patients, medical students aren't allowed to do anything) it will be a long, boring 3rd year.
2) Where do 3rd year evaluations come from?
Alot of people go in with this attitude "I am here to learn not to get grades." I agree with this attitude 85%. However, using that attitude indiscriminantly is impractical and can lead to some evaulations that you are not too happy with, it happens
You probably can't please everyone equally. This is especially true on surgery and medicine where there is not enough hours in the day.
Thus, the recommendation I make to everyone is to figure out roughly who writes the evaluation and what they expect and make sure you do a really good job on that. I do not recommend kissing up....However, it is really easy at times to get caught up in "which 5 minute presentation do I spend preparing for tomorrow. " This is why if you know who is grading you you can prioritize which person you pull the NEJM articles out for, and who gets the 15 minute before cram session off up-to-date.
Understand however while this happens at all schools (its how the beast works) not all schools do a reasonable job at making this fair or letting you know who is grading you or what you are supposed to do. Thus you should really make an effort to ask questions such as for every rotation do you have an attending directly responsible for evaluating you, or a preceptor (someone not taking care of patients that you are caring for who evaluates your academic abilities and analytic abilities? ideally your grade should come roughly equally from both.
3) Where do the students end up? If you dont want to do primary care, and 75% of school X does. Guess what, you are signing up for 15 weeks of primary care rotations at that school. Conversely, if you want to do general internal medicine or family medicine....and you come to a school that puts out 25 orthopods and 10 neurosurgeons a year.....you will spend alot of time learning about surgeries that you will never perform in your life.
4) How are medical students protected from scut?
If they cannot give you a real answer to this question expect to learn alot about running bloods to the lab and wheeling patients to the CT scanner and very little about managing an MI.
Some schools do a good job of setting up systems to prevent this, however I have also met interns who told me that they failed the surgery shelf because their school was rampant with scut and they didn't learn anything. I think my school did a very good job at scut control, however I have wheeled my share of patients to CT at 2 am.
5) How receptive is the administation to fixing problems and/or disciplining out of line behavior, espcially from residents?
trust me when you have an ID class where the course director is terrible, you will really appreciate it when a new course director is hired the next year.
6) how is the research opportunities at this school?
If you want to end up at an academic program, there will come a time when you will seek papers and if they are not there to be written then you will understand the meaning of this question. If not then forget I mentioned this.
7) how good is this school at focusing on the bread and butter?
This is especially relevant if you are looking at an academic powerhouse type place. Typically alot of times you will find that big tertiary centers tend to be filled with people who A) study esoteric diseases, B) specialize in highly uncommon or speciallized surgeries or diagnostic tests, or C) only doing big commando surgeries on cases people in the community looked at and said no way im touching that.
This is something you may be interested in as an attending or at the end of your residency. However in medical school most of these areas will not be your field and learning the literature on steroid tapers for patients with the CREST syndrome, the signs and symptoms of spinocerebellar ataxia 8 or how to resect a pseudomyxoma peritonei is probably not the best use of time in your only exposure to the area. Its easy to get caught up in that stuff, however good schools recognize the nature of the academic beast and try to make sure that you leave knowing the stages of active labor, how to read an EKG and how to manage childhood asthma.
I hope this helps
mike[/QUOTE]
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damn trolls ate my post... so here goes again.
I agree with everything you said, mike. And here are a few of my own added opinions (biases, or whatever)....
All medical schools are pretty much the same. People ahve to pass step one, etc. They are all accredited. You will get out of it what you put into it. Name means little.
Realize that while most student populations are similar, there are still personalities to schools. And if you don't believe me, ask anyone who interviewed at all four UT schools.. they all have really different personalities (vibes or what ever you call it) I am now on the East Coast. Here, I have had so many conversations with residents from herhe that are dumbfounded that I had a kid in medical school (my third year). It is heavily discouraged here. However, where I was, it was absolutely NO BIG DEAL> my school also had a good chunk of nontraditionals.
Essentially, the admissions director sets the theme for thier school. Its reflected in their student body. Go with your gut. If you are miserable at a great school, it will reflect in your letters, etc.
regarding third year:
struccture is important. You need to be learning how to MANAGE patients. I think learning to do a 300 pt exam and a full H&P (and you won't ever do these again) during your first two years is crucial. It takes time becoming comfortable with asking: when was the last time you shot up. Do you have sex with men, women or both? vaginal discharge?
You don't want yoru third year to be spent learning how to do all of this (and it takes time.. its not intuitive.) So, getting alot of experience during your first two years really helps. You ahve then spent most of your third year learngin to manage your patients and learn. As a fourth year you will look great. You know alot, you are a good presenter (because you were focused on this third year) and this is how you will look good.
And most importantly through it all, remember why you are there. You aren't there to get the highest grade, to look the smartest. You are there to be a doctor. People entrust thier health to you. And the most important thing you can do is advocate for them.
Your ego does not help them.
I agree with everything you said, mike. And here are a few of my own added opinions (biases, or whatever)....
All medical schools are pretty much the same. People ahve to pass step one, etc. They are all accredited. You will get out of it what you put into it. Name means little.
Realize that while most student populations are similar, there are still personalities to schools. And if you don't believe me, ask anyone who interviewed at all four UT schools.. they all have really different personalities (vibes or what ever you call it) I am now on the East Coast. Here, I have had so many conversations with residents from herhe that are dumbfounded that I had a kid in medical school (my third year). It is heavily discouraged here. However, where I was, it was absolutely NO BIG DEAL> my school also had a good chunk of nontraditionals.
Essentially, the admissions director sets the theme for thier school. Its reflected in their student body. Go with your gut. If you are miserable at a great school, it will reflect in your letters, etc.
regarding third year:
struccture is important. You need to be learning how to MANAGE patients. I think learning to do a 300 pt exam and a full H&P (and you won't ever do these again) during your first two years is crucial. It takes time becoming comfortable with asking: when was the last time you shot up. Do you have sex with men, women or both? vaginal discharge?
You don't want yoru third year to be spent learning how to do all of this (and it takes time.. its not intuitive.) So, getting alot of experience during your first two years really helps. You ahve then spent most of your third year learngin to manage your patients and learn. As a fourth year you will look great. You know alot, you are a good presenter (because you were focused on this third year) and this is how you will look good.
And most importantly through it all, remember why you are there. You aren't there to get the highest grade, to look the smartest. You are there to be a doctor. People entrust thier health to you. And the most important thing you can do is advocate for them.
Your ego does not help them.
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I'm a 3rd year, and I have to say that the OP has created the most helpful post for pre-meds I have ever seen on SDN.
Just the other day I was thinking about how we all went on those interviews and hung out with 1st years, who are in the first FOUR months of a 48 month adventure, and took their perspective as truth. The very best perspective on any given school comes from the 4th years who have already matched. This is because they are the only ones who can attest to EVERYTHING the school has to offer.
However, there was one small statistic in the US News report that I did allow to weigh heavily in my med school decision: the residency director rankings. I figured, "These are the people who witness the finished product in clinical action. They are the only ones who have a comparative real-life basis by which to evaluate the medical schools."
And in the long run, I think I chose wisely. I tried to ignore a lot of the stuff that the OP mentioned as crap. I tried to focus on a simple question: "Where do I think I have the best chance of becoming the best doctor I can be?" And the school I chose, well regarded by the residency directors, has put me through one hell of a challenging third year. Yet this tough year is precisely the time that has convinced me that I am capable of facing the challenges of residency head-on.
Just the other day I was thinking about how we all went on those interviews and hung out with 1st years, who are in the first FOUR months of a 48 month adventure, and took their perspective as truth. The very best perspective on any given school comes from the 4th years who have already matched. This is because they are the only ones who can attest to EVERYTHING the school has to offer.
However, there was one small statistic in the US News report that I did allow to weigh heavily in my med school decision: the residency director rankings. I figured, "These are the people who witness the finished product in clinical action. They are the only ones who have a comparative real-life basis by which to evaluate the medical schools."
And in the long run, I think I chose wisely. I tried to ignore a lot of the stuff that the OP mentioned as crap. I tried to focus on a simple question: "Where do I think I have the best chance of becoming the best doctor I can be?" And the school I chose, well regarded by the residency directors, has put me through one hell of a challenging third year. Yet this tough year is precisely the time that has convinced me that I am capable of facing the challenges of residency head-on.
This is the sort of thing that needs to be sticky'd. I think I got more out of this single thread than all of the others combined. This is good advice, whether you agree with the viewpoint or not, it gives good things to ponder, discuss and research. Thanks for taking the time to point us in the right direction. This is the content that makes SDN and nvaluable resource. The OP MUST have gone to a top 10 med school and an Ivy for undergrad...
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Ok, I will pre-emptively answer these questions, as I keep getting PM's asking them.
1) I went to the University of Oklahoma for undergrad, majored in english, did not graduate, but got into Columbia without a degree (long story). I took a year off between 3rd and 4th year to do research (highly recommended) and am currently applying in neurosurgery
2) Columbia is an awesome place to go to school and they did a wonderful job looking out for us and educating us (I really mean that). When you finish you will be among the best residents in the country (based on my experience with residents from Columbia who were, with rare expections, great doctors and teachers.
Mike
1) I went to the University of Oklahoma for undergrad, majored in english, did not graduate, but got into Columbia without a degree (long story). I took a year off between 3rd and 4th year to do research (highly recommended) and am currently applying in neurosurgery
2) Columbia is an awesome place to go to school and they did a wonderful job looking out for us and educating us (I really mean that). When you finish you will be among the best residents in the country (based on my experience with residents from Columbia who were, with rare expections, great doctors and teachers.
Mike
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stickied by request
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Hey, I'm going to unsticky this thread, as it has already been incorporated into the mega sticky. I've changed the thread title to reflect this. Sorry for the confusion.
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Great post! Now I have some questions:
Is this true?
This is exactly how I'm like. I play violin and I think I'm alright. I plan to continue taking lessons after getting in college, but my parents do not believe that playing violin helps me (I hope it does); they think I should just concentrate on academic and do nothing else. What do you think..? Well I've got some small awards and I hope I'll get bigger ones so I need to practice a lot also..
Is this true?
This is exactly how I'm like. I play violin and I think I'm alright. I plan to continue taking lessons after getting in college, but my parents do not believe that playing violin helps me (I hope it does); they think I should just concentrate on academic and do nothing else. What do you think..? Well I've got some small awards and I hope I'll get bigger ones so I need to practice a lot also..
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Now I'm not a 4th year or anything... but it wouldn't hurt to consider how 3rd/4th years felt the school prepared them for boards, would it?
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Very interesting post.. I like it.. it actually has a purpose - an explanation to many questions that ppl don't ask. Hm.. thanks for the info.
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bioviol said:
As a musician, you can appreciate how if you don't practice, it doesn't matter how good your instrument is. Greatness is earned by work, not just given. That being said, it does take more hard to be great with a Yamaha violin than if you had a Stratavarius
bioviol said:This is exactly how I'm like. I play violin and I think I'm alright. I plan to continue taking lessons after getting in college, but my parents do not believe that playing violin helps me (I hope it does); they think I should just concentrate on academic and do nothing else. What do you think..? Well I've got some small awards and I hope I'll get bigger ones so I need to practice a lot also..
I think you should continue to play if you enjoy it, but have a realistic idea of what your ambitions and expectations are. If you plan on auditioning for a city philharmonic, or your school has a well known music school and you want to be concertmaster of it, then you will need to work for it. However, if you don't want to go that far, then you should perhaps put less times towards it. If you're just entering college this year, you don't really have an idea of how much your life will change. I was the manager of my college orchestra, and it was a great frustration to me with many new students coming to the orchestra because they did it their entire life, but the college experience just changed their priorities, and they quit playing, and I had to deal with holes in the instrumentation. Also, college does require a lot of work outside of class, plus you'll want to do many other things your school has to offer. Take the time to take part in things that weren't available to you in high school. Taking private lessons may not be the best course of action if you aren't planning on going professional, cause it'll take time for the lessons, and then you'll have to put a great deal of practice in, plus the cost of lessons.
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Rogue_Leader said:
Thank you. I was actually pondering upon whether to continue violin lesson or not, and I've just reached the conclusion that I will not, but instead I will just practice by myself. I think it is more important to do community-reach activities rather than just enhancing my own musical experience, when now that I am going to go into medicine.
Do you think performing in community, such as a school, hospital, or nursery provides the sense that I am willing to help others and have passion into music?
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bioviol said:
It's hard to say what will go over well with adcoms. Just do things that show you have passion for things outside of pure academics. Music is good, but it's no better or worse than having a passion for hiking, or soccer, model trains, drawing, or whatever. Believe it or not, you are allowed to do things that are fun without having any benefit for the community (though I wouldn't mention your 24 hour doom-a-thon on your AMCAS
) As for your idea playing in a hospital, that's a pretty good idea. Get another violin, viola, and cello, and you could get a quartet to play in a children's hospital or something; that could really work well, espically if you enumerate in your application about how you set everything up and such.
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I disagree with the idea of giving up time spent on your instrument to pursue other things. Personally speaking, I've played the piano for 15 years and I found it hard to just throw all of that away once I entered college. If music is truly a part of you, then you should continue doing it, as you will always find some way to fit it in. I participated in plenty of extracurricular activities and still managed to keep up with my piano practice. Furthermore, music can be a huge relief (it was for me!) from the rigors of college classes, and was a good way for me to express myself. But hey, to each his own...
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For all the 3rd/4th years and residents posting in this thread:
If you do talk about your school, and how good it is or it was, please don't forget to mention the name of it please; it can become handy to some
Thanks!
If you do talk about your school, and how good it is or it was, please don't forget to mention the name of it please; it can become handy to some
Thanks!
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Beezump.
I agree with most of the comments, but not the early contact. My school (U Colorado) has a superb early contact program. Starting the second or third week of your first year, you spend half a day a week with a preceptor. Family/General Internal/Peds your first year, then you can go to specialists if you like. In-between you have excellent teaching sessions on physical exam and patient interviewing skills (with very good standardized patients who are absolutely "real"). By the time you enter the wards as an MSIII, you will have done a lot of H&Ps and will know the basics of how to ask the questions and how to do an exam. A lot of schools have really awful early-contact programs (i.e. one patient per year you get at Case Western, unless it changed in the past two years).
And I'll argue that lower-ranked schools have a lot fewer gunners (based on my experience vs that of friends at HMS, CWRU, Hopkins, etc.). It takes a lot of gunning to get into a Top 10 school, so guess who gets in?
On my second month of medicine now and I've been scutted two times. Both times I was asked to run upstairs with orders on my patients because my intern was stuck in the ICU. Not exactly terrible.
And yeah, I regularly express my opinion to my attendings about diagnoses, treatment plans, and physical exam findings. Only a couple of people I don't deal with regularly have had problems with that. Most respect the fact that you are actually thinking and not just going "yes, sir/ma'am." And if they don't, they shouldn't be on the teaching staff. Haven't had to kiss ass with NEJM articles either (I believe in the rule "Med student reads the titles, Intern reads the abstracts, Chief reads the conclusions, Attending reads the whole thing.") We'll see how I do grades-wise but the verbal feedback I've been receiving so far has been very positive.
I agree with most of the comments, but not the early contact. My school (U Colorado) has a superb early contact program. Starting the second or third week of your first year, you spend half a day a week with a preceptor. Family/General Internal/Peds your first year, then you can go to specialists if you like. In-between you have excellent teaching sessions on physical exam and patient interviewing skills (with very good standardized patients who are absolutely "real"). By the time you enter the wards as an MSIII, you will have done a lot of H&Ps and will know the basics of how to ask the questions and how to do an exam. A lot of schools have really awful early-contact programs (i.e. one patient per year you get at Case Western, unless it changed in the past two years).
And I'll argue that lower-ranked schools have a lot fewer gunners (based on my experience vs that of friends at HMS, CWRU, Hopkins, etc.). It takes a lot of gunning to get into a Top 10 school, so guess who gets in?
On my second month of medicine now and I've been scutted two times. Both times I was asked to run upstairs with orders on my patients because my intern was stuck in the ICU. Not exactly terrible.
And yeah, I regularly express my opinion to my attendings about diagnoses, treatment plans, and physical exam findings. Only a couple of people I don't deal with regularly have had problems with that. Most respect the fact that you are actually thinking and not just going "yes, sir/ma'am." And if they don't, they shouldn't be on the teaching staff. Haven't had to kiss ass with NEJM articles either (I believe in the rule "Med student reads the titles, Intern reads the abstracts, Chief reads the conclusions, Attending reads the whole thing.") We'll see how I do grades-wise but the verbal feedback I've been receiving so far has been very positive.
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Hey guys, thanks for the thread. I just wanted to know where you can obtain a list of medical schools and what percentage of their students matched at their first choice for residency, and what types of residencies most people pursue from particular med schools.
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This is such a broad question. I don't think there is a formal list. And the thing is, all schools put out people that go into all fields. So really, you shouldn't pick a school because it say, puts out tons of surgeons and you think you want to be a surgeon. You truly never know what is going to appeal to you while your going through med school. (the story of changes are immense, myself included). The key is to find a school that you fit in, in a location you can live in.
As you are in texas, you also have to look at residency (ie you probalby dont' want to apply to calif if you aren't a ca resident)
BTW, I graduated from UTHSCSA.
As you are in texas, you also have to look at residency (ie you probalby dont' want to apply to calif if you aren't a ca resident)
BTW, I graduated from UTHSCSA.
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roja said:
Thanks for the info. I actually have an interview comming up soon (8/16) at UTHSCSA and I'm really excited about it. Anything interesting I should know about your school? Cool stories, interesting programs, interviewing advice...
Thanks,
Trish
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SEUPATTY said:
Realize that at UTHSCSA, the interview is MOST important. The people on the committee that are interviewing do not have access to your mcat, gpa etc. They have where you went to college and your personal statement. Read over your PS in case you get asked questions about it.
Be prepared for the nebulous question: So, tell me about yourself. (and this doesn't have to be about medicine!)
Don't dismiss the MS4 interviews. The selection committee often weights these (especially Dr.J) heavier than the attendings/PHD interviews. They are often much more detailed.
The CIC course is amazing. Some of it seems like BS when I was going through it alll, and all the harping on professionalism seemed a little redundant, but they really know what they are doing. When you hit the wards third year, you are totally prepped. (or I was) which allows you to really focus on learning to manage patients, present patients. This makes you look GREAT during fourth year, when you do away rotations. The focus on professionalism is really important and often neglected in many medical schools.
The laid back attitude that people sense when the interview there is totally true. The faculty is OUTSTANDING. So nice. And so informative. Wards are great. You have to BEG for scut, generally. The focus is that youa re there to learn. So if you aren't learning from stufff, you are encouraged to read.
If you need your hand held for everything (someone to notice you need guidance,e tc) you could fall through the cracks. You have to have some degree of self awareness. If you grades are falling, they notice that. but you have to have some initiative. The assumption is you are an adult and you are treated as one. I suppose for a small sect of students, this isn't a good thing.
Best advice I got? go with your gut. All the BS about board scores and percentage matching is well, BS. Pick a school and city where you think you will fit in.
If you have specific questions, feel free to PM me.
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Samoa said:
Um, I'm highly doubt you will have the opportunity to intubate as a first year. Most interns have had very little experience at this, much less 3rd or 4th years med students. You may get to start an IV or suture a laceration in the ER if you're lucky.
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SEUPATTY said:
I don't think they release that information anymore.
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fourthyearmed said:
No. They don't. The NRMP stopped releasing this info to medical schools a year or two ago. Most schools will give you (if asked) the full list of where their students matched. Whether or not it was their first choice, I guess we'll never know.
Jason
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Jason110 said:
NEVER pay any attention to any data regarding what % of people got their top three picks in the match
Its totally riddled with selection bias
having just gone through the match in Jan....alot of people suddenly shifted their #1 after talking to the program and finding out that they were probably not within striking distance of being ranked to match....and then matched at their new number 1....however in reality they did not get to go where they wanted and thus did not truly get their number 1
as well, there is pre-interview, pre-application selection bias.....i.e. people from lower medical schools tend not to apply to MGH and UCSF for residency unless they are really the man.....and MGH and UCSF might not interview them....you wont rank anywhere you didnt interview and as such....while this person might have gotten their "first choice".....if they were to list every place possible and rank them according to preference.....many peoples top 20 would be littered with MGH, UCSF, Hopkins etc..so really they are not getting their top choice.
as well some may not be interested in going to the "top" programs due to geography or having little desire for gunning for #1 or being at some huge high powered academic setting.......chances are good if you are concerned with the % of students matching at a top place you are not one of those folks
I would suggest people who are interested in considering how a particular school fares in placing graduates consider how successful the school is at matching people into the ultracompetitive specialties.....these are
Derm
Neurosurgery
ortho
ENT
optho
Rads
some would add urology but I don't think its that tough to match relative to the above
you consider % of class matching, and where they go (i.e. elite places)....where they go is much more important than how many (the former is more bias prone)
this may be tough to gauge as an applicant, especially since you don't know how good the programs in those fields are
for example, in Neurosurgery, two of the best programs are USC and the barrow neurological institute in Phoenix....the former is not one you wouldnt rattle off as a top 10 unless you knew the field and the latter most of you havent heard of.......the best way to figure this is that if the program is at the MGH it is atleast not bad and likely is outstanding.....
the reason I suggest using this is that even if you plan on going to peds....going to a school that is able to place its tough specialties well generally means you can go anywhere you want in less competitive specialites
for example.....my school....which is very good which putting 1/2 the class into ortho and neurosurgery and other surgical sub's.......placed like 6 people at CHOP for Ped's, as well pretty much everyone else did very well a few at Boston childrens, they kept a few here etc
while some places might not be as "sucessful" numerically due to a primary care leaning for the students.....in my opinion, where they are able to stick people is probably the best gauge of how likely the school is to help you go whereever you want for residency regardless of what type of residency that is
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bump
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Bump for all those choosing schools right now.
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MikeS 78 said:
Nice post. And I agree with you philosophically but the above makes no sense. Since the match favors the applicant, you have nothing to lose by ranking a program number 1 where you think you don't have a chance. If it's your favorite program then you may as well rank it number one because you never know, lightning might strike (the airplane carrying many of the programs top picks to their other interviews) and when the dust settles you might end up there anyways. At worst you will bump down to programs lower on your list.
You shouldn't try to game the match. You will match as high up on your list as you possibly can. Ranking a long-shot number one in no way detracts from your probable eventual match into a program lower on your list.
For those of you who have not gone through it please visit my humble blog for a description of the match.
I ranked Duke number one (more because it would mean not having to move than for any other reason) even though the PD was explicitely clear that I was just a courtesy interview. If I had put Duke at the bottom of my rank list under the assumption that "I wasn't worthy" I would have still matched at the same program and if I had dropped off the bottom of my list and not matched (like I did last year) I would have dropped past Duke even if it was at the bottom of my list.
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Any new thoughts?
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bump
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This should be stickied btw.
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This gets the pandabearmd.blogspot.com seal of approval.
I have no shame when it comes to plugging my blog.
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I have to disagree with the impression of students being unimportant. In my interview experience, the overall "feel" of a student body can vary from school to school. You are going to be spending 4 years there -- make sure you like the people. Also, beware of programs that keep their students hidden from you -- not a good sign.
In line with my above post, while every school has gunners, the number/percentage of gunners definitely varies. And the number of gunners can definitely impact the tone of a class/school -- whether it leans towards the cooperative or the cutthroat. Often associated with this is the grading philosophy -- if most classes are graded on a curve, that tends to bring out the worst gunner qualities in people.
Your points about grading of clinical years are important when you are a student, but sort of tricky for an applicant. For one, the grading policies could radically change by the time one reaches third year, so this may not be the best basis by which to rank a school particularly high or low. Further, even with grading policies, a lot of one's experience and end result can vary highly depending on the personality of your residents and attendings. It is probably a good thing to learn about, but, unless particularly egregious, I wouldn't let it make or break my impression of a school.
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OP has some great suggestions for decision making time... Thanks, wherever you are!
Z
zimmie256
I think this is probably very good advice when thinking about different med schools...
Does anybody who has been through the process have any specific advice on how to find out about these things? These aren't things I'd necessarily feel comfortable asking in an interview... Is the best way to get answers contacting the school after you've been accepted, and if so who/how do you ask?
Does anybody who has been through the process have any specific advice on how to find out about these things? These aren't things I'd necessarily feel comfortable asking in an interview... Is the best way to get answers contacting the school after you've been accepted, and if so who/how do you ask?
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One school I had interviewed at had a lunch with students that was informal. If you get to spend ANY time with a student outside of an interview, ask them whatever you can - feel free to ask them what they think is the worst thing at that school. Also, try and get in touch with students on SDN, that has helped me.
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When I went on my interviews, I basically only asked the questions that MikeS 78 suggested and my interviewers were highly impressed with the questions. They mentioned that usually students ask about the first 2 years when they know that it doesnt' matter what the first 2 years are like. The only problem though is that no interviewer (unless they are a student) will admitt to students doing scut work; or not having hands on opportunities. I seemed to get better info on this when we had lunch with the students.
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