AZCOM - does anyone have anything bad to say?

[azcomdiddy]

Originally posted by lukealfredwhite
Well, *I* came here so I could do rotations in those places people seem to like so little.

If we had a teaching hospital, odds are we'd have fewer free rotations, and we certainly wouldn't have a preceptor format. It's entirely possible the current set-up was conceived as a financial as much as a didactic mechanism, but that's irrelevant. Fact is, it allows for flexibility other places don't have, and if we had the advantage of a teaching hospital we'd lose the others.

I suppose it's inevitable people will complain about not being able to stay in Phoenix, and with this sort of program that complaint's going to pop up wherever the school is. There will always be a group of people who chose the school for its location rather than its program. Which is, of course, fine, but there's no sense in acting all shocked and offended as if this were a huge surprise.

If you choose AZCOM for the program, it seems to me you can't help but be pretty happy. If you choose it for the location, I respectfully suggest that there might have been a better tactical move (say, a school that doesn't advertise itself as involving a fair bit of traveling). And if UofA wasn't an option for whatever reason, one might as well be happy with the 2.5 years minimum one does have in Phoenix. Better than nothing!

You didn't have attend AZCOM if you wanted to rotate in those rural hospitals, Most DO schools that lack a teaching hospital have a program very similar to ours.

Schools with teaching hospitals offer free rotations particularly in their fourth year. However, most of their students elect to finish their rotations in that hospital as opposed to traveling. It's a fact that our lack of a teaching hospital is entirely due to the lack of a budget. I already stated that our Downers Grove campus owned a teaching hospital and sold it due to the expense of running it. There is no conjecture in this. It is a fact. You can ask Dr. G. herself and she will have no problem admitting that we don't have the money to support a teaching hospital. The only private schools that can afford a teaching hospital receive a large endowment like Harvard and other schools like them. We are 7 years old, it will be a while before we can receive that type of fudning.

I came to AZCOM for the first two years. AZCOM is known for having amazing professors. The basic science years at AZCOM are far less malignant than at other schools. But our clinical rotatons while adequate are less than desirable. And anyone who tries to spin it and say that our clinicals are an assett are simply drinking the Kool Aid. If your goal is to attend a school with great clinical rotations, go to a school that has a teaching hospital. But if you don't mind a little inconvenience during your third year especially if you want a great experience with the basic sciences, AZCOM is a great choice. That is why I chose it.

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[LukeWhite]

If I hadn't heard differently from others whose opinion I trust, I'd perhaps defer to you as I haven't done any clinical rotations. However, as best I know, no other school has a preceptor program similar to ours. Simply being able to rotate nationally obviously isn't a big deal. The value lies in being able to rotate far more than someone chained to a teaching hospital can, and in being able to do one-on-one rural rotations when one is in system, such as it is.

Again, the cost motivations don't strike me as relevant. Whether AZCOM set up the program out of financial concerns or simply for the Greater Wellbeing Of Its Dear Students doesn't change the quality of the program one way or the other.

I can see how the program might not be as attractive to someone competing for a specialty, and so certainly understand your take on it. Personally, though, after seeing my grades rise in direct correlation to how many classes I skip, I'm buying into the general theory that preclinical education isn't going to make much of a quality difference wherever one goes to. For those going into broad primary care medicine, the niche I think AZCOM should be promoting itself to, the clinical years seem the best way to get the best Experience/Theory ratio possible.

 

[azcomdiddy]

Originally posted by lukealfredwhite
If I hadn't heard differently from others whose opinion I trust, I'd perhaps defer to you as I haven't done any clinical rotations. However, as best I know, no other school has a preceptor program similar to ours. Simply being able to rotate nationally obviously isn't a big deal. The value lies in being able to rotate far more than someone chained to a teaching hospital can, and in being able to do one-on-one rural rotations when one is in system, such as it is.

Again, the cost motivations don't strike me as relevant. Whether AZCOM set up the program out of financial concerns or simply for the Greater Wellbeing Of Its Dear Students doesn't change the quality of the program one way or the other.

I can see how the program might not be as attractive to someone competing for a specialty, and so certainly understand your take on it. Personally, though, after seeing my grades rise in direct correlation to how many classes I skip, I'm buying into the general theory that preclinical education isn't going to make much of a quality difference wherever one goes to. For those going into broad primary care medicine, the niche I think AZCOM should be promoting itself to, the clinical years seem the best way to get the best Experience/Theory ratio possible.

Great post- good points all around. And I agree with you. I think AZCOM is a great school overall but it's strengths do not lie with its clinical years. The preceptorship is nice but a little overated in my opinion.

I think where you are wrong is that most people I have spoken with would have preferred the convenience of a teaching hospital but go elsewhere because they have no choice.

And you are correct tht if you aren't trying to match in a specialty or in a competitive primary care program, it doesn't matter where you do your rotations.

 

[drusso]

Originally posted by Boomer

My point would be this--residency prepares you to be a physician. Med school NEEDS to prepare you for residency--meaning that working with interns and residents, seeing what is expected and what you will have to know about and know how to do once you graduate is EXTREMELY important. Most med students get this exposure early in their third year.....I did not.

This is absolutely correct. I think that it's embarrassing that the profession keeps supporting the opening of DO schools without securing affiliated hospital experiences. It's fine to be "ambulatory based" or "community based." But, if the profession wants to train top notch students who match at top rated academic programs, then osteopathic schools must train students in the "culture" of hospital-based medicine.

One of the biggest problems that I see with DO students from non-hospital affiliated COM's is not a knowledge deficit but a lack of experience in the "culture of medicine" that is learned in a teaching environment. There is a certain way to behave as a medical student in a teaching hospital that some DO students don't "get" because they were never exposed to it. DO students need to be exposed to the hospital heirarchy of intern, resident, senior resident, attending. They need to learn how to efficiently present patients on rounds, give academic talks, ask "appropriate" questions at morning report and conferences, etc and not flub it all up! It isn't rocket science and the skills can be learned in any teaching hospital (community or academic) but they need to be learned. I encourage DO's who want to match in competitive academically-oriented programs to get as much experience in these settings as possible.

 

[supahfresh]

I'll have to agree with many of the above posts. I think if you are thinking about attending AZCOM (or other DO schools with no hospital), the time to do it is in the next few years before other schools do what the U of Colorado has done--shut DOs out of visiting rotations.

In actuality, they just charge DO students 2K for a one month rotation. To me, thats too much to handle and a big gamble.

However, I would say that my clinical years at AZCOM were exemplary. Save for doing your 5 months in AZ during your 3rd year, you dictate your own schedule. You are the boss and its awesome.

I did my preceptor rotations in the beginning of my third year to get them out of the way and then right to a big teaching hospital from thence on. I could not have been happier wkith the way it has worked out. I did all my away rotations my fourth year at some of the very best programs in the country--in different specialties. Not many schools will allow you to pick and choose the best of the best from each specialty.

The 1st two years at AZCOM are awesome. The clinical years are a potential problem if you sit back and wait for the rotations to be set up for you. Thats the down side, you constantly have to make arrangements, send applications, etc. each month to go somewhere else. I got used to it and I wouldnt want it any other way.

So I give AZCOM a thumbs up....yes they probably were intended to be a diploma mill, but with great teachers and some very nice people in the clinical ed dept, it's excellent. You are just left to guide yourself.

 

[LukeWhite]

Originally posted by drusso
I encourage DO's who want to match in competitive academically-oriented programs to get as much experience in these settings as possible.

Well that's the rub, isn't it? Obviously there are plenty of DO's who are interested in matching into competitive, academically-oriented programs. There's a niche for that, and there are osteopathic schools that do well at that path.

But should that be the focus, or even a significantly competing priority, in most osteopathic education? I don't think so. The main thing osteopathic medicine has going for it isn't the little-used OMM or its vague claim to holistic medicine. It's the fact that osteopathic medicine takes on more than its share of the primary and underserved healthcare load.

Will an osteopathic FP-to-be who's had a primarily ambulatory clinical education be hurt in the short term by not knowing how to brown-nose his way through a rotation (er, be exposed to the hospital hierarchy)? Probably. That disadvantage is more than made up, though, I'd imagine, by having a head start on learning how to do well rather than how to watch well.

Osteopathic specialists are probably necessary to raise the profession's prestige, but there's a lot to be said for a standard osteopathic trajectory that involves an unopposed, primary care, community based residency. In such residencies, hospital politics aren't nearly the factor they are in the more competitive academic specialties. While it's nice that there are schools preparing those who want to go into the more specialized fields, I see nothing wrong with a school that builds its program such that the students who benefit most are those plannong on a career in underserved community medicine.

As far as I can tell, that's what AZCOM's program does, and though there will always be people for whom it's not the best fit, there's no sense in regressing towards the mean by making the program more like others. Better to have twenty-odd osteopathic schools that carve niches not for everyone than fifteen that do their utmost to gain respectability by looking as much as they can like their big allopathic brothers.

I'm very happy with the setup, others aren't, and most of us have a choice whether or not to attend. Better that than the tepid drone-education of traditional teaching hospitals where the decision to attend is often made more on vague prestige metrics or irrelevant research activities than actual applicability to one's ultimate career goals.