AZCOM get in while you still can!

[Aloha Kid]

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Hey guys,

In defense of AZCOM - Get in while you still can! I for one love AZCOM and cannot bear to see one of my classmates voice there opinion about how sad the whole situation is without a good strong rebutal. In novacek88's message, "AZCOM leave while you still can," there seems to be 4 issues of complaint. I will try to provide an adequate rebutal of all 4 issues.

1st Complaint:
AZCOM is essentially here to make money without contributing anything back to the well-being of the students

Rebutal:
Yes, our tuition is quickly approaching $35,000/year. This sucks. But if you look around at every other NON-government/state subsidized university, tuition rates will always be higher. For example, Western U. in Pamona california charges over $30000/year just like we do. Tuition for undergrad universities like USC charges greater than $25,000/ year and that's just undergrad! University of Colorado allopathic medical school charges around $60,000/year tuition to it's out-of-state students who like us, are not state subsidized. Novacek88, Dude! you chose a private school. That's just the way it is. Don't forget, we are also not in the midwest boon-docks where everything including school tuition is cheaper.
This, however, is besides the fact. The point is, everyone who comes to this school at one point or another makes a conscious decision to accept the tuition situation as it is. It may increase every year, but novacek88, I'm sure you thought of this before you came here right? You did listen in orientation the part about financial aid right?
Oh, and don't forget the quality faculty and facilities we have here at AZCOM. Everything is brand new and beautiful. Many of the professors are truly wonderful educators. The learning environment which MWU has set up stands second to none. Like Novacek88 said, this is just one of the things that stands out about AZCOM! Which is also the reason why 1st and 2nd year are exceptional.
In my personal opinion, the average physician salary is about $120000/year, it will take only a few years of living within ones means to pay off the debt. In the grand scheme of things, it is DOable.

Second complaint:
AZCOM students receive no help from their school whatsover in planning and organizing MS3 and MS4. In addition, the preceptorship has not served me well.
Rebutal:
Unfortunately, this is NOT a problem unique to AZCOM. It is also a problem seen in almost every Osteopathic school nation wide. For all pre MS 3 and 4s, this is the situation. AZCOM like many schools will set your rotations up for you. You could slide right by like butter without even having to lift up a finger. But, it's the quality of these rotations that stand in question. At times, if you are not proactive, you'll be sent to a rotation you may fell less than adequate. Ex/ doing an IM office based rotation when you are planning on going into IM hospital based medicine. However, If one also examines Allopathic medical students, they too complain left and right to some degree just like we do. MS3 and MS4s nationwide need to be proactive in setting up their rotations. We spend 4 years of undergrad proactively working towards a goal, and now when it comes to our third year of medical school all we can do is sit back and whine??? Novacek88, dude, that's just the way it is. No one is going to spoon feed you.
Preceptorship based rotations work great for some things like FP and Surgery. There is nothing better than being first assist, one on one, with your surgeon. It, however, does not work for everyone and every situation. This is even more reason to be proactive in setting up rotations.
In the long run, look at the end results. We have many students who match into specialty fields at prestigious institutions. Check out mwuweb.midwestern.edu and look under Deans office. You'll see the matches. When the wheel hits the pavement, AZCOM is getting the job done.

Third complaint: If you were admitted to other osteopathic schools particularly ones with good reputations, I would go there in a hearbeat. Or if your ambition was to attend an MD school and you settled on AZCOM; wait a year and reapply. I definitely would have done that. I know many of friends would have done the same.
Rebutal:
This is perhaps the most telling comment Novacek88 makes. In essence, he/she really is saying, "I wanted to be an MD, but couldn't get in to any MD schools. So, I settled for AZCOM becasue I didn't want to chance it and had no faith in myself to reapply. To be honest, all I want is prestige." Dude, it's okay really. We have lots of DO wanna be MDs. At times, we all lose hope. In essence, there is no rebutal to made here. Only the need to point out the primary derivative of the whining, a character flaw.

Fourth Complaint: I feel that our approach is detrimental to preparation for the boards. Our students do not perform particularly well on the USMLE Step 1.
Rebutal:
Uhh . . . YEAH! Last I checked AZCOM was an Osteopathic school. DO schools prepare their students to take the DO boards (COMLEX).
And by the way, our percentage pass rates are top notch of all schools. That means, even low end of the curve students in our class pass. And yes, in my opinion, I have not met a single person in my class who has scored below 55% on the COMLEX. True, this last statement may be my opinion, but don't forget, novacek88, so was your statement that our school doesn't prepare us well for USMLE 1. By the way, what did you score on USMLE 1?

AZCOM is a great school. Don't let Novacek88's opinion sway you. For every Novacek out there you will find an Aloha Kid. 😉

 

[Luck]

The thing about AZCOM I don't like is the clinical rotations. Boomer, who graduated from AZCOM, said it himself that if you want to have a good clinical education, you have to leave Arizona. This is pretty hard if you have a family and I think it's simply sad.

Aloha, could you please tell us what year you are in? Somehow I suspect you are a 1st or 2nd year and therefore really do not yet have an accurate perception of the 3rd and 4th years.

 

[Aloha Kid]

Luck,

I'm a fourth year just like novacek88. I understand where you are coming from. I have a family with kids too.

Fourth year in Arizona is awesome. You don't have to go anywhere becasue there are great hospital based rotations you can get into. Here's the list. 1 Mayo clinic - Scottsdale. 2. University of Arizona 3. Good Samaritan Med center 4. Maricopa County 5. St. Josephs med center 6. Phoenix childrens med center. 7. John C. Lincon med center 8. Kingman Reg med center. 9. VA Phoenix. Keep in mind though, that unless you want to do a residency in AZ, you seriously need to get out of state.

As far as third year, you can't get into Good sam, Maricopa, UA, Mayo, St. joe, Phoenix Childrens. But, it's okay because you can still set it up on your own. In reality, the one rotation you really need hospital based stuff for your third year is IM if you are doing adult med, or PEDS if you are going to deal with kids. I would be glad to explain my opinion in another post if you wish. Anyways, this only comes down to 1 rotation out of state - your third year. Keep in mind, that IM can be done in many community hospitals around phoenix.
I actually took my whole family with me on an away rotation. It was an experience. My family liked the area, and I am planning on applying there come match.

Unless you just want to plant yourself in one hospital/area and do residency in that hospital/area, you are going to have to travel at one point or another. Unfortunately it's not like undergrad anymore where you can just plop your butt down in the same class/building over and over and one day get a BS degree.

 

[Luck]

Luck,

I'm a fourth year just like novacek88. I understand where you are coming from. I have a family with kids too.

Fourth year in Arizona is awesome. You don't have to go anywhere becasue there are great hospital based rotations you can get into. Here's the list. 1 Mayo clinic - Scottsdale. 2. University of Arizona 3. Good Samaritan Med center 4. Maricopa County 5. St. Josephs med center 6. Phoenix childrens med center. 7. John C. Lincon med center 8. Kingman Reg med center. 9. VA Phoenix.

As far as third year, you can't get into Good sam, Maricopa, UA, Mayo, St. joe, Phoenix Childrens. But, it's okay because you can still set it up on your own. In reality, the one rotation you really need hospital based stuff for is IM if you are doing adult med, or PEDS if you are going to deal with kids. I would be glad to explain my opinion in another post if you wish. Anyways, this only comes down to 1 rotation out of state your third year. Keep in mind, that IM can be done in many community hospitals around phoenix.
I actually took my whole family with me on an away rotation. It was an experience. My family liked the area, and I am planning on applying there come match.

Thanks for providing a more accurate picture of AZCOM's clinicals. Maybe it is possible then to have a good clinical education and still stay in Arizona. I wonder why so many AZCOM students say otherwise then.

 

[jhug]

I wonder why so many AZCOM students say otherwise then.

luck, i personally feel it is bc of what i mentioned earlier (in another thread) the most vocal are usually the laziest (ie: need to be spoon fed everything & are not happy when they are not so they want everyone else to know how unfair it is), the most malignant, or the most ignorant...i think this holds true of a lot of things in life.
as a second year, and one excited to start clinicals soon, i am encouraged more by all those that are giving GREAT advice on how to succeed (like aloha and nikkitay)...and they outnumber those who are not, in the end, happy with the education azcom was able to provide them.

 

[San_Juan_Sun]

I wonder why so many AZCOM students say otherwise then.

Do you believe everything you read on the Internet?

And for the record, there are really only two individuals who've had consistently bad things to say about AZCOM. That would be azcomdiddy and novacek88 (one of whom mysteriously disappeared, and the other who mysteriously arrived. Coincidence?).

I certainly wouldn't put Boomer in that category, as Boomer's opinion has been much more balanced.

It's a huge overstatement to assume that "so many" AZCOM students have bad things to say. The overall picture by posters on this board has been overwhelmingly positive. This positive picture certainly grates on a small minorities nerves, but I find it telling that these bitter few would be so upset by the fact that their classmates are actually happy. In other words, it sounds like a personal problem to me.

Lastly, I find it a bit comical to read the posts for pre-meds and the like who think they've got the scoop on every paticular school (mainly from what they've read off the Internet 🙂 ). Even funnier are the dorks who try to knock everybody else as getting "weak clinical education", when the reality is they won't admit what medical school they go to (or even IF they go to one). Easy to throw stones on an anonymous forum, if you don't mind having SLOC (I'm looking in your direction Luck).

 

[Boomer]

Even though I have so much more to do, I feel the need to chime in my perspective on these statements.

1. I wouldn't say that the school is here JUST to make money, but I will say that seeing tuition rise 6-7% per year is a little steep, especially when the school is already so expensive. Many people's problem with the cost of tuition is the apparent lack of investment in clincal rotations. MD schools, as well as DO schools with full time clinical faculty/teaching hospitals, pay the attending to teach you....

Now, first two years, I'd put right up against any other school. Years 1 and 2 are very strong. However, in my opinion (as well as the opinion of many other people), years 1 and 2 are not the most important in med school.

2. My main problem wasn't so much doing the legwork on my own, but rather the lack of access to educated individuals who could help me achieve my goals. AZCOM's clinical faculty (the division directors) all have private practices to attend to, and are only on campus limited times. The people in the clin ed office truly have little insight into medical education, but they sure know how to fill a calendar--and that's all their job is.

3. Anyone at any DO school should be certain that they'll be happy as a DO. I knew I would be. It got me where I wanted to be. This topic is insanely old...

4. I agree with Aloha here. The school's job is to prepare you for COMLEX. Although the school does not "officially" release an average, our class's average was "rumored" to be around 60th percentile. That's soundly above the mean. That's comparable to an MD school averaging about 219 on USMLE step one. That's solid.

As for Aloha's other post re: 4th year locations, allow me to expand.

1. Mayo--you can do 2 months there--just like any other student from any other medical school in the US. No advantage/disdvantage here.

2. UofA--huh? Unless things have changed in the past two years (which I admit, is totally possible), they really don't want us. I know a friend of mine was told that a U of A rotation (can't remember specifically which one) would be as observation only, and would not be counted toward clin ed requirements.

3. Good Sam--Good Sam instated a policy when my class was 3rd year, that in order to do a 4th year IM rotation there, you must have done 8 WEEKS of TEACHING HOSPITAL BASED IM in your third year. This is a very thinly veiled shot at AZCOM, as they were aware that we don't have these rotations readily available. Interestingly enough, they take our graduates in mass quantities for their IM residency program--they just don't want us there as students.

4. County--At least used to require USMLE scores of mean or better or COMLEX scores of 83 percentile or better to rotate there. Still, as with Mayo above, any 4th year anywhere in the US can rotate here--no advantage/disad.

5. St. Joe's--largely regarded as poor quality--at least in terms of their residency program. They were the only IM program in AZ not to fill via the match this year (and they didn't even come close).

6. Phoenix Children's--can't comment. I know nothing about this hospital, except one classmate matched there.

7. John C. Lincoln--I didn't rotate here, but know people who did. Sounds like a decent place, but very popular, and very crowded between AZCOM and KCOM students.

8. Kingman--Are you F'n kidding me? It's in Kingman!!! Travel is implicit, which pretty much rules this out of the Phoenix discussion. I've heard it's decent there, but again, you're away from family (if this is a concern for you).

9. Phoenix VA--Again, not a place where I rotated. As you've mentioned, it's only available to 4th years, and I spent the first half of 4th year travelling to get the spot I got, and the second half of 4th year moving to my new place and on cake rotations (cause hey, when else are you going to have so much free time in the next few years?). If you're interested in staying in Phoenix, an early rotation at the VA fourth year is a good idea.

The one thing that this post misses out on though is third year. Yes, there are great opportunities 4th year (however, as I mentioned above, this is true at almost all schools in the US), but in order to take full advantage of 4th year, you need a solid base 3rd year. You need to walk in on day one as a 4th year and know what is expected of a student IN A TEACHING HOSPITAL (how to formally present, logistics of writing orders, details that seem simple until you're the one responsible for them). You can get this experience in community-based teaching hospitals--they don't have to be large academic centers--but you need to get them in third year. And, with a handful of exceptions, this means travelling during your third year.

I pm'd this next statement to jhug, but I think it's good to see:

I'm a week into my PGY-I year in Internal Medicine at an allopathic residency. Our program has 23interns, with an approximate breakdown of 50% US MDs, 30% FMG, 20% DOs. From my first impressions, I am neither no more or less competent from a medical knowledge standpoint than anyone else. All of the interns have about the same fund of knowledge The difference lies here: KNOWING WHAT TO DO NEXT!! The US MD grads are much better at this early stage in terms of what to order and how to get work done in the hospital. I would class us DOs next, and the FMGs behind. Thankfully, these skills can be learned, but I can't help but think that I wish they had been stressed more heavily in med school.

When I was applying (a long time ago) and using these boards, there was a guy who used to post here named Kent Ray (I even remember his name). He graduated from Des Moines. He used to make similar comments to the ones I am making now. I used to think, "What an a--hole. He's already got his education, why is he dumping on it for the rest of us." I now understand that Kent saw medical education from both the osteopathic and allopathic sides, and noticed that the MD schools by and large invest more time and money into their clinical ed. I wonder who'll remember "that Boomer a--hole" in 5 years....

There's good and bad in every situation. Good luck determining which is which.

And, SJS, thanks for noting that my opinion has been more balanced. That is generally what I strive for, but there have been several folks who would disagree....

 

[VentdependenT]

Solid post Boomer.

Internship includes an insane amount of hospital politics. The more time you spend in a hospital the better you will become at being versed at "getting $hit done." I would imagine that about everyone is at the same level within 3 months.

I can't even begin to imagine what internship would be like without having done a good proportion of my rotations in teaching hospitals. There is so much bs,paper pushing, presenting, calling, contacting seniors, and RESPONSIBILITY that not having an early exposure to hospital based clinicals (as opposed to preceptor based) would be a major hinderance.

The few preceptor based rotations I did were great, but I did the vast majority at teaching hospitals (lots o' travel and expenditure). The couple of sub-I's I did also helped tremendously (as far as establishing a sense of autonomy)...and I'm still just a jackas$.

Vent

 

[Luck]

Lastly, I find it a bit comical to read the posts for pre-meds and the like who think they've got the scoop on every paticular school (mainly from what they've read off the Internet 🙂 ). Even funnier are the dorks who try to knock everybody else as getting "weak clinical education", when the reality is they won't admit what medical school they go to (or even IF they go to one). Easy to throw stones on an anonymous forum, if you don't mind having SLOC (I'm looking in your direction Luck).

I do tend to believe AZCOM graduates like Boomer and Vent more than you since you're just a first year and really know nothing of your school's clinicals.

It seems to me that rotating at a teaching hospital is important to help in your internship and the preceptorship may not cut it. To rotate in teaching hospitals you have to go out of Arizona to do this, based on the above posts. The picture is becoming clearer now.

 

[Aloha Kid]

Here's some clarification from Boomers post regarding the different teaching hospitals in AZ with residency programs.

1. Mayo - Pretty much any fourth year rotation. Limit 1 rotation only. They fill fast since everyone across the nation wants in. Some guys from my class are doing rotations like ccu, cards, GI, plastics, Anesthesia, etc.
2. U of A - The rotation that turned into observation only was Anesthesia secondary to the high demand for slots by their own students and out-of-state students. Who knows though, this could be interpreted as trying to shut out DOs, BUT they end up shutting out other MD students as well. Other stuff like ER, IM, are still open and possible. Fouth years only. UA is the epitomy of MD territory, but some of my classmates still have things set up there.
3. Maricopa County - Awesome rotations all around. Max number is 2 per academic year. Typically fourth years only for majority of the rotations offered. Need board scores above 50% at least to rotate there. As far as I know, majority of my class is greater than 50% solid. I just finished CCU - got a couple central lines, A-lines, paracentesis, etc. Currently doing a Sub-I. Other rotations there include FP, IM-subspecialties, Trauma Surg, Neuro surg, Gen surg, etc.
4. Good Sam - A rule was applied that you need two hospital based IM rotations your third year before doing a fourth year IM rotation there. I talked to the clin ed coordinator. This rule applies for MD and DOs. It could be construed, however, that Good Sam is trying to lock DOs out depending on how you look at it. Anyways, if you are really planning on doing IM here your 4th year, make sure you do 2 hospital based IM rotaions your 3rd year. However, with that said, the clin ed coordinator also told me that if you complete another 1-2 hospital based IM rotation your fourth year, they will consider you application. Other rotations that are still open there are Gen surg, Ob/GYN, FP, etc.
5. St. Joes - talked to a guy who matched. He seems to think this is a descent program. Definitely not an academic powerhouse or anything. Basically, this is not a CRAP place. They have been putting out IM docs for a long time. 4th year rotations available are IM, FP, Solid Peds rotation (4th years with experience in peds), IM-subspecialties.
6. John C Lincon. - Solid DO FP residency program. Rotations available include FP, IM.
7. VA Phoenix - Don't know much about
8. Tuscon Medical hospital - Don't know much about
9. Kingman - Is 2.5 hours northwest of phoenix. Nonetheless, it is the DO hospital with residency programs in ER, Derm, FP, and transitional pgy-1 year. Don't know how solid these rotations are.
10. Phoenix childrens - Good peds program. Offers peds rotations.
9. Scottsdale Osbourne - Solid MD FP rotations and residency program.

Neighboring states possible rotations - University of Nevada Lasvegas, reno sites. University of New Mexico. University of Utah, LA programs, San Diego programs.

With the addition of another DO medical school near Las vegas, Nevada - more rotations and hospitals should open up at least in nevada. Of course, the opposite could happen as well where their students pile into AZ and CA due to lack of rotations. It will be interesting to see how this plays out. Nonetheless, Kingman which is 1.5 hours away from the new school will definitely see a lot of students from this new school. Kingman will probably be a key player, but they are truly a small fledgling hospital which most likely will not be able to accomodate further teaching programs and academics.

 

[San_Juan_Sun]

I do tend to believe AZCOM graduates like Boomer and Vent more than you since you're just a first year and really know nothing of your school's clinicals.

Actually, you tend to believe anything that's posted on SDN by persons who have yet to ENTER medical school. That's why you've got SLOC.

 

[Boomer]

Ah, Tucson Med Center, I forgot about that one.

I didn't do any rotations there, but I heard that IM and GS are both very strong there. They are part of the AZCOM lottery, and likely to be very popular due to their environment and quality.

True about Good Sam's limitation being applied to all, however it is well known that AZCOM has difficulty getting teaching hospital IM--which is why I referred to it as a thinly-veiled shot at our school.

AZCOM was attempting to establish rotations in Vegas, I agree that the addition of TUCOM-LV could limit those spots, however it could lead to TUCOM students being considered second choice for those spots in their own city (look at Phoenix for an example.....)

 

[Su4n2]

this isn't specific to AAZCOM, but to all the DO schools that don't offer HOSPITAL BASED ROTATIONS third year. why would u train at such a place?
I am a NYCOM student and we have our rotations in hospitals. when i see a school that doesn't offer 3rd year hospital rotations i think this: this school is just out to make money from u. think about it, the first 2 years you can practically do on your own, it's the 3rd year that you begin learning stuff that you cannot learn on your own. where is the 60K taht you are paying for 3/4 year going? why would you pay the price of a private medical education (comparable to bothy MD and DO) when you are getting less? again, this isn't specific to any school (i have heard that AZCOM is great school) but i think we need to stand up and demand what we pay for.

 

[LukeWhite]

Su,

Hospital-based rotations in third year are, in my opinion, a bit overrated. It's nice to have a few so that you can learn the ropes, but in any academic hospital worth its salt, the third years are in the back row behind the residents, interns, fourth years, random allied health folks, etc. You may get to observe quite a lot and will definitely get more didactics than you would in a preptor-based setup like AZCOM's, but how much will you actually do?

In a preceptor-based setup like AZCOM, didactics are admittedly weak since you're training with folks who are perhaps more interested in running their practices than teaching. The upshot is that there's a lot more opportunity to get hands-on experience instead of spending a big part of third year doing scutwork and neck-craning. Of course it's not so black-and-white either way, but I do think AZCOM's done a pretty good job of demonstrating that a preceptor-based rotation setup allows for more experience at the expense of formal instruction.

So, to answer your question on why anyone would choose this: I chose it because I'm more interested in developing a broad scope of practice than in thorough didactics. I'm also of the opinion that I'll have a better shot at impressing prospective residencies in fourth year if I've spent third year learning how to "do stuff" so that in fourth I can concentrate on perfecting and on doing the things that need done to get into a good residency.

Others will be of a different mind, and there's a case to be made that it's not the best system for someone who wants a highly competitive specialty that requires a lot of experience in cutting-edge research and hospital politics. For the vast majority of specialties, though, and most definitely for primary care, I think AZCOM's preceptor setup is brilliant. There are AZCOM students all over who have delivered dozens of babies by graduation--that would be impossible in a standard setup.

And finally, the flexibility's nice. You've probably seen some complaints about the travel required--it seems a plus to me, as I know some exceptional doctors with whom I'd like to rotate as soon as possible, and have interests that a teaching hospital won't help with--all the didactics in the world won't make a big-city academic hospital better at teaching frontier medicine than a good clinic in southwest Alaska.

Anyhow, that's an incomplete explanation for why I, and I think many of my classmates, chose AZCOM. Of course, there are a lot of fantastic things about the school in general that make it attractive even if one chooses it in spite of the final two years. For those angling towards a practice based on building competencies quickly, though, I think it's unmatched all four years.

 

[Luck]

Luke

I understand where you are coming from and I used to have your perspective on the issue until I starting rotating. I was excited by the preceptor model because of the hands on nature of it. I still think the preceptor model offers some advantages in this regard. But what you fail to appreciate is that working in a hospital setting is a language of its own. It's just different and the reality is that your residency will emulate a hospital based setting and not that of the cushy private practice setting. There are rules, customs, politics, paperwork etc. that you must learn in a hospital based setting so that you will be adept by the time you start residency. All interns have a major learning curve but your learning curve will be even greater if you don't expose yourself to enough hospital based rotations. Luke, you just finished your first year. Wait until you finish your third year before you tell us how overrated hospital based rotations are. You will see they aren't overrated at all.

Scutwork is an integral part of being a resident. Your attendings will consider you a burden because they will have to teach you things you should have learned during third year. For example, writing notes in a hospital based setting is a lot different than private practice. Regardless of your great hands on skills, if you write unorthodox notes, your resident will come down you hard. That's the first sign of a bad intern is they never learned the proper protocol the first time.

Thanks for giving us that description. It appears that AZCOM has some serious failings in their clinical years if they lack hospital based rotations. From what you have said, hospital based rotations seem very important.

 

[LukeWhite]

Novacek,

Of course I can't refute the charge that I've only finished a year--that is what it is. Like most of the folks in class, though, I've had prior experience in the healthcare world and so would like to think that my take on it isn't starry-eyed optimism.

While I agree that someone doing rotations exclusively in private practices would have a hard time of it, I don't know that's necessarily how it has to happen. I'd never rotate with my preceptors from this year--a private FP office-based practice in the valley doesn't have nearly enough variety to provide decent instruction. It's entirely possible, though, to do preceptor-based rotations in environments that aren't quite so suburban-med.

Obviously we're constrained a bit by the requirement that six months out of third year has to be in-system. This is a pretty mild requirement, though, and as I understand there are plenty of locations that are far closer to a clinic/hospital setting than a private practice. I certainly don't fault those folks who choose the valley rotations in a private office practice for complaining--they're getting lousy training, as best as I can tell. But that's not necessary, and if they chose to sacrifice the chance to hit excellent sites for locations in the valley, that's a choice they'll of course have to deal with.

To put it another way--it's entirely possible to do hospital-based rotations through a preceptor model if one's willing to put a little work into it. I've already started laying the groundwork for some of mine, as have others in my class. I've got connections at the mid-size hospital back home, which also features a small but highly-regarded FP residency. It will be easy to get rotations that preceptor-based in every sense of the word while still picking up an excellent sense of hospital protocol and administration. Many, perhaps most others in class have similar connections at least as good or better.

The people who lose out in AZCOM's setup, as best as I can gather, are those tethered by location and those who just coast through, putting all their energy into great second year grades, without giving thought to rotation planning. Like all flexible systems, AZCOM's carries the risk of an unsatisfactory experience. However, I don't think that the *possibility* of this should be confused with its inevitability--I see no reason why a proactive student willing to sacrifice a bit of comfort shouldn't be able to set up fantastic rotations both years.

Luck, just to clarify a key point--AZCOM doesn't lack hospital based rotations; rather, its clinical program isn't built upon them. Heaven help the student who doesn't do any hospital-based rotations...maybe it's possible given our setup; I don't know. But it would certainly be career, or at least competence suicide. Preceptor-based rotations and hospital-based rotations aren't mutually exclusive. It might be tougher to set up something involving both, and it will definitely take a bit of traveling if one wants to do a lot of that, but for the student who knows that that's what they want and why they want it, AZCOM's ideal.

 

[novacek88]

Novacek,

Of course I can't refute the charge that I've only finished a year--that is what it is. Like most of the folks in class, though, I've had prior experience in the healthcare world and so would like to think that my take on it isn't starry-eyed optimism.

I'm not accusing you of being starry-eyed. I am accusing you of being normal. We were all like you after first year. Basic sciences is great at AZCOM. You don't see the real horror until third year. The practical aspect of the preceptorship is useful but limited.

To put it another way--it's entirely possible to do hospital-based rotations through a preceptor model if one's willing to put a little work into it. I've already started laying the groundwork for some of mine, as have others in my class. I've got connections at the mid-size hospital back home, which also features a small but highly-regarded FP residency. It will be easy to get rotations that preceptor-based in every sense of the word while still picking up an excellent sense of hospital protocol and administration. Many, perhaps most others in class have similar connections at least as good or better.

Actually, it's not possible. Yes, some preceptorships are better than others. It would be misleading of me to suggest otherwise. But there is a clear distinction between a hospital based setting at a teaching hospital versus a preceptorship. You can't fool yourself into thinking that you can emulate one by choosing the right preceptorship. We all thought that too. I respect your previous health care experience but until you have been a third year student rotating in a hospital based setting, you can't accurately gauge the situation.Luke, your optimism is great but I still think you need to more patient and open minded before you come to any conclusion about this matter. You haven't experienced it yet.

 

[novacek88]

Even though I have so much more to do, I feel the need to chime in my perspective on these statements.

1. I wouldn't say that the school is here JUST to make money, but I will say that seeing tuition rise 6-7% per year is a little steep, especially when the school is already so expensive. Many people's problem with the cost of tuition is the apparent lack of investment in clincal rotations. MD schools, as well as DO schools with full time clinical faculty/teaching hospitals, pay the attending to teach you....

Now, first two years, I'd put right up against any other school. Years 1 and 2 are very strong. However, in my opinion (as well as the opinion of many other people), years 1 and 2 are not the most important in med school.

2. My main problem wasn't so much doing the legwork on my own, but rather the lack of access to educated individuals who could help me achieve my goals. AZCOM's clinical faculty (the division directors) all have private practices to attend to, and are only on campus limited times. The people in the clin ed office truly have little insight into medical education, but they sure know how to fill a calendar--and that's all their job is.

3. Anyone at any DO school should be certain that they'll be happy as a DO. I knew I would be. It got me where I wanted to be. This topic is insanely old...

4. I agree with Aloha here. The school's job is to prepare you for COMLEX. Although the school does not "officially" release an average, our class's average was "rumored" to be around 60th percentile. That's soundly above the mean. That's comparable to an MD school averaging about 219 on USMLE step one. That's solid.

As for Aloha's other post re: 4th year locations, allow me to expand.

1. Mayo--you can do 2 months there--just like any other student from any other medical school in the US. No advantage/disdvantage here.

2. UofA--huh? Unless things have changed in the past two years (which I admit, is totally possible), they really don't want us. I know a friend of mine was told that a U of A rotation (can't remember specifically which one) would be as observation only, and would not be counted toward clin ed requirements.

3. Good Sam--Good Sam instated a policy when my class was 3rd year, that in order to do a 4th year IM rotation there, you must have done 8 WEEKS of TEACHING HOSPITAL BASED IM in your third year. This is a very thinly veiled shot at AZCOM, as they were aware that we don't have these rotations readily available. Interestingly enough, they take our graduates in mass quantities for their IM residency program--they just don't want us there as students.

4. County--At least used to require USMLE scores of mean or better or COMLEX scores of 83 percentile or better to rotate there. Still, as with Mayo above, any 4th year anywhere in the US can rotate here--no advantage/disad.

5. St. Joe's--largely regarded as poor quality--at least in terms of their residency program. They were the only IM program in AZ not to fill via the match this year (and they didn't even come close).

6. Phoenix Children's--can't comment. I know nothing about this hospital, except one classmate matched there.

7. John C. Lincoln--I didn't rotate here, but know people who did. Sounds like a decent place, but very popular, and very crowded between AZCOM and KCOM students.

8. Kingman--Are you F'n kidding me? It's in Kingman!!! Travel is implicit, which pretty much rules this out of the Phoenix discussion. I've heard it's decent there, but again, you're away from family (if this is a concern for you).

9. Phoenix VA--Again, not a place where I rotated. As you've mentioned, it's only available to 4th years, and I spent the first half of 4th year travelling to get the spot I got, and the second half of 4th year moving to my new place and on cake rotations (cause hey, when else are you going to have so much free time in the next few years?). If you're interested in staying in Phoenix, an early rotation at the VA fourth year is a good idea.

The one thing that this post misses out on though is third year. Yes, there are great opportunities 4th year (however, as I mentioned above, this is true at almost all schools in the US), but in order to take full advantage of 4th year, you need a solid base 3rd year. You need to walk in on day one as a 4th year and know what is expected of a student IN A TEACHING HOSPITAL (how to formally present, logistics of writing orders, details that seem simple until you're the one responsible for them). You can get this experience in community-based teaching hospitals--they don't have to be large academic centers--but you need to get them in third year. And, with a handful of exceptions, this means travelling during your third year.

I pm'd this next statement to jhug, but I think it's good to see:

I'm a week into my PGY-I year in Internal Medicine at an allopathic residency. Our program has 23interns, with an approximate breakdown of 50% US MDs, 30% FMG, 20% DOs. From my first impressions, I am neither no more or less competent from a medical knowledge standpoint than anyone else. All of the interns have about the same fund of knowledge The difference lies here: KNOWING WHAT TO DO NEXT!! The US MD grads are much better at this early stage in terms of what to order and how to get work done in the hospital. I would class us DOs next, and the FMGs behind. Thankfully, these skills can be learned, but I can't help but think that I wish they had been stressed more heavily in med school.

When I was applying (a long time ago) and using these boards, there was a guy who used to post here named Kent Ray (I even remember his name). He graduated from Des Moines. He used to make similar comments to the ones I am making now. I used to think, "What an a--hole. He's already got his education, why is he dumping on it for the rest of us." I now understand that Kent saw medical education from both the osteopathic and allopathic sides, and noticed that the MD schools by and large invest more time and money into their clinical ed. I wonder who'll remember "that Boomer a--hole" in 5 years....

There's good and bad in every situation. Good luck determining which is which.

And, SJS, thanks for noting that my opinion has been more balanced. That is generally what I strive for, but there have been several folks who would disagree....

Great Post Boomer! If you put Alohakid on one of the spectrum and me on the other end, Boomer and Vent are in the middle. They have provided the most balanced and accurate opinion on these issues thus far.

 

[LukeWhite]

Novacek,

Completely understood. I'm sure I'll be surprised in more than one way come clinicals. I'm still unconvinced of the disastrous nature of the system, though, simply because I'm familiar with what its successes and failures have been. From everything I've seen, it's the optimal program for students with a particular set of career goals, and an above-average program for everyone else. I suppose it's possible the success stories I've heard and what I know about academic medicine will be refuted by personal experience, and I certainly wouldn't complain about more help from the clinical ed office. But there seems to be a particular track to success that's worked well for many, many people in AZCOM's program, and I've still seen no evidence that following it will result in anything but a way-above-par clinical education.

Most of the complaints I've seen about the program have come from people angling for a type of medical practice very different from the sort they're exposed to in preceptor-based settings. This is understandable. It seems, though, as if that's comparing apples and oranges. Most, if not all, of the negative opinions I've seen to date have come from folks either in or angling for hospital-intensive residencies. While I'll agree with your point that most any residency is going to be mainly hospital based, I don't think that the difference between, say, an FP residency and gas residency can be minimized to the extent it has been on this thread. They're different types of medicine and it amazes me that more schools haven't caught on to the idea that there should be different corresponding types of medical education.

 

[azcomdiddy]

Anyone who pretends that AZCOM is flawless is delusional. Why is it that when someone criticizes AZCOM, the pom pom squad emerges out of nowhere to refute every criticism layed upon the school. Can we not just admit that AZCOM has its strengths and weaknesses? Let's just admit that the school charges way too much money and has a poor clinical structure. This should be obvious by now and anyone who refutes probably denies the Holocaust as well. The first two years at AZCOM are great. The facilities, teaching and weather are also big draws but the clinical structure is subpar. For some of you, this weak clinical structure could be detrimental to your career especially if you want to go into surgery.

Also, I want to laugh at those who try to suggest that AZCOM purposefully chose the preceptor model. The reason why AZCOM offers the preceptorship is because they had no choice. It was the only thing they could offer. Do you honestly think AZCOM would bother with that backward preceptor model if they had full access to all the area hospitals; absolutely not! The University of Arizona School of Medicine blacklisted AZCOM students from rotating at their affiliated hospitals during their third year. The reason this happened is because AZCOM established themselves in Phoenix despite U of A's vocal protest. KCOM wanted to set up shop here as well but were told by U of A to stay away. In exchange, U of A allowed Kirksville's students to rotate in Phoenix.

AZCOM is like any other DO school in that it has its good and bad. Some people love it and others don't. The school is made for some and not for others. If you want to go into primary care then the preceptor model is ideal for you. If you want to specialize, I would check out other schools. Also, if you are seeking a school with a lot of diversity, AZCOM is not for you. But if you like a conservative environment, you will love AZCOM.

 

[VentdependenT]

I am in no way defending the school. However I don't know any other DO school that lets you rotate out your entire 4th year. For someone that wants to specialize that is a big plus in my mind as you can really land some stellar letters and do some big rotations. Versus being stuck at some local osteopathic/allopathic hospital that few people have heard of/has few people with national recognition...something to think about I guess.

That said 3rd year is a very rough one indeed if you are looking for big/moderate sized teaching hospital based rotations. I blew plenty of cash and time to travel and lodge in cities that provided me with that opportunity. I did get to first assist on every single one of my GS cases in Mesa. That was one solid rotation provided a la azcom...too bad that doc moved. Worst part in my mind about the school is total lack of career guidance. You have SDN, your buddies, and word of mouth to try and guide you through the mess.

As for the cost. They can't hide that $hit. You know what you're in for. Never the less I'm gone. 😀

 

[azcomdiddy]

I am in no way defending the school. However I don't know any other DO school that lets you rotate out your entire 4th year. For someone that wants to specialize that is a big plus in my mind as you can really land some stellar letters and do some big rotations. Versus being stuck at some local osteopathic/allopathic hospital that few people have heard of/has few people with national recognition...something to think about I guess.

The problem is that by the time 4th year starts, it's too late. You submit your application for residency by November of your 4th year and most applications go out before then. If you are relying upon letters of recommendation from 4th year attendings and residents, the chances are you won't receive strong ones because they haven't had enough time to spend with you. How well can they write someone a LOR if they have only had a month or two with them. That is why 3rd year is so important for people who are trying land competitive residencies. But unfortunately, I and many others will be stuck shadowing...I mean....getting hands on experience from Dr. Strangelove in his practice for the first 6 months during that precious 3rd year. Oh well, that's what a high class rank and a 240 on Step I is for.

 

[VentdependenT]

Most people get LOR's after one month of working with them. Research electives allow one to land powerful LOR's by big names in their respective fields.

That still gives someone May (3rd year, stick an elective in at the end), June, July, August, Sept, Oct, to land letters. I agree that Oct is most definitely crunch time but if you have the rest of your app complete lots of places will look past you not having another letter in on time. Its not ideal but its far from doomsday.

In accordance with your view it would be highly beneficial for AZCOM to cut out an FP or 2 and allow a couple more elective months during 3rd year. Plan far in advance for competitive residencies.

Best of luck in the future.

 

[jhug]

vent...thanks for the great advice!

 

[azcomdiddy]

Most people get LOR's after one month of working with them. Research electives allow one to land powerful LOR's by big names in their respective fields.

That still gives someone May (3rd year, stick an elective in at the end), June, July, August, Sept, Oct, to land letters. I agree that Oct is most definitely crunch time but if you have the rest of your app complete lots of places will look past you not having another letter in on time. Its not ideal but its far from doomsday.

In accordance with your view it would be highly beneficial for AZCOM to cut out an FP or 2 and allow a couple more elective months during 3rd year. Plan far in advance for competitive residencies.

Best of luck in the future.

Hey Vent

Thanks for the advice man. I didn't think about planning it that way. Good advice and great response.

later

 

[Aloha Kid]

Great Post Boomer! If you put Alohakid on one of the spectrum and me on the other end, Boomer and Vent are in the middle. They have provided the most balanced and accurate opinion on these issues thus far.

This is absolutely something I can agree on with Novacek88. Boomer and Vent have been awesome. When they write . . . read it. 👍

My only question though is, Vent, is that really your picture?? 😱

 

[Boomer]

This is absolutely something I can agree on with Novacek88. Boomer and Vent have been awesome. When they write . . . read it. 👍

My only question though is, Vent, is that really your picture?? 😱

That's really him....but his hair is bigger now.

Ditto the idea of scrapping an FP rotation.....ugh, 2 months is probably one month too many--there's only so much you can learn in FP, then it just goes to repetition....which is what residency's for....