AZCOM--quality of clinical rotations?

[chrisv]

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I recently met an alum (3/4 years out) from AZCOM (midwestern) and he told me that during your core clinical rotations, you don't ( ) actually get to touch the patients. Supposedly, the hospital where you do your core has a lot of restrictions, and students from another med school get preference. He ended up having to do a year-long internship to get experience before his residency.

I just got their secondary, and I'm debating if I should fill it out now. I didn't try to get more details from the alum cuz' it not a topic that he wanted to discuss. But he also told me that you have to set up MOST of your 3rd & 4th year rotations.

I'm not trying to spread rumours about the school...just wanting a perspective of AZCOM alum, and III, IV year students.

 

[siinew]

That definitely contradicts all the information I got (albeit mostly from the people presenting AZCOM in the best light) while doing an interview there a few weeks ago.

I came away very impressed by the fact that they do two things I am not aware of (to the same extent) any other DO schools do, in regards to MS 3 and MS4 rotations:

1) They spend between a few days and a few weeks prepping every student with all the techniques s/he will need for whatever rotation they are going out to next. For instance, they do not let anyone go out on an EM (or surgical, of course) rotation, without knowing how to tie off (sutures, etc) well.

They to this in order to ensure that their students are first in line to be part of the hands-on experience they need. I know from past, military medical experience that it is true... if you don't have some basic techniques down, you will be pushed off to the side when it comes time to work with a patient.

2) They have exams following each rotation, to ensure that their students weren't just "wall flowers" but actually learned and experienced what they were supposed to learn. These exams are mandatory and must be passed in order for the clinical rotation credit to be given.

I can't speak from experience that this former student obviously should be able to, but I don't see why they would go to all the trouble to prepare and then test their students if they weren't serious about them being right there in the thick of their clinical experiences.

 

[durak]

there is nothing to worry about - things have changed tremendously in the last 2-3 years. students now can rotate at pretty much all of the state teaching hospitals (VA, Good Sam, Maricopa County, St. Joes, etc). changes in state legislation have made this possible. i know the AZCOM clinical rotations rumors are still out there, but trust me, they'll all die down within a few years...

 

[cdreed]

I recently met an alum (3/4 years out) from AZCOM (midwestern) and he told me that during your core clinical rotations, you don't ( ) actually get to touch the patients. Supposedly, the hospital where you do your core has a lot of restrictions, and students from another med school get preference. He ended up having to do a year-long internship to get experience before his residency.

I just got their secondary, and I'm debating if I should fill it out now. I didn't try to get more details from the alum cuz' it not a topic that he wanted to discuss. But he also told me that you have to set up MOST of your 3rd & 4th year rotations.

I'm not trying to spread rumours about the school...just wanting a perspective of AZCOM alum, and III, IV year students.

I'm an MSIV at AZCOM, and my education these past two years has been very hands-on. I have delivered more babies, done more circs, performed more biopsies and sutures, and even gotten some experience with lap surgeries than a lot of interns I've met. Of course, I've put time and energy into setting up rotations that I felt would benefit me the most. I've even had multiple PDs and attendings tell me that my clinical skills are on par with interns and R2s. Things at AZCOM are much better now than in the past. I have very little/no concern that I'll be prepared for residency when I graduate this year.

Good luck.

Cyndi

 

[jhug]

cyndi is very right...
i'm also an MSIV and have absolutely LOVED these last two years! There are some rotations i've enjoyed more than others and i have been very proactive in setting up what i wanted and where.
like cyndi, i've delivered babies, lost count of central lines (somewhere over 11), art lines, paracentesis, arthrocentesis, LP (x1), sewed up a few pts uterus, closed surgeries, even got to cath a pt during cardiology, tracheostomy (x5)...so as far as touching pts- i don't feel i've missed out.
That being said, rotations for us are much better than they may have been 3-4 years ago...just as they will (hopefully) continue to get better and better for you.
and this extra year-long internship he is talking about is probably more due to the foolishness and inept organization known as the AOA than anything else...but that's a whole other topic🙂

 

[irish79]

I have to second, or third I guess, my classmate's sentiments. I am a 4th year AZCOM medical student and have never had any issue with setting up rotations, getting quality rotations, nor have I simply been a wallflower watching as the other "real" medical students do the work!

I have rotated at all of the major teaching hospitals here in the valley without much hassle in obtaining these rotations. This is even easier for the classes coming after us as our class has presented AZCOM quite favorably and the new state laws mandate they accept us as students—in equal positions as those coming from UA. In addition, I have rotated at UA, UW, U of I, U of Michigan and have found no trouble in obtaining the rotation or performing at the standards of these institutions.

During my third and fourth year rotations: I delivered 19 babies vaginally, scrubbed and assisted in all the C-sections, hysterectomies, TVT's, ablations, apogees / parigees, etc., performed numerous pelvic exams, culposcopies, and ultrasounds in OB-GYN; actually PERFORMED numerous cardiac catheterizations in Cardiology (with the attending watching), learned how to interpret nuclear scans, stress echoes, etc.; performed history and physicals, sports physicals, biopsies, suturing, knee injections, setting of fractures, participated in numerous CODES where I did CPR, pushed drugs and defibrillated (a skill the UA students had yet to learn as they weren’t certified in ACLS), floated 2 swans, put in numerous Foleys, A-lines, IV's, central lines, intubated about 10 people all during Family and Internal Medicine; assisted and closed in all cases during surgery; created and reviewed histological slides for MOES surgery during dermatology; I have written admit notes, SOAP notes, orders, discharge notes and had a myriad of other experiences. The information you were given is outdated and probably from someone with a less than eager disposition to get involved.

I hope this helps! Feel free to ask any further questions.

 

[VentdependenT]

I got plenty of hands on experience my 3rd and 4th years.

First assisted the general surgeon in 3rd yr surg core almost every case. no resident there. Yippie fer me.

 

[Swiffles]

I am coming into the first year at AZCOM this fall. I am interested in finding out where some of your favorite rotations have been, so that I can set them up in a couple of years. Is there anyway of knowing how the rotation will be and how to choose where to go before setting it up? I would not want to spend four weeks in a location which does not welcome my presence as much, while another similar rotation spot would have allowed me to really get into it.

 

[San_Juan_Sun]

I am coming into the first year at AZCOM this fall. I am interested in finding out where some of your favorite rotations have been, so that I can set them up in a couple of years. Is there anyway of knowing how the rotation will be and how to choose where to go before setting it up? I would not want to spend four weeks in a location which does not welcome my presence as much, while another similar rotation spot would have allowed me to really get into it.

Since the situation is so fluid, I would wait a little while before worrying about rotation sites. It seems to get better every year, so what will be available to you may be far different from what has been available the last two years. Also, you probably will want to figure out if an academic/ ward-based rotation, or a preceptor model suits you better.

The good news is, your upper classmen will be able to fill you in on what they liked. You won't need to commit anything to paper until about January of your 2nd year, and even then you have plenty of opportunity to switch things around. Also, you can review student evals of the rotation site in the Clin. Ed. office.

 

[Stimulate]

I graduated from AZCOM in 2003. I found that the preceptor-based rotations were good in the sense that you aren't standing in line behind the residents and fellows. However, when you are learning Internal Medicine or Family Practice from a preceptor, your exposure is only to the style of that preceptor. Thus, you need to seek out the strong rotations by talking to people ahead of time. If you sit back and let the Clinical Education office choose your rotations for you, you may be missing out on much better opportunities. I found that my rotations at Good Samaritan hospital were especially strong. I also found that my knowledge level and skills were above those of the University of Arizona students, and so did the attending who wrote a nice letter of recommendation for me. Also, if you are looking into the ACGME-world for residency you should seriously consider rotating in an academic/ACGME institution for the purposes of securing a letter from an attending (ideally well-known in your future field) who can compare you to allopathic students. Lastly, for the soon to be MS-I at AZCOM, no offense but you have bigger worries (i.e. anatomy, biochem, etc) than where you should rotate. Focus on nailing Step 1 for now and keep your ears open to what rotations the seniors like.

 

[LukeWhite]

My classmates have given a pretty comprehensive list of the things that you can do during clinical years at AZCOM. My experience was similar (but 5 trachs, Jason? Swans, Matt? I'm jealous).

I'll note, though, that these folks are among the very best in the class: motivated, enthusiastic, and willing to go through some inconvenience to get great rotations. Others in our class have not been as aggressive in finding great rotations and have had commensurately poor clinical rotations. If you let the school schedule your rotations, and don't frequently change your plans (at the risk of irritated admins) when you hear about better rotations, you'll have bad clinical years.

The secret to AZCOM: Be willing to travel a bit to get good rotations, and take advantage of the fact that we don't have an established, regimented educational culture. Never ask to go home; stick around when your other-med-school compatriots have gone home because of silly work-hour rules. Take overnight call every single time. Never refuse a procedure.

I'm applying for IM residencies in Manhattan. In many ways, my audition rotations have been a step backwards: you will never do as much in the City as you can do one-on-one with a preceptor out west. Jason and I were throwing subclavians four months into our third year; I've met top-flight pulm/critical care fellows out here who have put in one over the course of their career. Senior residents who have never done a paracentesis, avoid arterial lines like the plague...etc. One year traveling to good rotation sites in the west will give you more procedural experience than three years at many traditional residencies.

I went to AZCOM mainly because it was going to give me the flexibility to do my clinical years where I wanted with access to a lot of procedures. I got exactly that. Best procedure-oriented school in the nation, if you make it so.

 

[acurarte]

I graduated in 2002 and am glad to hear things have changed for year 3 and 4. It used to be terrible. Good luck!

 

[bla_3x]

Dang Jason, Cyndi, Luke…You guys are making me jealous!
I am a fourth year as well and can vouch for another side, not the extreme, but probably pretty average I’d say.
My preceptor based rotations were for the most part (and still are) pretty bad. What I mean, and someone already mentioned this, is that this setup really limits the kind of “teaching” that you get on your rotation when compared to a formal residency based rotation. I learned more on my VA/good sam med rotation in ONE DAY than I learned in a month with a preceptor this year. PP docs just don’t lecture often (time crunch) and there is little to no formal didactics. Granted, if you care little about didactics and teaching rounds then this is a non issue.
The thing I would take home from this is that the system allows for MUCH variability in the kind/quality of rotation experiences that students will get. So know this and be OK with it and you will LOVE it. You can read up on reviews of preceptors, but I studied my A@@ off looking at reviews of preceptors and such and I still got the shaft! However, my hospital rotations (good sam, VA, copa, Scaryvale) were freakin awesome.
It’s all good though…if your rotations suck in the procedural arena like mine just do your EM rotation at a teaching hospital and you will be hooked up! LPs, Tubes, SCs Fems, chest tubes, I/D, and lacs to your hearts content!!
All in all, I have learned more than I thought was possible in these 3+ years at AZCOM.

 

[dofool]

I am also a 4th year at AZCOM. I can tell you these rotations are the best in the known universe. Some of the things I have done include: delivered babies, 1st assist in general surgery, amputations, craniotomies, flown to the moon, consulted the president of the united states, published 100 papers in the new england journal, resolved the question of dark-matter, and as part of an ob/gyne assignment I was REQUIRED to have sex with jessica alba, paris hilton, and pam anderson(at the same time)....but seriously folks, the rotations are not too bad.

 

[bla_3x]

I am also a 4th year at AZCOM. I can tell you these rotations are the best in the known universe. Some of the things I have done include: delivered babies, 1st assist in general surgery, amputations, craniotomies, flown to the moon, consulted the president of the united states, published 100 papers in the new england journal, resolved the question of dark-matter, and as part of an ob/gyne assignment I was REQUIRED to have sex with jessica alba, paris hilton, and pam anderson(at the same time)....but seriously folks, the rotations are not too bad.

Its funny that is totally what it sounds like when some people talk about their rotations....

Does anyone remember the commercial about the "The one-upper"? That commercial reminds me of our class when we have a lecture or something and people talk about their rot. experiences.
Thank god we don't "have" to be on campus every other Tuesday. I would always feel like the bastard step child that never got to do anything 🙂