Better teaching at university hospitals?

[Ypo.]

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I'm at a community hospital right now and I heard a fourth year student complain today that the attendings did a lot more teaching in the university hospitals he's been to than at the community hospital. Was wondering if anyone else found this to be true. My personal experience is that it's luck of the draw. The theory is because at community hospitals you are working with community physicians who may have no obligation to teach or involve you, and also because it's not technically an "academic" site, people are more concerned with getting the job done than teaching.

 

[bjackrian]

I disagree that university hospitals have better teaching. While the didactics are typically better, attendings at community sites often have more time to teach because they don't have to deal as much with research. They also don't burn out as fast on teaching as university hospital attendings. I feel that many if not most of my best teachers have been in community hospital settings.

 

[MeowMix]

Depends what you call "teaching." If you like powerpoints and lectures, then I've had more of those at university programs. If you like 1:1 discussion of the medicine associated with specific pts, I've had more at community programs. I personally hate the powerpoints and lectures.

 

[UKCatBird]

Private hosp/Private practice is def the way to go.... The rotations that I learned the most and was actually taught to most were when it was just me and an older doctor that was just thrilled to have someone to talk to about his lifes work.... good for them and good for me..... 50 somethings that know their $hit and getting ready to retire in a the forseeable future are by far the best teaches and most interested in me and my future career....University rotations I was basically a work horse..get people in and out...learn if you get time, after you do your work...

 

[Top Gun]

I'm at a community hospital right now and I heard a fourth year student complain today that the attendings did a lot more teaching in the university hospitals he's been to than at the community hospital. Was wondering if anyone else found this to be true. My personal experience is that it's luck of the draw. The theory is because at community hospitals you are working with community physicians who may have no obligation to teach or involve you, and also because it's not technically an "academic" site, people are more concerned with getting the job done than teaching.

Not necessarily. A university hospital might offer better didactics. But, at a community hospital, you might get better practical teaching.

 

[SoCuteMD]

Count me amongst those who think that the didactics tend to be better at university hospital, but that the bedside and practical teaching is (usually) much stronger at private or community hospitals. The one exception is when the physicians are very focused on their paycheck...those are the ones who tend to be less interested in teaching when in a community or private hospital.

 

[PeepshowJohnny]

Community doctors tend to have a lot of time for teaching, but in my experience, they're not always as rigorously evidence based as a univeristy institution is. A couple times working with community doctors, they'd tell me something I didn't know and I'd go to read about. When I went to a modern textbook or UptoDate or literature, I'd sometimes find what they were telling me was either A) commonly accepted as true, but the evidence was conflicting or B) had been disproven in a study.

It was more with minor stuff and never really affected patient care, but it was something I became wary about.

 

[Mayhem]

In general, I had more teaching at the university hospital and it was more extensive. At our community hospitals the focus tended to be on the common things that the doctors saw often. On the other hand, community rotations tended to be more hands on while at the university it's more theory than practice. Also, a lot of times we get pulled out of clinic or elsewhere to go to a lecture, although that might be an issue just at my school.

 

[Anka]

It also depends on who is doing the teaching. I rotated at a community hospital for two rotations, both of which had residents who were just... not the sharpest sticks in the forrest. Which meant what didactics they had were kinda low level (like, I got more out of reading Blueprints low level). At one of those sites, the community attendings did a lot of teaching, and I learned a lot. At the other, the attendings just totally ignored the med students (like you ask a question and they turn towards you, give you a look, and then walk away), and so there was very little learning in the hospital (although Blueprints, casefiles, and PreTest saved the day).

Anka