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[The Last Reclaimer]

I get that I sound like a naive prat with the following question but I'm curious as to what the answer really is beside my speculations. Why is this allowed? You're seriously going to look me in the eye and tell me the GME leadership is this oblivious, or they really are all THAT corrupt? If the yearly graduate outcome number is close to the number of available residencies total, I don't know, just stop approving med schools until further notice? What am I missing here.

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[Goro]

I get that I sound like a naive prat with the following question but I'm curious as to what the answer really is beside my speculations. Why is this allowed? You're seriously going to look me in the eye and tell me the GME leadership is this oblivious, or they really are all THAT corrupt? If the yearly graduate outcome number is close to the number of available residencies total, I don't know, just stop approving med schools until further notice? What am I missing here.

ACGME is completely divorced from med school accreditation.

 

[The Last Reclaimer]

ACGME is completely divorced from med school accreditation.

I understand that already. My question was, why are those who are responsible for medical school accreditation allowing for a surplus of graduates when considering the number of residency spots available? What's the rhetoric for doing so? (Or better yet, what am I not seeing here?).

 

[Goro]

I understand that already. My question was, why are those who are responsible for medical school accreditation allowing for a surplus of graduates when considering the number of residency spots available? What's the rhetoric for doing so? (Or better yet, what am I not seeing here?).

Honestly, I think the AOA and COCA folks live in a dream world.

 

[Ho0v-man]

I understand that already. My question was, why are those who are responsible for medical school accreditation allowing for a surplus of graduates when considering the number of residency spots available? What's the rhetoric for doing so? (Or better yet, what am I not seeing here?).

Because they don’t care. Student success/failure in the match has nothing to do with the bottom line. The only ones these schools are accountable to are COCA who will either not enforce their current standards or just lower them to accommodate the schools.

If it doesn’t make sense, it probably makes money.

 

[LondonVibes]

Honestly, I think the AOA and COCA folks live in a dream world.

Could this be a double edged sword in a way? The match rates of the newer schools would go down, but also people’s chances to enter medical school to begin with would go up with new schools being created, and that medical school entry could be the chance many need.

 

[Goro]

Could this be a double edged sword in a way? The match rates of the newer schools would go down, but also people’s chances to enter medical school to begin with would go up with new schools being created, and that medical school entry could be the chance many need.

If one doesn't match, one doesn't get to practice Medicine.

I suppose that if we reach a point where too many people from a school fail to match, then COCA will sanction them and force a reduction in class size, make the school create residencies, or maybe even close.

 

[FootballAndSkiing]

If quality rotations are the problem here, why are foreign medical schools allowed have their medical students rotate in the US? Especially because these new DO schools and their students are pretty much competing with foreign schools.

 

[LondonVibes]

If one doesn't match, one doesn't get to practice Medicine.

I suppose that if we reach a point where too many people from a school fail to match, then COCA will sanction them and force a reduction in class size, make the school create residencies, or maybe even close.

Are you suggesting that you’d rather see an applicant rejected than accepted in a school with a 80-89% match rate?

 

[sunshinefl]

Are you suggesting that you’d rather see an applicant rejected than accepted in a school with a 80-89% match rate?

I don’t know if he is, but I would say that, yes. Especially for low 80s true match rate, and high 80s total final placement rate.

 

[calivianya]

I don’t know if he is, but I would say that, yes. Especially for low 80s true match rate, and high 80s total final placement rate.

I agree. I’d rather see applicants rejected.

If med school was cheaper, I’d be okay with more people getting a chance... but honestly, graduating with $400k or more in debt and then being unable to get a job is just awful. People who don’t match are going to spend their entire lives under that debt... or is it forgiven after 25 years of on-time payments now? I forget, and besides, some people take out private loans for med school, and there is no forgiveness for those.

I know the average debt is supposedly around $180k but my school is closer to $270k, plus a very large percentage of my class have physician parents paying cash. I suspect the average debt of people who take out debt, not just the average debt of all med students, is quite a bit higher than anyone in med school admin will admit to.

There are few fields where anyone can pay back this kind of debt, and a lot of them require a degree, so what, people would just have to stack even more debt on top to have a chance to make a decent income? How much debt do we want to put people in - $500k? $600k? Even more when it snowballs because the minimum payments they can afford under income-based repayment with whatever non-physician job they can get are less than the interest accruing per month? Awful, awful thing to do to people.

I’d rather be rejected outright than have a higher chance of being put in that situation for sure. The chance is already too high as it is considering the extreme debt burden.

 

[Goro]

If quality rotations are the problem here, why are foreign medical schools allowed have their medical students rotate in the US? Especially because these new DO schools and their students are pretty much competing with foreign schools.

The clinical rotations people at the hospitals are bribed, umm, on the payroll of the Carib schools.

Are you suggesting that you’d rather see an applicant rejected than accepted in a school with a 80-89% match rate?

Yes, absolutely. Not everyone gets to be a doctor. There's a reason why we tell people not to go Carib....a school with match stats like the above has no business accepting students.

And to think like "well, 80 people get to be doctors" while 20 don't and are in debt to the tune of several Teslas is an appalling ends justify the means mindset.

 

[FootballAndSkiing]

The clinical rotations people at the hospitals are bribed, umm, on the payroll of the Carib schools.

Thats what I thought, just seems like a bad system. DO schools just arnt will to pay as much? Rely on the fact they are US schools so their applicants get the benefit of the doubt when applying to residency? Cant compete financially because they don't have as many people failing out of preclinical?

 

[LondonVibes]

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[LondonVibes]

The clinical rotations people at the hospitals are bribed, umm, on the payroll of the Carib schools.


Yes, absolutely. Not everyone gets to be a doctor. There's a reason why we tell people not to go Carib....a school with match stats like the above has no business accepting students.

And to think like "well, 80 people get to be doctors" while 20 don't and are in debt to the tune of several Teslas is an appalling ends justify the means mindset.

The question would then be why should someone turn down an 85% chance (or even 80%) or so at becoming a doctor.

I think an opposing point could be is that some people have familial and or financial issues that are preventing them from being competitive to the schools that match >95%, so it makes sense for them to take the school with an 80% match rate so that they can be level with everybody else when school starts. When you matriculate into medical school, you become eligible for loans and often move to a new city, which can alleviate the issues at least for the duration of medical school and residency, although only an individual knows if their issues will be alleviated through matriculation.

You could say that the only way that one should attend a school with an alarmingly low match rate could be if their rejections are more EC based while the stats are fine. If they have strong stats, they may be do well in their classes and have a higher chance of being among those who match successfully.

Either way, a person with solely an acceptance to a school with a low match rate would probably need to do serious introspection to see if they will truly make it through and become a doctor.

 

[LondonVibes]

The clinical rotations people at the hospitals are bribed, umm, on the payroll of the Carib schools.


Yes, absolutely. Not everyone gets to be a doctor. There's a reason why we tell people not to go Carib....a school with match stats like the above has no business accepting students.

And to think like "well, 80 people get to be doctors" while 20 don't and are in debt to the tune of several Teslas is an appalling ends justify the means mindset.

I feel like the mentality of needing to get into schools with a match rate of 95+% suggests that, if you can’t get into a school with a 95+% match rate, you don’t deserve to be a doctor at that time, which in the extremely competitive medical school landscape, is the wrong message to give to applicants who have secured acceptances at the newer schools. They have the chance to be doctors in their hands.

 

[Goro]

I feel like the mentality of needing to get into schools with a match rate of 95+% suggests that, if you can’t get into a school with a 95+% match rate, you don’t deserve to be a doctor at that time, which in the extremely competitive medical school landscape, is the wrong message to give to applicants who have secured acceptances at the newer schools. They have the chance to be doctors in their hands.

The problem is the applicants who are going to the newer schools include a larger cohort than normal who are truly not equipped to make it through medical school. And these schools with a financial motuve to fill seats with Warm Bodies, because their tuition driven model doesn't care about the risks that these students are taking.

Now add in the for-profit business model of the McRVUs, and you have a medical school behaving as if it were a franchise like Dunkin Donuts or Arby's, rather than an honest-to-god medical school.

 

[FootballAndSkiing]

To add on, its not a random 15% chance. Bet on yourself not to be the bottom 15%.

 

[FootballAndSkiing]

The problem is the applicants who are going to the newer schools include a larger cohort than normal who are truly not equipped to make it through medical school. And these schools with a financial motuve to fill seats with Warm Bodies, because their tuition driven model doesn't care about the risks that these students are taking.

Now add in the for-profit business model of the McRVUs, and you have a medical school behaving as if it were a franchise like Dunkin Donuts or Arby's, rather than an honest-to-god medical school.

If new schools had better rotation sites would it make it ok? Or do you think the problem is just subpar students keeping up academically?

 

[Goro]

If new schools had better rotation sites would it make it ok? Or do you think the problem is just subpar students keeping up academically?

Yes to both

 

[LondonVibes]

Not that match rate is the only factor in picking a medical school, but what would be considered an acceptable match rate?

 

[BoneWizard]

Not that match rate is the only factor in picking a medical school, but what would be considered an acceptable match rate?

Somewhere around 90% match, 99% placement.

 

[drstranger]

To add on, its not a random 15% chance. Bet on yourself not to be the bottom 15%.

No one plans to be in the bottom 15% but med school is a different game than undergrad

 

[hallowmann]

If quality rotations are the problem here, why are foreign medical schools allowed have their medical students rotate in the US? Especially because these new DO schools and their students are pretty much competing with foreign schools.

It's not IMG rotations are any better than DO rotations, and there are many that are worse. I have heard some pretty appalling things about rotations from students at "the Harvard of the Caribbean", arguably one of the schools with the best rotations if Caribbean schools.

The other issue is lack of motivation. To most of these DO schools, preceptorships are fine. Heck, my school declined paying to join one of the largest OPTIs back in the day, but ended up (over time) establishing enough GME to more than cover rotations (until the most recent expansion).

To be completely honest, with the upcoming interns having half their rotations be online, I'm curious to see if it even means anything. Clinical rotations are wildly variable, and not just in DO schools, and the learning curve is so steep in residency, that either way you need to either rise to the occasion or you'll fall off regardless of where you start.

 

[sunshinefl]

It's not IMG rotations are any better than DO rotations, and there are many that are worse. I have heard some pretty appalling things about rotations from students at "the Harvard of the Caribbean", arguably one of the schools with the best rotations if Caribbean schools.

The other issue is lack of motivation. To most of these DO schools, preceptorships are fine. Heck, my school declined paying to join one of the largest OPTIs back in the day, but ended up (over time) establishing enough GME to more than cover rotations (until the most recent expansion).

To be completely honest, with the upcoming interns having half their rotations be online, I'm curious to see if it even means anything. Clinical rotations are wildly variable, and not just in DO schools, and the learning curve is so steep in residency, that either way you need to either rise to the occasion or you'll fall off regardless of where you start.

Hey it wasn’t that bad! I had 1.5 online for the end of M3, and 3 online for M4. Out of 11 M3 rotations, and 11 M4 rotations.

 

[hallowmann]

Hey it wasn’t that bad! I had 1.5 online for the end of M3, and 3 online for M4. Out of 11 M3 rotations, and 11 M4 rotations.

1/4-1/2 depending on the school then. It doesn't matter, even if it was half. I'm telling you, the curve is really steep regardless, I think most will be fine.

 

[sunshinefl]

1/4-1/2 depending on the school then. It doesn't matter, even if it was half. I'm telling you, the curve is really steep regardless, I think most will be fine.

Oh yeah I agree with you. I just don’t think we’re going to be much worse off than other intern classes.

 

[Redpancreas]

Oh yeah I agree with you. I just don’t think we’re going to be much worse off than other intern classes.

and I think that's a testament to the poor quality to how the rotations are organized are. We have well meaning students, well meaning residents, and well meaning attendings, but the clinical setting for some who've never carried a real job before (i.e. me in the past) it was really rough. I think in this area you'll shine though.