Choosing a medical school: an insider's perspective

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For years there have been debates about what factors to consider in choosing a medical school, and how heavily each one should be weighted. Cost is often at or near the top, as are location, reputation, curriculum, etc. After a number of years in the biz, and after attending many professional meetings and speaking with innumerable colleagues, I believe the strength and stability of an institution's clerkships/clinical rotations has grown more important than ever.

This is probably easiest to frame around two new schools: OUWB and Hostra. Both are joint efforts by universities and large healthcare systems, replete with residencies, facilities, and clinical faculty. I am willing to bet that at neither school would an M3/M4 be concerned about overall clerkship capacity or rotation choice, nor would he or she be worried about doing away rotations to complete core requirements. Compare this to some other schools, both new and old, who rely on tenuous affiliations with non-academic health centers and are constantly fending off encroachment.

Given the increase in number of medical schools, both MD and DO, and the general increase in class sizes of existing ones, this comes as no surprise. Academic health centers, or at least facilities that can provide teaching to medical students, cannot preemptively expand to keep pace with demand. It obviously varies a lot by geographic region and circumstance, but the general trend seems fairly clear: good clerkship slots are finite and competition is increasing. While sound clinical education is still the rule, the day may come when it cannot be taken for granted.

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Thank you for the post, I think this factor occasionally gets lost in the middle of the hysteria that is medical school admissions where many (understandably of course) think foremost simply to be accepted somewhere.

An innocent premed student question, for the sake of constructing my future list of schools to apply to: what are efficient ways for me to study the fortitude of an institution's clerkship/clinical rotation stability?
 
Thank you for the post, I think this factor occasionally gets lost in the middle of the hysteria that is medical school admissions where many (understandably of course) think foremost simply to be accepted somewhere.

An innocent premed student question, for the sake of constructing my future list of schools to apply to: what are efficient ways for me to study the fortitude of an institution's clerkship/clinical rotation stability?

Honestly the best way is probably talking to M3 and M4 students during interview days and tours, so not super helpful for constructing a preliminary list of schools to apply to. Generally, if there is a large affiliated academic medical center with several different residency programs you shouldn't have a problem getting an adequate clinical experience in most, if not all, core specialties as well as several subspecialties. I think the problems arise when all of the affiliated sites are community hospitals, especially those without residency programs. While many community hospitals will give you great clinical experience, they tend to be more susceptible to mergers, buyouts, etc. Academic medical centers also tend to be more closely monitored to ensure they are up to ACGME standards. I feel that in general, you'd be more likely to receive a strong clinical training from University of XYZ Medical Center compared to a mix and match of community hospitals that could be bought up by University of XYZ at any point. A medical school saying that they send students to over 10+ affiliated clinical locations isn't necessarily a good thing. Other things too look at would be clinical affiliations with VA hospitals and Children's Hospitals as these generally provide several good rotations for medical students.
 
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