Clinical Rotations

[arc5005]

Where can I find information on how good a specific COM's clinical rotations are? Do all DO schools have away rotations? How does finding your own away rotations work? Can they only be with DO affiliated programs?

I want to learn as much about the different options before I apply next cycle.

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[Bones 2020]

I would start here:

http://forums.studentdoctor.net/threads/pros-and-cons-of-your-do-school.407104/

http://forums.studentdoctor.net/threads/politico-article-on-rotation-spots-in-new-york.1164910/

While I am not a student yet, from what I understand even MD schools suffer from a flux of rotations

 

[Dr. Death]

SDN, contact the school

Yes, there are almost no true "home" rotations because most DO schools do not have a teaching hospital.

School dependent. Some schools have a lottery, many schools will let you schedule your own rotations (at least some of them) if you have the desire.

No idea.

No. I don't think clinical rotations distinguish themselves as DO or MD

 

[IslandStyle808]

Where can I find information on how good a specific COM's clinical rotations are?

The list provided above is as good as it gets. Usually it is safer to do rotations under residencies, but there are definitely good preceptor based rotations (doctor and student only learning).

Do all DO schools have away rotations?

The definition of away rotations refers to rotations done for a particular specialty at a different institution (i.e. done in 4th year). A lot of DO schools have their students do their 3rd year core rotations away from their schools. These rotations are pick in different ways, most of which are lottery.

How does finding your own away rotations work? Can they only be with DO affiliated programs?

I believe you have to contact the residency program or medical school (not sure about this one ?) about a rotation with them. These rotations can be anywhere MD or DO so long as they agree. Even core rotations can be done with allopathic residents as long as the school has connections to the hospital.

 

[Para-dox]

How does finding your own away rotations work? Can they only be with DO affiliated programs?

From what I understand (MS1):
4th year away rotations are completed via Visiting Student Application Service (VSAS), which is common to both DO and MD students. Your school determines when you have rotations (ie. July-Sept are 3 elective rotations, Oct is medicine selective, Nov is surgery selective, etc), and you apply for where to spend those rotations. The school can also set requirements as to which rotations can be away and which have to be in-house (within the network of that school's clinical rotation sites). There is also a limit on how many weeks a student can spend in a certain specialty.

 

[Seth Joo]

Where can I find information on how good a specific COM's clinical rotations are? Do all DO schools have away rotations? How does finding your own away rotations work? Can they only be with DO affiliated programs?

I want to learn as much about the different options before I apply next cycle.

If you are worried about that only go to the established DO schools like PCOM, KCUMB, CCOM, Rowan, Ohio, TCOM, NSU, and you won't have issues with having to relocate for your clinical education. The unfortunate reality for most DO schools is that many DO students wind up moving around during their clinical years which creates a disconnect in the educational experience.

 

[arc5005]

If you are worried about that only go to the established DO schools like PCOM, KCUMB, CCOM, Rowan, Ohio, TCOM, NSU, and you won't have issues with having to relocate for your clinical education. The unfortunate reality for most DO schools is that many DO students wind up moving around during their clinical years which creates a disconnect in the educational experience.

what about UNECOM & NYIT-NYCOM

 

[Dr. Death]

If you are worried about that only go to the established DO schools like PCOM, KCUMB, CCOM, Rowan, Ohio, TCOM, NSU, and you won't have issues with having to relocate for your clinical education. The unfortunate reality for most DO schools is that many DO students wind up moving around during their clinical years which creates a disconnect in the educational experience.

What about DMU and OSUCOM

 

[Para-dox]

what about UNECOM & NYIT-NYCOM

Solid rotations for both. From what I remember, UNE has different geographic focus tracks I suppose I could call it. They have rotations at Maine Medical Center, which I think is a major hospital in the region. Other locations might have you move around a bit. The NJ track allows FM rotations with Martin Levine, DO -- past president of the AOA.

 

[Seth Joo]

What about DMU and OSUCOM

DMU and OSU are pretty solid as well. So is MSU. Schools associated with large public universities tend to be excellent. NYIT-COM is another solid program.

 

[MisterFutu]

What about AZCOM?

 

[Drrrrrr. Celty]

If you are worried about that only go to the established DO schools like PCOM, KCUMB, CCOM, Rowan, Ohio, TCOM, NSU, and you won't have issues with having to relocate for your clinical education. The unfortunate reality for most DO schools is that many DO students wind up moving around during their clinical years which creates a disconnect in the educational experience.

Unfortunately, or maybe fortunately only half of our class can remain in Kansas City. That being said only half the class ever usually wants to stay to begin with and many end up wanting to go to our other affiliated hospitals through out the state and country.

In either case, the rotation situation at KCU isn't perfect, but it isn't bad either.

 

[Seth Joo]

Unfortunately, or maybe fortunately only half of our class can remain in Kansas City. That being said only half the class ever usually wants to stay to begin with and many end up wanting to go to our other affiliated hospitals through out the state and country.

In either case, the rotation situation at KCU isn't perfect, but it isn't bad either.

Yeah but the point is that you stay wherever you go for that year, at some schools you move from place to place, its not unheard for people to relocate to geographically distant locales four or five times during OMS III at many schools, particularly at many of the new schools.

 

[Drrrrrr. Celty]

Yeah but the point is that you stay wherever you go for that year, at some schools you move from place to place, its not unheard for people to relocate to geographically distant locales four or five times during OMS III at many schools, particularly at many of the new schools.

That's.... absurd actually.

As I've said again, the biggest issue with osteopathic medicine is both in that it's a poorly understood or known field in the public's eyes with poor advertisement by the AOA, but also because the lower schools produce graduates that are pooled together with people who graduate from stronger clerkships and educations. We know that MD PDs don't know DO schools and as such a bad graduate from ex. LUCOM = a program not taking any DO students.

 

[Seth Joo]

That's.... absurd actually.

As I've said again, the biggest issue with osteopathic medicine is both in that it's a poorly understood or known field in the public's eyes with poor advertisement by the AOA, but also because the lower schools produce graduates that are pooled together with people who graduate from stronger clerkships and educations. We know that MD PDs don't know DO schools and as such a bad graduate from ex. LUCOM = a program not taking any DO students.

Clinical education is the big Achilles heel with many DO programs, some schools manage to provide acceptable clinical education to their students but many just seem to place their students wherever they can find a hospital willing to take their students. Its just a reality of life.

In the real world, PDs see us as all the same whether we came from PCOM or one of the brand new "shake and bake" DO schools that COCA just approved.

 

[arc5005]

Clinical education is the big Achilles heel with many DO programs, some schools manage to provide acceptable clinical education to their students but many just seem to place their students wherever they can find a hospital willing to take their students. Its just a reality of life.

In the real world, PDs see us as all the same whether we came from PCOM or one of the brand new "shake and bake" DO schools that COCA just approved.

What's a PD?

 

[MisterFutu]

Program Director

 

[arc5005]

Clinical education is the big Achilles heel with many DO programs, some schools manage to provide acceptable clinical education to their students but many just seem to place their students wherever they can find a hospital willing to take their students. Its just a reality of life.

In the real world, PDs see us as all the same whether we came from PCOM or one of the brand new "shake and bake" DO schools that COCA just approved.

Even if you are a "DO," what really matters is the specialty, right? Once you are a DO or MD at whatever hospital/clinic, you are looked at just the same as others in your department? Is there any difference in pay? I understand there may be a difference in marketability and job selection/options, but once you are such and such anesthesiologist (or any field), the DO or MD title isn't as important, eh?

Do MDs have better/easier transitions into residency, because they have a better clinical education? What makes MD programs better clinical education programs?

 

[Seth Joo]

Even if you are a "DO," what really matters is the specialty, right? Once you are a DO or MD at whatever hospital/clinic, you are looked at just the same as others in your department? Is there any difference in pay? I understand there may be a difference in marketability and job selection/options, but once you are such and such anesthesiologist (or any field), the DO or MD title isn't as important, eh?

Do MDs have better/easier transitions into residency, because they have a better clinical education? What makes MD programs better clinical education programs?

Once you are done with residency you are the pretty much on the same footing as an MD with the same training, the issue that I am raising here is that many of the newer schools are opening but without any actual plan with regards to guaranteeing that their students get quality clinical training. At most MD schools except for some of the newer community based programs this is non-issue, but many newer DO schools tend to have issues with their clinical training.

This is something that you should be concerned about as it is a very important part of your education, you are also going through a tremendous amount of expense to get your education, check the COA at many schools, which is quite expensive, I think any prospective students wants to get the maximum value for their investment.

One of the reasons why many MD schools tend to have better clinical education is that they have "Clinical Schools", many have have their own established tertiary teaching hospitals dedicated to training students, whereas many DO students often will rotate at community hospitals.

 

[simbad8]

Alright first of all, your first goal should be getting into med school and making it through the first two years, then worry about rotations. You won't know if they're good or bad until you actually experience it. Two people can go to the same rotation, one can have a great experience and the other can have a terrible experience... It's all how YOU make it. Second of all, saying that DOs don't have as great of a clinical education as MDs is total BS. We have the privilege of rotating at places with residency programs (get the hang of the academic setting and learn how to work with residents) AND we get to work one on one with preceptors (community hospital or private practice; where you're way more likely to get actual hands on experience and not be a glorified shadower). And again, it's all what you bring to the rotation. If you're lazy or don't have any interest in the rotation you're on, you're probably not gonna learn much. If you work hard and keep an open mind, the world is your oyster. Just my 2 cents.

 

[DrBowtie]

Alright first of all, your first goal should be getting into med school and making it through the first two years, then worry about rotations. You won't know if they're good or bad until you actually experience it. Two people can go to the same rotation, one can have a great experience and the other can have a terrible experience... It's all how YOU make it. Second of all, saying that DOs don't have as great of a clinical education as MDs is total BS. We have the privilege of rotating at places with residency programs (get the hang of the academic setting and learn how to work with residents) AND we get to work one on one with preceptors (community hospital or private practice; where you're way more likely to get actual hands on experience and not be a glorified shadower). And again, it's all what you bring to the rotation. If you're lazy or don't have any interest in the rotation you're on, you're probably not gonna learn much. If you work hard and keep an open mind, the world is your oyster. Just my 2 cents.

Your tag says OMS II. Is that current and you're just passing along propaganda and rationalizations from upperclassman?

 

[simbad8]

Your tag says OMS II. Is that current and you're just passing along propaganda and rationalizations from upperclassman?

You bet but I feel like that philosophy applies to most things in life. I don't think it's coincidence that the upperclassmen I know who killed boards and rotations are extremely hard workers.

 

[22031 Alum]

AND we get to work one on one with preceptors (community hospital or private practice; where you're way more likely to get actual hands on experience and not be a glorified shadower)

I just had to chime in at this. From the allopathic faculty side, a lot of the "glorified shadowing" I've seen has been from students who had preceptor-based experiences. We once had a sub-I (OMS 4) who'd never done postpartum rounding (physical exam + note) because her preceptor had a midwife who did that, and she just followed him between deliveries and the office. While I'm sure "one on one attention" and "seeing what practice is like" is a major selling point of that type of rotation, at some point you need to learn to do the things you'll be doing as a resident. Now, postpartum rounding is extremely simple, and the student caught on quickly. But before I started to learn about the different rotation setups, I never in my life imagined that a fourth year medical student would have no experience with such a fundamental task. It certainly didn't help the case I've been trying to make for my program to become more "DO friendly."

TL;DR: What attendings (preceptors) do isn't what residents do. And you have to be a resident first.

 

[IslandStyle808]

Alright first of all, your first goal should be getting into med school and making it through the first two years, then worry about rotations. You won't know if they're good or bad until you actually experience it. Two people can go to the same rotation, one can have a great experience and the other can have a terrible experience... It's all how YOU make it. Second of all, saying that DOs don't have as great of a clinical education as MDs is total BS. We have the privilege of rotating at places with residency programs (get the hang of the academic setting and learn how to work with residents) AND we get to work one on one with preceptors (community hospital or private practice; where you're way more likely to get actual hands on experience and not be a glorified shadower). And again, it's all what you bring to the rotation. If you're lazy or don't have any interest in the rotation you're on, you're probably not gonna learn much. If you work hard and keep an open mind, the world is your oyster. Just my 2 cents.

I have to extremely disagree with this. I have interviewed with places that have almost zero clinical affiliations with residencies. To worry about it after the fact is a big mistake. People get fooled by the all the bells and whistles the schools show and not truly asking the questions that need to be asked. There are far to many medical students and residents who have stated the importance of training like a resident. It is up to you, as you and other have stated. However, everything in life is a two way street. It is important the hospital is giving you the training as well.

There was a CHC of ATSU-SOMA in the state that I live that has stopped taking students. The reason is because the local hospitals had sign contracts with the local MD medical school of the spots. Thus SOMA students were only give spots left over or they had to scramble to find another rotation. You're basing your judgement off your school only and not the collective of DO schools. Asking about rotations should be the top question and everything else secondary.

 

[lisa002]

Not all schools have hospital . You can inquire about the program first and try decide which is best .

 

[arc5005]

Alright first of all, your first goal should be getting into med school and making it through the first two years, then worry about rotations. You won't know if they're good or bad until you actually experience it. Two people can go to the same rotation, one can have a great experience and the other can have a terrible experience... It's all how YOU make it. Second of all, saying that DOs don't have as great of a clinical education as MDs is total BS. We have the privilege of rotating at places with residency programs (get the hang of the academic setting and learn how to work with residents) AND we get to work one on one with preceptors (community hospital or private practice; where you're way more likely to get actual hands on experience and not be a glorified shadower). And again, it's all what you bring to the rotation. If you're lazy or don't have any interest in the rotation you're on, you're probably not gonna learn much. If you work hard and keep an open mind, the world is your oyster. Just my 2 cents.

I really think that the quality and opportunity of rotations is extremely important as a pre-med. If I'm going to be paying X amount of tuition to a school, then I would hope that I am getting the best possible education. It's better to figure out the pros and cons of the programs, especially 3rd and 4th year before just taking an acceptance (if you have options).

 

[simbad8]

I just had to chime in at this. From the allopathic faculty side, a lot of the "glorified shadowing" I've seen has been from students who had preceptor-based experiences. We once had a sub-I (OMS 4) who'd never done postpartum rounding (physical exam + note) because her preceptor had a midwife who did that, and she just followed him between deliveries and the office. While I'm sure "one on one attention" and "seeing what practice is like" is a major selling point of that type of rotation, at some point you need to learn to do the things you'll be doing as a resident. Now, postpartum rounding is extremely simple, and the student caught on quickly. But before I started to learn about the different rotation setups, I never in my life imagined that a fourth year medical student would have no experience with such a fundamental task. It certainly didn't help the case I've been trying to make for my program to become more "DO friendly."

TL;DR: What attendings (preceptors) do isn't what residents do. And you have to be a resident first.

I guess it completely depends on the school and rotations. One of our OBGYN rotations, you're delivering babies on the second delivery you see. I can only assume that if you're delivering babies, you're also doing the postpartum exam, but then again maybe not. Besides, I can't say this for all DO schools, but I'm pretty sure the majority of them have where you do fake encounters with patients aka full history, physical, and note. So if you already know the basics of that, why couldn't you just ask preceptors to let you present to them like you would at a ward based rotation?

 

[simbad8]

I really think that the quality and opportunity of rotations is extremely important as a pre-med. If I'm going to be paying X amount of tuition to a school, then I would hope that I am getting the best possible education. It's better to figure out the pros and cons of the programs, especially 3rd and 4th year before just taking an acceptance (if you have options).

So then why even bother applying DO? If you do MD where their rotations are at hospitals with residencies then you don't even have to worry.

 

[22031 Alum]

I guess it completely depends on the school and rotations.

Ding ding ding!! And this variation tends to be more pronounced on the DO side from what I have seen.

One of our OBGYN rotations, you're delivering babies on the second delivery you see.

What I posted wasn't about deliveries. That student had done deliveries. This is about the not as "cool" parts of specialty training- basic inpatient floor work. Interns have orientation, but program directors take comfort in knowing that they'll all start with the same basic experience from med school.

So if you already know the basics of that, why couldn't you just ask preceptors to let you present to them like you would at a ward based rotation?

You totally could. Good on you if that's what you plan to do. But I've also seen students not do that either because they didn't know better or because they see resident-style work as "scut" and turn their nose up at it. They're getting to see what "real" practice is like, after all.

 

[simbad8]

You totally could. Good on you if that's what you plan to do. But I've also seen students not do that either because they didn't know better or because they see resident-style work as "scut" and turn their nose up at it. They're getting to see what "real" practice is like, after all.

Lol we all have to start somewhere.

 

[Torilynn92]

Somewhat off-topic question, but I've always wondered:
What do people do when they're out on rotation about living circumstances? Do they maintain a "home base" apartment near their school? Or do they just move around every 6 weeks and live in hotels and such? Are there services to help find housing for rotations? What am I supposed to do with my cat??
I think my little sister may be stuck longterm pet-sitting her godkitty in a few years.

 

[cliquesh]

I really think you can go to any crappy school and spend 2 months of your 4th year in the icu at a medium sized university hospital and you'll be fine for intern year. This assumes you read and are self motivated.

 

[blah12346497]

Somewhat off-topic question, but I've always wondered:
What do people do when they're out on rotation about living circumstances? Do they maintain a "home base" apartment near their school? Or do they just move around every 6 weeks and live in hotels and such? Are there services to help find housing for rotations? What am I supposed to do with my cat??
I think my little sister may be stuck longterm pet-sitting her godkitty in a few years.

I would like to know this as well

 

[SLC]

There was a CHC of ATSU-SOMA in the state that I live that has stopped taking students. The reason is because the local hospitals had sign contracts with the local MD medical school of the spots. Thus SOMA students were only give spots left over or they had to scramble to find another rotation. You're basing your judgement off your school only and not the collective of DO schools. Asking about rotations should be the top question and everything else secondary.

Did you ever follow up with what happened to that CHC at SOMA? They shut it down (the CHC is still there, SOMA backed out). They're sending those students to Chicago now.

It says something to me that Uhawaii thought the rotations were good enough to absorb.

I got an excellent education at SOMA, at the end of the day, I am doing as well as I am doing with residency because SOMA gave me such a solid foundation to build on.

 

[IslandStyle808]

Did you ever follow up with what happened to that CHC at SOMA? They shut it down (the CHC is still there, SOMA backed out). They're sending those students to Chicago now.

It says something to me that Uhawaii thought the rotations were good enough to absorb.

I got an excellent education at SOMA, at the end of the day, I am doing as well as I am doing with residency because SOMA gave me such a solid foundation to build on.

Not sure what happened from that point on. Both of my friends who told me this (one from the MD school the other from SOMA) have graduated. So I don't know the current situation so far. The MD school is still increasing its class size so I doubt that SOMA could come back to Hawaii. I have visited the site before and had a wonderful tour. The model would still be fine if it weren't for the expansion of schools and class sizes. I fear that SOMA students could be pushed out of rotations at certain CHCs. However, I do like the fact that the school treasures its students and making sure they get a good clinical education. I am pretty sure that is why they chose Chicago where there are very good hospitals.

 

[SLC]

Not sure what happened from that point on. Both of my friends who told me this (one from the MD school the other from SOMA) have graduated. So I don't know the current situation so far. The MD school is still increasing its class size so I doubt that SOMA could come back to Hawaii. I have visited the site before and had a wonderful tour. The model would still be fine if it weren't for the expansion of schools and class sizes. I fear that SOMA students could be pushed out of rotations at certain CHCs. However, I do like the fact that the school treasures its students and making sure they get a good clinical education. I am pretty sure that is why they chose Chicago where there are very good hospitals.

Yes, to my knowledge there are no plans to return to Hawaii. SOMA is no longer affiliated with that site. We shut down the Alabama site too (my class was the last one to go through there) because of ACOM coming into the area.

It's always a risk that a school will be muscled out of an area, but at least as you say, SOMA cares enough to move when the training suffers in one place. My clinical training was quite strong in Portland, I have no regrets.