CSPM and early clinical exposure

[JEWmongous]

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Can any current students tell me their thoughts of Cali and their emphasis on early clinics? I know some people (from other pod schools) think the idea is just a marketing scheme of attracting applicants. One CSPM 4th year said it was a very good experience overall but it required many hours lecture hours (morning till evening) during your 2nd year on non-clinic days. However, they also said they would have favored more externships though. It seems you only get 4 externships at cali, can anyone verify this???

For newbies: CSPM

1st year - 5 days lecture
2nd year - 3 days lecture / 2 days clinic
3rd year - 1 day lecture / 4 days clinic
4th year - All clinic or rotations (choice of an 8 month core at various locations in the US)

 

[j0ez0r]

not a student there but ive heard that its about as useful as just shadowing a pod in undergrad. i dont think i will be prepared to go to clinic in my second year because i will not have taken all the classes that prepare you for seeing patients, but who knows....

 

[Feli]

... thoughts of Cali and their emphasis on early clinics? I know some people (from other pod schools) think the idea is just a marketing scheme of attracting applicants.

http://forums.studentdoctor.net/showthread.php?t=412973

As I said in the other thread, I just don't think students are ready for clinic as 2nd years. How can you read foot XRs when you've never had radiology? Recommend or write a Rx when you haven't had pharm? Interpret a culture or lab test when you haven't had micro or pathology? Do a pod physical when you haven't taken biomechanics or pod med?

Obviously, 2nd year clinic just makes no sense to me. Maybe it's just glorified shadowing, but that's still time that could be spent better. 2nd year courses are hard, full of important info (that shows up on boards), and relevant (err... required) for future clinical practice. 2nd year pod/med students need to be focused on the curriculum and exams at that point IMO.

 

[Feli]

not a student there but ive heard that its about as useful as just shadowing a pod in undergrad. i dont think i will be prepared to go to clinic in my second year because i will not have taken all the classes that prepare you for seeing patients, but who knows....

I agree^

You can always shadow on your own time at any school, but the pod should not require it for any significant amount of time (ie 2 days per week... ouch). As a basic sciences student, I asked to hang out in the Barry athletic training foot clinic, and one of my clinical faculty told me "no, just get good grades and prep for later clinics... you aren't ready." He was right. I would later have his clinic as a 3rd year, and I quickly realized that I would've been totally lost if I hadn't had radio, biomech, sports med, pod med, pharm, path, etc beforehand.

I'm actually fairly suprised Cali students haven't lobbied the school to make 2nd year clinic optional so that they can go to class 5d per week, get more out of their 2nd year classes, increase their school's NBPME pt1 pass rates, etc. I think there is a reason that almost all of MD/DO/DPM/dent/etc schools nationwide have a 2+2 setup.

 

[kmyprimeval]

Can any current students tell me their thoughts of Cali and their emphasis on early clinics? I know some people (from other pod schools) think the idea is just a marketing scheme of attracting applicants. One CSPM 4th year said it was a very good experience overall but it required many hours lecture hours (morning till evening) during your 2nd year on non-clinic days. However, they also said they would have favored more externships though. It seems you only get 4 externships at cali, can anyone verify this???

For newbies: CSPM

1st year - 5 days lecture
2nd year - 3 days lecture / 2 days clinic
3rd year - 1 day lecture / 4 days clinic
4th year - All clinic or rotations (choice of an 8 month core at various locations in the US)

I am a second year at CSPM. Currently loving our schedule. I initially thought it was going to be some form of shadowing too but NOPE!! During the second semester of first year, we have an introduction to clinical medicine course (ICM) so we are aware of common pathologies that we might encounter during our start on clinics. ICM was where we've already started doing H&P and LEPE, writing soap notes, and began debriding our own nails with our podiatry tool kits, read and write prescriptions (rx)..became familiar w/ vocabulary and abbreviations...by the last ICM class, all of us gave each other a hallux block with 1% lidocain LOL.

Yes we get mondays and fridays off a week for clinicals but longer hours of lecture during the 3 days in between. And no, it's not shadowing.

I've learned a lot this summer....half of us started out on a simulation center rotation during the span of the summer (dealt with a lot of emergency situations i.e. anaphylatic shock, syncope, cardiac arrest.. how to scrub-in the OR.. and much more). They don't just throw us in there they make us read some literature before each session. We also get 2 radiology rotations in conjunction w/ our 2nd year clinics. The attendings don't expect us to know much but we're perfecting our charting abilities, doing full H&Ps (we have a general medicine rotation in january), we're already reading radiographs (just had a final exam last week that heavily tested us on our LEA knowledge in different xr views), giving hallux blocks, nail avulsion (under supervision of course), presenting to attendings w/ confidence, and we do MOSTLY palliative care. Just last week a classmate recognized gangrene on a diabetic that just came in for palliative care. So we referred her to vascular. Still think we don't know much? lol. And the supervision is good too in case we miss something. And so far, they make us look up 5 things that we don't know per clinic session and actually present what we find the following clinic session. It keeps the learning process going. And now that classes have started, we're learning things that we can apply in clinic.

Personally, I think it's great. I also don't mind the long lecture hours at all...i find my classes this year very interesting. But some might disagree w/ me but it's my opinion. I was concerned about studying enough for boards too. But the class of 2010 did fine. I think it was 96% for part I.

 

[kmyprimeval]

As for study time, we get plenty of study time. Think about it, we have mondays and fridays off from school. Some of the rotations are only 4 hours (i.e radiology A/B and simulation center) so we get to spend the rest of the day studying or watever we wanna do. Only on the rotations where we're dealing with real patients do we stay 8 hours. Also, consider that we have about 7 months of rotations in the span of the whole year. That means about 4 or 5 months of no clinics...during those 4 or 5 months of no clinic, we have 4 day weekends. I landed with a group that has November, December, April, and May off (finals month). In short, I aint trippin lol. It's not hardcore clinicals like 3rd year...but it's enough to balance w/ with our work load during 2nd year.

Finally, it would be better if there were more externships...for a lot of people. As for me, i'm a california resident...the bay area is home to me. u can probably guess where i want to go lol.

 

[Feli]

...Still think we don't know much?...

No, I don't... and I knew relatively little as a beginning 2nd year student. That's the way it is for everyone. As I said, a 2nd year pod med student is not ready for clinics and seeing patients IMO. There are hospitals and attending docs (ie Kaiser Cali) that won't let 4th year clerkship students scrub, see patients, etc since they do not know enough. 4th years... as in, about to graduate. But, with that in mind, you are telling me that a beginning 2nd year knows enough to grab a chart and start examining or treating patients? Wow.

...now that classes have started, we're learning things that we can apply in clinic....

I guess that is certainly one way of looking at it.^

IMO (and the opinion of many others), patient care is simply not something that one should get a crash course in and then be thrown into while they take the rest of the classes. I'd imagine most patients feel the same way lol. Again, at 99% of professional med/dent/pod/etc schools in the US, the first two years of basic and clinical science lectures are PRE-REQs for clincal years with good reasoning: it works better that way. I am in school clinics with 3rd year students. They have passed boards, all basic sciences, some clinical sciences, etc and know a lot. However, they still have tons to learn. I can't imagine if 2nd years were just thrown in with only half the knowledge that 3rd years have. It's called a knowledge "base" for a reason... you build on it. To build a good finished product, you have to have a very solid base and foundation first and foremost. That is they underlying principle here.

I am a second year at CSPM. Currently loving our schedule. I initially thought it was going to be some form of shadowing too but NOPE!! During the second semester of first year, we have an introduction to clinical medicine course (ICM) so we are aware of common pathologies that we might encounter during our start on clinics. ICM was where we've already started doing H&P and LEPE, writing soap notes, and began debriding our own nails with our podiatry tool kits, read and write prescriptions (rx)..became familiar w/ vocabulary and abbreviations...by the last ICM class, all of us gave each other a hallux block with 10% lidocain LOL...

Stuff like this simply proves my point.^
How do you write Rx when you haven't taken pharmacology yet? Am I missing something here?

And where do you find "10% lidocain"? I've only used 1% and 2% lidocaine... and I learned the mechanism, concentration, dosages, administration, and toxicities of it, and hundreds of other Rx, in pharmacology class before I started injecting into people 😉

...I aint trippin lol. It's not hardcore clinicals like 3rd year...
...the supervision is good in case we miss something...

I really hope it is.^

 

[cool_vkb]

Yes I do. As I said, a 2nd year student is not ready for clinics IMO.


I guess that is one way of looking at it... wow.

IMO (and the opinion of many others... I'd imagine most patients), patient care is simply not something that one should get a crash course in and then be thrown into while they take the rest of the classes. Again, at 99% of professional med/dent/pod/etc schools, the first two years of basic and clinical science lectures are PRE-REQs for clincal years with good reasoning: it works better that way. I am in school clinics with 3rd year students. They have passed boards, all basic sciences, some clinical sciences, etc and know a lot. However, they still have tons to learn. I can't imagine if 2nd years were just thrown in with even less knowledge. It's called a knowledge "base" for a reason... you build on it. To build a good finished product, you have to have a very solid foundation first. That is they underlying principle here.

Stuff like this proves my point. How do you write Rx when you haven't taken pharmacology yet? Am I missing something here?

And where do you find "10% lidocain"? I've only used 1% and 2% lidocaine... and I learned the mechanism, concentration, dosages, administration, and toxicities of in pharmacology class before I started injecting it into people 😉

I really hope it is.^

yeah you are right. this is like teaching any biology major how to give this that medicine or doing this procedure without developing logical thinking in him.

iam not sure how can one really understand what he/she is doing in a clinic without the knowledge of basic pharmacology, surgery, pathology, biomechanics,etc etc. This is like someone learning by following. for example an untrained housewife also gives her kids tylenol for fever, actified/sudafed for cold or claritinD for allergy,debride corns/calluses with stuff frm walgreens without any idea of its mechanism, dosage,affects,reactions,etc. This looks like the same case to me. How can one appreciate what is going on without taking the courses.

Now i dont know, how much self study the students do there. If they are studying the night before what medications they are going to prescribe and their affects. then thats awesome. but if its just "IF-THEN (just giving the drug bcoz thats what everyone gives)" logic. then thats really bad. there has to be thought process.

 

[Feli]

yeah you are right. this is like teaching any biology major how to give this that medicine or doing this procedure without developing logical thinking in him.

iam not sure how can one really understand what he/she is doing in a clinic without the knowledge of basic pharmacology, surgery, pathology, biomechanics,etc etc. This is like someone learning by following. for example a housewife knows to give her kids tylenol for fever, actified/sudafed for cold or claritinD for allergy without any idea of its mechanism, dosage,affects,reactions,etc. This looks like the same case to me.

I agree...
Keep in mind that the OTC (over the counter) meds you mention are OTC and not Rx-only like NSAIDs, antibiotics, pain killers, steroids etc which pods routinely prescribe, apply, inject, etc. There is strong, well considered, reasoning for that OTC versus Rx designation. No medicine is without potential side effects, and the only way to minimize those adverse effects is to have really studied the pathology you are educating your patients about or the treatments you are telling them to follow.

When you are talking about Rx meds, injects, treatment plans, XRs and exposing patients to radiation (albiet minimal amounts in pod XRs), I think it's pretty serious business. You have to know what you are doing to see patients, and I think that knowledge involves - at bare minimum - finishing the pre-req coursework.

 

[kmyprimeval]

i can see where u guys are coming from. Honestly, i didn't really care if clinics started early or during 3rd year. Now that i've experienced it, I think it's good cuz it helps perfect our bedside manners, perfect our technique, speed up efficiency, encourage literature search, etc way before 3rd year starts. In most of the rotations, the chartings are already done by the attending and PCP but we get our chance to do mock chartings and the attending grades us and gives us feedback. In about 2 of the rotations, we do legit chartings with great supervision. Like i said it's MOSTLY palliative care and majority of the patients are geriatric patients who are nonambulatory doing routine debridement of dystrophic nails, calluses, etc. We already know what they suffer from, what medications they are on, what precautions we should take etc. The attending double checks...if it's beyond our knowledge they wouldn't let us handle it.

Taking pharmacology, pathology & those other good classes now. Everything is starting to make sense. Our general med rotation starts next semester cuz we're taking general medicine courses this semester. Keep in mind that half of our rotations are not dealing w/ real patients. So don't be so shocked lol.

Another reason why i think early exposure is great......is sometimes w/ all the crazy studying during basic sciences, it's slightly hard to see the light at the end of the tunnel. It's like so much material when does it end...right?...but because they gave us a chance to see how we can apply what we've already learned so far in real life setting, it makes us look forward to keep on goin. I know i'm not alone in thinking like this.

 

[kmyprimeval]

woops!! i meant 1% lidocain LOL ...10% would've sucked.

 

[kmyprimeval]

ok, this will be my last post. Just simply giving people a picture of second year early clinicals. Of all 7 months of rotation, only 3.5 of it is dealing w/ real pt's. Of those 3.5 monts, 95% is palliative care. the other 3.5 months are spent in lecture style rotations...but on a more one on one basis. Imagine having a class of only 4 people. Yep that's about it. PM me if u are interested in learning more.

 

[DJ Quik]

Giving your opinion on something you have not experienced or know anything about seems kind of pointless to me. If you don't think 2nd years should be allowed SUPERVISED clinical experience, take it up with the APMA. I think a lot of you are either misinformed or stuck in second year classes wishing you could see a little more fruit of your labors. Bashing one school doesn't somehow make yours any better. I love my school and I know all my classmates. I am a first year there and think its great. Spending another year in class won't teach you how to debride a wound or cut nails any better than spending one will. Second year students aren't doing amputations and bunion removals, they are doing SUPERVISED simple procedures and recommending treatments after presenting to the SUPERVISING doctor. Did I mention they are well supervised?

Just my two cents

GO CSPM!!!
Man, we need a mascot....😀

 

[Feli]

Giving your opinion on something you have not experienced or know anything about seems kind of pointless to me. If you don't think 2nd years should be allowed SUPERVISED clinical experience, take it up with the APMA. I think a lot of you are either misinformed or stuck in second year classes wishing you could see a little more fruit of your labors. Bashing one school doesn't somehow make yours any better. I love my school and I know all my classmates. I am a first year there and think its great. Spending another year in class won't teach you how to debride a wound or cut nails any better than spending one will. Second year students aren't doing amputations and bunion removals, they are doing SUPERVISED simple procedures and recommending treatments after presenting to the SUPERVISING doctor. Did I mention they are well supervised?

Just my two cents

GO CSPM!!!
Man, we need a mascot....😀

I was not "bashing," and I am not a 2nd year student. I did experience bits and pieces of patient care in my first two years... at health fairs on Saturdays, holidays, etc:
http://cbs4.com/video/[email protected]

CSPM with 2 days per week of 2nd year students in clinic is unique. The point of the thread topic was to discuss how it is good, bad, etc for students. Like I said, I think 2nd year should be purely didactic; that is the accepted model (2+2) of professional medical programs across the country. Students are "stuck in second year classes" for a reason: they do not have the knowledge base for clinc IMO.

In shorter healthcare degree programs like PA, nursing, etc, there is more of the "learn by doing" philosophy. There has to be. However, the medical model has more time to teach you, and its philosophy has always favored completing the extensive basic and clinical sciences prior to beginning any significant amount of clinical exposure.

Don't get me wrong... I am all for 2nd year students - heck even 1st year students - who feel caught up with classes and coursework getting their feet wet at health fairs, doing shadowing, etc on their free time. I just don't think it should be in the curriculum that 2nd years see patients. At that point, they have not completed the clinical pre-reqs and have way too much important info to be focused on in their important classes: radiology, biomech, micro, path, pharm, surgery, medicine. Those are all going to be vitally important subjects for boards, interviews, residency, practice, etc etc etc. I think it's ill advised to split students' focus and study time during that second year, and I think that is why very very few professional medical programs have 2nd year clinic. I guess we will agree to disagree.

 

[JEWmongous]

One thing that I found interesting is that the CSPM students rotate at the school's simulation center during 2nd year. This involves the life-like mannequins which mimic a variety of normal + emergency situations.

From what I understand, they may be one of the ONLY pod schools where the students utilize this. Temple does have mannequins but they are at the health science campus. The admissions guy keep boasting about these learning tools but I heard from students, the DPM's do not use them!

Des Moines has a pretty sweet mannequin setup. We took a tour and they were showing it to DPM/DO/DPT students. I am not positive if the pod students actually use them. I believe they use this device which simulates heart sounds/problems during their 2nd year cardio systems course.