curriculum vs. rotations

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alibubble

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Hi, I started this thread in the Osteopathic forum, but realized I should have started it here. I'd appreciate any input-- opinions, personal reflections based on experiences, etc:

What's more important careerwise: a solid education from a well established school that has a limited network of rotations or a great network of rotations at a school which is undergoing a curricular overhaul?

In terms of acquiring a residency, which is more influential? I know med schools are basically the same, but there is something to be said about the reputation of a school and the strength of its academic program when considering the competition for residencies. At the same time, what's the point of getting a great education during the first two years of med school when you're sacrificing the quality of the education during the last two years or vice versa? Again, if anyone has any ideas about this, I'd really appreciate a different point of view. Thanks, -A 😕
 
IMHO the name of the school matters somewhat, and the quality of clinical rotations matter somewhat, but Step 1 score matters A LOT and that is what the 1st two years prepare you for. It's really a silly backwards kind of system since overall it's clinical rotations that prepare you the most for residency.

If a school is going through a curriculum overhaul I would look at the history of their board scores. If it's good then it is likely that you will still do well despite the changes. If they are rethinking things because they have a dismal history of low scores then I would look elsewhere.

As for breadth of rotation sites - a few well developed sites/rotations are MUCH better than many scattered sites where the attendings don't really know what to do with students. Just my $0.02.
 
Agree with Seaglass above...

For me, My 2 most important factors in choosing a med school (besides location) was the schools reputation/name, and the quality of the school's teaching hospital.

The reputation/name is important b/c that is what will be stapled to every application you fill out for the rest of your life. You will be screened and judged when you apply to residency based on your med school and after residency, nobody will ever see your grades/rank again, but they WILL see your school name and will judge you off it's reputation (not your individual performance at that school).

The school's teaching hospital is very critical IMO b/c it can tell you a lot about the curicullum. For instance, a school who does NOT have it's own teaching hospital will require you to commute a lot and work at hospitals where attendings and residents have nothing invested in you. You will end up shadowing and probably won't get to participate a lot, which means you won't learn nearly as much. A program that has it's own teaching hospital where you do all your rotation at will have standard objectives and attendings/residents who are used to have students. You will have regular responsibilities and will be allowed to participate in clinical patient care much more autonomously. You will be afforded more procedure opportunities and teaching will likely be much better as well b/c it is an academic environment which is invested in YOU. In addition to finding a medical school with it's own teaching hospital, I would suggest making sure the medical school is located INSIDE or ADJACENT to the hospital (not on another campus). The best teachers during the 1st 2 years of med school are MD's... NOT PhDs (who don't know an ounce of what is important clincally--which is what YOU NEED TO KNOW). If your campus is away from the hospital, MD's are much less likely to drive all the way down in the middle of a busy ward month or during a research session ot give you a lecture. This means that your lecture quality may suffer greatly.

Overall your Step I board scores are critical to an awesome residency, but if you have the determination to study hard durnig your boards month and do some extra reading, you should do fine no matter what school you go to. The clerkships during 3rd year will prepare you most for residency, so again, having your own hospital is CRUCIAL.
 
Thanks for the responses so far! One of the schools is located on/at a hospital, but the other is not. However, the one without the hospital has great rotation sites. I guess bad lectures can't be so bad-- in the end, it's our responsibility to learn the material despite any insufficiencies in how the info is presented.

So, the name of the school matters, but my board scores will matter more in the acquisition of a residency? Also, the clinical education during third and fourth year will be more immediately relevant to residency than the first two years of med school education-- assuming I have mastered everything from the first two years?

Hmmm... makes the choice very difficult. Did anybody here have a really tough decision to make when considering which school to pick?
 
However, the one without the hospital has great rotation sites.

Yes, they all have "great" rotation sites. Seriously, it is difficult to get an objective opinion about rotation sites from students at a school because a) that is all they know, and b) most don't want to admit that their school is lacking in any way. The best sources are grads who are a couple of years out so that their info is still current but they have the freedom to be a little bit more honest. For example, I did a rural medicine rotation at a place that was a core rotation site for LECOM students for FP. The LECOM students thought it was a great rotation, I thought it was in the bottom 2-3 of rotations I had done. Perhaps our standards were a bit different.
 
alibubble said:
Thanks for the responses so far! One of the schools is located on/at a hospital, but the other is not. However, the one without the hospital has great rotation sites. I guess bad lectures can't be so bad-- in the end, it's our responsibility to learn the material despite any insufficiencies in how the info is presented.

So, the name of the school matters, but my board scores will matter more in the acquisition of a residency? Also, the clinical education during third and fourth year will be more immediately relevant to residency than the first two years of med school education-- assuming I have mastered everything from the first two years?

Hmmm... makes the choice very difficult. Did anybody here have a really tough decision to make when considering which school to pick?


hmm. . .from what i've realized--ANY school, from HMS to the caribbean schools, is going to have good lectures and bad lectures. The most famous name profs aren't always the best teachers/lecturers--this i know from personal experience.

Sometimes an idolized persona in any field turns out to be the worst lecturer ever and too removed from students' level thinking to explain things clearly, and it turns out one of his/her "nobody" grad students ends up being the most valuable resource that helped you understand some complicated concept.

Unfortunately, med school no longer has TAs (at least not at my med school), no more things like "office hours", no problem sets. It's all just reading and memorizing/learning. The concepts aren't profound by any means. It just up to you to get through it all in time for the exam. I ended up not even wasting time in lecture, b/c no matter how good or bad it was, all i needed to do was sit down by myself and pour over the material. I'm a slow reader, so I couldn't afford to spend 3-6 hours a day sitting in lectures that didn't even cover everything we needed to know and that I only retained like 5-10% from.

Thus, I'd say of all things, the "quality" of the lectures in preclinical years means NOTHING. In terms of judging quality of a school's curriculum, I'd recommend looking at whether they involve small group/PBL learning, what exactly the PBLs at a particular school entail, when do you start rotations (3rd year vs before 3rd year). I think the quality of clinical experience is far more important b/c you're less dependent on yourself for learning. The variety of pathology, diversity of patient population, technology avail in the hospital, whether its a level I trauma center, the quality of residents, do you have to fight over rotations with other med schools or PA schools. . .those are all very important to keep in mind while looking for a good clinical education at a med school, imo

Also keep in mind that it could be that the school that's overhauling its curriculum is making a significant improvement over what was in place before. My school just overhauled its preclinical curriculum last year, which eliminated a lot of redundancy (e.g. we had a 3 week micro course, and then in a few months, we had another 2-week course on infectious disease 😛 ), allowing students to start rotations in the spring of MS2 instead of beginning of MS3. That way, students would be taking Step 1 with some clinical experience under their belts (unlike my class). Med schools that have already been doing this (Baylor, Penn, Duke) tend to do better on Step 1 than schools that dont (like HMS, which still does well, but not quite as well).

Another thing is that if you choose a med school with a lot of residency programs, first of all you get to experience what it would be like as a resident, more so than if you rotate at some community hospitals that don't belong to the school itself, that don't have any residents. Second of all, often the residency programs at one's home med school will have some preference for their own students, if not outright, then simply b/c programs often prefer to stick with applicant whom they know and have worked with in the past. So, choosing on the basis of quality of residency programs at that particular school is a good idea too.
 
alibubble said:
Thanks for the responses so far! One of the schools is located on/at a hospital, but the other is not. However, the one without the hospital has great rotation sites. I guess bad lectures can't be so bad-- in the end, it's our responsibility to learn the material despite any insufficiencies in how the info is presented.

So, the name of the school matters, but my board scores will matter more in the acquisition of a residency? Also, the clinical education during third and fourth year will be more immediately relevant to residency than the first two years of med school education-- assuming I have mastered everything from the first two years?

Hmmm... makes the choice very difficult. Did anybody here have a really tough decision to make when considering which school to pick?

Your board scores will be a much more significant factor in residency placement than the name of your school - while this may matter, in general it is an insignificant factor or only used to decide between nearly identical candidates.

The reason that your clinical rotations will be more relevant to your residency is that while you may learn that a certain drug under goes First Order Kinetics in your Pharm class, your clinical rotations will actually teach you the proper usage, dosage, etc. - clinically relevant stuff.
 
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