Des Moines University

[Kent Ray]

Hi, I am currently completing a Transitional year internship at Bi county/Henry Ford. I just wanted to tell you that if anyone is considering IM you should first complete an Osteopathic internship than apply to an allopathic school. I don't have a chip on my shoulder but I am being realistic. Osteopathic hospitals consist of private physicians who don't have time to teach. An internship in an Osteopathic hospital will teach you how to think independently but you will not receive much teaching. Also it is fairly easy to land an allopathic residency in IM after an internship (it is not that hard without an internship).
I wanted to say that DMU like all the private Osteopathic schools is very weak in clinical education. If you are planning your rotations do them at large teaching allopathic hospitals. If you don't I can tell you that you will not learn much.
For all those peeople that would say that I am an MD wannabe, I would say that I am Kent Ray, DO. I am realistic and we should all challenge the schools to do a much better job.
I would be glad to answer questions either from the message board or you could email me @ [email protected]



[This message has been edited by Kent Ray (edited 10-22-2000).]

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[TNT]

Hi Kent,

Thanks for your candid response. I take your advice more seriously because you have been through this process and can look back on your education with clarity. I do have one question for you though. Most of the state public schools (MI, OK, etc) prefer their own residents, so for most of us, we are stuck with going to a private DO school. You mention that the clinicals for these schools suck, but do you know, based on your experience, which of the private schools have the best clinicals. thanks.

 

[turtleboard]

Not all private DO schools have crappy clinicals, although I tend to agree with the original poster, however. The best clinical education you'll get at ANY DO school, in my opinion, is at NYCOM.


Tim of New York City.

 

[kidterrific]

I second the previous question: which private schools have the best clinicals?

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KidT
[email protected]

 

[TNT]

This is a very informative question. For people who know, can you please make a ranking of the clinical programs for 1-10, or as high as you can go. Knowing that NYCOM is one of the best helps, but what about people that didn't appy there or get accapted there, whats the next best choice. Thanks.

 

[KWBum]

Pertaining to the original post, in my understanding the third and fourth year clinicals must be done in osteopathic hospitals.

That is, until your actual residency, you are "stuck" in the DO system, as it were. Then, once you pass the boards, you are free to seek residency placement in both DO and MD programs.

You can either do a rotating DO internship for a year and then apply to residencies, or simply apply directly to MD/DO residencies.

So, my basic question; "Are you in fact confined to DO rotations in the third and fourth years while still in medical school?"

 

[turtleboard]

That's not entirely true. MANY osteopathic schools have their clinical rotations in allopathic hospitals which, more often than not, have an osteopathic education department. NYCOM, for example, rotates students through Brookdale University Hospital and Medical Center and Maimonides Medical Center, two of the largest hospitals in Brooklyn, each of which has its own osteopathic education department.

So being in DO school doesn't mean you're "stuck in the system" until you graduate. I believe UMDNJ-SOM rotates through several allopathic hospitals, as does MSU-COM.

As for ranking the clinical programs at other osteopathic schools, I think that'll just cause another one of those "mine is bigger than yours" debates where some egos get hurt and others get superinflated.

It is my opinion, however, that NYCOM, PCOM, UMDNJ-SOM, MSUCOM, and CCOM have the best clinical programs of all osteopathic schools in the country. If someone wants to rank them, go right ahead, but I draw the line here.

Tim of New York City,
your allopathic fan of NYCOM

 

[rtk]

Kent Ray and KMBum;

I graduated from DMU a few years ago. I'm not sure if thing's have changed in 3rd-4th years since that time, but my clinical years were excellent. When I was an MS-2 I had to set up my rotations. There's a lottery system to det'n where you'll do your core rotations for the first year of rotations, but for the remaining 12 months, it's wide open. My core rotations were excellent (maybe alittle too much emphasis on outpatient family practice) but overall very good.

How good your clinical years are is really det'ned by how hard you're willing to work. There are advantages and disadvantages to this arrangement. If you want to slack off during rotations, you can schedule 'cake' rotations; if you want to learn and work hard you can arrange for rotations at Mayo Clinic, UCSF, etc... Obvious advantage to this arrangement is that you can rotate at programs that you're interested in for residency. Example: a classmate (middle class rank and mediocre board scores) is now an ER resident at a large east coast university.

 

[Kent Ray]

rtk,
Your opinion is valid but dosen't address my point. First of all as a medical student I had no idea how I should set up my rotations.
Second, the clinical years at DMU are disorganized and not taken seriously by the school. They don't pay clinical faculty to teach and as a result we are denied a proper education.
I worked very hard during my clinicals. Still my education was poor. Medical education cannot be self taught.
This problem is not only with DMU but most Osteopathic schools. Although many of the schools have started to create OPTIs, they still are not addressing the real problems.
I wrote to the Executive director of the Board at DMU about the same things I a have been discussing. She told me that DMU doesn't have the money to pay clinical faculty! She said that most physicians, Osteopathic or allopathic, are not paid to teach. Both statements are not true. Physicians who are on staff at a university hospital are salary. They are required to teach. Osteopathic physicians are private and for the most part do not get paid. Private physicians are usually very busy and don't have time to teach.
You cannot argue with facts.

 

[rtk]

Kent Ray;

Don't know where you did your rotations but my core was Des Moines metro. I had OB/Gyn and psych at Broadlawns (paid faculty, good rotations), Medicine and surgery at VAMC (paid faculty, good rotations), Family medicine at SE clinic (paid faculty, good rotation), ER at St. Barnabas Bronx (paid faculty, good rotation), Medicine at U of Colo, etc...

Granted some of the paid faculty were paid through other affiliations, but I had good experiences with non-paid staff on two other rotations as well. I may have been one of the lucky students, but many in my class had similar experiences.

I understand your point. However, I'm not sure that I agree that paid faculty equates a good learning experience in all circumstances. I agree that clinical teaching staff must recieve some form of compensation (monetary or otherwise) and certainly not all physicians are altruistic... I must've been lucky in my experience.

I'm unclear as to why you would recommend AOA GME training when you're clearly dissatisfied with your experience in medical school. I think you would agree that the majority of what you'll use in practice, you learn during residency.. so why would you make a recommendation to warn students of the poor clinical rotations that are in store (something they have little control over) yet recommend they pursue the same poor quality training when it really counts (and something that the student has total control over)?

 

[TNT]

Good response rtk,

Kent Ray, I am interested in hearing your response. This is extremely helpful for students going into med school now.

 

[Kent Ray]

rtk,
Sometimes I am not as clear as I should be. As far as AOA GME, I recomend completing an internship for several reasons. First you learn to think for yourself and you get a broad base of knowledge. The teaching is not that great (depending where you are) but the experience is benificial. Second you will be able to practice in all states. Third, if you are applying to ACGME programs an internship is usually very helpful.
You mentioned that you did your rotations at broadlawns, and the VA. All broadlawns faculty is paid by the university of Iowa if they teach. The VA faculty are paid by the US government. DMU has no control over these people and cannot regulate the faculty. Did you ever have to take a test at the end of your rotations? I know the answer is no. Why not? How does the school know that you are learning anything?
I agree that if you know how to set up your rotations than you might get a good education. My concern is that most students including myself had no idea. Also, most people don't have the money to travel all over the united states. How crazy are things when you have to travel from Des Moines, to New York, back to Des Moines, then to Colorado. Great experience but don't you think it is the schools responsibilty to offer the same quality of rotations in Des Moines
Did you know that Medodist hospital offered to take our students and they would be a core hospital for DMU. This was several years ago. The only stipulation was that the UofI would regulate our education (this only means that we would take the same end of rotation tests as their students). Our school turned them down because they wanted around 100.00 per student per rotation!
If you are a student looking at this post please consider what you want in a medical school. If you want a school that is going to look out for your best interests DMU is not the school for you. Also look at all the schools. Many will claim that they have so many hospital affiliations. This means nothing. Are the affiliations teaching hospitals, do they have residents and interns. An affiliation with a hospital that has no medical education department means nothing. Watch out and be smart. any questions please email me at [email protected]

 

[rtk]

Kent;

In the present health care environment, university hospitals across the country are struggling to stay afloat (and that's with government support in the form of Medicare dollars for GME, disportionate share dollars, state funds for medical training costs and research grant monies). Can you imagine how difficult it would be for a fairly small, private institution to subsidize clinical education much beyond the scope that is now offered at nearly every osteopathic institution?

I'm not sure how you can equate your experience at UOMHS as a testimonial to the clinical training that occurs across the country at private institutions. I shared my clinical experience at UOMHS to balance your blanket remarks regarding clinical training. You recieved your medical training at UOMHS and are now a physician and recieving residency training because of that degree... As I stated in my earlier post, the majority of what you learn that is applicable to the practice of medicine in your chosen field is learned during the intensive training in residency (an arguable point for sure, but that's why there's GME and why physicians don't go into practice directly after medical school). What you get in the last two years of medical school is an opportunity to sample the different fields of medicine and apply your didactic knowledge in a real-life clinical setting. Perhaps that's why you suggest that new DO's pursue an AOA internship... using your own words: "First you learn to think for yourself and you get a broad base of knowledge. The teaching is not that great (depending where you are) but the experience is benificial". By your own logic, why waste the time?

My point being simply for those of us who have been given an opportunity to become a physician, it matters more what we make of the opportunity than by what means we are given it...

 

[docflight2]

I think it is important to remember that each students experience is unique. I felt my training at DMU/UOMHS was outstanding overall. I am a big advocate of the 'idea' of the core clinic/hospital system. I agree there has to be more regulation and post rotation testing to be sure people aren't slacking off. I knew a bunch who did and it hurt them bigtime on the boards. During each rotation I would ask the attending I was working with to tell me who they thought was the "best clinical Cardiologist, or ER doc, or Internist".... and then I'd call them and set up a rotation. I was able to fly with the Lifeflight team on ER, first assist on C-Sections on OB/GYN, LOTS of OR time on Ortho, blah, blah, blah. I am telling you this because I think the system CAN work if you use it correctly. My training at DMU was good enough to get me into a very competitive Allopathic residency and I feel every bit as prepared as my classmates. Good luck to you all.