DO Clinical Rotations

[civ64]

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Hi,

I'm curious what DO clinical rotations are like. How much hands-on experience do you get? What is a typical day like in say surgery or OBGYN? And, what is the culture like? I know this might vary from program to program, but I'm curious if there are general differences between DO and MD programs.

Thanks!

 

[AlteredScale]

Try asking this on the medical student forum!

 

[IslandStyle808]

I agree with above. From what I have read, the DO rotations are usually more hands on than MD. This is mainly because more DO clinical rotations are at community hospitals and the attending does not have many residents under them. So you are more on the front lines. It is really dependent on the program and how willing the attending is in teaching you. Better to hear it from the medical students and residents.

 

[civ64]

Oops. I should have done that. Re-submitting this thread in the med forum. Thanks!

 

[cliquesh]

Hi,

I'm curious what DO clinical rotations are like. How much hands-on experience do you get? What is a typical day like in say surgery or OBGYN? And, what is the culture like? I know this might vary from program to program, but I'm curious if there are general differences between DO and MD programs.

Thanks!

It will depend on which school you attend, the hospital you rotate at, the specific attendings/residents you work with, and the rotation you are on. Some attendings will let you do more and some won't let you do anything (you literally just stand there). Some attendings/residents are nice and will teach you. Some attendings/residents will completely ignore you. Consequently, some students at the same school may have wildly different clinical experiences. I, for instance, was never first assist during surgery. I usually just held the retractor or suctioned stuff. My wife, on the other hand, who attended the same school as me, was first assist all the time, and she felt comfortable doing some general surgery procedures, like a cholecystectomy, at the end of her surgery rotation. I, however, put in 3+ central lines as a med student, but my wife didn't do any as a med student. But does that it really matter how many procedures you do as a med student? Probably not. You will learn it as an intern/resident pretty quickly. My wife put in at least one central line a day during her first month of her residency.

 

[PlasticBag]

It will depend on which school you attend, the hospital you rotate at, the specific attendings/residents you work with, and the rotation you are on. Some attendings will let you do more and some won't let you do anything (you literally just stand there). Some attendings/residents are nice and will teach you. Some attendings/residents will completely ignore you. Consequently, some students at the same school may have wildly different clinical experiences. I, for instance, was never first assist during surgery. I usually just held the retractor or suctioned stuff. My wife, on the other hand, who attended the same school as me, was first assist all the time, and she felt comfortable doing some general surgery procedures, like a cholecystectomy, at the end of her surgery rotation. I, however, put in 3+ central lines as a med student, but my wife didn't do any as a med student. But does that it really matter how many procedures you do as a med student? Probably not. You will learn it as an intern/resident pretty quickly. My wife put in at least one central line a day during her first month of her residency.

Thanks for this explanation, I have always wondered how DO rotations work, especially that so many people (on SDN) argue for their inferiority. What would be some good questions to ask regarding rotations when we're visiting schools? For example, I used to think that a rotation in some doctor's private office seems pretty crappy in comparison with a rotation at a teaching hospital (unless it's family medicine/primary care, I guess?) but someone pointed out to me that you might actually get to do more if it's just your preceptor and you.

I also read a number of times that "if you're proactive, you can find better rotations", what does this mean exactly? How would you go about finding a rotation site for yourself? I'm wondering especially about some rotations that might not be in your core but you might need if that's the specialty you want to go into (ENT? neurology? etc.). I did look at the medical forum but since I don't know the basics of how this works, it's hard for me to glean any meaningful information... Thanks in advance

 

[cliquesh]

Thanks for this explanation, I have always wondered how DO rotations work, especially that so many people (on SDN) argue for their inferiority. What would be some good questions to ask regarding rotations when we're visiting schools? For example, I used to think that a rotation in some doctor's private office seems pretty crappy in comparison with a rotation at a teaching hospital (unless it's family medicine/primary care, I guess?) but someone pointed out to me that you might actually get to do more if it's just your preceptor and you.

I also read a number of times that "if you're proactive, you can find better rotations", what does this mean exactly? How would you go about finding a rotation site for yourself? I'm wondering especially about some rotations that might not be in your core but you might need if that's the specialty you want to go into (ENT? neurology? etc.). I did look at the medical forum but since I don't know the basics of how this works, it's hard for me to glean any meaningful information... Thanks in advance

I think asking for a list of their affiliated hospitals is a good place to start. I personally think the bigger (300+ beds) the hospitals the better, and the more residencies associated with the hospitals the better. I think rotating at a private office for family medicine is fine, but everything else should be inpatient at a teaching hospital with residencies. I had much better educational experiences at teaching hospitals than private offices. But I'm sure other people had the opposite experience.

I think for most schools your 3rd year rotations are setup by the school and you cannot set up your own 3rd year core rotations. You can, however, set up your electives anywhere that will take you. There is a thing called VSAS which is an online service to setup elective rotations. Most, but not all, university hospitals use it. It is what I used to set up electives, and you could use it to set up your ENT/neurology electives. Alternatively, you can directly call many rotation sites and set it up that way.

You will soon learn that medical education is messed up and disorganized, and it's really up to you to learn anything during your 3rd and 4th years.

 

[PlasticBag]

I think asking for a list of their affiliated hospitals is a good place to start. I personally think the bigger (300+ beds) the hospitals the better, and the more residencies associated with the hospitals the better. I think rotating at a private office for family medicine is fine, but everything else should be inpatient at a teaching hospital with residencies. I had much better educational experiences at teaching hospitals than private offices. But I'm sure other people had the opposite experience.

I think for most schools your 3rd year rotations are setup by the school and you cannot set up your own 3rd year core rotations. You can, however, set up your electives anywhere that will take you. There is a thing called VSAS which is an online service to setup elective rotations. Most, but not all, university hospitals use it. It is what I used to set up electives, and you could use it to set up your ENT/neurology electives. Alternatively, you can directly call many rotation sites and set it up that way.

You will soon learn that medical education is messed up and disorganized, and it's really up to you to learn anything during your 3rd and 4th years.

Thanks, this was really helpful!

Sorry for hijacking the thread but if I can ask a few more questions...
so if you want to match into a specialty that is not in your core (say ENT/neurology/urology/allergy/etc.), is it okay time-wise to take that elective at the beginning of your fourth year? Does it happen that someone couldn't match into their desired specialty because they couldn't get the elective done on time before residency applications? And is it any different between DO and MD schools? I just want to make sure, while choosing schools (assuming I'll have a choice!), that I don't have to eliminate some specialties only because of some administrative issues and also that I won't have an NP as my surgery preceptor or be stuck in a private office for internal medicine... It seems like in those situations, even if I put max effort into trying to learn something, I'd be starting from a much lower baseline.

Thanks!

 

[cliquesh]

Thanks, this was really helpful!

Sorry for hijacking the thread but if I can ask a few more questions...
so if you want to match into a specialty that is not in your core (say ENT/neurology/urology/allergy/etc.), is it okay time-wise to take that elective at the beginning of your fourth year? Does it happen that someone couldn't match into their desired specialty because they couldn't get the elective done on time before residency applications? And is it any different between DO and MD schools? I just want to make sure, while choosing schools (assuming I'll have a choice!), that I don't have to eliminate some specialties only because of some administrative issues and also that I won't have an NP as my surgery preceptor or be stuck in a private office for internal medicine... It seems like in those situations, even if I put max effort into trying to learn something, I'd be starting from a much lower baseline.

Thanks!

Yeah, rotating at the beginning of your 4th year is fine. Some competitive programs, like AOA ortho/ENT/urology, will not interview you unless you rotate at their program, so if you don't rotate at enough programs you will have little chance matching. Sometimes people won't have any electives in the beginning of their 4th year and they basically get screwed. DO and MD students basically have the same schedules and core rotations, but MD students are not expected to do "audition" rotations, which makes their life easier. Audition rotations are really only required for AOA surgical residencies. I didn't do any for anesthesia.

 

[PlasticBag]

Yeah, rotating at the beginning of your 4th year is fine. Some competitive programs, like AOA ortho/ENT/urology, will not interview you unless you rotate at their program, so if you don't rotate at enough programs you will have little chance matching. Sometimes people won't have any electives in the beginning of their 4th year and they basically get screwed. DO and MD students basically have the same schedules and core rotations, but MD students are not expected to do "audition" rotations, which makes their life easier. Audition rotations are really only required for AOA surgical residencies. I didn't do any for anesthesia.

AOA, meaning osteopathic residencies? If I start med school next year (hopefully...), then I guess I'd be matching when MD and DO residencies are already merged. But it's probably beneficial to "audition" for competitive residencies as a DO anyway? Given how competitive they are for everyone, and probably even more so if you're a DO? And I'd imagine you need LORs from a given specialty.

Wow, that's crazy that some students have to do other residencies because they their schedule didn't have electives at the beginning of their 4th year. I would think that it's good for the school if someone matches into one of the competitive residencies (good-looking match list?) so wouldn't they help the student schedule the electives they need?

 

[cliquesh]

AOA, meaning osteopathic residencies? If I start med school next year (hopefully...), then I guess I'd be matching when MD and DO residencies are already merged. But it's probably beneficial to "audition" for competitive residencies as a DO anyway? Given how competitive they are for everyone, and probably even more so if you're a DO? And I'd imagine you need LORs from a given specialty.

Wow, that's crazy that some students have to do other residencies because they their schedule didn't have electives at the beginning of their 4th year. I would think that it's good for the school if someone matches into one of the competitive residencies (good-looking match list?) so wouldn't they help the student schedule the electives they need?

Yea, AOA meaning osteopathic. The merger won't change anything, really. If you want to do ortho, your only realistic option will be the previously AOA accredited programs. It's not like the merger is going to make everything fair over night. Acgme programs that never take DOs now will not all of the sudden start taking take DOs after the merger.

You still have required rotations during your 4th year. Only a finite amount of students can have their electives in the beginning of the year and their required rotations at the end of the year. It usually works out, though, and you can often trade elective time with your class mates. And, as I mentioned previously, early electives are only a big deal for the AOA surgical specialities.

 

[PlasticBag]

Yea, AOA meaning osteopathic. The merger won't change anything, really. If you want to do ortho, your only realistic option will be the previously AOA accredited programs. It's not like the merger is going to make everything fair over night. Acgme programs that never take DOs now will not all of the sudden start taking take DOs after the merger.

You still have required rotations during your 4th year. Only a finite amount of students can have their electives in the beginning of the year and their required rotations at the end of the year. It usually works out, though, and you can often trade elective time with your class mates. And, as I mentioned previously, early electives are only a big deal for the AOA surgical specialities.

It's looking pretty grim for those interested in surgical subspecialties then... I'll hope I fall in love with something less competitive. Thanks again for shedding some light on this process.