Does anyone else find it irritating

[futurehealer117]

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when people still quote the Flexner Report as a reason for inhibiting any kind of change in Medical Education? Admittedly it was entirely necessary to standardize practices at the time at which it was written, but is it so applicable in our modern context? At the time in which it was penned there were no accrediting bodies to insure quality education, few if any standardized residency training, little legal interference with medical practice; all of which is abundant in modern American Medicine. I refer in particular to the jump in medical school openings and the proposition of more for profit schools when state tax structures and lack of funding make it increasingly difficult to open non-profit institutions.

 

[JaggerPlate]

Flexner was important and if you go to a DO school that survived it, awesome. However, most of the time when people pull it out in arguments on this site ... they seem to be grasping at straws.

 

[Instatewaiter]

when people still quote the Flexner Report as a reason for inhibiting any kind of change in Medical Education? Admittedly it was entirely necessary to standardize practices at the time at which it was written, but is it so applicable in our modern context? At the time in which it was penned there were no accrediting bodies to insure quality education, few if any standardized residency training, little legal interference with medical practice; all of which is abundant in modern American Medicine. I refer in particular to the jump in medical school openings and the proposition of more for profit schools when state tax structures and lack of funding make it increasingly difficult to open non-profit institutions.

God I know, what an outdated report. For profit medical education is a laudable goal to fill the physician shortage. I mean if you have the funds to make a med school, it makes total sense you would try and make a profit off of the students. The flexner report is like 100 years old. It doesn't hold water today.

And while we're at it Newton's Principia is sooooo outdated. Clearly it has no relevance today. Gravity and newtonian mechanics... what are those things.

 

[JaggerPlate]

God I know, what an outdated report. For profit medical education is a laudable goal to fill the physician shortage. I mean if you have the funds to make a med school, it makes total sense you would try and make a profit off of the students. The flexner report is like 100 years old. It doesn't hold water today.

And while we're at it Newton's Principia is sooooo outdated. Clearly it has no relevance today. Gravity and newtonian mechanics... what are those things.

Did you read in the Macy report about the allo school forming in Florida that is probably going to try and pull off a for profit model due to some technical language?

http://www.josiahmacyfoundation.org/...chools_web.pdf

Analysis:

"If you read the wording carefully, the school has to be A) non-profit or B) PART OF a non-profit. "Planning is not yet far enough along for the school to seek preliminary accreditation by the LCME. Because the LCME now states that a medical school should be, or be part of, a not-for-profit institution,"

What this means to me is that I can go to 500-bed Hospital X in City A and tell them that I would like to be apart of their hospital so that I can open my for-profit medical school. In return for allowing me to be apart of your institution and for letting my students rotate with you, we will allow your clinicians to be apart of our school (teachers) and also give you 10% of our profits."

(ChiDO)

 

[MLT2MT2DO]

Did you read in the Macy report about the allo school forming in Florida that is probably going to try and pull off a for profit model due to some technical language?

http://www.josiahmacyfoundation.org/...chools_web.pdf

Analysis:

"If you read the wording carefully, the school has to be A) non-profit or B) PART OF a non-profit. "Planning is not yet far enough along for the school to seek preliminary accreditation by the LCME. Because the LCME now states that a medical school should be, or be part of, a not-for-profit institution,"

What this means to me is that I can go to 500-bed Hospital X in City A and tell them that I would like to be apart of their hospital so that I can open my for-profit medical school. In return for allowing me to be apart of your institution and for letting my students rotate with you, we will allow your clinicians to be apart of our school (teachers) and also give you 10% of our profits."

(ChiDO)

Florida is the new California

 

[scpod]

Did you read in the Macy report about the allo school forming in Florida that is probably going to try and pull off a for profit model due to some technical language?

For-profit education is not new and its growing in every segment. For all I know, it may be the future of education. Many states learned years ago that their own systems were inefficient and began opening bids to run state-owned entities. Things like prisons operate so much more efficiently when someone is looking at every dollar going out the window. State-supported schools of every kind, medical schools included, waste a lot of dollars that they really don't have to spend simply because if they don't spend it this year, it will get cut out of their budget next year.

If I was to support for-profit institutions of any kind I would much rather see a for-profit medical school than aa for-profit hospital.... and there aren't a lot of people bitching about for-profit hospitals here.

Think about it.... a for-profit medical school still teaches the same subjects and prepares the student for residency in the same way. So what if it costs a little more to do it. So long as the same standards are upheld it should produce a qualified student. Where does that compromise patient care in the end?

However, a for-profit hospital directly affects patient care in every way. My local hospital recently decided it could save $40,000 yearly by taking a certain antibiotic out of its formulary and replacing it with another. Note that the literature on the replacement antibiotic is sketchy at best. It decided to stop stocking Lantus for a cheaper long-acting insulin. Actually, there is a whole new list that shows "If you order drug X, we will be giving drug Y." It decided to buy isolation gowns that are cheaper-- even though they soak through if you get them wet (hope you don't get blood on you.) IT cut nursing services to the bone. Do you really think a hopital stocked with a few for-profit medical school graduates is gonna hurt patient care more than some of the money-saving hospital ideas?

I'm really no fan of for-profit medical education.... but I think it may be here to stay.

 

[JaggerPlate]

I'm really no fan of for-profit medical education.... but I think it may be here to stay.

I completely agree and essentially was hinting at the same thing.

 

[IDBasco]

For-profit education is not new and its growing in every segment. For all I know, it may be the future of education. Many states learned years ago that their own systems were inefficient and began opening bids to run state-owned entities. Things like prisons operate so much more efficiently when someone is looking at every dollar going out the window. State-supported schools of every kind, medical schools included, waste a lot of dollars that they really don't have to spend simply because if they don't spend it this year, it will get cut out of their budget next year.

If I was to support for-profit institutions of any kind I would much rather see a for-profit medical school than aa for-profit hospital.... and there aren't a lot of people bitching about for-profit hospitals here.

Think about it.... a for-profit medical school still teaches the same subjects and prepares the student for residency in the same way. So what if it costs a little more to do it. So long as the same standards are upheld it should produce a qualified student. Where does that compromise patient care in the end?

However, a for-profit hospital directly affects patient care in every way. My local hospital recently decided it could save $40,000 yearly by taking a certain antibiotic out of its formulary and replacing it with another. Note that the literature on the replacement antibiotic is sketchy at best. It decided to stop stocking Lantus for a cheaper long-acting insulin. Actually, there is a whole new list that shows "If you order drug X, we will be giving drug Y." It decided to buy isolation gowns that are cheaper-- even though they soak through if you get them wet (hope you don't get blood on you.) IT cut nursing services to the bone. Do you really think a hopital stocked with a few for-profit medical school graduates is gonna hurt patient care more than some of the money-saving hospital ideas?

I'm really no fan of for-profit medical education.... but I think it may be here to stay.

I have a few reservations about RVU, but honestly, the for profit status is down the list a ways. When they are charging $75k a year and delivering weak education, the profit aspect will be a legit concern. Until then, its speculation and needless worry or alarmism by those that typically hate the idea of a profit regardless of its source (pharma, etc.). Nevermind that the best thing about being nonprofit is the ability to dodge taxes- oh and the PR they gain because the average dupe thinks it means that they aren't making any money.

 

[MLT2MT2DO]

Since RVU has opened it has made me wonder; would there have been such dissension if the first "for-profit" medical school would have been an allopathic one.

 

[FutureCTDoc]

People go to Flexner as the basic principles are still true. For profit education has an inherent conflict of interest. Flexner was right in ending proprietary medical schools, making medicine from trade to profession and increasing the caliber of physician approved. Prior to Flexner medicine was not held in that high regard, he helped elevate into the respected position it holds today.

 

[MLT2MT2DO]

People go to Flexner as the basic principles are still true. For profit education has an inherent conflict of interest. Flexner was right in ending proprietary medical schools, making medicine from trade to profession and increasing the caliber of physician approved. Prior to Flexner medicine was not held in that high regard, he helped elevate into the respected position it holds today.

Yet there are tons of "for-profit" hospitals in this country...

 

[FutureCTDoc]

Yet there are tons of "for-profit" hospitals in this country...

This issue is somewhat different, where I'm from most hospitals are non-profit teaching hospitals and this isn't an issue. I haven't had enough time to examine this issue in enough depth to come to a satisfactory response about this. The argument for both for-profit schools and hospitals is efficiency and efficacy. There is clearly a conflict of interest in schooling i.e. pass and pay or low admission standards (Caribbean schools). Hospitals have the same issue potentially i.e. more expenses, longer stays and more surgery or invasive procedures being pushed. This issue has not really been addressed. This would be better dealt with on another thread.

 

[jkmph]

And while we're at it Newton's Principia is sooooo outdated. Clearly it has no relevance today. Gravity and newtonian mechanics... what are those things.

That makes no sense. That's not even apples and oranges. It's apples and space shuttle. There is no relationship, analogy or semblance to be had.

 

[scpod]

People go to Flexner as the basic principles are still true. For profit education has an inherent conflict of interest. Flexner was right in ending proprietary medical schools, making medicine from trade to profession and increasing the caliber of physician approved. Prior to Flexner medicine was not held in that high regard, he helped elevate into the respected position it holds today.

Flexner recommended against for-profit schools but it had absolutely nothing to do with any conflict of interest, nor was it due to the caliber of the physician. His claim was the a for-profit school would be so costly to attend that it wouldn't be able to provide the same services as a state-supported school. That seems to have beem disproven in modern times. There are many schools that are way more costly than the only for-profit school in the US.

 

[WNT Signaling]

Since RVU has opened it has made me wonder; would there have been such dissension if the first "for-profit" medical school would have been an allopathic one.

This is a non-issue becomes LCME wouldn't accredit a for-profit institution. Yeah, as other people have noted, there is a loophole that non-profit affiliated institutions can gain accreditation, but I'm sure LCME will clarify that non-profit affiliated refers to pre-existing non-for-profit universities that decided to start medical schools

 

[JaggerPlate]

This is a non-issue becomes LCME wouldn't accredit a for-profit institution. Yeah, as other people have noted, there is a loophole that non-profit affiliated institutions can gain accreditation, but I'm sure LCME will clarify that non-profit affiliated refers to pre-existing non-for-profit universities that decided to start medical schools

They can say whatever they want, but the loop hole probably will be exploited, and the institution will be 'for profit' when you get right down to the facts (check out the thing I posted if you didn't already).

 

[Bacchus]

That makes no sense. That's not even apples and oranges. It's apples and space shuttle. There is no relationship, analogy or semblance to be had.

Apples vs. oranges isn't a good argument anymore.

http://improbable.com/airchives/paperair/volume1/v1i3/air-1-3-apples.html

 

[Bones DO]

For-profit education is not new and its growing in every segment. For all I know, it may be the future of education. Many states learned years ago that their own systems were inefficient and began opening bids to run state-owned entities. Things like prisons operate so much more efficiently when someone is looking at every dollar going out the window. State-supported schools of every kind, medical schools included, waste a lot of dollars that they really don't have to spend simply because if they don't spend it this year, it will get cut out of their budget next year.

If I was to support for-profit institutions of any kind I would much rather see a for-profit medical school than aa for-profit hospital.... and there aren't a lot of people bitching about for-profit hospitals here.

Think about it.... a for-profit medical school still teaches the same subjects and prepares the student for residency in the same way. So what if it costs a little more to do it. So long as the same standards are upheld it should produce a qualified student. Where does that compromise patient care in the end?

However, a for-profit hospital directly affects patient care in every way. My local hospital recently decided it could save $40,000 yearly by taking a certain antibiotic out of its formulary and replacing it with another. Note that the literature on the replacement antibiotic is sketchy at best. It decided to stop stocking Lantus for a cheaper long-acting insulin. Actually, there is a whole new list that shows "If you order drug X, we will be giving drug Y." It decided to buy isolation gowns that are cheaper-- even though they soak through if you get them wet (hope you don't get blood on you.) IT cut nursing services to the bone. Do you really think a hopital stocked with a few for-profit medical school graduates is gonna hurt patient care more than some of the money-saving hospital ideas?

I'm really no fan of for-profit medical education.... but I think it may be here to stay.

I agree with most of this. If any aspect of health care being for-profit is bad, it's the hospital because the corner-cutting will directly affect patient care and/or the ability of a physician to perform well in that setting. The hospitals don't have to keep the consumers happy because most people are already unhappy with what they encounter in hospitals. By contrast, for-profit medical schools MUST produce a good product IE high board scores and good match lists in order to survive and thrive.

IMO for-profit medical education isn't a bad thing, first of all, because a school can charge industry standard (like RVU does) and easily make a killing off of it.

Secondly, and perhaps most importantly, I have sat in the lecture halls of NYCOM, Touro-COM in NY and RVU-COM and find their teaching to be on-par with each other. All lectures are done by PhD's MDs and DOs. Curriculum is very similar, because lets face it, we're all working towards the same D.O. degree.

Third, the matriculation statistics for RVU's first class are FAR superior to any inaugural class's numbers I've seen. Their first class was only .08 off of the average cum GPA and 1 point lower on average MCAT than NYCOM's c/o 2012. When compared to Touro NY's first class, RVU-COM's first class is over .2 GPA points ahead in terms of both sci and cum GPA. This impressed me and may account for the trouble Touro-NY's first class had with the COMLEX.

The last reason I chose to go to RVU myself this Summer is that it is far better-run than any other medical school I've ever had contact with. It's too early for me to tell of this is because it is for-profit or if it's just because they know they have something to prove being the first for-profit medical education venture in the US.

Based on this personal analysis of mine, it is my prediction that RVU's first class is going to obliterate the COMLEX and USMLE. That, and in order for RVU to succeed as a business, they can do nothing less. They know that, and are doing everything possible to achieve that end.

Wow that ended up being a lot longer than I thought it would be. Sorry!

 

[Bones DO]

apples vs. Oranges isn't a good argument anymore.

http://improbable.com/airchives/paperair/volume1/v1i3/air-1-3-apples.html

lol

 

[FutureCTDoc]

While some med schools may turn out good products, you should read about what some students have to say about for profit Caribbean schools i.e. they try and fail students out because there aren't enough clerkships, they don't care, match lists are all primary care, they face discrimination and ridicule because of where they went. Is a PD in all honesty going to choose a DO grad from a for profit institution over an equivalent DO from any other school barring any red flags? As to quality there is a lemming born every minute. A med school can get by on the promise of the possibility of a spot in 4 years. What makes you think that a for second that there will be more concern about the consumer (student) than the bottom line. It is a sad day when education is a commodity. http://www.businessweek.com/magazin...op+news_top+news+index+-+temp_news+++analysis
This is an article about the way for profits operate.

 

[jkmph]

lol

+1. Touche Bacchus, touche.

 

[MLT2MT2DO]

While some med schools may turn out good products, you should read about what some students have to say about for profit Caribbean schools i.e. they try and fail students out because there aren't enough clerkships, they don't care, match lists are all primary care, they face discrimination and ridicule because of where they went. Is a PD in all honesty going to choose a DO grad from a for profit institution over an equivalent DO from any other school barring any red flags? As to quality there is a lemming born every minute. A med school can get by on the promise of the possibility of a spot in 4 years. What makes you think that a for second that there will be more concern about the consumer (student) than the bottom line. It is a sad day when education is a commodity. http://www.businessweek.com/magazin...op+news_top+news+index+-+temp_news+++analysis
This is an article about the way for profits operate.

COCA seems lax, but if RVU started going the way of the Caribbean, as far as "wash out" rate, I think they would step in and pull accreditation if necessary.

 

[Bones DO]

While some med schools may turn out good products, you should read about what some students have to say about for profit Caribbean schools i.e. they try and fail students out because there aren't enough clerkships, they don't care, match lists are all primary care, they face discrimination and ridicule because of where they went. Is a PD in all honesty going to choose a DO grad from a for profit institution over an equivalent DO from any other school barring any red flags? As to quality there is a lemming born every minute. A med school can get by on the promise of the possibility of a spot in 4 years. What makes you think that a for second that there will be more concern about the consumer (student) than the bottom line. It is a sad day when education is a commodity. http://www.businessweek.com/magazin...op+news_top+news+index+-+temp_news+++analysis
This is an article about the way for profits operate.

I personally think that in this case at least the quality of the product, the consumer and the bottom line are unavoidably linked. Having been to the school several times and through contact with several current students I can tell you that at least for now, it really isn't anything like carib schools, especially in regard to fail out rates and enterance standards.

 

[Instatewaiter]

Did you read in the Macy report about the allo school forming in Florida that is probably going to try and pull off a for profit model due to some technical language?

http://www.josiahmacyfoundation.org/...chools_web.pdf

Interesting. That is something I hadn't heard about. It seems like it is in the very infancy of creation though. We'll see what comes.

Since RVU has opened it has made me wonder; would there have been such dissension if the first "for-profit" medical school would have been an allopathic one.

I'm gonna be honest- I am still very, very skeptical that this will happen in the allopathic community for a few reasons.

First, there are more barriers to entry in the allopathic accrediting process. Second and most importantly, the allopatic world is full of ivory tower ideologues. These people also hold very significant weight in academic circles and they would raise such a stink that I do not think that the LCME could possibly accredit a for profit med school. We'll see though.

I will raise even more of a fuss if this comes to pass in the allopathic world.

I agree with most of this. If any aspect of health care being for-profit is bad, it's the hospital because the corner-cutting will directly affect patient care and/or the ability of a physician to perform well in that setting. The hospitals don't have to keep the consumers happy because most people are already unhappy with what they encounter in hospitals. By contrast, for-profit medical schools MUST produce a good product IE high board scores and good match lists in order to survive and thrive.

Actually, reality is it is the exact opposite of the bolded section. The reason people have problems with your school (RVU) is that it doesn't matter much what kind of product they put out- students will continue to apply. So they can, and eventually will, cut corners and it will not change how many students fill the class. Dont believe me?

Exhibit A- the carribean schools
These schools are in a completely different country, in a carribean ****hole, have terrible attrition rates, cost a fortune, have miserable board pass rates and even worse residency placement. To top if off, many states will not allow you to practice in them if you graduate from a carribean school. AND THEY have no problem attracting students.

Medical education is an inelastic good. So, even when the price goes up and quality goes down, the demand does not change much.

 

[scpod]

.... So they can, and eventually will, cut corners and it will not change how many students fill the class. Dont believe me?

Exhibit A- the carribean schools
These schools are in a completely different country, in a carribean ****hole, have terrible attrition rates, cost a fortune, have miserable board pass rates and even worse residency placement. To top if off, many states will not allow you to practice in them if you graduate from a carribean school. AND THEY have no problem attracting students....

Here's the basic flaw in your argument. The Carribean schools are not accredited by a licensing agency that holds them responsible. If RVU has enormous attrition rates and students are not passing boards in big numbers then they will lose accreditation. That means they will no longer exist and Tien will lose his whole investment. He's not stupid enough to let that happen.

 

[JaggerPlate]

If RVU has enormous attrition rates and students are not passing boards in big numbers then they will lose accreditation.

I hope there would be this type of repercussions, but I have a feeling RVU will operate just like any other COM and things will be fine.

 

[Instatewaiter]

Secondly, and perhaps most importantly, I have sat in the lecture halls of NYCOM, Touro-COM in NY and RVU-COM and find their teaching to be on-par with each other. All lectures are done by PhD's MDs and DOs. Curriculum is very similar, because lets face it, we're all working towards the same D.O. degree.

I have said it before and will say it again. Your medical education has less to do with your classroom education and more to do with your clinical education. Why do you think residency is done in the hospital? That they are similar (after sitting in 1 lecture) means next to nothing

Based on this personal analysis of mine, it is my prediction that RVU's first class is going to obliterate the COMLEX and USMLE. That, and in order for RVU to succeed as a business, they can do nothing less. They know that, and are doing everything possible to achieve that end.

I highly, highly doubt it. Furthermore, I highly doubt that that data will even be made available.

See red

I personally think that in this case at least the quality of the product, the consumer and the bottom line are unavoidably linked. Having been to the school several times and through contact with several current students I can tell you that at least for now, it really isn't anything like carib schools, especially in regard to fail out rates and enterance standards.

Just looked up the stats of carribean schools:

SGU- MCAT 28, GPA 3.34-
AUC MCAT 25, GPA 3.3
Ross- MCAT 24 GPA 3.2

SO how much does RVU blow these scores out of the water. My guess is that it doesn't

 

[Instatewaiter]

Here's the basic flaw in your argument. The Carribean schools are not accredited by a licensing agency that holds them responsible. If RVU has enormous attrition rates and students are not passing boards in big numbers then they will lose accreditation. That means they will no longer exist and Tien will lose his whole investment. He's not stupid enough to let that happen.

Actually that is not a flaw. The fact that carribean schools are unaccredited yet still attract a ton of students (SGU has something like 2500 students) confirms the argument. Students will put up with essentially anything to get their medical degree. So if RVU loses accreditation, they become just like the carribean schools, which as I have already said are not struggling for enrollment. The only difference is that people will no longer have to leave the US to get a carribean degree

 

[JaggerPlate]

See red



Just looked up the stats of carribean schools:

SGU- MCAT 28, GPA 3.34-
AUC MCAT 25, GPA 3.3
Ross- MCAT 24 GPA 3.2

SO how much does RVU blow these scores out of the water. My guess is that it doesn't

I'd be skeptical of numbers coming from these schools. They are always off. SGU quotes their MCAT at a 26 on their site, with cGPA at 3.3 and sGPA at 3.17, and I'm still not convinced these are completely legit.

http://www.sgu.edu/about-sgu/medical-students-enrollment-statistics.html

 

[JaggerPlate]

So RVU loses accreditation, then they are just like the carribean schools which as I have already said are not struggling for enrollment. The only difference is that people will no longer have to leave the US to get a carribean degree

If it isn't accredited by COCA or LCME though, could it grant either the DO or MD on US soil???

 

[The Poet Sings]

where can i find a list of the schools that survived the flexner report? i'm just curious. thanks.

 

[JaggerPlate]

where can i find a list of the schools that survived the flexner report? i'm just curious. thanks.

Flexner happened in like 1910 err something, so I guess if your school was established before then, they survived. Now, this doesn't mean they didn't have to change and adapt a little to survive (I'm sure mine did ... est late 1800s), but they survived.

 

[DO Anes]

Second and most importantly, the allopatic world is full of ivory tower ideologues. These people also hold very significant weight in academic circles and they would raise such a stink that I do not think that the LCME could possibly accredit a for profit med school.

That is the point. For-profit education is an anathema to the medical world and the existence of RVU disgraces and dishonors the profession. Saying that its quality and standards are high is like saying that your sister is the most beautiful prostitute in town.

 

[Instatewaiter]

I'd be skeptical of numbers coming from these schools. They are always off. SGU quotes their MCAT at a 26 on their site, with cGPA at 3.3 and sGPA at 3.17, and I'm still not convinced these are completely legit.

http://www.sgu.edu/about-sgu/medical-students-enrollment-statistics.html

Yeah I got my data from their FAQ pdf file. http://etalk.sgu.edu/faqs/medfaq.pdf

It doesn't matter though which is right. The point I was trying to make was that the carribean averages aren't far off from RVU, and many schools have better stats.

 

[The Poet Sings]

Flexner happened in like 1910 err something, so I guess if your school was established before then, they survived. Now, this doesn't mean they didn't have to change and adapt a little to survive (I'm sure mine did ... est late 1800s), but they survived.

oh ok, thanks. i have no idea why i didn't think of it that way 😀.

 

[JaggerPlate]

Yeah I got my data from their FAQ pdf file. http://etalk.sgu.edu/faqs/medfaq.pdf

It doesn't matter though which is right. The point I was trying to make was that the carribean averages aren't far off from RVU, and many schools have better stats.

Yeah, therein lies my issue ... one set of numbers on the site, another one in the FAQ that are significantly different. Frankly, I just don't trust numbers from Caribbean schools (with regards to anything - attrition rates, matching, matriculation stats, etc).

 

[Instatewaiter]

The FAQ says these are the averages for North American Students, so it likely takes out students actually from the carribean and those from india etc.

 

[JaggerPlate]

The FAQ says these are the averages for North American Students, so it likely takes out students actually from the carribean and those from india etc.

Probably, but again, this is what they do with numbers.