Does the med school clinical ed matter?

[unicorn06]

I'm currently applying to med school and am trying to choose between several schools. At some of these schools, I feel I will get a better clinical education (Pitt, UMich, UWash, OHSU), and at others I feel I will have more research opportunities (Yale, Stanford, Harvard).

My question is this: Does the clinical education that you get in med school really matter that much in the end? I would think that it's the internship and residency where you truly learn the clinical skills that you will be using as a physician and that as long as you learn the basics in medical school (which any competent med school should teach you), you'll be fine. Have you found/heard this to be true? I guess having an excellent clinical education as a med student would put you a little ahead at the beginning of residency, but I would think this would even out after a few months.

I'm anxious to hear your responses since my current perspective is only based on speculation.

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[Iwy Em Hotep]

Have you been accepted to all of these schools? If so, congratulations! You'll probably be fine at any of them.

 

[ToxicFugu]

This is purely speculation, as I'm only an M1, but I think med school will only give you the absolute basics in clinical skills. The overwhelming majority of your clinical expertise will be acquired in residency. Afterall, I doubt any 4th year who matches into surgery is capable of even the most basic surgical procedure.

I do believe that the pre-clinical curriculum of a given school is very important and you should be careful in choosing a school that will adequately prepare you for Step 1.

Those are some pretty hotshot schools though. I'm sure you'll be fine at any of them.

 

[Rendar5]

schools w/ better clinical exposure will help give u an edgethere too. I know attendings like to have students who don't act like idiots around patients and have a good idea of what they're doing. Course, since I'm going into EM, it's a bit more important there, and that's where i got told this info from.

 

[hakksar]

Although you learn most of your clinical skills that you will actually use in your practice in your residency you get your exposure to a vast variety of fields in medical school. For this reason I feel that clinical education is very important. Even if you are going to be a surgeon you should at least have a decent understanding of Psychiatry or Family Practice (etc.). You get this exposure in medical school, so I would say yes it is important (that being said I feel any of those schools will provide you with adequate clinical education). Also, it is important to remember that most people decide what they want to do in medical school so it would be nice to have decent clinical education so that you can make an informed choice.

 

[unicorn06]

Although you learn most of your clinical skills that you will actually use in your practice in your residency you get your exposure to a vast variety of fields in medical school. For this reason I feel that clinical education is very important. Even if you are going to be a surgeon you should at least have a decent understanding of Psychiatry or Family Practice (etc.). You get this exposure in medical school, so I would say yes it is important (that being said I feel any of those schools will provide you with adequate clinical education). Also, it is important to remember that most people decide what they want to do in medical school so it would be nice to have decent clinical education so that you can make an informed choice.

So is the consensus then that an average clinical education during med school is just fine? I realize that getting exposure is important, but I would get that at any of the schools I mentioned.

What I'm really concerned about is the difference between say, Stanford and Michigan. I have talked to several different sources who say that Stanford students tend not to have great clinical skills coming out of med school and that Michigan students are excellent compared to their peers at the beginning of residency. I think this probably has a lot to do with Stanford's research focus or maybe just with the style of their curriculum. However, I was thinking that a Stanford-educated resident would catch up quite quickly and that there wouldn't be any real disadvantages after a month of residency had gone by. Plus, the research advantages at Stanford (especially the clinical opportunities) are amazing.

 

[THP]

So is the consensus then that an average clinical education during med school is just fine? I realize that getting exposure is important, but I would get that at any of the schools I mentioned.

What I'm really concerned about is the difference between say, Stanford and Michigan. I have talked to several different sources who say that Stanford students tend not to have great clinical skills coming out of med school and that Michigan students are excellent compared to their peers at the beginning of residency. I think this probably has a lot to do with Stanford's research focus or maybe just with the style of their curriculum. However, I was thinking that a Stanford-educated resident would catch up quite quickly and that there wouldn't be any real disadvantages after a month of residency had gone by. Plus, the research advantages at Stanford (especially the clinical opportunities) are amazing.

From the tone of your posts it seems as if you already have your mind made up. If research is something you are really interested in then go where you think you will have the best opportunity to do it.

 

[Ypo.]

So is the consensus then that an average clinical education during med school is just fine? I realize that getting exposure is important, but I would get that at any of the schools I mentioned.

What I'm really concerned about is the difference between say, Stanford and Michigan. I have talked to several different sources who say that Stanford students tend not to have great clinical skills coming out of med school and that Michigan students are excellent compared to their peers at the beginning of residency. I think this probably has a lot to do with Stanford's research focus or maybe just with the style of their curriculum. However, I was thinking that a Stanford-educated resident would catch up quite quickly and that there wouldn't be any real disadvantages after a month of residency had gone by. Plus, the research advantages at Stanford (especially the clinical opportunities) are amazing.

I really think that if there is any difference, it would even out within the first couple of months (if not sooner) just like you think.
If you like Stanford's curriculum better, than go for Stanford. Besides, in clinical experiences, there is only so much that a medical student is going to be allowed to do-and there isn't that much difference between schools when it comes to the type of experience they offer. you will be are the type of acticities you actively seek-if you focus on research and ignore patient skills, then thats what you'll get...I truly don't believe that Stanford hammers out socially awkard physicians and that students play no part in the matter, I'm sure they offer the same type of experiences that every other school does.

Its kind of like people who say that you should take undergrad anatomy-yes, it helps a little, but that difference evens out pretty quick. My friends who took undergrad anatomy don't spend any less time studying than I do, and aren't scoring better on the exams.

 

[unicorn06]

Thanks for all of your comments. They're very helpful!

 

[MadameLULU]

Don't forget that your learning will largely depend on what you put into it. I've met ppl at so called "top clinical insitutions" who say they didn't learn much on some rotations b/c they didn't care or put forth the time necessary. If you're willing to dedicate some time and energy and are motivated to do well, then I'm sure you will do fine at any institution. That is my opinion as an MS1...

 

[Samoa]

The big advantage of going to a clinically strong school is that you get to make most of your stupid patient care blunders while you're a student and have 5 or so people looking over your shoulder and checking your findings. It's true you can learn the assessment and plan as a resident, but almost never will you see a resident's physical exam skills checked in any meaningful way. And it's pretty easy to fudge a physical exam (not that I've done this), and just spend more money on lab tests and studies to compensate for your lack of skill. And that's a bad thing, for statistical reasons I'm too tired to explain right now, as well as the fact that it wastes health care resources.

Of course, you can learn exam skills wherever you go, but it's so much easier when you're at a school that has an extensive formal process for you to learn them.

 

[Iwy Em Hotep]

I just want to know how you all are determining which schools are "clinically strong" schools.

 

[tupac_don]

I just want to know how you all are determining which schools are "clinically strong" schools.

Exposure to patients, ability to do procedures as a student. Amount of stuff attendings will let you do. After all best education in med school is attained from hands on experiences. The more they let you do at a hospital, and more you see, the better the "clinical" experience. Typically innercity type hospitals will have pretty much everything and you will have a great clinical experience. Places like Chicago, Detroit, Philladelphia. Does it give you an advantage, I think so, if you want to be predominantly a clinician. But it's a lot more important where you do residency I think than medical school.

 

[Rendar5]

I just want to know how you all are determining which schools are "clinically strong" schools.

talking w/ EM attendings where i did clinical research and shadowing. only gave me an idea about northeast schools, though. they only mentioned teh good ones, not the bad ones (mentioned einstein, downstate, and upitt. i'm sure there are others, never asked in-depth).

 

[AJM]

Exposure to patients, ability to do procedures as a student. Amount of stuff attendings will let you do. After all best education in med school is attained from hands on experiences. The more they let you do at a hospital, and more you see, the better the "clinical" experience. Typically innercity type hospitals will have pretty much everything and you will have a great clinical experience. Places like Chicago, Detroit, Philladelphia.

Interesting. Just an observation, but based on the criteria listed above, Stanford would be considered a clinically strong school. (which I feel it is clinically strong, but like at any school it's based on how much effort you put into your clinical training.)

As a student at stanford, i did a ton of procedures, saw lots of patients, etc, etc. In fact, for example, as a med student I had done more thoracenteses than most IM residents I know have done in their entire residency... But the end result was that I definitely felt like I came out of med school at least as prepared as my other co-residents.

Anyway, my point is that stanford and the other research-oriented schools can give you great clinical training if you want it. If you seek out procedures, you will do procedures. If you seek out a huge patient load you will get it. If you work on being independent and try to make your own decisions, they will let you -- as long as you're not being totally stupid...
But if you want to avoid clinical training or procedure skills, etc, then it will probably be easier to avoid at the research-oriented programs than the non-research programs.

It all depends on what you want. But as is true for most med schools, you will get out of it what you put into it.

And finally - I agree that in med school you only learn the absolute basics of patient care. Most of the training is in residency -- and that's where the clinical experience is crucial.

 

[footcramp]

wow, a drop of one or two places in the usnews rankings and suddenly umich goes from a research school to a clinical school. i love it!

 

[IlianaSedai]

So is the consensus then that an average clinical education during med school is just fine?

Absolutely -- and not only that, pretty much all clinical education at all med schools is "average" and highly dependent on who you're with that week. Because after you graduate and become a resident, YOU will be the one teaching medical students during clinicals. Some people graduate with higher grades and board scores and interview better than others, but that says absolutely nothing about residents who got good residencies being good TEACHERS. Ooops. They don't choose residents based on how well they teach medical students, so in the respect the teaching you'll get during your clinical rotations is somewhat dependent on you and somewhat dependent on the residents whom you are assigned with arbitrarily..

If you go to an accredited medical school in the US, you'll get pretty much an adequate and comparable education anywhere (unless the school's heading into bankruptcy, the hospitals and affiliated residency programs have multiple citations and are about to be shut down, etc -- can't think of any off the top of my head that have those problems, and certainly not the ones you've listed).

Rather than looking at the "quality" of clinical education which is pretty much the same all over, look at the Match List of what specialties and residencies the graduating students chose (and obtained). Think about what you would be doing if you WEREN'T going to be a doctor. You don't have to have a specialty picked out. Would you be a social worker, a school teacher, a sports coach or a counselor? Then maybe primary care specialties (internal medicine, pediatrics, family medicine) and psychiatry would be high on your list -- in that case, you can go to any medical school and do fine. On the other hand, are you highly technical and would be an engineer (for example) if you weren't going to med school? If you anticipate something more technical (surgery, radiology, anesthesia, etc) look at the match list and see whether they have anyone who matched in those fields (keeping in mind that fewer people go into those than primary care wherever you go). Also look at the range of WHERE they matched -- all over the country or mostly locally?

Bottom line -- you can go into any field by going to med school anywhere, and come out the same with little or difference in clinical "skills" -- most of which are indeed gained during residency and not before.

 

[mendel121]

wow, a drop of one or two places in the usnews rankings and suddenly umich goes from a research school to a clinical school. i love it!

Seriously, I mean it's only one of the top few best funded (NIH) research institutions in the country - but research takes a back seat really - I mean I did a PhD there, and finding funding wow!, nearly impossible - nobody does research at that place (dripping with sarcasm)

 

[dz88]

unicorn, if u don't mind, could u tell me what ur ECs were, seeing that you got into those great schools!

 

[Archimedes]

Given that you at least PASS the USMLE I and II, how important are those scores in residency applications? Is there like a percent of application points on the res application they allot to USMLE scores?

Are USMLE scores weighed more heavily into the picture or Clinical experiences?

 

[ellia08]

According to info presented at the last AAMC OSR meeting, items considered by residency directors are:

M3 grades
Usmle scores
letters of rec.

(are the big three, and to a much lesser extent...)

M1/2 grades (if you have them)
Deans letter

This is according to a poll of resendency directors conducted by the university of michigan.

So basically,...everything counts. Different programs weight things differently. Check the residency directors rankings for their take on good programs.

As far as comparing umich with stanford though... they are both pretty stellar as far as I'm concerned. Pick the one you like.


PS: In the interests of full disclosure.... Go Blue!