Hospital exclusivity contracts and Electives

[Blunt Dissection]

I was wondering if any 3rd or 4th years have encountered issues with exclusivity contracts that don't allow hospitals to take students that aren't affiliated with a certain school unless it is specifically for an audition rotation during 4th year. The reason I ask is because I've recently heard that in parts of Florida, because there are so many medical schools like USF/UF/UCF/LECOM/NSU/FIU etc etc that unless you're a student from one of the Florida schools, it's incredibly difficult to find a hospital that will take you for a specialty elective. How common is it for DO students to run into problems like this considering very few DO schools actually have their own dedicated hospitals?

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[khnz786]

All the time


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[Blunt Dissection]

All the time


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If that's the case, then is the only option to find private practice specialists in the area or look for smaller community hospitals?

 

[GrignardsReagent]

I'm at a small rural MD campus and yes we are running into the same issues as well. Our school has given us free reign in contacting physicians though but only within certain health networks which has been frustrating for the class above me and me.

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[khnz786]

If that's the case, then is the only option to find private practice specialists in the area or look for smaller community hospitals?

I go to one of the schools that you listed... i just went where my school happened to send me... my school has an affiliation agreement with a few hospitals (not great) but I just do the required rotations there and then find private practice physicians for electives... it gets a little dicey if the physician rounds at a hospital and your school does not have an affiliation agreement with that hospital...


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[Blunt Dissection]

I'm at a small rural MD campus and yes we are running into the same issues as well. Our school has given us free reign in contacting physicians though but only within certain health networks which has been frustrating for the class above me and me.

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Man, I didn’t realize it was a problem for MD students as well. Coming from an undergrad with a large academic MD program, I’ll admit I’m ignorant to the problems that smaller MD schools face, but it sounds like it’s similar to ours too.

I go to one of the schools that you listed... i just went where my school happened to send me... my school has an affiliation agreement with a few hospitals (not great) but I just do the required rotations there and then find private practice physicians for electives... it gets a little dicey if the physician rounds at a hospital and your school does not have an affiliation agreement with that hospital...


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That’s one of the things I’m afraid of running into in this situation - I’ve learned that it’s so easy to accidentally step on political toes in medicine. Especially when you start talking about surgical specialties, a lot of surgeons I know that even have their own private clinics have a hospital that they’re affiliated with for admit and surgical needs.

 

[hallowmann]

...That’s one of the things I’m afraid of running into in this situation - I’ve learned that it’s so easy to accidentally step on political toes in medicine. Especially when you start talking about surgical specialties, a lot of surgeons I know that even have their own private clinics have a hospital that they’re affiliated with for admit and surgical needs.

So this happens a lot. I would try and find hospitals within your school's affiliation network. That is what I did for the vast majority of my non-core electives. I'm not sure where you go, but a lot of schools have some pretty solid hospitals on their list, but the region might be limited.

 

[Blunt Dissection]

So this happens a lot. I would try and find hospitals within your school's affiliation network. That is what I did for the vast majority of my non-core electives. I'm not sure where you go, but a lot of schools have some pretty solid hospitals on their list, but the region might be limited.

A majority of our larger sites are in Tennessee, Kentucky, and Virginia with 5 or 6 scattered sites in the nearby states. We submit a rank list of our choices and that's factored into the lottery system for rotation sites. The thing that I dread the most is that what I want to do my non-core elective in during 3rd year isn't something that would be available at a majority of our sites since many of them are smaller rural hospitals. Our 3rd year schedule then is based really on what cores they can fit us into so for some of us we might start 3rd year with 2 cores and then an elective, or we might end up with an elective from day 1.

In an ideal world, I would like to find a specialist in Florida to do my non-core elective since it gives me an opportunity to network in a state I ultimately want to do residency and practice in, but I have no idea how I would essentially finish a core rotation on Friday in Tennessee and get settled and ready for my non-core elective in Florida by Monday

 

[trs88]

A majority of our larger sites are in Tennessee, Kentucky, and Virginia with 5 or 6 scattered sites in the nearby states. We submit a rank list of our choices and that's factored into the lottery system for rotation sites. The thing that I dread the most is that what I want to do my non-core elective in during 3rd year isn't something that would be available at a majority of our sites since many of them are smaller rural hospitals. Our 3rd year schedule then is based really on what cores they can fit us into so for some of us we might start 3rd year with 2 cores and then an elective, or we might end up with an elective from day 1.

In an ideal world, I would like to find a specialist in Florida to do my non-core elective since it gives me an opportunity to network in a state I ultimately want to do residency and practice in, but I have no idea how I would essentially finish a core rotation on Friday in Tennessee and get settled and ready for my non-core elective in Florida by Monday

You aren't going to rank the Florida core site as number 1?

The good news is that I've already (almost) done the having to move from site to site. Let's say you get your 3rd choice and end up at Knoxville. You're there for month 1 and 2, but month 3 is your elective in Florida. Just tell whichever preceptor you are with that you need to leave early on that thursday or friday because you have to move. 100% they will be fine with it. If you have a comat on that friday, you're only there for 2 hours and then you're done. If you know you need to leave that thursay, just speak with the comat dcom staff and ask for the date to be moved because you have to travel cross country. They've already had to move some of my comat dates because of comlex PE.

If you are concerned about packing and traveling. I was able to pack my car in under 5 hours, leave on a friday morning, drive 13 hours, stop at a 24 hour rest stop, sleep for 6, then kept driving for 10 more hours and that was a Saturday afternoon/ early evening. So you'll have some time to make the travel time.

As for living arrangements for that one month, I'm using air B and B to find some places and I think I've seen rotating room being suggested.

You also have one last option, is that after you get your core site and you're given that individuals email address. You can make a compelling request that you want all of you selective and elective rotation grouped together because you want them at one specific (long distance) location and having to travel back and forth is a killer. My core site coordinator worked with me on it, but a new person then became our coordinator and I doubt that person would make the changes. Then you just keep dcom in the loop and it's all good.

 

[Blunt Dissection]

You aren't going to rank the Florida core site as number 1?

The good news is that I've already (almost) done the having to move from site to site. Let's say you get your 3rd choice and end up at Knoxville. You're there for month 1 and 2, but month 3 is your elective in Florida. Just tell whichever preceptor you are with that you need to leave early on that thursday or friday because you have to move. 100% they will be fine with it. If you have a comat on that friday, you're only there for 2 hours and then you're done. If you know you need to leave that thursay, just speak with the comat dcom staff and ask for the date to be moved because you have to travel cross country. They've already had to move some of my comat dates because of comlex PE.

If you are concerned about packing and traveling. I was able to pack my car in under 5 hours, leave on a friday morning, drive 13 hours, stop at a 24 hour rest stop, sleep for 6, then kept driving for 10 more hours and that was a Saturday afternoon/ early evening. So you'll have some time to make the travel time.

As for living arrangements for that one month, I'm using air B and B to find some places and I think I've seen rotating room being suggested.

You also have one last option, is that after you get your core site and you're given that individuals email address. You can make a compelling request that you want all of you selective and elective rotation grouped together because you want them at one specific (long distance) location and having to travel back and forth is a killer. My core site coordinator worked with me on it, but a new person then became our coordinator and I doubt that person would make the changes. Then you just keep dcom in the loop and it's all good.

Oh that's mega helpful to know! I'd like to ideally rank the Florida core as my #1, but knowing that there are so many exclusivity contracts in place, I'll have to start looking early for physicians that I'd be able to work with. I'll message you about some stuff!

 

[What'sTheWifiPassword]

the whole concept of away third year electives is weird tbh. i'd personally just do one at your home institution then do VSAS for 4th year