FinalAnalyst

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Hi guys, I have a 3.3 cGPA and sGPA. 26 ( 10 P 9 B 7 V), and a 497 (dont remember the break down but psych was really low).

I don't want to go to a Carribbean school which is a diploma mill. I applied to DO programs but I would prefer getting an internationally recognized degree to be honest.

Im a little new to the Australian programs, are they similar to Caribbean programs with larger class sizes and attrition rates or are they smaller ?

I was looking at the Irish programs, unfortunately their MCATS are really really high, and for now I decided Im just gonna grind it out and do well on the next MCAT because my above scores resulted from not batting an eye at the MCAT or prepping for it ever.
 

drvfedorov

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Hey, having navigated through the various options, I would suggest you try your best to get into a DO school first. If after re-taking your courses and MCAT you still don't feel comfortable then explore the international options. I am not sure what your nationality is, but the "recognition" aspect doesn't have much bearing if you plan on practicing in North America.

I ranked Australia and Ireland above the Caribbean due to better living conditions in the former. I placed Australia above Ireland, because I would rather be in Australia for 4 years than Ireland. Australia also provides you with a "chance" to remain there after finishing school, which isn't the case with Ireland. It should be noted that class sizes are fairly large in the bigger schools (UQ, Sydney, Mel), but most people seem to suggest that class isn't really important because you mostly self-study and interact with smaller groups of student (PBL). I am not too sure about attrition rate, but I haven't heard much.

There is a lot more information about your questions on the boards, so use the search button and do some research.
 

pitman

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You should def do some research on the forums to get a broader understanding of the differences between Australian and Carib schools (both types of which are hard to generalize), but in response to your specific questions: Attrition of N. Americans is essentially non-existent in Australia aside from those who leave after getting into a N. American school. Class sizes can be massive but vary by school (e.g., UQ has around 500 per year, while Flinders has around 150). If by 'class' you instead mean the N. American vernacular referring to the size of lectures for particular subjects, this also varies greatly between med schools and even within any school (e.g., you never see anywhere near 500 students in a main lecture at UQ after the first couple of weeks, while for different disciplines like micro, path, PBL (ok, not really a discipline but an ideology), etc., sizes break down to anywhere from 10 to 50 or so students. For clinical teaching size also varies by school and discipline (e.g., clinical coaching on the various wards vs. lectures for students in a particular campus vs. PBL...).
 
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According to mededpath staff, the attrition rate is 6%, and the % of students who failed the final exam last semester was 7%. Let's say a little more than half of those who take remediation exam passed, that would leave about 3% per semester who are held back. 3 x 2 = 6% per year who are held back. It's useful to note that "attrition" mostly means you are dismissed, which means you must have failed more than once. It's better to ask how many % of students graduate in four years.
 
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pitman

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According to mededpath staff, the attrition rate is 6%, and the % of students who failed the final exam last semester was 7%. Let's say a little more than half of those who take remediation exam passed, that would leave about 3% per semester who are held back. 3 x 2 = 6% per year who are held back. It's useful to note that "attrition" mostly means you are dismissed, which means you must have failed more than once. It's better to ask how many % of students graduate in four years.
There's no way that 30 students are held back each year (far fewer than half would fail remediation). I would believe that 6% of any class for one reason or another doesn't graduate on time, which would include those who dropped out of med for personal reasons, got into or transferred to another med school, etc.
 

sean80439

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There's no way that 30 students are held back each year (far fewer than half would fail remediation). I would believe that 6% of any class for one reason or another doesn't graduate on time, which would include those who dropped out of med for personal reasons, got into or transferred to another med school, etc.
Yeah, I've heard of like 1 person repeating, and I don't even think they're an American.
 
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from my perspective, Americans are actually doing pretty poorly here at UQO. The Australians are on it, the Canadians have their **** together, and the American's are treating it like freshman year undergrad 2.0. I know of one Ochsner student who had to repeat first year, and after sem 1 final, there were a disproportionate amount of Americans taking the supplemental. And I don't mean "oh, I just barely passed Anatomy, oops, I'll study a bit harder." There was one kid who failed ALL THREE of our exams and had to retake.

That being said, the people that do poorly are the ones that don't study on their own time. It's really set up as a teach yourself program, where Dr. Wiki Googletube is your professor. I would 100% put this program above Caribbean schools. You get access to excellent hospitals, a top 10 research university, and all your clinical in the states. It's a win/win if you can't get into US.

Also, you might want call MedEdPath and ask about your MCAT score. They will let you in with a 7 in one section.
 
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mcat_taker

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from my perspective, Americans are actually doing pretty poorly here at UQO. The Australians are on it, the Canadians have their **** together, and the American's are treating it like freshman year undergrad 2.0. I know of one Ochsner student who had to repeat first year, and after sem 1 final, there were a disproportionate amount of Americans taking the supplemental. And I don't mean "oh, I just barely passed Anatomy, oops, I'll study a bit harder." There was one kid who failed ALL THREE of our exams and had to retake.

That being said, the people that do poorly are the ones that don't study on their own time. It's really set up as a teach yourself program, where Dr. Wiki Googletube is your professor. I would 100% put this program above Caribbean schools. You get access to excellent hospitals, a top 10 research university, and all your clinical in the states. It's a win/win if you can't get into US.

Also, you might want call MedEdPath and ask about your MCAT score. They will let you in with a 7 in one section.
I wouldn't generalize like that. There are 120 Ochsner's and most of the ones I know are plenty smart and on their ****. 3o or so kids total taking one of the supps out of a class of 540? is not really that large a number. In fact the only people I know who didn't pass a supp were Australians not Ochsners. So to say Americans are treating this like freshman year undergrad 2.0 is kinda insulting. And to say that Americans are doing pretty poorly at UQ in your opinion because you might know 5 Ochsners who had to take a supp is grossly misleading about the Cohort.
 

sean80439

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Yeah, I have no idea what Numb is talking about, unless his cohort is different. I can tell you that I literally looked at zero pre-readings, lectures, notes, or went to a single class so far this semester other than CBL and did fine on the midsem exam (and I sure as hell wasn't the only one). All of the UQO students are focused on studying for the USMLE. If the students are doing poorly on UQ exams, who cares? The entire point is to just pass the UQ exams and do well on Step 1 and clinical rotations. You might have that perception because you don't see any of the Ochsner students, but from what I can tell from the UQO group I tutor, they all work pretty hard and are all independently studying. The only person I know that left and came back was an international that left halfway through Y1 in our cohort and rejoined your cohort. I haven't heard of any UQO students failing anything. I know we had 3 Canadians quit and go home in the first month last year.
 

sean80439

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I will be honest and say that our cohort got f'ed around with a ton and based on my experiences I would have a hard time at this point recommending the program. It's hard to explain. It's like the SoM is acting like students waiting to the last minute to prep everything for us that it has turned into a giant joke for the 2nd semester of Y2. The clinical stuff is really good, and CBL tends to be 'okay' except they aren't including thorough tutor notes anymore for some dumb reason of not wanting students to get a hold of them. The SoM has this fetish with wasting a good 10-15% of exam questions asking absolutely atrociously worded terrible questions that rely on slide recall of dumb stats (in some cases wrong) or dumb math than it does on demonstrating integration of clinical knowledge. For example there was a question on our midsem that literally asked if you double a source of sound, what is the increase in decibels (how that is relevant to clinical science, I have yet to see). Another was asking the prevalence of undiagnosed saccular aneurysms with an answer of 1-2% listed and an answer of 5-10% listed (the range is between 1-8% last I checked). A third asked about the mechanism of action of azithromycin in CF, except they listed the actual correct MoA of a macrolide (50S inhibitor) along with an option including anti-inflammatory and mucolytic effects (except they don't actually know what it actually does in CF patients, there are theories that it also works on Cl- channels as well) which is what I assume they wanted us to answer, even though it's a terrible question.


Oh and don't get me started on the person running the research component for our year. She has missed every deadline and has these wild weird expectations from students who have far more important things than her ridiculous requirements.
 

akinetopsia

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from my perspective, Americans are actually doing pretty poorly here at UQO. The Australians are on it, the Canadians have their **** together, and the American's are treating it like freshman year undergrad 2.0. I know of one Ochsner student who had to repeat first year, and after sem 1 final, there were a disproportionate amount of Americans taking the supplemental. And I don't mean "oh, I just barely passed Anatomy, oops, I'll study a bit harder." There was one kid who failed ALL THREE of our exams and had to retake.

That being said, the people that do poorly are the ones that don't study on their own time. It's really set up as a teach yourself program, where Dr. Wiki Googletube is your professor. I would 100% put this program above Caribbean schools. You get access to excellent hospitals, a top 10 research university, and all your clinical in the states. It's a win/win if you can't get into US.

Also, you might want call MedEdPath and ask about your MCAT score. They will let you in with a 7 in one section.
I'll respectfully disagree with your assessment that Americans are doing pretty poorly here at UQ. I know several Ochsners that were offered supplemental exams last semester for different reasons, which usually boiled down to either not knowing how to study effectively, or trying to work hard & play hard but not being as effective in the former. Maybe you can count on one hand how many Americans are treating it like freshman year undergrad 2.0, as you said, but I'd say they are most certainly the exception and not the rule, out of the 120 or so of us here.

I have friends in US MD & DO & the Caribbean, and a common thread is that lecture quality is highly variable regardless of where you are in the world and you do end up having to do a lot of self-study, especially for Step. The good news is that if you prepare adequately for USMLE, you'll be fine on UQ exams. You may miss some points if you completely ignore the lectures/lecture slides, but you won't be in the territory of being offered supplemental exams at the end of a semester.
 

mcat_taker

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Yeah, I have no idea what Numb is talking about, unless his cohort is different. I can tell you that I literally looked at zero pre-readings, lectures, notes, or went to a single class so far this semester other than CBL and did fine on the midsem exam (and I sure as hell wasn't the only one). All of the UQO students are focused on studying for the USMLE. If the students are doing poorly on UQ exams, who cares? The entire point is to just pass the UQ exams and do well on Step 1 and clinical rotations. You might have that perception because you don't see any of the Ochsner students, but from what I can tell from the UQO group I tutor, they all work pretty hard and are all independently studying. The only person I know that left and came back was an international that left halfway through Y1 in our cohort and rejoined your cohort. I haven't heard of any UQO students failing anything. I know we had 3 Canadians quit and go home in the first month last year.
Are you a second year? I wish I had whatever exam you had. I'm a first year, and I thought the midsem we just took was hard as hell lol, lots of tricky questions and q's on material that was not heavily emphasized. Lots of anatomy which was kinda shocking for a midsem. But then again, Neuro and MSK are pretty challenging systems I guess.
 
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sean80439

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Are you a second year? I wish I had whatever exam you had. I'm a first year, and I thought the midsem we just took was hard as hell lol, lots of tricky questions and q's on material that was not heavily emphasized. Lots of anatomy which was kinda shocking for a midsem. But then again, Neuro and MSK are pretty challenging systems I guess.
The MSK/Neuro/GI/Biochem block was hard. 2nd semester of first year was probably the most difficult I thought. We also did GI/Nutrition/half of MSK first, then finished with MSK and Neuro.

The test was still difficult, it's just that we have all spent a ton of time studying everything for USMLE that unless it's a stupid UQ stat question it's not that complicated to figure out.
 

simbathelion

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Yeah, I have no idea what Numb is talking about, unless his cohort is different. I can tell you that I literally looked at zero pre-readings, lectures, notes, or went to a single class so far this semester other than CBL and did fine on the midsem exam (and I sure as hell wasn't the only one). All of the UQO students are focused on studying for the USMLE. If the students are doing poorly on UQ exams, who cares? The entire point is to just pass the UQ exams and do well on Step 1 and clinical rotations. You might have that perception because you don't see any of the Ochsner students, but from what I can tell from the UQO group I tutor, they all work pretty hard and are all independently studying. The only person I know that left and came back was an international that left halfway through Y1 in our cohort and rejoined your cohort. I haven't heard of any UQO students failing anything. I know we had 3 Canadians quit and go home in the first month last year.
May I ask what you're using to "first pass" a topic? Like I know Pathoma is pretty popular with you USMLE takers, but surely it's not comprehensive enough for learning things on first pass?? Same with First Aid.

I'm a first year and I don't go to lectures, but without the readings I'd be completely lost. I think I have to read at least 3 different sources on something just to understand it. Thank you!

Also I can add that I failed a clinical examination, and at least 7 of the ~10 people who failed and had to do the retake were international :)
 

sean80439

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May I ask what you're using to "first pass" a topic? Like I know Pathoma is pretty popular with you USMLE takers, but surely it's not comprehensive enough for learning things on first pass?? Same with First Aid.

I'm a first year and I don't go to lectures, but without the readings I'd be completely lost. I think I have to read at least 3 different sources on something just to understand it. Thank you!

Also I can add that I failed a clinical examination, and at least 7 of the ~10 people who failed and had to do the retake were international :)
Is this for UQ? I read Robbins, G&H, and Sherwood. I also would read through FA. You should have access to Becker as well, we didn't get it until 2nd year. I also used Najeeb, Pathoma, and Kaplan videos. There should be a hard drive floating around with like 400gb of videos and books. There were always a couple super tryhards in our cohort that would post a review of the semester. Flipping through the slides is always useful because UQ loves to put dumb questions on their exams that relate to nothing and usually is some dumb table or stat that you have to memorize. Also, used blue histo and Utah webpath, and a ton of WIKIPEDIA.

forgot - Also Firecracker.
 
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May I ask what you're using to "first pass" a topic? Like I know Pathoma is pretty popular with you USMLE takers, but surely it's not comprehensive enough for learning things on first pass?? Same with First Aid.

I'm a first year and I don't go to lectures, but without the readings I'd be completely lost. I think I have to read at least 3 different sources on something just to understand it. Thank you!

Also I can add that I failed a clinical examination, and at least 7 of the ~10 people who failed and had to do the retake were international :)

No real use in arguing about it. It's great that people feel so strongly about their own progress that they think no one else is doing poorly. I guess I'm just around the wrong people, which is why I said it's my perception. With the exception of the guy failing all 3 exams last semester, I know the kids sitting sups, retaking first year (no, that person didn't leave for personal reasons or start as an international, they failed and had to repeat through Ochsner. A stat I'm sure they're trying to suppress) personally.

I think they've changed our year to make it harder, too. We now have to pass anatomy and histology, which previous years did not. I'm not sure what it means, but our anatomy scores are the lowest the department has seen in years. Either we are not studying enough, they are teaching differently, or they are increasing the difficulty of the spotter. I'm glad previous years had an easy time of it, but I'm not so sure it's still applicable. Anyway, FWIW, I personally like Robbins, Pathoma, FA, Firecracker, and to make my own anatomy fill-in's on my ipad.
 
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Medstart108

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from my perspective, Americans are actually doing pretty poorly here at UQO. The Australians are on it, the Canadians have their **** together, and the American's are treating it like freshman year undergrad 2.0. I know of one Ochsner student who had to repeat first year, and after sem 1 final, there were a disproportionate amount of Americans taking the supplemental. And I don't mean "oh, I just barely passed Anatomy, oops, I'll study a bit harder." There was one kid who failed ALL THREE of our exams and had to retake.

That being said, the people that do poorly are the ones that don't study on their own time. It's really set up as a teach yourself program, where Dr. Wiki Googletube is your professor. I would 100% put this program above Caribbean schools. You get access to excellent hospitals, a top 10 research university, and all your clinical in the states. It's a win/win if you can't get into US.

Also, you might want call MedEdPath and ask about your MCAT score. They will let you in with a 7 in one section.
Not surprised about the first comment, i'm guessing the poster is referring to the regular program not Ochsner and I know some of you might get on me for this but from a logical point of view, it makes sense that the Aussies and the Canucks are doing well compared to the Americans.

The kind of people who don't get into medical school in Canada and then go abroad typically have stats that would have gotten them into a low-tier MD or DO school in the states. There are people who have done well on most measures but because they came out lacking slightly on one aspect (usually GPA or MCAT), they don't get in. Also, the Canadians are going in with the knowledge that coming back to Canada is an uphill battle and going to the states they will be at a disadvantage compared to their american counterparts so they are more willing to put in that effort.

About the Australians, we are talking about the cream of their own crop, people who got into a good solid medical school, so it also comes as no surprise that these people have their study habits down solid.
 

sean80439

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No real use in arguing about it. It's great that people feel so strongly about their own progress that they think no one else is doing poorly. I guess I'm just around the wrong people, which is why I said it's my perception. With the exception of the guy failing all 3 exams last semester, I know the kids sitting sups, retaking first year (no, that person didn't leave for personal reasons or start as an international, they failed and had to repeat through Ochsner. A stat I'm sure they're trying to suppress) personally.

I think they've changed our year to make it harder, too. We now have to pass anatomy and histology, which previous years did not. I'm not sure what it means, but our anatomy scores are the lowest the department has seen in years. Either we are not studying enough, they are teaching differently, or they are increasing the difficulty of the spotter. I'm glad previous years had an easy time of it, but I'm not so sure it's still applicable. Anyway, FWIW, I personally like Robbins, Pathoma, FA, Firecracker, and to make my own anatomy fill-in's on my ipad.
Anatomy was always self-directed learning, and the spotters were always pretty fair if you read Wragg's notes. Try and find a tutor to go through the prac with you if you can. Or get a study group to redo the pracs as you get close to finals. I wasn't alone, but I spent probably a solid 30-40 hours in anatomy lab prior to the finals - usually 2-3 weeks out (the last week is a disaster trying to find space). I'm not sure why you assume your year is harder than the 2018 cohort. Yes, you have to pass histology and anatomy, but the pass mark is 55-60% and honestly there are enough questions on there that this score is not difficult to achieve if you prepare for the exams prior to taking them. I have heard that there are Anki cards floating around of all of the Anatomy pracs that Wragg is approving that are on the 2019 cohort facebook group (supposedly they are quite good?). There should be giant powerpoints floating around of all of the histology that they examine and what to look for as well. You also have the practice exams from our year, which we didn't have; plus a far better order of learning based on feedback from our year.

As to the comment about Ochsner students doing poorly from the other poster - you realize that 1. grades are irrelevant down here as long as you pass; and 2. All of us are studying for Step 1 instead, on top of having to deal with a whole ton of dumb UQ requirements (hey 2019's just wait until you have to deal with the hilarious disaster of 7241/42 that we are currently suffering through) including some ridiculous research component, OSCE's that literally serve no purpose for Ochsner students, Australian ethics/law that is irrelevant to American practice, and pretty much having no good place to study in Y2. On top of that, many of us tutor first years to pass along the tradition of helping, since we all had the opportunity to get USMLE tutoring during our first year as well. This is all wildly time consuming. All of us are just slogging through this while studying for Step.
 
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mcat_taker

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Not surprised about the first comment, i'm guessing the poster is referring to the regular program not Ochsner and I know some of you might get on me for this but from a logical point of view, it makes sense that the Aussies and the Canucks are doing well compared to the Americans.

The kind of people who don't get into medical school in Canada and then go abroad typically have stats that would have gotten them into a low-tier MD or DO school in the states. There are people who have done well on most measures but because they came out lacking slightly on one aspect (usually GPA or MCAT), they don't get in. Also, the Canadians are going in with the knowledge that coming back to Canada is an uphill battle and going to the states they will be at a disadvantage compared to their american counterparts so they are more willing to put in that effort.

About the Australians, we are talking about the cream of their own crop, people who got into a good solid medical school, so it also comes as no surprise that these people have their study habits down solid.
@Medstart108 I'm a UQO student here, and your assessment is reasonable. The Australians are the cream of the crop. The Canadians do have good scores but relatively speaking it is harder to get into med school in Canada so thats why a lot of them are here internationally. But the point I was trying to make is that its not fair to generalize about all the Americans here just cause he/she knows a few who took the supps. Cause the vast vast majority are doing just as well and keeping pace with the cream of the crop Australians and everyone else. A lot of them had offers to DO schools back home in the states anyway and came here instead so their stats are pretty good actually. There is definitely a work hard play hard mentality at UQ where people go out a lot, and there are a lot of social functions to take advantage of if you want to, but people buckle down and study hard also. I would say that the Australians go out just as much as the Americans so I have no idea where this freshman year 2.0 comment is coming from, especially as the American cohort on average is several years older than the Australian and Canadian cohort.

To be honest the fact that the majority of the American med school rejects do just as well as the cream of their own crop Australians, shows you how many qualified candidates for med school there are in the states, and how if given an opportunity these alleged U.S. med school rejects can excel and how onerous it is to get into med school in the U.S.
 
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pitman

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The MRTP now reports on attrition rates. From the October 2016 release:

UQ attrition rate for domestics (2014):
1st years: 3 students (4%)
Subsequent years: 4 students (3%)
(identical to USyd)
UQ attrition rate for internationals (2014):
1st years: 1 student ?? not incl Oschner
subsequent years: 0 students

I don't think there's a separate stat for Oschner students, but I have no reason to believe that the other ~100 UQ internationals (almost all N. Americans) would be doing any better or worse than them.

http://www.health.gov.au/internet/main/publishing.nsf/content/work-pubs-mtrp-19
 
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Even if retention is high, I'm not sure that says much about the quality of a program, so much as, they try not to fail you. The real test is how good those clinical and diagnostic skills are when the grads become interns. (there has to be some public health research nut looking into this somewhere, given how valuable international students are towards Australian schools).

Quality or robustness of programs (or "bench marking") is something even the medical schools grapple with all the time. A number of med schools were and are actually comparing themselves with the use of the MDANZ (medical deans of aus & nz) exams each year. As in they'd make the final years sit this hour long exam at the the end of the year and threatening them with re-sitting etc. etc if they didn't make an earnest effort and try to pass them. It was introduced in 2013..and now every final year class has been subjected to them since. Some schools (I think UQ was one) were so embarrassed by how everyone scored they didn't even report the scores to students let alone publish them. That said, no one I've ever spoken to at any school ever took these exams very seriously. They weren't worth any grades, and no one actually had to re-sit them. That I know of. UQ i think published something about how their final years did on the 4 hour long IFOM exam, which is an exam written by the organizers of the USMLE Steps, to compare themselves to other med schools internationally. Their conclusion was that UQ students overall do worse than the international average.
https://www.mja.com.au/journal/2016/204/9/benchmarking-australia-using-international-foundations-medicine-clinical-science

If only it was collated somewhere and reported - what the numbers of students who start med school and the number that graduate on time v.s the number that eventually graduate. That's one interesting measure. on the flip side - also a good measure of how robust an academic program is the employment rates. Like how many actually applied back home and got positions. Schools are happy to report lofty percentages - of our applicants for residency programs in i.e. North America, 80% matched. What they leave out is how many of their internationals actually went through with applying back home. Because a chunk stay in Australia and never even take the steps or bomb the steps and so forget about even applying. On top of that, would love to know how grads fair while working and how their employers feel about them.

This is an interesting thread, on the whole haha.
 
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pitman

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Completely agree, but the OP was interested in attrition rates (at least in comparison to the Carib schools).

I can't seem to read the mja article, can log in but it doesn't recognise me as a legite subscriber, the jerks.
How did the stats break down, and how did other Australian med schools do?
 
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Oh I'd meant it as a general response ~ to encourage everyone to look beyond attrition rates.
Initially I'd felt the same as a student. woo-hoo. Low drop out rates! then realized by the end it isn't really saying much, as the weeding out process continues through residency years. Just because you'd passed and gotten a degree, it's still survival of the fittest after that. At least here, I have to re-apply for jobs every year until registrar training, that's after I apply and get into registrar training.

There's still moments as an intern when I'm filled with regret over not studying more for some subjects. Nothing worse than, say, me showing up the first day of clinics as an intern for a particular rotation and there's no more shadowing or observing. It's 'this stack of patients is yours. In you go.'

ALso my bad - UQ wasn't as terrible as I'd initially quoted on the IFOM.
"The UQ cohort performed better (31% scored below 500) than the ICG (55% below 500). However 49% of the UQ cohort did not meet the USMLE Step 2 CK minimum score."

At least the abstract and general gist should be available publicly here:
http://www.tandfonline.com/doi/abs/10.3109/0142159X.2013.849331?journalCode=imte20

I'm not sure what the exact stats are, as they never publicly shared or published the data as promised for the MDANZ. That's the only exam used as a comparative tool across most Australian medical schools (Not all have tried the IFOM). At least not to my knowledge/while I was still in med school. But it wasn't good. That said, no one had any particular motivation to do well anyway.

MDANZ is still being done every year, they change the topic. One year it was Internal Medicine, another year it was Paeds, or Surgery.
So there's also the compounding factor of when students did their respective rotation. If paeds was the previous rotation, they were probably going to do better, if it was ages ago, probably not.

To add to the chatter about comparing the different nationalities in a cohort - it's comparing apples to oranges. As in there's no point to comparing them.
There's also always going to be variability in people let into med schools. Particularly at places without interviews or simply need the money.

Say we're talking about Steps -
In context - the select Canadians who chose to write the Steps do comparatively better than their respective American peers who are forced to do it. That's because not all Canadians will take it, whereas all UQO students are expected to take the Steps, as part of contract. Whereas not all Canadians will, as they don't have any special program. it's just traditional 4 years with the Aussies. Some will also only do the 'EE. Increasingly, some do neither and just try their luck in Australia. There's a skew in that. Obviously, if you're going to invest that much time and money voluntarily, you're going to be more motivated and high achieving than the rest of the entire cohort essentially. It's thousands of dollars to do the steps and they're 8 hour exams.

Grades-wise, I'd agree with some of the commenters up there.
For the USA and Canada - no one understands Australian grades unless you've attended an Australian med school. Most program directors have probably never been to Australia.
They're left with their standardized exams score relevant to their respective countries, referees (based in those countries) and CVs (leadership, research etc). Also that you're passing. Some programs look at class ranking. It's no surprise if North Americans hell bent on returning home don't really care as much about the internal exams at a particular medical school.

For the clinical years, you can't compare the North American rotations to the Australian ones I would say. Anecdotally, so take what I say with a grain of salt, having done rotations in both continents and caught up with friends who are residents there now with their own students etc.

It's treated as work in the North American hospitals, so the whole philosophy is different. It's possibly related to the fact that there's no internship year over there, you go straight into a full year of med or surg. Not like the internship year here, where it's a mix of surg, med, emerg etc. The sort of general internship was eliminated from Canada in the 90s. They also believe you should learn on the job, the patient is the textbook. You might get a week off to study for rotation exams in Australia, you're lucky to even get a morning off over there. It's much more practical. In Australia, I think some clinicians would like to see a move to a more practical, but as of yet, it's more didactic or about observation. You observe a ward round, may be get to write a coupla notes for the team and then you go home and watch lectures and read about it. Or see patients and practice doing cases on your own and find some nice registrar to present to. If lucky, I'd get to do admissions. Or I'd get to run clinics, but this wasn't always the case.

One Australian consultant joked to me that the real learning begins in intern year. In North America, they aren't joking when they call final year the sub-intern year. Students get 30 hours shifts and pagers. Not saying if one system is better than the other by the way, just that they're a helluva lot different. The plus side to being in Australia at least is better lifestyle and arguably, more spare time to do well on the Steps or the 'EE.
 
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bashwell

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Oh I'd meant it as a general response ~ to encourage everyone to look beyond attrition rates.
Initially I'd felt the same as a student. woo-hoo. Low drop out rates! then realized by the end it isn't really saying much, as the weeding out process continues through residency years. Just because you'd passed and gotten a degree, it's still survival of the fittest after that. At least here, I have to re-apply for jobs every year until registrar training, that's after I apply and get into registrar training.

There's still moments as an intern when I'm filled with regret over not studying more for some subjects. Nothing worse than, say, me showing up the first day of clinics as an intern for a particular rotation and there's no more shadowing or observing. It's 'this stack of patients is yours. In you go.'

ALso my bad - UQ wasn't as terrible as I'd initially quoted on the IFOM.
"The UQ cohort performed better (31% scored below 500) than the ICG (55% below 500). However 49% of the UQ cohort did not meet the USMLE Step 2 CK minimum score."

At least the abstract and general gist should be available publicly here:
http://www.tandfonline.com/doi/abs/10.3109/0142159X.2013.849331?journalCode=imte20

I'm not sure what the exact stats are, as they never publicly shared or published the data as promised for the MDANZ. That's the only exam used as a comparative tool across most Australian medical schools (Not all have tried the IFOM). At least not to my knowledge/while I was still in med school. But it wasn't good. That said, no one had any particular motivation to do well anyway.

MDANZ is still being done every year, they change the topic. One year it was Internal Medicine, another year it was Paeds, or Surgery.
So there's also the compounding factor of when students did their respective rotation. If paeds was the previous rotation, they were probably going to do better, if it was ages ago, probably not.

To add to the chatter about comparing the different nationalities in a cohort - it's comparing apples to oranges. As in there's no point to comparing them.
There's also always going to be variability in people let into med schools. Particularly at places without interviews or simply need the money.

Say we're talking about Steps -
In context - the select Canadians who chose to write the Steps do comparatively better than their respective American peers who are forced to do it. That's because not all Canadians will take it, whereas all UQO students are expected to take the Steps, as part of contract. Whereas not all Canadians will, as they don't have any special program. it's just traditional 4 years with the Aussies. Some will also only do the 'EE. Increasingly, some do neither and just try their luck in Australia. There's a skew in that. Obviously, if you're going to invest that much time and money voluntarily, you're going to be more motivated and high achieving than the rest of the entire cohort essentially. It's thousands of dollars to do the steps and they're 8 hour exams.

Grades-wise, I'd agree with some of the commenters up there.
For the USA and Canada - no one understands Australian grades unless you've attended an Australian med school. Most program directors have probably never been to Australia.
They're left with their standardized exams score relevant to their respective countries, referees (based in those countries) and CVs (leadership, research etc). Also that you're passing. Some programs look at class ranking. It's no surprise if North Americans hell bent on returning home don't really care as much about the internal exams at a particular medical school.

For the clinical years, you can't compare the North American rotations to the Australian ones I would say. Anecdotally, so take what I say with a grain of salt, having done rotations in both continents and caught up with friends who are residents there now with their own students etc.

It's treated as work in the North American hospitals, so the whole philosophy is different. It's possibly related to the fact that there's no internship year over there, you go straight into a full year of med or surg. Not like the internship year here, where it's a mix of surg, med, emerg etc. The sort of general internship was eliminated from Canada in the 90s. They also believe you should learn on the job, the patient is the textbook. You might get a week off to study for rotation exams in Australia, you're lucky to even get a morning off over there. It's much more practical. In Australia, I think some clinicians would like to see a move to a more practical, but as of yet, it's more didactic or about observation. You observe a ward round, may be get to write a coupla notes for the team and then you go home and watch lectures and read about it. Or see patients and practice doing cases on your own and find some nice registrar to present to. If lucky, I'd get to do admissions. Or I'd get to run clinics, but this wasn't always the case.

One Australian consultant joked to me that the real learning begins in intern year. In North America, they aren't joking when they call final year the sub-intern year. Students get 30 hours shifts and pagers. Not saying if one system is better than the other by the way, just that they're a helluva lot different. The plus side to being in Australia at least is better lifestyle and arguably, more spare time to do well on the Steps or the 'EE.
I'm not so sure about that? From what I've been told by friends, in general 3rd year in US med schools was the crazy busy one, whereas 4th year (their final year) is somewhat more laid back, some more time for flying around the country and interviewing, etc. Also, I've been told by the same friends who graduated from US med schools that there was a lot of wasted time in 3rd year where they weren't learning anything meaningful even though they had to be there for a long time and that intern year was a big learning experience for them too. But I completely agree with you about your larger point that we can't really compare the Australian and US and Canadian systems. I think the most we can say is they're each good enough for their respective healthcare systems.
 
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Winged Scapula

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I'm not so sure about that? From what I've been told by friends, in general 3rd year in US med schools was the crazy busy one, whereas 4th year (their final year) is somewhat more laid back, some more time for flying around the country and interviewing, etc. Also, I've been told by the same friends who graduated from US med schools that there was a lot of wasted time in 3rd year where they weren't learning anything meaningful even though they had to be there for a long time and that intern year was a big learning experience for them too. But I completely agree with you about your larger point that we can't really compare the Australian and US and Canadian systems. I think the most we can say is they're each good enough for their respective healthcare systems.
He's correct when speaking about US 4th year "sub-Is" which are required by most schools and "audition rotations".

During those rotations (usually done in the first few months of 4th year), students often wear a pager, are "first call" and take in house call with them team, sometimes working more hours than the residents (given that work hour restrictions aren't often done for medical students, although its getting better). The last few months of 4th year are relaxed and most students take slower electives during Nov-Jan, peak interview season but its not the case that the entire 4th year.

The major difference IMHO is also accurate in his post above: US students are much more hands on, much longer hours. I was told in Australia, numerous times, "you don't need to know that" or "you'll learn that as an intern", only to find it was expected that I already knew "that". Most Australian learning comes during those Foundation Years in terms of practical and patient management skills.
 

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He's correct when speaking about US 4th year "sub-Is" which are required by most schools and "audition rotations".

During those rotations (usually done in the first few months of 4th year), students often wear a pager, are "first call" and take in house call with them team, sometimes working more hours than the residents (given that work hour restrictions aren't often done for medical students, although its getting better). The last few months of 4th year are relaxed and most students take slower electives during Nov-Jan, peak interview season but its not the case that the entire 4th year.

The major difference IMHO is also accurate in his post above: US students are much more hands on, much longer hours. I was told in Australia, numerous times, "you don't need to know that" or "you'll learn that as an intern", only to find it was expected that I already knew "that". Most Australian learning comes during those Foundation Years in terms of practical and patient management skills.
Just to be clear I wasn't disagreeing with his major points, only the part I bolded (which, actually, I wasn't so much disagreeing with as wondering about or comparing what I've heard from friends who have gone through med school in the US).

I definitely did not mean to say or imply all of 4th year in US med school is laidback. As I originally said, it's "somewhat more laid back" (i.e., in comparison to 3rd year), not that it's laid back, full stop. Besides, I was basing what I said on his comment equating "final year" with "the sub-intern year" (i.e., "In North America, they aren't joking when they call final year the sub-intern year").

In general, however, I agree with the main point that Australian med schools are probably more laidback than US med schools (at least if we compare the postgrad programs, I don't know what Australian 5 or 6 year med schools are like). (To be fair, one could probably say that about Australian society and culture as a whole -- i.e., Australian society and culture are probably more laidback than US society and culture in general). Anyway, does being comparatively more laidback make one worse or better than the other, whether that's med school, residency, life as an attending/consultant, or life in general? I have no idea.

Also I think things may have changed a bit since when you were in Australia as a med student (maybe a decade or so ago)? For example, I personally don't ever remember being told you'll learn that as an intern or you don't need to know that. Also I got to be quite hands-on but then again I often asked to do things too.

But otherwise thanks and I do appreciate the perspective.
 
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My experience was similar to Winged Scapula and I'm just finishing internship in Australia. So there's no 10 year gap for me. Similarly, many of my friends felt the same way. That said, hospital based rotations were more demanding, than say family med.

Australia isn't at "0" for hands-on. Also if I chose smaller hospitals or the rural ones - I would get to do more. (I think pitman also mentioned that somewhere too, I can't remember if it was this thread) It was also team dependent. Just saying that very generally, I always felt I had to be more proactive in Australia as a student.

I'll be more concrete. In North America, it'd be more like here are your patients. Not, here's a list of patients you could practice on. There's more responsibility over care. Similarly, my surgically inclined classmates were closing every operation overseas as 3rd or 4th year students. Meanwhile in Australia I was lucky to be taught how to do a skin closure as a surgical intern. On emerg, I'd be attempting to juggle 3-4 patients at a go overseas, similar to the way I would as an intern on emerg rotation in Australia, just less competently, less efficiently and with lower expectations. Thankfully. I was lucky to see one patient at a go on my own during an emerg shift on my Australian rotation in emerg. That said, I had far more learning materials and teaching modules in Australia at my finger tips. Far more tutorials offered by ED consultants/attendings. I could do with some tutorials now as an intern/resident, but then again, not like I'd have time to attend anyway. Teaching time is so protected for students.

I didn't get necessarily told that I wouldn't have to learn particular things until intern year, I was however told to go home by 4-5 pm while I could as a student. Don't worry about weekends. Which was nice. It gave me enough time to go home and hit the books. Enjoy life before work. Now that I'm an intern sometimes I'm in clinics that can run over time to 7 or 8 pm. I wish I could go home on time with the students. Or I'm on weekend cover shifts for multiple teams and sometimes hundreds of patients that run from 7 am till 10 pm. And it's just me and a registrar. (Most patients are stable, by the way, not all will be horribly sick at once, or we'd both be crushed). It's not like a 30 hour shift, but it's not fun either. Never had any experience as a student in Australia to really prepare me for that, but I survived, along with everyone else. I learned how to do jobs as a student, but not how to multitask and prioritize dozens of jobs at a go until I was an intern on a busier rotation.

There was a gap I found too, in Australia, like Scapula.
Between what examiners felt we should know as students, but what we were actually taught or had 'practice' in as students on the rotation. Some rotations were better structured than others at bridging this gap. I think each year some coordinators do strive to figure out what's lacking and try to change things.

One exception is where final students in Australia get to do a pre-internship year, where they shadow an intern and help do their jobs. This isn't offered at all Australian schools. It's brilliant though.

There is talk of changing the internship year. Based on the independent review the Australian government commissioned, where they studied both medical student and intern responsibilities. Link here:
http://www.coaghealthcouncil.gov.au/portals/0/review of medical intern training final report publication version.pdf. I've yet to read the full thing. Page 36 discusses the realities they found overall about current Australian students versus where the researchers think we should be. There was talk about recommending that the internship year be removed and Australia adopt the North American system - it was met with a resounding no by AMA CDT (council of doctors in training) and AMSA on consultation.
 
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bashwell

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My experience was similar to Winged Scapula and I'm just finishing internship in Australia. So there's no 10 year gap for me. Similarly, many of my friends felt the same way. That said, hospital based rotations were more demanding, than say family med.

Australia isn't at "0" for hands-on. Also if I chose smaller hospitals or the rural ones - I would get to do more. (I think pitman also mentioned that somewhere too, I can't remember if it was this thread) It was also team dependent. Just saying that very generally, I always felt I had to be more proactive in Australia as a student.

I'll be more concrete. In North America, it'd be more like here are your patients. Not, here's a list of patients you could practice on. There's more responsibility over care. Similarly, my surgically inclined classmates were closing every operation overseas, I was lucky to be taught how to do a skin closure as a surgical intern. On emerg, I'd be attempting to juggle 3-4 patients at a go overseas, similar to the way I would as an intern on emerg rotation in Australia, just less competently, less efficiently and with lower expectations. Thankfully. I was lucky to see one patient at a go on my own during an emerg shift on my Australian rotation in emerg. That said, I had far more learning materials and teaching modules in Australia at my finger tips. Far more tutorials offered by ED consultants/attendings. I could do with some tutorials now as an intern/resident, but then again, not like I'd have time to attend anyway.

I didn't get necessarily told that I wouldn't have to learn particular things until intern year, I was however told to go home by 4-5 pm while I could as a student. Don't worry about weekends. Which was nice. It gave me enough time to go home and hit the books. Enjoy life before work. Now that I'm an intern sometimes I'm in clinics that can run over time to 7 or 8 pm. I wish I could go home on time with the students. Or I'm on weekend cover shifts for multiple teams and sometimes hundreds of patients that run from 7 am till 10 pm. And it's just me and a registrar. (Most patients are stable, by the way, not all will be horribly sick at once, or we'd both be crushed). It's not like a 30 hour shift, but it's not fun either. Never had any experience as a student in Australia to really prepare me for that, but I survived, along with everyone else. I learned how to do jobs as a student, but not how to multitask and prioritize dozens of jobs at a go until I was an intern on a busier rotation.

There was a gap I found too, in Australia, like Scapula.
Between what examiners felt we should know as students, but what we were actually taught or had 'practice' in as students on the rotation. Some rotations were better structured than others at bridging this gap. I think each year some coordinators do strive to figure out what's lacking and try to change things.

One exception is where final students in Australia get to do a pre-internship year, where they shadow an intern and help do their jobs. This isn't offered at all Australian schools. It's brilliant though.

There is talk of changing the internship year. Based on the independent review the Australian government commissioned, where they studied both medical student and intern responsibilities. Link here:
http://www.coaghealthcouncil.gov.au/portals/0/review of medical intern training final report publication version.pdf. I've yet to read the full thing. Page 36 discusses the realities they found overall about current Australian students versus where the researchers think we should be. There was talk about recommending that the internship year be removed and Australia adopt the North American system - it was met with a resounding no by AMA CDT (council of doctors in training) and AMSA on consultation.
Sorry typing on my mobile or cell phone, please forgive any errors etc: I just want to be clear again I wasn't ever entirely disagreeing with you. In fact, I think I mostly do agree what you've said and what you've been saying. I know much of what you've gone through reflects my own experience as well. Like you and pitman it sounds like, I too got to do more in rural placements here in Australia. But to be fair I felt I got to do a lot in the city hospitals in Sydney as well. But again I was proactive like you said, though I'm probably just proactive in general, and I imagine I would've been proactive had I gone to the US for med school too (and I did get accepted to some US med schools, I'm a dual citizen). I also agree for example I had more responsibility or ownership of patients when I was in the US, exactly as you said. However I should note I never did a full year or two years in the US like UQ-O may do (and perhaps you did as well). I only got to do short electives or away rotations, and therefore I can only compare what I saw and experienced in a short period of time on elective. That said, at least on my electives in the US, there was frequently some down time, despite the long hours, and it didn't feel completely different from my experience in Australia. Same or similar experiences with some of my friends in the US as I mentioned above. And neither I nor my friends have had a 10 year gap either. Anyway, all this aside, I think we're mostly agreeing with each other, from what I can tell? However my main point was just that, at the end of the day, our comparisons of US and Australian medical education and training are based on our own experiences (as well as people or friends we know) but I don't know how accurate or representative different people's personal experiences are if they disagree? Regardless I feel like writing so much about this topic is going to give the impression that we disagree a lot more than we actually do, even though I think we actually agree far more than we disagree, and even our disagreements may be pretty minor overall. Thanks for the discussion though and I'll stop now so as not to further this impression or misimpression! All the best. :)
 

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Sorry this will be my last post and then I'll bow out, but the following paper might be helpful. Or at least hopefully more helpful than personal opinions (including mine). However, I haven't read it, so I don't know if it truly is helpful or not. Also, it looks like it might only be comparing one med school in Australia with one med school in the US rather than Australian and US med schools in general which would presumably be better.

"Differences and Similarities in the Practice of Medicine Between Australia and the United States of America: Challenges and Opportunities for The University of Queensland and the Ochsner Clinical School"
 
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Oh no need to apologize!
I'm happy to discuss things. Or I wouldn't be hanging around this forum.

You mentioned you weren't sure so about my last comment or quote that 'internship is where the real learning begins'. So I clarified my pov further.

Some of it's a reflection on my part, after I'd finished med school and will be soon to finish internship.
How did I really feel on looking back and how did it serve or not serve me well when I actually started working.

Yes there is downtime in the Americas, but it wasn't comparable to the amount of downtime I had in Australia.
However, by final year I got used to it, made the most of whatever system I was in. To the point where, if I had done my research and picked the right hospital to rotate to, I enjoyed myself wherever I was.

If you're proactive enough, you get trusted with more responsibilities in Australia. It was a lot more self-directed or self-motivated. Depending on team of course. This does however, have the potential to (metaphorically speaking) fail students who are not as pro-active and are at the tertiary setting. *addit - unfortunately, this probably applies to most students at one point or another. who are left feeling like observers than part of the team. There will be moments where even being proactive won't help on busier teams.

So that I'm not continually pushing my own personal experiences and anecdotes, I'd included mentioning a national independent review, commissioned by a government. While I haven't thoroughly read all 100 pages, I have thoroughly read the sections that piqued my interest. Mainly because of the impact that their recommendations may have on my future and those of my peers, a government doesn't just hire an independent research group for just interest's sake.

My point is as follows - neither myself or Winged Scapula are alone in our observations. I know you're not disagreeing with anyone here, but you keep saying you've heard or felt differently. So I brought up that paper.

Here are the points the researchers made about medical students in summary:
Currently:
"- Medical students have limited roles in, and responsibility for, patient care in many settings, resulting in a steep transition into internship
- Employers report that medical graduates are not work-ready on entry
- There is no evidence to determine whether graduates have met expectations on entry
- The initial transition to work is focused on learning workplace systems and processes, to the detriment of clinical learning and/or the unnecessary repetition of learning"

What researchers recommend:
"- Medical students have defined responsibilities in the clinical team and opportunity to learn skills and apply knowledge
- The capabilities and experience that graduates are expected to possess on entry are clearly articulated, with evidence that they have been developed and assessed
- Graduates have a good understanding of the systems and processes of the workplace and are therefore better prepared, in their initial transition, to focus on clinical learning."

It was not intended to argue with you, but you were doubtful of where I (or Winged Scapula) were coming from or if what we were saying was relevant or actually occurring in present day.

With the UQO paper - I'm not entirely sure what conclusions you're trying to make with posting a link to it. At any rate, it did prompt me to be more clear about what I was doing with my quoted paper (which is shabby posting on my part).
Also, the UQO paper is not comparing two schools, it's discuss a unique program within UQ that has the two final clinical years based in New Orleans. Or a school within a school. Then it very briefly discussed general differences in US & Australian healthcare training systems at the bones. UQO is still subject to UQ rules and all students write UQ exams and get UQ grades. It's not its own school entirely, while it's rigorous, it's possibly still not as rigorous as domestic schools - or so I was told by a few of its graduates that went onto to work at other US hospitals with students under them. UQ for instance, does not believe in imposing 30 hour shifts on students. I'm not a graduate of UQO, by the way.

The paper was also written by faculty trying to formulate research in addition to offering support of the program they created. Not implying it's bad, but it carries its own biases, particularly as that program entails costing each student 60k in USD a year for 4 years. It's a bit similar to a pharmaceutical company publishing results on a particular drug they would like to market.
 
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Hmm, may be I'm coming on a bit too strongly.
It's hard with written posts as your intended tone doesn't always come across.

I agree with your earlier comment - it is quite rightly, two different systems we're discussing.
They're each suited to their own purposes with their own strengths and weaknesses. They're different continents, as well as countries. There's a reason why Australian med schools are more laidback - the post-graduate training process is more drawn out. Nothing wrong with that either. The pros to it is that it offers better lifestyle and hours. Obviously cons mean that you're a trainee for longer (*with fewer hours, it does reduce the amount of learning, hence more years to make up the difference). However, Australia compensates its trainees arguably better than most Western countries.

On your other reflection about whether being laidback is good or not -
"does being comparatively more laidback make one worse or better than the other, whether that's med school, residency, life as an attending/consultant, or life in general? I have no idea."
Personally, if I actually thought that laidback was a bad thing, I wouldn't be in Australia to begin with.

While there are merits to the Australian system, there are things that do need to be improved.
On the glass half full end of it, it's on the minds of everyone at every rung of the training pipeline, from students to faculty to government. I'm hopeful that it will lead to something.

My main intent in posting is for international students investing a lot of money into 4 years to have some greater depth of understanding of the risks to what they're signing up for. I'm not trying to disagree with you either, I can see what you're trying to say. However, I'm also very aware of the fact that many pre-medical students come to these forums to find out more about the programs in countries completely different to their own. They don't wish to go in blind. Their ideas of what medical school should be like based on their own backgrounds, particularly the clinical years, may not be in fact what they experience in another country foreign to their own. It's not saying it's bad. However, it's a surprise, that occasionally leads to disillusionment. It's very individualistic, what the feeling and response is.

When I post, I'm not trying to win a debate or argument or defend things per se.
It's bearing mind that there's an audience. It's a public forum, of mainly full-fee paying international pre-med and med students. What is it that I would like them to know, after going through everything they're about to go through. Many things you're pointing out tactfully and politely are triggering me to be more clear so that I'm not misleading the conversation or too enthusiastically going down a single direction.
 
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Winged Scapula

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Neither of you needs to apologize as we all have our own individual experiences.

In fact, the most autonomy I ever got as a medical student was during a rural surgery rotation in AliceSprings: we had such a high volume of abscesses that needed to be incised and drained that I was literally given my own operating theater and perform the procedures with only the anesthetist in attendance. That would never happen in the United States.

And while my experience was more than 10 years ago, I have kept in touch with faculty and current students so I am pretty cognizant of the differences in the educational system. However there may be individual differences based on student location, and Consultants practices.

Thank you both for your input, we really appreciate it.


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I think the medical schools in Australia are very similar in their syllabus, all of which, are reasonably robust and good in my opinion. About half are undergraduate-entry, and the other half are graduate-entry. Either way, the first half is pre-clinical and basic sciences, the second half are the clinical clerkships through the various specialties; which is similar to our UK and US colleagues. I won't bother disputing the trivialities of the graduating with the traditional MBBS versus the new-age MD (which involves some benign reluctant research project); at the end of the day, both allow you to apply for a job as a doctor and register with the medical board.

Upon graduation (PGY = post-graduate years; i.e. years from graduation from medical school):
PGY 1 = Intern (one year of provisional medical board registration with mandated rotations in emergency medicine, an internal medicine specialty and surgical specialty, before moving to general registration)
PGY 2+ = Resident (typically two years of rotating through elective clinical rotations to gain further junior doctor experience, before enrolling on a specialist training program as a registrar)
PGY 3 or 4+ = Registrar (on a specialist training program; varies from 3 to 7 years, depending on your specialty; and yes, GP is now a specialty requiring 3-years training)
PGY 6 to 8+ = GP or Consultant-Specialist (usually you should be a fully qualified doctor for independent unsupervised practice by this stage and eligible for specialist medical board registration and Medicare billing rights)

Interns, Residents and Registrars, are considered 'Junior Doctors' in Australia; they are all supervised by fully-qualified GPs or Consultant-Specialists, who have completed their fellowship specialty exams. Australia has numerous specialty colleges that are responsible for the vocational training of their relevant specialty (e.g. Australasian College of Emergency Medicine, Royal Australasian College of General Practitioners, Royal Australasian College of Surgeons, et cetera.). Some people don't choose to specialise (and become an over-glorified senior resident), but in this day and age, you honestly should specialise to be competitive in a modern job market, especially with a surplus of medical graduates in the last decade. Most of the specialty training programs are robust and peer-reviewed and well-accredited on-par (if not better) with our UK or US counterparts.

Australia places more emphasise on 'experiential' and 'time-based' learning, hence the preference to have two or more years (after internship) rotating through various specialties before deciding on a specialty to enrol in, and then another average five years of further specialty training before full qualification. There's no rush to become a Consultant/Attending-Physician, and there's a lot of bad habits to pickup inadvertently as a junior doctor. Medicine is one of those vocations where the more you see the more you know, and this can only happen with time and experiences; so I'm personally glad we have such long (at time, tedious) but worthwhile training programs that rightfully ensures the fully-qualified Specialists our patients are seeing have at least 8 years of experience and at least 6 years of experience for our GPs.
 
Jan 8, 2017
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A galaxy, far, far away
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Resident [Any Field]
Hey BigPikachu,
So, to quote Bashwell from an earlier post, the systems are different because they are suited to different purposes or post-graduate training programs.
I still disagree that they are similar in structure. I'm not disputing quality here. Education is education, and it's sufficient enough that any Australian graduate can start residency (if they get an offer) in the USA or Canada. That's why there's a massive phenomenon of North American students studying in Australia, Ireland and the Caribbean in order to return home for residency.

Thanks for outlining Australian post-graduate training.
Let me clarify what the North American training program entails:
Medical School (4 years, must have done some undergrad studies, like bachelor degree, no direct entry from high school)
Residency, 3-5 years
(Optional: Fellowship - which also comes after registrar training in Australia)
Consultant, or what North Americans refer to as Attending.
Done. No internship, no "resident" years as it is defined in Australia.

In North america, you go straight into vocational training after medical school (or enroll straight into a training program). Obviously there's still some foundation rotations in the first year out, but it's very different to an Australian internship. There's also no such thing as a registrar in North America. *It's considered being a senior resident, because all residents are considered trainees on a program. No one will have ever heard of the term registrar unless they studied in the UK or Australia. Again, while intern year in Australia = 8 weeks of emergency, 10 weeks internal medicine, 10 weeks general surgery (rest of the year filled with other elective rotations), there's no such similar intern year in North America. This is because North America utilizes their clinical year students far more heavily as a workforce, and there's a subinternship year (final year).

E.g. Cardiology in USA/Canada is:
Residency = PGY1 - med/cardio intern year, but it is only in medical terms (no emergency, no surgery. just medicine - medical specialties and internal medicine)
PGY2 or 3 = straight into your specialty for the rest of residency, which could be up to 4 or 5 years (including the "cardio intern year"). It's not necessarily being a 'registrar', you could be a cardio resident for a full year before having equivalent responsibilities to the cardio reg let's say. Then after 4-5 years total of residency, you become the attending in that field or consultant. Family medicine is even shorter, it's 2-3 years of post graduate training after medical school.

The years are short in USA/Canada, but the hours are much longer, and there's things like 30 hour work shifts. There's no loss in experience, because they work much longer and demanding hours, whereas the lifestyle is better in Australia, however trade off is that training is longer. (Lifestyle is why some North Americans choose to stay in Australia).

Again, not disputing which system is better or worse. The emphasis is differences here, because again - this is a thread involving mainly North Americans contemplating Australian schools (if you scroll up - and the original poster, now blocked ironically, is North American) and whether they should move across an ocean to a new country (one that most will have never been too before) for a degree and drop 250-300k for roughly half a decade of their lives.

What North Americans are used to and exposed to is different to Australia, this means North American students have different expectations of what medical school and residency is like.
If they understand what the potential differences are, perhaps they will adjust better to the system that is different to home. Honestly, some do not adjust well. I've had classmates count down the days to returning home to their home system and the familiarity of it. Some prefer the shorter training interval (and longer hours during it) - and it is their right and preference. It is highly individual. (I mean, I have my opinions too, but I prefer that they form their own - because they have to live with whatever decision they make for the rest of their lives, whether to stay in Australia or go home)

On the side, and I don't mean this in any serious way. just..humourous observation.
I always find it ironic that the Aussie residents and regs comment on how training is too short, based on the number of years over in North America. On the flip side to that some of the North American doctors I know comment on how limited or short the number of hours and shifts Australian residents or trainees have. Both say the exact same thing..how does one learn enough or gain experience in that "other" system. I give up trying to explain, as essentially everyone thinks their own system is best. I avoid getting into these arguments as either I'm a traitor to my home country or to the country that trained me. I would just rather be Switzerland.
 
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