How to judge clinical training at a program

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Lucky Day

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I’m in the process of considering schools to matriculate. I’m torn and I think it’s going to come down to the quality of the clinical training. I’ll be making contact with MS3s and MS4s from the respective programs soon, but what are other ways to gauge the quality of the clinical training at a program from the experience of everybody here? For example, would the breadth of residency and fellowship programs say anything? Would the program rankings on doximity be telling?


I’ve done my work searching the forums for questions to ask. I’m mainly going off advice from these threads:
Choosing a medical school: an insider's perspective
How to tell strength of clinical years?
 
I didn't read the threads, nothing you mentioned besides talking to students is a good way to tell so far

You don't need to. Primarily, they recommend questions.
 
There isn't really a good way to tell. Highly ranked residency/fellowhips are nice, but as an M3 that is just more and more people above you on the totem pole. I'd say talk to the older students, especially those who have gone on away rotations and see how they feel their training compared to what they saw at other programs
 
It's really unlikely that you'll find information that will be truly revealing. And while your clinical training starts in medical school, truthfully residency and fellowship are 99.8% responsible for the type of physician you'll be as an attending. I barely remember a single thing in terms of medical knowledge from my med school clerkships now. There's a reason why intern year is daunting - you have to go from knowing only the absolute bare minimum to reasonable degree of expertise pretty rapidly.

What schools are you considering if my first question, some of us who are attendings on SDN may be able to provide an idea of reputation for residency/fellowship training, but that's still not answering your question.

The problem I foresee, even if you got great information, is how are you actually going to compare these people's experiences and reach a meaningful outcome for you? Unless you know at this very instant that you are going to be a psychiatrist or a pediatric orthopedic surgeon or an oncologist specializing in Non-Hodgkins Lymphoma or a reproductive endocrinologist with absolutely no possible way you'll deviate from that plan, how will you interpret someone telling you "well everyone loves our IM clerkship but hates peds, because in IM we have really useful daily lectures, but peds is haphazard and the residents are typically worthless which is probably why they don't fill in the match every year" when another one tells you "IM is the worst at our school, the residents have no interest in teaching and they're overworked, but in peds it's well thought out, it's geared towards our shelf and the residents recognize not everyone will be a pediatrician so they really try to find cases that will appeal to what you want to do", or "pretty standard stuff, nothing really stands out, surgery is totally reasonable and a good experience unless you get placed on the Red Team, then it's absolute hell, just stay away from being put on the Red Team unless you want to be a surgeon, and even then you don't want that team". If you know what you want to do, then it *might* make sense to go to a place with a strong clerkship, but if you don't know where your career will take you, how do you actually prioritize any of the information you're likely to get?

(descriptions of clerkships above are accurate representations of 3 different medical schools I'm very familiar with, BTW)

As someone who is now out in the attending side of things, my recommendation would be to go to the most reasonably priced school you can. If they're all within about $20k in terms of tuition, then go to the highest ranked school.
 
Gracias, folks. This was helpful advice. If any of y'all have any experiences or anecdotes about USF, that's the program I have a lot of leg work to on their clinical training.
 
In all honesty, your clinical experience during your MS3 and 4 years are defined by how much effort you put in. You can be in the best team of the hospital with resident and attendings who are dedicated to teaching but if you're not motivated then you won't get much out of it. On the other hand, if you're motivated enough you're gonna get a lot out of your clinical years. That being said, a lot of your experience will also be directly affected by the resident and attendings you encounter. A great attending/resident can make you fall in love with a specialty or completely turn you off of it. And therein lies the problem. You won't be doing clinicals till 3 years from now and by that time a lot of the information you're gathering now will be irrelevant. A lot can and will change: the residents will move on, attendings retire or change jobs, schools add/lose clerkship locations, etc etc. All of which is completely out of your control. You just have to hope it doesn't change too much by the time you get there. So, just make a decision and strive to do your best wherever you go.

I second BigRedBeta. As an attending the thing that annoys me the most is my medical school loans. Choose the cheapest medical school, you can be whatever you want to be coming from any school as long as you do well, work hard and get killer STEP1 scores. Your debts follow you forever unless your parents are paying your schooling.
 
In all honesty, your clinical experience during your MS3 and 4 years are defined by how much effort you put in.

The counterpoint is when I’ve spoken to MS4s who use externships as reference of case load/responsibility/developed capabilities.

But I get your point, it’s well taken. Thank you.
 
Echoing @getdown it is largely a product of luck: specifically the team you get placed on. Doesn't matter if you're at Man's Greatest Hospital or Middle of Nowhere Community Hospital; if your resident is a jerk or doesn't care about teaching then that is going to be your experience. The only caveat I'd suggest is to go to a busier hospital center if possible-more variety of patients, more opportunities to actually help out, etc. I tell incoming students to go to a place with pass/fail grading and recorded lectures. Third and fourth year are virtually indistinguishable from place to place.
 
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