How your clinical sites were decided

[UncleSam7176]

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I am a MS 1 on a committee that is responsible for the lottery system to decide clinical sites for the current second years. My school currently picks ping pong balls out of a hat and the Dean would like to change this to possibly a online system. Please let me know how your school ran there system and how it work out for your class.

 

[Morsetlis]

What's wrong with ping pong balls and hats? 😕

 

[UncleSam7176]

absolutly nothing. the Dean wants to change it and I am looking for other ways. I guess a lot of students last year got upset.

 

[sanityonleave]

How many do you have / does it change with each rotation?

Ours are determined during the application process -- there are three clinical "branch campuses," and you put a list of your preferences when you apply. Our main campus is by far the most popular, but there are always a few students who want to go to the other two. The rest of the spots are filled from the waitlist -- waitlisted students who are accepted aren't given a choice of campus, so they're assigned to whichever one has open spots.

It's only for core clerkships, though -- everyone can come back for sub-Is and electives.

Not sure if that would work for you guys, but significantly cuts down on the griping since everyone's just happy to be admitted, ha.

 

[Rollo]

Why is a first year student on a committee like this?

Anyway, our school you are given 12 possible rotation orders to rank and submit. People's names are chosen randomly one by one and they got assigned to their first choice if there is a spot available within that group. If there is no spot available, then they move to your second choice and assign you to that group....if there is a spot available there. If not, then they move down your third choice and assign you to that group...if there is a spot available there. And so on...

 

[turkeyjerky]

How many do you have / does it change with each rotation?

Ours are determined during the application process -- there are three clinical "branch campuses," and you put a list of your preferences when you apply. Our main campus is by far the most popular, but there are always a few students who want to go to the other two. The rest of the spots are filled from the waitlist -- waitlisted students who are accepted aren't given a choice of campus, so they're assigned to whichever one has open spots.

It's only for core clerkships, though -- everyone can come back for sub-Is and electives.

Not sure if that would work for you guys, but significantly cuts down on the griping since everyone's just happy to be admitted, ha.

wait, are you saying that the students who were waitlisted when applying to the school get screwed on rotation sites? That's pretty f'ed up, imo.

 

[KeyzerSoze]

My school has a "lottery" which is really more of an auction. At the beginning of 3rd year, each student gets a certain number of points to spend on a track and individual clinical sites for each rotation. It's a bit complicated, but the overall effect is that it's not random, and everyone can get whatever is most important to them.

 

[Siverhideo1985]

We have a lottery system for the overall 3rd year rotation schedule (student ranks all possible combinations from 1-16 and then gets assigned when his lottery number comes up).

Each rotation then has a subsequent lottery where students again rate clinical sites within that rotation and they are, again, assigned to their preference according to their lottery number

Each student is allowed one "wildcard" that can be used once during 3rd year. This can be used to ensure a spot at a clinical site in a specific rotation of your choosing. I.e. Student John Doe wants the big main hospital for his pediatrics rotation to get a letter of rec from teh program director...he'd use his wildcard.

Works out pretty well for most people I'd say.

 

[45408]

For the rotation order, it was an online lottery at MCW.

For the sites of each rotation, you got to request what you wanted, and I got almost every one of them. It was first-come, first-served though, so I sometimes didn't get my first choice (several times, this was a good thing in hindsight). For some rotations though, if you were at one place for one thing, you'd automatically get sent to the other place for the other thing (e.g., M3 medicine rotation at main campus meant you were doing your M4 medicine sub-I at the VA, or vice versa).

 

[sanityonleave]

wait, are you saying that the students who were waitlisted when applying to the school get screwed on rotation sites? That's pretty f'ed up, imo.

They don't get screwed -- essentially we have three campuses: Birmingham, Tuscaloosa, and Huntsville. B'ham is UAB's flagship hospital, and it's by far the biggest and has the most specialty services. Huntsville and Tuscaloosa are both smaller, but they also have very few residents and fewer medical students, so students who rotate there get a lot of 1 on 1 face time with attendings (a lot of the surgery kids do it because they can first assist on a lot of procedures).

Birmingham is definitely the most popular campus and the kids who are accepted off of the waitlist usually are forced to go to Tuscaloosa/Huntsville. I don't see why that's a problem... they're not "bad" rotation sites, just different. Less desirable? Perhaps -- but I still don't see why it's a problem. You can come back to Birmingham for all of your electives and sub-Is anyways.

 

[turkeyjerky]

They don't get screwed -- essentially we have three campuses: Birmingham, Tuscaloosa, and Huntsville. B'ham is UAB's flagship hospital, and it's by far the biggest and has the most specialty services. Huntsville and Tuscaloosa are both smaller, but they also have very few residents and fewer medical students, so students who rotate there get a lot of 1 on 1 face time with attendings (a lot of the surgery kids do it because they can first assist on a lot of procedures).

Birmingham is definitely the most popular campus and the kids who are accepted off of the waitlist usually are forced to go to Tuscaloosa/Huntsville. I don't see why that's a problem... they're not "bad" rotation sites, just different. Less desirable? Perhaps -- but I still don't see why it's a problem. You can come back to Birmingham for all of your electives and sub-Is anyways.

You don't think it's a problem to treat formally waitlisted students as second class?

 

[sanityonleave]

You don't think it's a problem to treat formally waitlisted students as second class?

Woah -- you're definitely putting words in my mouth. There are plenty of students who are not waitlisted who opt to go to either of the branch campuses, and I don't think they consider themselves "second class." Maybe the reason I don't understand is that there's not a huge difference between our clinical campuses the way it seems like a lot of people above have indicated there are for theirs. All of them are good and all of them provide good education. They each have their strengths. Nobody's getting screwed, here -- there are some students who are not offered a choice, but nobody is being treated as "second class."

As far as the waitlisted folks not being offered a choice... no, I have no problem with that. I think the disconnect is that we just don't have any really poor clinical sites. If people getting in off the waitlist were being sent to notoriously poor sites for their clinicals, that would be a whole different story (and arguably unethical) -- but they're not. They just have to go wherever there is space -- in some years the Birmingham campus has spots open and the other two are filled. It's a matter of practicality and, imho, the most "fair" way to do it. The reason it's done that way is because it can affect a student's decision as to whether to attend -- one of the girls in my clinical medicine group is married to a guy working in Huntsville, so had she not gotten into the Huntsville campus, they would have had to make the decision about whether to live apart for 4 years or have him try and get a job in Birmingham. A guy that I went to undergrad with got in off the waitlist and got assigned to a campus he didn't want and decided to attend a different school. I think that's far more fair than letting someone in and then two years later going: "Sorry, the ping pong ball said you have to go live 3 hours from your husband for two more years. Sucks for you!"

EDIT: Sorry for taking this thread off topic, but actually this does bring up another important point -- perhaps if the clinical sites require people to move around or are geographically distant it might be important to give people that information up front? Perhaps hard to do with 12 clinical sites though.

 

[ScubaStarved]

Maybe the reason I don't understand is that there's not a huge difference between our clinical campuses the way it seems like a lot of people above have indicated there are for theirs. All of them are good and all of them provide good education. They each have their strengths. Nobody's getting screwed, here -- there are some students who are not offered a choice, but nobody is being treated as "second class."

To be clear, your argument is separate but equally strong? I understand your point, that it's better for the process to be transparent, but based on your post it seems obvious that waitlistees may or may not have a choice in their rotation site. Even if all three sites were geographically and academically equal, these students are still being treated quite differently than those admitted earlier.

I've much love for UAB, but this system always seemed awkward and is purportedly a source of hurt feelings and drama every year. When I applied, the whispered advice from upperclassmen was to indicate only one site preference, lest you get sorted to your #2 or #3 before all others who gave a single preference.

 

[sanityonleave]

To be clear, your argument is separate but equally strong? I understand your point, that it's better for the process to be transparent, but based on your post it seems obvious that waitlistees may or may not have a choice in their rotation site. Even if all three sites were geographically and academically equal, these students are still being treated quite differently than those admitted earlier.

I see what you did there 🙄. In fairness, not sure whether that was intentional or not, but I definitely laughed when I read it.

I believe the system is best for students -- it allows students to make an educated decision about whether to attend with full knowledge of what the next four years hold. My argument about the equal quality of clinical sites was merely to point out that it's not a bad system since there are no "bad" choices. However, you're right that waitlisted students are not given a choice at all, and that's not fair -- that said, neither is life. We don't really get a choice when it comes to residency, either. You can either rank or not rank, and the rest is history. That's real life, unfortunately, as much as higher education would have us believe that everything is decided according to a utilitarian sense of fairness. I think that it would be equally unfair for me to make a decision to attend UAB and buy a condo (which I did) and then in two years have someone flip a coin and decide I had to sell my condo and move for at least a year.

I've much love for UAB, but this system always seemed awkward and is purportedly a source of hurt feelings and drama every year. When I applied, the whispered advice from upperclassmen was to indicate only one site preference, lest you get sorted to your #2 or #3 before all others who gave a single preference.

It's definitely awkward -- I don't disagree with you there. There are lots of rumors and half-truths and the system isn't entirely transparent with regard to regular decision applicants as to how to rank your choices. That said, I still believe it's to the students' advantage.

 

[ArcGurren]

I see what you did there 🙄. In fairness, not sure whether that was intentional or not, but I definitely laughed when I read it.

I believe the system is best for students -- it allows students to make an educated decision about whether to attend with full knowledge of what the next four years hold. My argument about the equal quality of clinical sites was merely to point out that it's not a bad system since there are no "bad" choices. However, you're right that waitlisted students are not given a choice at all, and that's not fair -- that said, neither is life. We don't really get a choice when it comes to residency, either. You can either rank or not rank, and the rest is history. That's real life, unfortunately, as much as higher education would have us believe that everything is decided according to a utilitarian sense of fairness. I think that it would be equally unfair for me to make a decision to attend UAB and buy a condo (which I did) and then in two years have someone flip a coin and decide I had to sell my condo and move for at least a year.



It's definitely awkward -- I don't disagree with you there. There are lots of rumors and half-truths and the system isn't entirely transparent with regard to regular decision applicants as to how to rank your choices. That said, I still believe it's to the students' advantage.

Um, what...

There is a difference between ranking residency spots based upon what places will take you and which ones you think you have the best chance of getting into, versus automatically herding all waitlist students into a different category for no other reason than the fact that they were waitlisted.

Sure, life has hard decisions, but this is an unnecessary poor decision.

 

[stickyfingers]

Um, what...

There is a difference between ranking residency spots based upon what places will take you and which ones you think you have the best chance of getting into, versus automatically herding all waitlist students into a different category for no other reason than the fact that they were waitlisted.

Sure, life has hard decisions, but this is an unnecessary poor decision.

I think it sounds like there's been a miscommunication. I took the original post to mean that there was a new waitlist created before 3rd year after all the clinical spots were filled. From that list, students were assigned randomly to open clinical sites. I did NOT take it to mean that students who had been admitted off the waitlist prior to matriculating were disregarded in terms of their clinical rotation preference.

 

[123165]

Ours is electronic. Students submit their top 6 choices. Additionally, before the electronic lottery, students can submit letters to their #1 choice. The director of each site has the option to take half their students from this letter (each student can write a letter to their #1 choice). After the spots are selected by letters, the remaining students go into the electronic match.

Students are randomly chosen by computer, and if their first choice is available, they get it, otherwise it moves to their second choice. If that spot is taken, it moves to 3rd, an so on. This proceeds until all the students have been accounted for. The computer does this 10 times, and selects the attempt that gave the most students one of their top 3.

Some students will not get there top 3, or occasionally not match at all. These students can retain their selected spot, or go into a scramble of the remaining spots.

I believe this system is extremely fair.

Why would you have the need to do something else with waitlisted students? It makes no sense.

 

[MossPoh]

Rotation site selection has been a hot topic at my school for the last few years. For my class, they did a "mini-match" where we ranked our locales and then wrote essays explaining why we wanted each site. Then a group of administrative people went through and determined it.We were allowed to enter as a group where we'd get a less popular locale or individually. We all got our envelopes and opened at the same time. While a cute idea, I think it is destined for failure.

I offered to write a basic program for my school for the lottery system. My goal was to eliminate the human element of the decisions and the manipulating and gaming for positions. It was really simple. You submit your rank list. Every rank is weighted (i.e., a certain number of marbles in the pot) and then the computer just assigns each person from that. There could then be an open trade period where you put your name on the list and if someone wants a mutual trade, you can do it. Simple and nobody to blame. (There is also a promise that no money was exchanged, which hinges on honesty)

I've never been a big fan of exemptions (excluding extraordinary circumstances like a dying family member or splitting kids from their parents). The reason is that I think you accept the risk associated with where you end up for rotations by attending that school. I don't care if you bought a condo in a certain location because you thought you'd live there. Shouldn't have bought that friggin condo.

 

[123165]

Rotation site selection has been a hot topic at my school for the last few years. For my class, they did a "mini-match" where we ranked our locales and then wrote essays explaining why we wanted each site. Then a group of administrative people went through and determined it.We were allowed to enter as a group where we'd get a less popular locale or individually. We all got our envelopes and opened at the same time. While a cute idea, I think it is destined for failure.

I offered to write a basic program for my school for the lottery system. My goal was to eliminate the human element of the decisions and the manipulating and gaming for positions. It was really simple. You submit your rank list. Every rank is weighted (i.e., a certain number of marbles in the pot) and then the computer just assigns each person from that. There could then be an open trade period where you put your name on the list and if someone wants a mutual trade, you can do it. Simple and nobody to blame. (There is also a promise that no money was exchanged, which hinges on honesty)

I've never been a big fan of exemptions (excluding extraordinary circumstances like a dying family member or splitting kids from their parents). The reason is that I think you accept the risk associated with where you end up for rotations by attending that school. I don't care if you bought a condo in a certain location because you thought you'd live there. Shouldn't have bought that friggin condo.

I totally agree about the exceptions. The only one we may have, is if you have a spouse from a previous year at a certain site, but I am not sure that is an absolute exception.

 

[tehdude]

I'm curious how far clinicals are spread out at most schools. It seems at mine, about 70% of the class will have to move at least a couple hours away for part or all of their rotations.

 

[Rollo]

I'm curious how far clinicals are spread out at most schools. It seems at mine, about 70% of the class will have to move at least a couple hours away for part or all of their rotations.

For us, I'd say roughly 70% of us stay in Philly for majority of our rotations give or take couple months here and there. Even then, those away rotations are all roughly 2 hours from Philly and they all provide housing with few exceptions.

 

[SouthernSurgeon]

This all makes me very glad I went to a school where we did 90+% of our rotations at the University hospital and no one got shafted trying to find adequate rotation sites.

 

[lildave2586]

I've never been a big fan of exemptions (excluding extraordinary circumstances like a dying family member or splitting kids from their parents).

*

 

[2012mdc]

I'm curious how far clinicals are spread out at most schools. It seems at mine, about 70% of the class will have to move at least a couple hours away for part or all of their rotations.

Outside of 3 weeks where we do rural medicine all of our time is in the metro area