Insight on clinical education

[fldoctorgirl]

I know that these threads have been posted a lot, and I've gone through what feels like a million of them, but I'm looking for some up-to-date info (a lot of threads on this topic are super old). Also, the search function on SDN is not the most helpful when it comes to looking for specific info on particular schools.

In short, I know that one of the biggest stigmas against DO schools is their clinical education, mainly because many of them utilize mostly preceptor-based rotations. I know that this varies greatly between schools. In particular, the schools I am interested in finding out about are KCU, RVU, and DMU (my top choices out of the schools I have IIs at so far).

If you could, I would appreciate it if you could share with me your experiences on clinical rotations thus far at your DO school (even if it isn't one of the three I mentioned). If you're still pre-clinical but have heard feedback from friends/classmates, that works too.

Specifically, can anyone address how likely it is to have majority preceptor-based rotations at these 3 schools? Also, if anyone can share their personal experience with preceptor-based rotations, and whether or not you felt it hindered your medical education.

Again, I know this has been a much discussed topic on SDN. It's really important to me to pick the school I want to go to for the right reasons, and a large part of that includes the quality of the clinical education.

I'm going to tag some people who I know are knowledgable about the DO world.... @Goro @AnatomyGrey12 @AlteredScale (I know there are more of you but I had 3 exams this week and can't think lol; no pressure to respond if you don't feel like it)

I appreciate you all and any input you can give

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[fldoctorgirl]

Totally meant to post this in the Med Student - DO forum. If a mod could possibly move it, that would be nice......

 

[Goro]

Best to ask the question in the school-specific forums, and the rotations forum.

 

[ananasmed]

Take my thoughts with a grain of salt as I'm just a third year student

I don't go to one of those 3 schools, but I can tell you that this is going to be highly variable even within a given school. I go to a DO school that is known for "good" clinical rotations, even then there are some less-than-stellar rotations. Not everyone gets their top choices for sites/preceptors, and on top of that, not everyone knows what they want or what would be best for them. Things can change suddenly and your rotations might get changed.

Some rotations/specialties are more conducive to preceptor based learning than others. I've had one preceptor based rotation so far (no residents) and I didn't feel like it was a problem or that I learned more in my other rotations, during which I worked with residents. Sometimes you get terrible residents who ignore you and you wish you could be one-on-one with an attending so you might actually learn instead of having to be 100% self-directed. Maybe those residents are just having a bad month, and the students who go to that site the following block will have a great experience. You just never know.

I think, as with most things in life, a healthy mix is ideal. It's important to do wards based rotations where you work with residents and learn how to function in that setting, so you're prepared to be competent as a fourth year student and as an intern. It can also be nice to work more closely with an attending who might give you a little more personal attention and mentorship. As long as you're getting mostly inpatient experience, and working with residents a fair amount through your 3rd year, don't sweat a few preceptor based rotations. I know it's practically a dirty word on SDN, but real life is a bit different.

The three schools you are deciding between will give you a good education. There will almost certainly be times, at any of those schools or others, that you'll feel frustrated about some aspect of your curriculum, your rotations, etc. And you can't predict all of that or change it. Ultimately, I believe you will be prepared for residency if you are putting in the work along the way at any of those schools. Good luck with your choice, and congrats!

 

[fldoctorgirl]

Take my thoughts with a grain of salt as I'm just a third year student

I don't go to one of those 3 schools, but I can tell you that this is going to be highly variable even within a given school. I go to a DO school that is known for "good" clinical rotations, even then there are some less-than-stellar rotations. Not everyone gets their top choices for sites/preceptors, and on top of that, not everyone knows what they want or what would be best for them. Things can change suddenly and your rotations might get changed.

Some rotations/specialties are more conducive to preceptor based learning than others. I've had one preceptor based rotation so far (no residents) and I didn't feel like it was a problem or that I learned more in my other rotations, during which I worked with residents. Sometimes you get terrible residents who ignore you and you wish you could be one-on-one with an attending so you might actually learn instead of having to be 100% self-directed. Maybe those residents are just having a bad month, and the students who go to that site the following block will have a great experience. You just never know.

I think, as with most things in life, a healthy mix is ideal. It's important to do wards based rotations where you work with residents and learn how to function in that setting, so you're prepared to be competent as a fourth year student and as an intern. It can also be nice to work more closely with an attending who might give you a little more personal attention and mentorship. As long as you're getting mostly inpatient experience, and working with residents a fair amount through your 3rd year, don't sweat a few preceptor based rotations. I know it's practically a dirty word on SDN, but real life is a bit different.

The three schools you are deciding between will give you a good education. There will almost certainly be times, at any of those schools or others, that you'll feel frustrated about some aspect of your curriculum, your rotations, etc. And you can't predict all of that or change it. Ultimately, I believe you will be prepared for residency if you are putting in the work along the way at any of those schools. Good luck with your choice, and congrats!

Thanks so much for taking the time to write this all out!

I really appreciate your insight...I think you hit the nail on the head with what I'm more concerned about when you mentioned inpatient experience. I think that is more my worry than having preceptor-based rotations: I want to be able to be in an inpatient setting, rather than floating around from clinic to clinic. I made an assumption that preceptor-based rotations were mostly outpatient, which may be wrong.

Thank you

 

[kubyx]

I think it's easy to lose sight of this, but even MD schools have subpar rotations. There's a well-regarded state MD school near me that rotates students at an understaffed and run down Medicaid clinic. I've talked to a few students and they all have the same grumblings of a rotation where they see and do very little because no one has time for them. Just the name of the game.

 

[ananasmed]

Thanks so much for taking the time to write this all out!

I really appreciate your insight...I think you hit the nail on the head with what I'm more concerned about when you mentioned inpatient experience. I think that is more my worry than having preceptor-based rotations: I want to be able to be in an inpatient setting, rather than floating around from clinic to clinic. I made an assumption that preceptor-based rotations were mostly outpatient, which may be wrong.

Thank you

Right, you can have inpatient preceptor-based rotations... preceptor doesn't necessarily equate to outpatient/clinic. It's good to have some outpatient, too, but you're right to think that it's important to consider how much will be outpatient vs. inpatient.

 

[deleted462159]

I recently heard an MD school dean (I'm sure it holds for DO schools) comment that it is getting increasingly difficult to place students at sites. Due to reimbursement changes, provider organizations have less time to care for patients, and even less time to teach students. Plus, due to patient safety concerns, there is more supervision and less clinical decision-making for students. The dean believes students are graduating less prepared.