M3 rotations question

[Deecee2DO]

Hey so Im an M2 and we have to rank our hub sites for rotations next year. So every week for past several weeks we have had each hospital come in to present to us what makes theirs great and there is an M3 rep there that talks about their experience at that particular spot. The general vibe I am getting is that the students that are at a rotation site with minimal to no residents hype up the fact that they get tons of attention and autonomy as med students since they are treated as “residents”. As I formulate my rank list since its a lottery what should I make priority in choosing these? Ideally I want a site closest to home so I can live at home for 2 yrs and potentially save thousands of dollars. Does the lack of residents/increased autonomy at a site actually improve clinical experience or is this all BS? Should I be looking at the faculty/attendings at each site and how connected they are in the fields I am interested in?

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[Roxas]

That's all bollocks. You definitely want to be at a site with residents.

 

[Dr. Death]

Hey so Im an M2 and we have to rank our hub sites for rotations next year. So every week for past several weeks we have had each hospital come in to present to us what makes theirs great and there is an M3 rep there that talks about their experience at that particular spot. The general vibe I am getting is that the students that are at a rotation site with minimal to no residents hype up the fact that they get tons of attention and autonomy as med students since they are treated as “residents”. As I formulate my rank list since its a lottery what should I make priority in choosing these? Ideally I want a site closest to home so I can live at home for 2 yrs and potentially save thousands of dollars. Does the lack of residents/increased autonomy at a site actually improve clinical experience or is this all BS? Should I be looking at the faculty/attendings at each site and how connected they are in the fields I am interested in?

It is almost all BS. Go to a place with residents and you'll be better equipped for residency. The counter will always be that you aren't likely to have as good a surgical experience. You'll hear your classmates brag that they first assisted everything. Truth is that if you are going into a surgical field you are going to suck as an intern no matter how many cases you first assisted as a med student.

 

[Deecee2DO]

It is almost all BS. Go to a place with residents and you'll be better equipped for residency. The counter will always be that you aren't likely to have as good a surgical experience. You'll hear your classmates brag that they first assisted everything. Truth is that if you are going into a surgical field you are going to suck as an intern no matter how many cases you first assisted as a med student.

Out of curiosity why would more residents make you more equipped for residency vs having an attending all to yourself and having more of their time to teach you if there werent any residents? Are the residents just more willing to teach and care more? Thank you for your response

 

[Deecee2DO]

That's all bollocks. You definitely want to be at a site with residents.

What is the reasoning if you dont mind explaining?

 

[Roxas]

Out of curiosity why would more residents make you more equipped for residency vs having an attending all to yourself and having more of their time to teach you if there werent any residents? Are the residents just more willing to teach and care more? Thank you for your response

What is the reasoning if you dont mind explaining?

Learning from an attending as an M3 is like trying to go from point A to point D. Your goal as a medical student is to learn how to be an intern and a resident, not necessarily to practice exactly like an attending. There's a lot of thought that goes in to being able to present a patient, formulate a coherent A/P, and write a good note. All of it is necessary learning during residency to make a good attending, but at a certain point the attending doesn't do those things anymore. They're stepping stones the attending has now passed. You'll likely miss out on some of those stepping stones.

In addition, generally attendings in academics should have at least some interest in teaching given that it's part of their job. Some suck, but generally it's why they're there. You're going to be amazed at how many attendings in the outpatient or community setting have exactly zero interest in you or your education, and are only taking you because the school begged them to in order to place all of their students. All they want is to get through their day and you are an obstacle. It sucks, but it's how it is. There's already an appalling amount of shadowing as a medical student in a teaching hospital, and several fold moreso in community settings.

The resident interest in teaching can vary, but it's much more likely you'll do more and be involved in the team with residents. You'll thank me when you hit your subi's and already know the general flow of a workday in a residency program, rather than tackling that steep learning curve on top of everything else while trying to be impressive.

 

[Deecee2DO]

Learning from an attending as an M3 is like trying to go from point A to point D. Your goal as a medical student is to learn how to be an intern and a resident, not necessarily to practice exactly like an attending. There's a lot of thought that goes in to being able to present a patient, formulate a coherent A/P, and write a good note. All of it is necessary learning during residency to make a good attending, but at a certain point the attending doesn't do those things anymore. They're stepping stones the attending has now passed. You'll likely miss out on some of those stepping stones.

In addition, generally attendings in academics should have at least some interest in teaching given that it's part of their job. Some suck, but generally it's why they're there. You're going to be amazed at how many attendings in the outpatient or community setting have exactly zero interest in you or your education, and are only taking you because the school begged them to in order to place all of their students. All they want is to get through their day and you are an obstacle. It sucks, but it's how it is. There's already an appalling amount of shadowing as a medical student in a teaching hospital, and several fold moreso in community settings.

The resident interest in teaching can vary, but it's much more likely you'll do more and be involved in the team with residents. You'll thank me when you hit your subi's and already know the general flow of a workday in a residency program, rather than tackling that steep learning curve on top of everything else while trying to be impressive.

Makes a lot of sense. thanks for your input

 

[Roxas]

Makes a lot of sense. thanks for your input

Happy to help. And good luck with your lottery/rank list 🙂

 

[Espressso]

At my school, it was shocking me how many classmates preferred to go to the locations that had 0 resident exposures simply due to the "you get to do more!!" schtick.

 

[AnatomyGrey12]

Truth is that if you are going into a surgical field you are going to suck as an intern no matter how many cases you first assisted as a med student.

Especially since most people don't seem to realize that interns don't really go to the OR at most surgery programs. It's all floor work.

Out of curiosity why would more residents make you more equipped for residency vs having an attending all to yourself and having more of their time to teach you if there werent any residents? Are the residents just more willing to teach and care more? Thank you for your response

There's a lot of thought that goes in to being able to present a patient, formulate a coherent A/P, and write a good note. All of it is necessary learning during residency to make a good attending, but at a certain point the attending doesn't do those things anymore. They're stepping stones the attending has now passed. You'll likely miss out on some of those stepping stones.

This. And I know people are always like, "well you pick it up quick after doing one rotation at an academic center!" but I would greatly caution to not think like that. I've been on service with auditioners on almost every rotation so far, and they have all been on multiple others before coming, and it's pretty easy to pick out who is still learning how to function as part of a resident led team. Obviously a few do pick it up quickly and do just fine, but a lot of them don't and it shows. It's kind of awkward when the 3rd year is better at presenting than the auditioner. There are definitely ways to make up for this deficit if you don't have access to these types of rotations, but if you have that opportunity I would take it.

 

[Roxas]

It's kind of awkward when the 3rd year is better at presenting than the auditioner.

Nice humblebrag bro 😎



😛

 

[AnatomyGrey12]

Nice humblebrag bro 😎



😛

Lmao, that was unintentional. I wasn't thinking of myself when I wrote that.

 

[Doctor_Strange]

I'm at a site w/o residents. It is honestly demoralizing the level of apathy I see and deal with on most of my rotations. Some docs are well-intentioned, but others do not care. And I don't blame them most of the time. I chose to pick a site that was in my hometown so that I could live at home and decrease costs especially since my parents are going through some financial hardships. In hindsight, it was a mistake I think. A few of my friends at other sites, especially those w/ residents, seem to enjoy not only stronger clerkships, but better teaching. None of my NBME shelf scores have been above average and that is likely related to my sh**ty rotations.

Now, I have worked it out to my own personal benefit in that I am interested in EM, and, for instance, during my psychiatry rotation we were assigned to the facility and were expected to float between different docs. I rotated w/ a doc who I knew personally who he gave me autonomy (did my own H&Ps, etc.) for three days only. He did my evaluation. The rest of the rotation I either took off or went in to a local ED w/ an adjunct faculty attending and did like 9 shifts or so. During my Surgery rotation, I split a 4 week with an anesthesiologist I was also friendly w/. Unsurprisingly, those encounters have been my favorites. The rest of my M3 so far has been average to below average to terrible. I did my pediatrics rotation in an outpatient setting and the doc would only let me do a PE on the patient, never let me do my own H&P. Nice guy, but pretty average rotation.

Don't fall into the same trap that I convinced myself. Go to a site w/ residents. I had told myself the same, but at the last minute, decided to come home for better weather, comfort, and familiarity. I would say it has largely been a misfire, but I try to remain optimistic in that I have more free time for wellness and that most of M3 for most people in the DO world is not great relative to MDs and even for MDs, it's not all sunshine and roses (especially for Carib folks). Glorified shadowing is part of the game, just much more prevalent for DOs (not only in my experience, but based off SDN, reddit, and speaking w/ classmates). I should have gone w/ my gut because I had a decent shot at ranking and matching at a program w/ a few residencies, but also a well-established system that had been taking students. I'm grateful, though, I have a good Step 1 score (243), that will hopefully negate the bumps I expect to endure during M4 auditions if I choose to do something outside of EM or anesthesiology. But, in short, I think this will hurt me.

/rant

edit: But to again reiterate and help answer your question: go to a place w/ residents. I would rather not do much during third year, but learn, than do scut work and not learn. I felt I did a lot of scut work on my Surg rotation, didn't really learn about processes or pathology. That's my 2 cents. Ideally, you go somewhere where you do stuff and also learn, but -- and I say this only based off my friend who attends a respectable MD school w/ a great hospital w/ a ton of residents -- that even MD students do their fair share of shadowing, but they have better didactics (eg. weekly conference etc.).

 

[SOOyC52H1Sof]

Go to a site with residents. It's my biggest regret.

Sent from my SM-N950U1 using Tapatalk

 

[Deecee2DO]

Thank you all for your insight. Looks like I will be trying for a site with residents

 

[BorntobeDO?]

If there is a considerable cost saving I might just dothe cheap one and schedule an away at a FM program that lets 3rd years come. They are out there, especially old DO residencys.

 

[Sardonix]

While I am not AT ALL saying places without residents are superior, to play devils advocate here: half our class rotates at places with residents and I hear just as much complaining as those who go to places without them. Some of our students going into the same specialties as me were truly miserable.

The grass is always greener, beauty is in the eye of the beholder etc.

 

[Deecee2DO]

If there is a considerable cost saving I might just dothe cheap one and schedule an away at a FM program that lets 3rd years come. They are out there, especially old DO residencys.

thanks for the insight but why FM?

 

[Doctor_Strange]

While I am not AT ALL saying places without residents are superior, to play devils advocate here: half our class rotates at places with residents and I hear just as much complaining as those who go to places without them. Some of our students going into the same specialties as me were truly miserable.

The grass is always greener, beauty is in the eye of the beholder etc.

As one of my fourth years bluntly put when I asked what should I look for when ranking a site: "They all suck." LOL

 

[hallowmann]

Another big draw to programs with residencies which I think people fail to realize is as a safety net. If you have a bump in the road, fail an exam, the PE etc., then you'll have a residency familiar with you that you can fall back on. People who know you would be much more willing to take a chance in spite of red flags. In addition, you have people affiliated with GME that can write you LORs.

This was a big draw. In the end it was unnecessary, but I know a handful of classmates that were glad they rotated with residents for this exact reason.

 

[Oh_Gee]

While I am not AT ALL saying places without residents are superior, to play devils advocate here: half our class rotates at places with residents and I hear just as much complaining as those who go to places without them. Some of our students going into the same specialties as me were truly miserable.

The grass is always greener, beauty is in the eye of the beholder etc.

what are their complaints?

 

[Espressso]

While I am not AT ALL saying places without residents are superior, to play devils advocate here: half our class rotates at places with residents and I hear just as much complaining as those who go to places without them. Some of our students going into the same specialties as me were truly miserable.

The grass is always greener, beauty is in the eye of the beholder etc.

Well, yeah people will complain regardless of the situation. The point here is that rotating at sites with residents better sets you up for fourth year sub-i's and intern year in general. The students complaining about whatever they're complaining about is probably unrelated to that? The important part is to better prep yourself during third year and I think you get that if you have more exposure with residents and actual teaching. Rather than preceptors who don't really care.

 

[Sardonix]

what are their complaints?

Well, yeah people will complain regardless of the situation. The point here is that rotating at sites with residents better sets you up for fourth year sub-i's and intern year in general. The students complaining about whatever they're complaining about is probably unrelated to that? The important part is to better prep yourself during third year and I think you get that if you have more exposure with residents and actual teaching. Rather than preceptors who don't really care.

"I don't get to do any actual patient care."

"I can't see anything happening during surgery."

"All I do is stand in a corner."

"My residents are jerks who make me only do scutwork and don't teach."

"My attending has no idea who I am."

Again, not advocating that rotating at places without residents is BETTER... but I find it hilarious that residents must be present to have a good learning experience while I have classmates complaining about large academic rotations in 3rd year for those same reasons. My overall view is if you are going into a competitive specialty like surgery or gunning for premiere academic IM, yeah, you'll want to be at a big institution simply because you NEED to see the different pathology and hierarchy learning systems because that's what you'll be doing for the next several years.

If you're an average student who wants to do general FM/IM/EM/Peds/Psych... no one cares if you didn't have residents in 3rd year. It is not the end of the world in any capacity.

 

[Chibucks15]

"I don't get to do any actual patient care."

"I can't see anything happening during surgery."

"All I do is stand in a corner."

"My residents are jerks who make me only do scutwork and don't teach."

"My attending has no idea who I am."

Again, not advocating that rotating at places without residents is BETTER... but I find it hilarious that residents must be present to have a good learning experience while I have classmates complaining about large academic rotations in 3rd year for those same reasons. My overall view is if you are going into a competitive specialty like surgery or gunning for premiere academic IM, yeah, you'll want to be at a big institution simply because you NEED to see the different pathology and hierarchy learning systems because that's what you'll be doing for the next several years.

If you're an average student who wants to do general FM/IM/EM/Peds/Psych... no one cares if you didn't have residents in 3rd year. It is not the end of the world in any capacity.

To add to this, unless you're socially inept and have never been on a team before, it really isn't THAT hard to assimilate into your role on the team. A mix of both seems to be an ideal solution because you get more personalized experiences with an attending (which then leads to a better letter, even if its not a super big shot name) and you get to do more things. There isn't a hard and fast rule though, as much as SDN loves to make huge generalized comments about every preceptor in the country in one sentence

 

[vin5cent0]

"I don't get to do any actual patient care."

"I can't see anything happening during surgery."

"All I do is stand in a corner."

"My residents are jerks who make me only do scutwork and don't teach."

"My attending has no idea who I am."

Again, not advocating that rotating at places without residents is BETTER... but I find it hilarious that residents must be present to have a good learning experience while I have classmates complaining about large academic rotations in 3rd year for those same reasons. My overall view is if you are going into a competitive specialty like surgery or gunning for premiere academic IM, yeah, you'll want to be at a big institution simply because you NEED to see the different pathology and hierarchy learning systems because that's what you'll be doing for the next several years.

If you're an average student who wants to do general FM/IM/EM/Peds/Psych... no one cares if you didn't have residents in 3rd year. It is not the end of the world in any capacity.

I have heard this as well, and it makes it hard to know who is right - Is all of the complaining on here about DO rotations sucking legitimate, or is it more of the typical anti-DO SDN stuff that is hard to separate out? I'm assuming it's probably a little bit of both. I talked with two 3rd years at my school pretty extensively before choosing my site for next year, both of them told me they learned a lot more on their preceptor-based rotations and that their rotations with residents netted them very little actual work. I'm assuming at this point that a good mix of the two is ideal, but I guess I'll find out next year.

 

[sab3156]

I have heard this as well, and it makes it hard to know who is right - Is all of the complaining on here about DO rotations sucking legitimate, or is it more of the typical anti-DO SDN stuff that is hard to separate out? I'm assuming it's probably a little bit of both. I talked with two 3rd years at my school pretty extensively before choosing my site for next year, both of them told me they learned a lot more on their preceptor-based rotations and that their rotations with residents netted them very little actual work. I'm assuming at this point that a good mix of the two is ideal, but I guess I'll find out next year.

One major problem with listening to 3rd years and 4th years review their rotation sites is that they probably don't even realize how little they learned or how poorly prepared they are.

There is a reason why the vast majority of the ACGME world sets up clinical training the way they do. The reason DO schools are stuck with mainly preceptor based settings in random places isn't because they think it's a great educational experience - unfortunately, it's just that DO schools can't do any better than that.

 

[Dr.Bruh]

One major problem with listening to 3rd years and 4th years review their rotation sites is that they probably don't even realize how little they learned or how poorly prepared they are.

There is a reason why the vast majority of the ACGME world sets up clinical training the way they do. The reason DO schools are stuck with mainly preceptor based settings in random places isn't because they think it's a great educational experience - unfortunately, it's just that DO schools can't do any better than that.

Def best to ask recently matched student. I’ve talked to a lot of KCU 4th years applying and recently matched they rotated in KC. Lots of solid matches. Same for those at but teaching hospital sites. But idk how kids in the rural sites are matching in comparison. Be interested to see

 

[vin5cent0]

One major problem with listening to 3rd years and 4th years review their rotation sites is that they probably don't even realize how little they learned or how poorly prepared they are.

There is a reason why the vast majority of the ACGME world sets up clinical training the way they do. The reason DO schools are stuck with mainly preceptor based settings in random places isn't because they think it's a great educational experience - unfortunately, it's just that DO schools can't do any better than that.

Yeah, those are fair points. It's insane to me that a school as established as KCU seems unprepared preceptor-wise for our enormous class size. Literally to the point where they're letting us find our own 3rd year sites, which they say is for our benefit, but just seems like a way for them to get us to find them additional sites for them.

 

[AnatomyGrey12]

but I find it hilarious that residents must be present to have a good learning experience

No one ever said that....

To add to this, unless you're socially inept and have never been on a team before, it really isn't THAT hard to assimilate into your role on the team.

You would think, but unfortunately this has not been the case from what I've seen with auditioners across a number of specialties. I caution anyone against simply thinking, "oh I'll just pick it up right quick" because there are people who think they are picking it up, when in reality while they are "picking it up" the residents are fawning over the student who came in with it already picked up and is truly acting in a sub-internship role. Guess which student the residents go tell the PD they really like and want to heavily consider for their program? I've literally seen this situation play out with my own eyes.

 

[Dr. Death]

I have heard this as well, and it makes it hard to know who is right - Is all of the complaining on here about DO rotations sucking legitimate, or is it more of the typical anti-DO SDN stuff that is hard to separate out? I'm assuming it's probably a little bit of both. I talked with two 3rd years at my school pretty extensively before choosing my site for next year, both of them told me they learned a lot more on their preceptor-based rotations and that their rotations with residents netted them very little actual work. I'm assuming at this point that a good mix of the two is ideal, but I guess I'll find out next year.

Speaking as a 4th year coming from a school where clinical rotations were supposed to be a "strength," I can tell you that DO rotations are very poor. I did a sub-i at a large ACGME university medical center and picked the brains of the MS3s about their rotations. It isn't even close to the same quality. My school has it's own hospital with it's own residencies and has hundreds of preceptors in the community that take medical students and our rotations can't hold a candle to the experience they got at the MD school.

Anecdotally, when I was a 3rd year on my surgery rotation we had one auditioner who had done his 3rd year rotation with a preceptor. He was clueless how to present patients or work as part of the resident team. He could suture as well as an intern but nobody GAF about that when he bumbled and fumbled through his patient presentations as bad or worse than the third years. He failed to match but that is beside the point, his 3rd year rotations poorly prepared him for his 4th year rotations and if he had matched in surgery he would have been a crap intern.

 

[Leo260]

Yeah, those are fair points. It's insane to me that a school as established as KCU seems unprepared preceptor-wise for our enormous class size. Literally to the point where they're letting us find our own 3rd year sites, which they say is for our benefit, but just seems like a way for them to get us to find them additional sites for them.

Sorry to derail the thread a little bit, but is there any possibility that this can be used to our advantage? Incoming student here with several-year work experience at an academic institution that collaborates closely with the IM residency coordinator, so I know how important this topic is despite the info that DO schools tout with preceptorships. Just wondering how (if at all) feasible it is for KCU students to potentially set up 3rd-year rotations at an AGCME center/someplace with residents through this seemingly DIY route. Sounds like an immensely ginormous pain in the ass to set up but quality rotations are really important to me if given the option.

 

[AnatomyGrey12]

Sorry to derail the thread a little bit, but is there any possibility that this can be used to our advantage? Incoming student here with several-year work experience at an academic institution that collaborates closely with the IM residency coordinator, so I know how important this topic is despite the info that DO schools tout with preceptorships. Just wondering how (if at all) feasible it is for KCU students to potentially set up 3rd-year rotations at an AGCME center/someplace with residents through this seemingly DIY route. Sounds like an immensely ginormous pain in the ass to set up but quality rotations are really important to me if given the option.

Most places simply won't let outside students do 3rd year core rotations with them unless there is some pre-existing contract with the school. So no, you can't just like do the 3rd year rotations with the students at KU for example.

 

[fldoctorgirl]

Sorry to derail the thread a little bit, but is there any possibility that this can be used to our advantage? Incoming student here with several-year work experience at an academic institution that collaborates closely with the IM residency coordinator, so I know how important this topic is despite the info that DO schools tout with preceptorships. Just wondering how (if at all) feasible it is for KCU students to potentially set up 3rd-year rotations at an AGCME center/someplace with residents through this seemingly DIY route. Sounds like an immensely ginormous pain in the ass to set up but quality rotations are really important to me if given the option.

It seems like a huge pain in the ass, like you said. The school does zero of the work and makes you do everything..you pretty much have to reach out to people and guarantee you'll have a rotation in every single required field. As mentioned, a place like KU isn't going to take KCU students just because they ask. Also, what happens if one of your rotations doesn't pan out a month before? You're left scrambling trying to find a replacement. This "DIY" thing seemed really weird to me since the work to set it up falls 100% on you. I would stick with the established rotation sites, unless you are somehow really connected at a good place and know they won't screw you last minute, because at least you're not responsible for anything then.

 

[AnatomyGrey12]

Sorry to derail the thread a little bit, but is there any possibility that this can be used to our advantage? Incoming student here with several-year work experience at an academic institution that collaborates closely with the IM residency coordinator, so I know how important this topic is despite the info that DO schools tout with preceptorships. Just wondering how (if at all) feasible it is for KCU students to potentially set up 3rd-year rotations at an AGCME center/someplace with residents through this seemingly DIY route. Sounds like an immensely ginormous pain in the ass to set up but quality rotations are really important to me if given the option.

Most places simply won't let outside students do 3rd year core rotations with them unless there is some pre-existing contract with the school. So no, you can't just like do the 3rd year rotations with the students at KU for example.

 

[Leo260]

Most places simply won't let outside students do 3rd year core rotations with them unless there is some pre-existing contract with the school. So no, you can't just like do the 3rd year rotations with the students at KU for example.

Most places simply won't let outside students do 3rd year core rotations with them unless there is some pre-existing contract with the school. So no, you can't just like do the 3rd year rotations with the students at KU for example.

It seems like a huge pain in the ass, like you said. The school does zero of the work and makes you do everything..you pretty much have to reach out to people and guarantee you'll have a rotation in every single required field. As mentioned, a place like KU isn't going to take KCU students just because they ask. Also, what happens if one of your rotations doesn't pan out a month before? You're left scrambling trying to find a replacement. This "DIY" thing seemed really weird to me since the work to set it up falls 100% on you. I would stick with the established rotation sites, unless you are somehow really connected at a good place and know they won't screw you last minute, because at least you're not responsible for anything then.

Thank you for the replies, I really appreciate it! Definitely helps put things in perspective, especially with the falling through scenario - that seems like a nightmare greater than what it's worth.

In terms of the KC rotation locations, do they offer wards-based for (at least) IM ??? Definitely understand what I'm signing up for with DO schools, but (already) a little frustrated how they severely lack in this aspect and trying to convince them and do something otherwise is like moving mountains, especially once you realize how important this stuff is in the real world of medicine. My institution won't offer an invite (even for a sub-i) to any student who's only done preceptor based M3 rotations in the field (which includes one of the MD schools in the city). You think that programs would start to beef up these program components....

 

[vin5cent0]

Sorry to derail the thread a little bit, but is there any possibility that this can be used to our advantage? Incoming student here with several-year work experience at an academic institution that collaborates closely with the IM residency coordinator, so I know how important this topic is despite the info that DO schools tout with preceptorships. Just wondering how (if at all) feasible it is for KCU students to potentially set up 3rd-year rotations at an AGCME center/someplace with residents through this seemingly DIY route. Sounds like an immensely ginormous pain in the ass to set up but quality rotations are really important to me if given the option.

In theory, yes, you could do that. In reality, it's a nearly impossible task to find a place that will take you for FM, IM, OB, peds, etc. You need them all. It just felt like a hail mary KCU is throwing out in case 1 or 2 students out there have extensive contacts that the school can leverage to increase its 3rd year contracts.

 

[Ho0v-man]

Yeah, those are fair points. It's insane to me that a school as established as KCU seems unprepared preceptor-wise for our enormous class size. Literally to the point where they're letting us find our own 3rd year sites, which they say is for our benefit, but just seems like a way for them to get us to find them additional sites for them.

This is appalling. What are you even paying for? Why is this considered such a great DO school, again?

To the OP, if you don’t go somewhere with residents at least in IM and/or your preferred field, your getting screwed out of your tuition. For instance, on IM we’d have weekly board review. We’d have daily afternoon lectures where they’d discuss topics way beyond what a third year should know which gives you a peek into what training in that field really means. Once per week they even asked the students what they’d like to talk about. I said once that I was having trouble with some of the questions in uworld that required me to know a little about vent settings. They got one of the pulmonologists to give a presentation and he broke it down for me. It might’ve been the first time my tuition dollars went toward my education lol. On my preceptor rotations, there’s been some pimping and some light teaching here and there but there’s no comparison.

Residents vs preceptors is literally a learning vs doing decision. There’s plenty good to be said about doing, but you’re there to learn.

 

[sab3156]

Speaking as a 4th year coming from a school where clinical rotations were supposed to be a "strength," I can tell you that DO rotations are very poor. I did a sub-i at a large ACGME university medical center and picked the brains of the MS3s about their rotations. It isn't even close to the same quality. My school has it's own hospital with it's own residencies and has hundreds of preceptors in the community that take medical students and our rotations can't hold a candle to the experience they got at the MD school.

Anecdotally, when I was a 3rd year on my surgery rotation we had one auditioner who had done his 3rd year rotation with a preceptor. He was clueless how to present patients or work as part of the resident team. He could suture as well as an intern but nobody GAF about that when he bumbled and fumbled through his patient presentations as bad or worse than the third years. He failed to match but that is beside the point, his 3rd year rotations poorly prepared him for his 4th year rotations and if he had matched in surgery he would have been a crap intern.

Exactly. Anyone who is trying to offer a bunch of positive comments about these DO rotation sites is either in denial or totally unaware of what the standards are like in ACGME teaching hospitals. I've been around tons of residents and rotating students at numerous ACGME institutions over the years. The culture and structure of these programs allows for a level of education that is simply not seen in random DO sites, even if these DO sites have residency programs. People need to realize that impressing Dr. Uncle-Joe-Never-Taught-A-Resident-Before-Ever back at Community Hospital XYZ by delivering a baby is not the same thing as dealing with polished and vastly experienced faculty at programs that have a long history of resident education. There is plenty to say about why these sites are garbage, but it's just too long of a discussion.

Like I said - there is a reason why the leaders in medical education in the ACGME world do things the way they do. Anyone who says "I got an incredible education in my DO school during 3rd year" is likely to be so uninformed that they don't know how little they know.

 

[Deecee2DO]

This is appalling. What are you even paying for? Why is this considered such a great DO school, again?

To the OP, if you don’t go somewhere with residents at least in IM and/or your preferred field, your getting screwed out of your tuition. For instance, on IM we’d have weekly board review. We’d have daily afternoon lectures where they’d discuss topics way beyond what a third year should know which gives you a peek into what training in that field really means. Once per week they even asked the students what they’d like to talk about. I said once that I was having trouble with some of the questions in uworld that required me to know a little about vent settings. They got one of the pulmonologists to give a presentation and he broke it down for me. It might’ve been the first time my tuition dollars went toward my education lol. On my preceptor rotations, there’s been some pimping and some light teaching here and there but there’s no comparison.

Residents vs preceptors is literally a learning vs doing decision. There’s plenty good to be said about doing, but you’re there to learn.

I like this post. Thanks for the input 👍

 

[Deecee2DO]

Exactly. Anyone who is trying to offer a bunch of positive comments about these DO rotation sites is either in denial or totally unaware of what the standards are like in ACGME teaching hospitals. I've been around tons of residents and rotating students at numerous ACGME institutions over the years. The culture and structure of these programs allows for a level of education that is simply not seen in random DO sites, even if these DO sites have residency programs. People need to realize that impressing Dr. Uncle-Joe-Never-Taught-A-Resident-Before-Ever back at Community Hospital XYZ by delivering a baby is not the same thing as dealing with polished and vastly experienced faculty at programs that have a long history of resident education. There is plenty to say about why these sites are garbage, but it's just too long of a discussion.

Like I said - there is a reason why the leaders in medical education in the ACGME world do things the way they do. Anyone who says "I got an incredible education in my DO school during 3rd year" is likely to be so uninformed that they don't know how little they know.

I wish you could present this post to literally every M3 at my school who says they are “treated like a resident from day one” who are rotating at some middle of nowhere hub site with no residents. They raveeee about this stuff lol

 

[Doctor_Strange]

Exactly. Anyone who is trying to offer a bunch of positive comments about these DO rotation sites is either in denial or totally unaware of what the standards are like in ACGME teaching hospitals. I've been around tons of residents and rotating students at numerous ACGME institutions over the years. The culture and structure of these programs allows for a level of education that is simply not seen in random DO sites, even if these DO sites have residency programs. People need to realize that impressing Dr. Uncle-Joe-Never-Taught-A-Resident-Before-Ever back at Community Hospital XYZ by delivering a baby is not the same thing as dealing with polished and vastly experienced faculty at programs that have a long history of resident education. There is plenty to say about why these sites are garbage, but it's just too long of a discussion.

Like I said - there is a reason why the leaders in medical education in the ACGME world do things the way they do. Anyone who says "I got an incredible education in my DO school during 3rd year" is likely to be so uninformed that they don't know how little they know.

I will say that my buddy at a PA site is getting so much surgery exposure it's nuts. The hospital does have a residency program, so it has a MD feel to it. But, point being some DO sites are at least adequate.

And after reading my post yesterday I think I was feeling sorry for msyelf. Today has been great on the L&D floor. Yeah I spent about 1 hr with a nurse, but I scrubbed in for a few cases, saw an epidural, and at least feel involved. The difference was today I took ownership of my education. I’ve been passive — if a doc doesn’t come up to me and talk then I just continue sitting and do Anki on my phone. Today I walked up to the doc and said can I scrub in? He said sure and began teaching me in the OR. Yesterday was a bit different since I had an anesthesiologist, and after expressing my interest in the specialty, blow me off. It was upsetting. Again, the ups and downs of DO clerkships which likely doesn’t go on in the MD world at least not as much...

 

[sab3156]

I wish you could present this post to literally every M3 at my school who says they are “treated like a resident from day one” who are rotating at some middle of nowhere hub site with no residents. They raveeee about this stuff lol

It's so funny but so sad. I like how they are being "treated like a resident" by attendings who have probably never taught residents before in their lives, lol. Sounds like a Caribbean medical school TV advertisement.

I will say that my buddy at a PA site is getting so much surgery exposure it's nuts. The hospital does have a residency program, so it has a MD feel to it. But, point being some DO sites are at least adequate.

The issue isn't about how much exposure you get. If exposure was what actually mattered, then everyone training with Dr. Bone-Wizard-Who-Did-Residency-In-OMM-And-Has-Never-Trained-Any-Residents in rural bumble**** would be going around impressing everyone.

The real issue is how do these programs structure themselves in a way that they are able to train the full spectrum of undergraduates and graduates.

 

[shadowlightfox]

I wish you could present this post to literally every M3 at my school who says they are “treated like a resident from day one” who are rotating at some middle of nowhere hub site with no residents. They raveeee about this stuff lol

Lol what!? There are actually M3's saying that!? I definitely don't believe that. I can definitely tell you there is a huge difference between the students and residents.

 

[NVO]

i honestly loved my no-call no-nights no-residents Monday-Friday OB and surgery rotations

 

[Deecee2DO]

Lol what!? There are actually M3's saying that!? I definitely don't believe that. I can definitely tell you there is a huge difference between the students and residents.

Swwearrrr! So many i wont name names but yes. craY

 

[Sardonix]

Again, not advocating that rotating at places without residents is BETTER... but I find it hilarious that residents must be present to have a good learning experience while I have classmates complaining about large academic rotations in 3rd year for those same reasons. My overall view is if you are going into a competitive specialty like surgery or gunning for premiere academic IM, yeah, you'll want to be at a big institution simply because you NEED to see the different pathology and hierarchy learning systems because that's what you'll be doing for the next several years.

If you're an average student who wants to do general FM/IM/EM/Peds/Psych... no one cares if you didn't have residents in 3rd year. It is not the end of the world in any capacity.

No one ever said that....

Are you just nitpicking there bud, orrrr?

That's all bollocks. You definitely want to be at a site with residents.

It is almost all BS. Go to a place with residents and you'll be better equipped for residency. The counter will always be that you aren't likely to have as good a surgical experience. You'll hear your classmates brag that they first assisted everything. Truth is that if you are going into a surgical field you are going to suck as an intern no matter how many cases you first assisted as a med student.

And that's just the stuff posted before you responded to me, let alone after the usual apocalyptic comments started rolling in.

Oh and before some wet blanket comes along and claims I'm defending crappy DO rotations, remember that I agree strong academic rotations are required for competitive specialties outside of what I said above.

 

[Roxas]

"I don't get to do any actual patient care."

"I can't see anything happening during surgery."

"All I do is stand in a corner."

"My residents are jerks who make me only do scutwork and don't teach."

"My attending has no idea who I am."

Again, not advocating that rotating at places without residents is BETTER... but I find it hilarious that residents must be present to have a good learning experience while I have classmates complaining about large academic rotations in 3rd year for those same reasons. My overall view is if you are going into a competitive specialty like surgery or gunning for premiere academic IM, yeah, you'll want to be at a big institution simply because you NEED to see the different pathology and hierarchy learning systems because that's what you'll be doing for the next several years.

If you're an average student who wants to do general FM/IM/EM/Peds/Psych... no one cares if you didn't have residents in 3rd year. It is not the end of the world in any capacity.

There are many fair criticisms of being a student at a large teaching institution. Namely, I recall working an average of 60 hours a week or more as a student. Even on rotations like FM. Contrasted to my peers who were regularly at 35-40 hours a week, it felt like I was getting shafted. Add on to that there may be a lot of scutwork, it is harder to get to know an IM or GS attending if you wanted a letter, etc. All valid complaints.

I can only extrapolate my own experience and those of my friends who did not rotate with a residency, and I stand by my assertion that all other things being equal, one of those scenarios is better. That said, there are some robust current residents who did all community rotations and they still matched really well. The truth is that it's true, all DO rotations are freaking terrible. The goal is to find something that's a little less terrible to set yourself up for what you want to do.

 

[Sardonix]

There are many fair criticisms of being a student at a large teaching institution. Namely, I recall working an average of 60 hours a week or more as a student. Even on rotations like FM. Contrasted to my peers who were regularly at 35-40 hours a week, it felt like I was getting shafted. Add on to that there may be a lot of scutwork, it is harder to get to know an IM or GS attending if you wanted a letter, etc. All valid complaints.

I can only extrapolate my own experience and those of my friends who did not rotate with a residency, and I stand by my assertion that all other things being equal, one of those scenarios is better. That said, there are some robust current residents who did all community rotations and they still matched really well. The truth is that it's true, all DO rotations are freaking terrible. The goal is to find something that's a little less terrible to set yourself up for what you want to do.

And that there is a statement I can agree with. For people who want to do FM/IM/Peds/EM/Psych, large academic rotations aren't particularly necessary for 3rd year, whereas for competitive specialties I think they're a vital asset.

 

[AnatomyGrey12]

Are you you just being pedantic there bud, orrrr?





And that's just the stuff posted before you responded to me, let alone after the usual apocalyptic comments started rolling in.

Oh and before some wet blanket comes along and claims I'm defending crappy DO rotations, remember that I agree strong academic rotations are required for competitive specialties outside of what I said above.

Lmao. Again, no one said residents must be present for a good learning experience.... did you even read what you quoted?

 

[IntheClouds4ever]

Having done both, it’s all hit or miss. Been with some ****ty residents that made the rotation excruciating and did zero teaching. I’ve been with other residents that I learned a lot with and it was a good experience. The same goes with preceptors. Had some real hands off preceptors that was nearly a vacation month, but had others that gave a “lecture” every day over lunch as well as teaching at every opportunity (I learned more about a speciality than I will ever need, but damn it, his information stuck with me when it came up at other sites). If you are going to a competitive specialty, you should probably try to get elective rotations in both settings and do your research on where you’re going to make sure itll be a good experience. If you aren’t going to anything competitive, then just do what makes your outside life easier (kids, family, money, etc)

-also, it helps to know how you like to learn. I zone out on mind-numbing traditional rounding that takes hours and is unbeneficial to my learning style. I prefer “doing”as it sticks for me and it’s cemented in my head. Just realize you need to be able to present a patient for your traditional folks and others will stop you in the middle and say cut to the chase as they want a 1 minute rundown instead of a full long winded IM presentation.Be able to do both and adapt to your surroundings.. keep Anki, UpToDate, and Sanford Guide onyour phone and you’ll be fine on nearly every rotation