More merger worries

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Nikj

Nikj

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That guy always blows everything out of proportion. Take everything in that with a pound of salt.


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Old new from our pal Norman. The sky is NOT falling.


Nikj said:
I know there are other posts, but this paper makes some good but downright scary implications for anyone in or considering going to a DO school.

http://aodme.org/wp-content/uploads/The_Unintended_Consequences_of_the_ACGME_Merger.pdf

The response from the AOA hardly addressed many of the concerns raised in the paper. Any thoughts?

Edit: I saw old posts, but I want to hear more from students who are actually feeling the affects.
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This might be me wholesale ignorance of politics but why is it so hard to expand GME? We know that there is a shortage of physicians (or a mal distribution) and mostly of primary care physicians. We see this coming problem yet we still expand the number of medical students. Has the issue not come up for discussion with our legislators? I am just confused on why nothing seems to be done with this problem.
 
Norman Gevitz is on top of being a sensationalist, is a staunch conservative who believes extraordinarily regressive notions about medical education. He's gotten recent attention for his comments in which he attempts to claim osteopathic medical education should be fundamentally based around rural and clinic based clerkships.

His position outside of the history of osteopathic medicine is largely irrelevant in my opinion.
 
AnatomyGrey12 said:
An extremely sensationalistic article.
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Drrrrrr. Celty said:
Norman Gevitz is on top of being a sensationalist, is a staunch conservative who believes extraordinarily regressive notions about medical education. He's gotten recent attention for his comments in which he attempts to claim osteopathic medical education should be fundamentally based around rural and clinic based clerkships.

His position outside of the history of osteopathic medicine is largely irrelevant in my opinion.
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Ok, it did seem a bit sensationalized, but if he's that biased then I suppose its not as bad.
 
My question is why does SDN allow pre-meds to post in the non-pre-med forums about issues/topics that they know very little about. Most current DO students who are "in the loop" know who Dr. Gevitz is and know his agenda. It's funny that this article surfaces only when pre-meds want to opine on the topic.

To the OP, if you are so concerned, read up on actual threads where current DO students have chimed in about this topic or just apply MD. only. Not that complicated.
 
You can make editorialized, ad hominem statements against Norman Gevitz if you want but he is more knowledgeable than the vast majority of us when it comes to the history of osteopathic medicine and it's still troubling that the AOA was completely incapable of actually addressing the concerns in the letter, some of which are issues that many students and physicians actually want to know about.
 
From that article:

"Last year, 500 US MD graduates
did not find residency positions after their scramble. By contrast, all DO
graduates who wanted a residency position found a residency position
because we have a safety net."

I very seriously doubt that 500 U.S. MD seniors who were actively participating in the match and SOAP failed to find a residency program.

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Ioannes Paulus said:
My question is why does SDN allow pre-meds to post in the non-pre-med forums about issues/topics that they know very little about. Most current DO students who are "in the loop" know who Dr. Gevitz is and know his agenda. It's funny that this article surfaces only when pre-meds want to opine on the topic.

To the OP, if you are so concerned, read up on actual threads where current DO students have chimed in about this topic or just apply MD. only. Not that complicated.
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I'm asking precisely because I don't know about it. Thats what the forums are for. Where else and who else am I going to ask? I want the opinions of several students who are making their way through DO school who could give more insight on the issue as the merger continues to finalize.

This article hasn't been talked about recently, and as we get closer to the merger it's important for all of us premeds to know and understand what is going on right now.

There is quite a divide among students and physicians on the outcomes of the merger, so getting input on the topic is important, and not just reading older posts that really don't address many concerns going forward.

 
cbrons said:
From that article:

"Last year, 500 US MD graduates
did not find residency positions after their scramble. By contrast, all DO
graduates who wanted a residency position found a residency position
because we have a safety net."

I very seriously doubt that 500 U.S. MD seniors who were actively participating in the match and SOAP failed to find a residency program.

Sent from my SM-N910P using SDN mobile
Click to expand...

How about looking at the data.
Look at table 15: 990 US MD seniors were unmatched
Look at table 19: 635 got positions in the SOAP.
Leaves 355 US MD graduates without a position after the SOAP.
Feel sorry for the 355.
http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

Of course, I will not be surprised if some poster now chimes in that the 355 must be bad students and bad candidates. Yes. They were so bad they managed to get through medical school.
 
jkdoctor said:
How about looking at the data.
Look at table 15: 990 US MD seniors were unmatched
Look at table 19: 635 got positions in the SOAP.
Leaves 355 US MD graduates without a position after the SOAP.
Feel sorry for the 355.
http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

Of course, I will not be surprised if some poster now chimes in that the 355 must be bad students and bad candidates. Yes. They were so bad they managed to get through medical school.
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I would be willing to guess these 355 might want to take a science year to try again because they were unwilling to do a less competitive specialty. Some might just be downright bad applicants with multiple failures.
 
I was in a program undergoing the merger / pre-accreditation process before transitioning to an ACGME one. I don't know the results since it's been about 2 years since I was last there, but I do know the initial application had to be resubmitted after many deficiencies were found. I suspect that of the 4 programs there (FP, IM, Surg, and transitional), one of them will probably shut down by 2020. The area I was at just could not support what ACGME wanted probably. That said, they claimed that all current residents would graduate and go through the DO board certification process like usual, but what about incoming interns? What about afterwards? There were a lot of questions but I was already planning my way out so I didn't pay too much attention.

I do agree with those who did feel this was inevitable, for many reasons. The biggest reason to me is that the AOA had little negotiation power to levy against the ACGME. I never understood why the ACGME didn't do this sooner (threaten to restrict DOs from MD residencies) to seize control of all GME and eliminate all specialty colleges from the DO side. Just think about the money that will be going to the ABIM after 2020 instead of the ACOI as just one factor to the massive gains that the MD accreditation bodies get. If we can count on anything, it's that people in this process want to make as much money as possible, just like any other business.
 
Imo the ACGME had all the leverage because the AOA allowed DO student enrollments to expand far beyond the number of DO residency spots. If DO students were shut out of ACGME spots then very large numbers of DO grads would be jobless.
The threat of locking them out of ACGME fellowships was a first shot across the bow.
The AOA basically surrendered after the first shot.
 
I don't want to stir the pot, but just something to consider:

Post 2020, all DO's will train in ACGME programs. Granted, DO's will be on the ACGME board of directors, but probably not represented enough to prevent any top-down agendas. And they are not currently represented in other MD governing bodies.

What's stopping the AMA/LCME/AAMC/ACGME from using this profound leverage to merge medical school accreditation? This shouldn't panic anyone but it does deserve discussion. For the sake of argument, imagine that graduating from a future LCME-accredited osteopathic medical school would earn one an MD, FAOA (Fellow of the American Osteopathic Association).
 
BurghStudent said:
What's stopping the AMA/LCME/AAMC/ACGME from using this profound leverage to merge medical school accreditation? This shouldn't panic anyone but it does deserve discussion. For the sake of argument, imagine that graduating from a future LCME-accredited osteopathic medical school would earn one an MD, FAOA (Fellow of the American Osteopathic Association).
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Is that a bad thing though? We complain about COCA nonstop.
 
starri said:
Is that a bad thing though? We complain about COCA nonstop.
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Not at all exactly. LCME accreditation has numerous benefits: a certain amount of research activity is expected at a medical school (would help osteopathic students become more competitive, a limit is set on the percent of operating budget that can be derived from tuition which we need not say more about etc...)
 
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From a DO student in M3/M4 perspective, there's some solid future gains for the profession as a whole, but some significant losses to be had initially and personally.

DOs will lose the great benefit of attempting AOA and then have a 2nd runthrough of ACGME. Losing that "safety net" as it is called is indeed a short term loss. It will hurt DO students at the lower end of the class.
Also, we now have to share our formerly DO-exclusive spots with MDs. Not really thrilling from a DO perspective, now hurting those more at the top of the class.

The gains are less of a hassle, better quality programs by virtue of losing smaller programs or less qualified programs (although I think there is a incorrect notion that smaller = inept).
 
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Just study for the USMLE and cram for the COMLEX. Nobody gives a damn about that test by 2020.
 
BurghStudent said:
I don't want to stir the pot, but just something to consider:

Post 2020, all DO's will train in ACGME programs. Granted, DO's will be on the ACGME board of directors, but probably not represented enough to prevent any top-down agendas. And they are not currently represented in other MD governing bodies.

What's stopping the AMA/LCME/AAMC/ACGME from using this profound leverage to merge medical school accreditation? This shouldn't panic anyone but it does deserve discussion. For the sake of argument, imagine that graduating from a future LCME-accredited osteopathic medical school would earn one an MD, FAOA (Fellow of the American Osteopathic Association).
Click to expand...

If the LCME took over probably 5% of existing DO programs would survive. The faculty to student ratio for most DO schools is horrendous, clinical rotations poor, research barely existent, lack of faculty mentorship.


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DocWinter said:
Also, we now have to share our formerly DO-exclusive spots with MDs. Not really thrilling from a DO perspective, now hurting those more at the top of the class.
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But you also assume that the former AOA residency will reject DO candidates for MD candidates. Given the number of IMG farms and the fact that plenty of PDs won't look at a DO application twice mean that they might still give preference to the DOs who apply?
 
starri said:
But you also assume that the former AOA residency will reject DO candidates for MD candidates. Given the number of IMG farms and the fact that plenty of PDs won't look at a DO application twice mean that they might still give preference to the DOs who apply?
Click to expand...

Some of these programs will have to do so. The ACGME requirements have some stringent research expectations and we can be honest, DO students do not compare to MD students in the realm of strong and impactful research (and you'd be fooling yourself to think otherwise).

PDs will want to recruit those who can help upkeep those research requirements.


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My thoughts. The merger is good for the future of medicine (my opinion) in general. The merger process is painful to some, especially those wanting more competitive specialties or those who are at the bottom of the class. I suspect it will eventually be NBD in 7 or 8 years. Many programs will close. Many will remain open.

Best thing any DO student can do for themselves with the merger is study for and plan to take the USMLE. Unless you're scoring <210 in practice tests a week out, I think it's worth taking it. AT LEAST Step 1 and possibly step 2 depending on your decided specialty.

If you're class of 2018 or 19, I'd forego the AOA match entirely. If you're class of 2017 and going for anything more than a 3 year program, I'd only go ACGME. Too much uncertainty regarding places that could potentially not meet accreditation standards by 2020 and leave you hanging for your last couple years of residency.
 
Nikj said:
I'm asking precisely because I don't know about it. Thats what the forums are for. Where else and who else am I going to ask? I want the opinions of several students who are making their way through DO school who could give more insight on the issue as the merger continues to finalize.

This article hasn't been talked about recently, and as we get closer to the merger it's important for all of us premeds to know and understand what is going on right now.

There is quite a divide among students and physicians on the outcomes of the merger, so getting input on the topic is important, and not just reading older posts that really don't address many concerns going forward.
Click to expand...
It is not my intent to run you off however to help you better understand how this forum can better help you and you better understand and help it I recommend you first do a full search of the top an fully read all of the threads and understand those. Next try to post in pre osteo. Many of us will pop in and reply to post there so you do get the med student perspective. Finally post here.
Look with you being premed you really need to stay within your own scope. It should be your goal to get into the best medical school you possibility can and follow the rules of thumb about applying to medical schools. You should focus on getting in. If you apply and get in and you are looking at a DO school thats when you can worry about the merger. If you are curious, observe but try to stick to your scope.
 
DocWinter said:
From a DO student in M3/M4 perspective, there's some solid future gains for the profession as a whole, but some significant losses to be had initially and personally.

DOs will lose the great benefit of attempting AOA and then have a 2nd runthrough of ACGME. Losing that "safety net" as it is called is indeed a short term loss. It will hurt DO students at the lower end of the class.
Also, we now have to share our formerly DO-exclusive spots with MDs. Not really thrilling from a DO perspective, now hurting those more at the top of the class.

The gains are less of a hassle, better quality programs by virtue of losing smaller programs or less qualified programs (although I think there is a incorrect notion that smaller = inept).
Click to expand...

Actually, I would argue that this is a huge benefit of the merger. I'm only really familiar with my own specialty, but I think it would be safe to extrapolate from my experience that even the best AOA residency is only middle of the road at best when compared to ACGME programs.

Currently, students at the mid to bottom have to decide to "settle" for AOA programs versus reach for ACGME programs. In the future, students who might be middle to lower in the class can apply to a much wider range of programs and feel better that they at least tried to match at their dream place but ended up safely matching elsewhere. Imagine a scenario where your total number of interviews is sufficient to match but they are divided between AOA and ACGME. That is a crappy situation to be in. The merger helps eliminate that possibility while also culling the inadequate programs from the pool. It is a win for everyone despite what your flat earth society OMM faculty tell you.
 
BurghStudent said:
I don't want to stir the pot, but just something to consider:

Post 2020, all DO's will train in ACGME programs. Granted, DO's will be on the ACGME board of directors, but probably not represented enough to prevent any top-down agendas. And they are not currently represented in other MD governing bodies.

What's stopping the AMA/LCME/AAMC/ACGME from using this profound leverage to merge medical school accreditation? This shouldn't panic anyone but it does deserve discussion. For the sake of argument, imagine that graduating from a future LCME-accredited osteopathic medical school would earn one an MD, FAOA (Fellow of the American Osteopathic Association).
Click to expand...
I hope they do change the accreditation down the line. You can keep the osteopathic distinction at DO schools but otherwise standardize medical school.
DocWinter said:
From a DO student in M3/M4 perspective, there's some solid future gains for the profession as a whole, but some significant losses to be had initially and personally.

DOs will lose the great benefit of attempting AOA and then have a 2nd runthrough of ACGME. Losing that "safety net" as it is called is indeed a short term loss. It will hurt DO students at the lower end of the class.
Also, we now have to share our formerly DO-exclusive spots with MDs. Not really thrilling from a DO perspective, now hurting those more at the top of the class.

The gains are less of a hassle, better quality programs by virtue of losing smaller programs or less qualified programs (although I think there is a incorrect notion that smaller = inept).
Click to expand...
Is the AOA match truly a safety net though? It happens first so if you're a borderline applicant who wants ACGME than you don't stand a chance of getting it if you apply AOA. AOA match just takes opportunities away of those midtier applicants.
 
samac said:
I hope they do change the accreditation down the line. You can keep the osteopathic distinction at DO schools but otherwise standardize medical school.

Is the AOA match truly a safety net though? It happens first so if you're a borderline applicant who wants ACGME than you don't stand a chance of getting it if you apply AOA. AOA match just takes opportunities away of those midtier applicants.
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Not sure the above poster you quoted is using the "safety net" idea correctly. When people refer to the AOA "safety net," they are usually referencing the excess of AOA residency positions in general. They are a "safety net" because after the AOA match there are still ~1,000 unfilled PGY-1 positions. DOs who skip the AOA match and then fail to match into an ACGME program can then go back and fill those unfilled spots, hence the "safety net."
 
the argus said:
Not sure the above poster you quoted is using the "safety net" idea correctly. When people refer to the AOA "safety net," they are usually referencing the excess of AOA residency positions in general. They are a "safety net" because after the AOA match there are still ~1,000 unfilled PGY-1 positions. DOs who skip the AOA match and then fail to match into an ACGME program can then go back and fill those unfilled spots, hence the "safety net."
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Oh thanks for explaining, I misunderstood his take.
 
The DO grad placement rate has been higher than the US MD placement rate for years because of the safety net.

In 2016 the DO placement rate was 99.61%. There were only 24 DOs in the entire nation who did not obtain a residency spot.
https://www.aacom.org/docs/default-source/data-and-trends/2016-match-report.pdf?sfvrsn=20

In 2016 the US senior MD student placement rate appears to be 98.05%
see http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf based on 355 out of 18187 US seniors with no placement after SOAP
(Look at table 15: 990 US MD seniors were unmatched
Look at table 19: 635 got positions in the SOAP.
Leaves 355 US MD graduates without a position after the SOAP)

Overall these numbers indicate 355 MD students (that number is about 2 students per school) vs. 24 DO students (that number is less than one student per school) without a placement.

There were 535 DO students who placed into AOA spots post match per the aacom link.

I am not convinced that loss of the safety net will not be a negative for DO students.
 
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ACGME= post- graduate medical education
LCME = pre-graduate medical education.

That's a big difference, and the chartering for the DO schools falls under COCA, not LCME.

BurghStudent said:
What's stopping the AMA/LCME/AAMC/ACGME from using this profound leverage to merge medical school accreditation?
Click to expand...

Only 1-2 COMs out of the current ~30??? No. What would probably happen is that a lot of schools, especially the newer ones, would have to contract their class sizes, and also be forced to make investments to come up to LCME standards. So for example, that earns less money going to VCOM's parent organization and whatever auxiliary school, and more to the COMs themselves. No more robbing the profitable Peter to pay the money-losing Pauls.


AlteredScale said:
If the LCME took over probably 5% of existing DO programs would survive. The faculty to student ratio for most DO schools is horrendous, clinical rotations poor, research barely existent, lack of faculty mentorship.
Click to expand...

Most DO students (OK, at least mine) take both COMLEX and USMLE. We encourage only our weakest students to stick with COMLEX only, and target AOA programs. In the future, this will probably shift to "stick with programs that are OK with COMLEX. Keep in mind that right now there are only some 2-3000 AOA residencies, but ~6500 DO grads. To your suggestion, it will be more and more important for students interested in the more competitive specialties to do research. Obviously, this might not be possible at the home institution, but it's doing in electives or 4th year. One of my OMSIVs is now doing clinical research at a Big Name MD School.

abolt18 said:
Best thing any DO student can do for themselves with the merger is study for and plan to take the USMLE. Unless you're scoring <210 in practice tests a week out, I think it's worth taking it. AT LEAST Step 1 and possibly step 2 depending on your decided specialty.

If you're class of 2018 or 19, I'd forego the AOA match entirely. If you're class of 2017 and going for anything more than a 3 year program, I'd only go ACGME. Too much uncertainty regarding places that could potentially not meet accreditation standards by 2020 and leave you hanging for your last couple years of residency.
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We can only hope!!!!

Dustbowl12 said:
Merger is fantastic for DO. COCA is gone next
Click to expand...
 
abolt18 said:
My thoughts. The merger is good for the future of medicine (my opinion) in general. The merger process is painful to some, especially those wanting more competitive specialties or those who are at the bottom of the class. I suspect it will eventually be NBD in 7 or 8 years. Many programs will close. Many will remain open.

Best thing any DO student can do for themselves with the merger is study for and plan to take the USMLE. Unless you're scoring <210 in practice tests a week out, I think it's worth taking it. AT LEAST Step 1 and possibly step 2 depending on your decided specialty.

If you're class of 2018 or 19, I'd forego the AOA match entirely. If you're class of 2017 and going for anything more than a 3 year program, I'd only go ACGME. Too much uncertainty regarding places that could potentially not meet accreditation standards by 2020 and leave you hanging for your last couple years of residency.
Click to expand...

One important thing to remember is that if a 3 year residency decides not to pursue ACGME accreditation then the program will probably not be taking new residents after the 2017 match. This means that there will be no future crops of entering first-year residents to help spread out any scutwork. This could mean higer workloads for upper level residents.

See http://osteopathic.org/inside-aoa/s...Documents/Program deadline charts 3-18-16.pdf
 
Goro said:
Only 1-2 COMs out of the current ~30??? No. What would probably happen is that a lot of schools, especially the newer ones, would have to contract their class sizes, and also be forced to make investments to come up to LCME standards. So for example, that earns less money going to VCOM's parent organization and whatever auxiliary school, and more to the COMs themselves. No more robbing the profitable Peter to pay the money-losing Pauls.
Click to expand...

Or drive up the price of tuition even more at these schools?
 
Nikj said:
I know there are other posts, but this paper makes some good but downright scary implications for anyone in or considering going to a DO school.

http://aodme.org/wp-content/uploads/The_Unintended_Consequences_of_the_ACGME_Merger.pdf

The response from the AOA hardly addressed many of the concerns raised in the paper. Any thoughts?

Edit: I saw old posts, but I want to hear more from students who are actually feeling the affects.
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Not speaking about this specific report-- but I really enjoyed his other work. The D.O.'s by Norman Gevitz.

To parrot what others have said-- the merger doesn't look like the doomsday it has been professed to be-- if anything I expect a net positive. But those gunning for Urology or Neurosurgery at the handful of AOA programs might feel the heat go up--same for those at the bottom of brand new schools but to the majority I expect a net gain.
 
Goro said:
Only 1-2 COMs out of the current ~30??? No. What would probably happen is that a lot of schools, especially the newer ones, would have to contract their class sizes, and also be forced to make investments to come up to LCME standards. So for example, that earns less money going to VCOM's parent organization and whatever auxiliary school, and more to the COMs themselves. No more robbing the profitable Peter to pay the money-losing Pauls.
Click to expand...

I may have over-exaggerated the estimates a bit. I would say with the school contraction however they would have to beef up clinical rotations as well as increase faculty research in some way (just as an example, of the faculty that do research at my school, only one or two have external funding!).
 
AlteredScale said:
beef up clinical rotations
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Just wondering, in general, how are clinical rotations evaluated at schools and even though DO schools may not have all of their clinical rotations at academic centers or even in hospitals with residents, what evidence suggests they have inferior clinical experience



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tux4 said:
Just wondering, in general, how are clinical rotations evaluated at schools and even though DO schools may not have all of their clinical rotations at academic centers or even in hospitals with residents, what evidence suggests they have inferior clinical experience



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Click to expand...

The clinical evaluation requirements that are written in LCME guidelines is very very stringent with pathology exposure and types of experiences that are expected compared to coca.

At many DO schools you are allowed to do your medicine rotations (one of the most important) with a private practice preceptor and never step foot in a hospital the whole rotation. If you're lucky you can even take house call (where you drive around and visit patients). Or spend an EM rotations working from the harsh hours of 8am to 2pm. If it's the holiday season on your with a preceptor you're in luck because you don't have to come back for a week, enjoy the holidays.

None of these things would fly at an MD school for third year. Sure they get outpatient exposure but to never step foot in a hospital for your internal medicine rotations?

But by all means don't just take my anecdotal accounts, program directors notice that DO students are behind come fourth year when they don't know how to round nor how to work with residents. Instead of spending fourth year to shine as a Sub-I, they are getting their first exposure to ward based, resident lead medicine.


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AlteredScale said:
If the LCME took over probably 5% of existing DO programs would survive. The faculty to student ratio for most DO schools is horrendous, clinical rotations poor, research barely existent, lack of faculty mentorship.


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Click to expand...

I highly doubt that. A few might close, but even still a private med school is still a huge money maker. Even if they had to invest and beef up rotations, they'd still benefit from existing. Some may even be forced to affiliate with undergrad universities, like MD standalone med schools have had to do in the past, which honestly would probably be a good thing for future students.

racerwad said:
Actually, I would argue that this is a huge benefit of the merger. I'm only really familiar with my own specialty, but I think it would be safe to extrapolate from my experience that even the best AOA residency is only middle of the road at best when compared to ACGME programs.

Currently, students at the mid to bottom have to decide to "settle" for AOA programs versus reach for ACGME programs. In the future, students who might be middle to lower in the class can apply to a much wider range of programs and feel better that they at least tried to match at their dream place but ended up safely matching elsewhere. Imagine a scenario where your total number of interviews is sufficient to match but they are divided between AOA and ACGME. That is a crappy situation to be in. The merger helps eliminate that possibility while also culling the inadequate programs from the pool. It is a win for everyone despite what your flat earth society OMM faculty tell you.
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Honestly, this is a constant problem. It's a problem I personally have as well, because of the nature of certain dual-accredited programs in my region of interest that by policy only take DOs in the AOA match.

It's also a problem if say your number 1 spot is ACGME, but 2-6 are AOA, because you have to decide if the chance of matching at your number 1 is worth the risk of matching at your #7 or below.

I also can't tell you the number of classmates I know that are borderline, who have a decent number of ACGME interviews, but not enough to risk not being in the AOA match for those couple of mediocre AOA programs that they'll most likely match into.

AlteredScale said:
The clinical evaluation requirements that are written in LCME guidelines is very very stringent with pathology exposure and types of experiences that are expected compared to coca.

At many DO schools you are allowed to do your medicine rotations (one of the most important) with a private practice preceptor and never step foot in a hospital the whole rotation. If you're lucky you can even take house call (where you drive around and visit patients). Or spend an EM rotations working from the harsh hours of 8am to 2pm. If it's the holiday season on your with a preceptor you're in luck because you don't have to come back for a week, enjoy the holidays.

None of these things would fly at an MD school for third year. Sure they get outpatient exposure but to never step foot in a hospital for your internal medicine rotations?

But by all means don't just take my anecdotal accounts, program directors notice that DO students are behind come fourth year when they don't know how to round nor how to work with residents. Instead of spending fourth year to shine as a Sub-I, they are getting their first exposure to ward based, resident lead medicine.


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Click to expand...

I have to be honest, I have not experienced a single rotation like that. I've had a bad day here or there, but honestly, having talked to plenty of MDs in my area, my experience seems no different than there's, save an OMM rotation and a bunch of required primary care focused rotations where MDs have vacations, "research months" or electives.

Now I don't doubt that some students experience what you've described (I've heard about them myself from DO students), but I can say with some confidence that the majority of students at my school don't regularly experience this. And to be honest, the people who do experience those types of rotations at my school tend to be the ones that seek them out.

I completely agree that those types of experiences should be eliminated, but while it may cost DO schools, I doubt it would be very hard for most to implement, they just need some incentive like a threat of losing accreditation.
 
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ChiTownBHawks said:
Yup. I know more than a handful of US MD students and their complaints about third year are eerily similar to the DO students on here. Further, I worked at a MD school before med school and quite a few of their rotations were glorified shadowing/ shelf study time.
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There's no way your MD friends had the opportunity to spend their two medicine rotations out of a hospital the entire time (unless they were in some primary care or rural track) or take house call. There's no way because LCME regulations have rules about what is expected exposure wise in that setting.

I mean I understand that something of the sort (in the way of poor clinical training) can be found at MD schools but it's the exception by far and not the rule. I think we can agree that the type of clinical training you get is without a doubt better at MOST MD schools as supposed to a DO school with say four faculty that compose their specialty medicine dept (whole you don't even rotate with) and ONE surgeon who's primary appointment is as a professor of medicine at a different MD school and makes one short appearance at our school to teach us how to tie sutures. And this isn't some new school too this is a school we are both quite connected to.




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ChiTownBHawks said:
All I'm saying is that tons of students think that if they went to an MD school that all their rotations would be rainbows and every patient would have some bizarre tropical disease. And I was talking in totality not specific to IM rotations. But, since you brought up IM, a good friend's IM rotations were not so different than those lamented by DO students on this forum and he is at a respectable MD school. Is it possible that his experience was a rarity? Yes. And I am not disputing that more DO students get left hanging than MD students but it's not as lopsided as this entire thread makes it seem. That was my point. I'm all for better education for DO students (pre-clinical, clinical, residency, fellowship) and would help be a part of that change. But, no one has actually come up with a solution in this thread.
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Honestly the truth is that the clinical years in medical education as a whole have some fairly large issues. The days of the student actually having a meaningful place in patient care and creating treatment plans are slowly disappearing. I think it's sad when I hear attendings talk about their experiences as a student and then hear students talk about their current experiences, they are often pretty different.
 
AnatomyGrey12 said:
Honestly the truth is that the clinical years in medical education as a whole have some fairly large issues. The days of the student actually having a meaningful place in patient care and creating treatment plans are slowly disappearing. I think it's sad when I hear attendings talk about their experiences as a student and then hear students talk about their current experiences, they are often pretty different.
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I don't know if that's strictly true. Perhaps it's just the difference between third and fourth year, but I've been managing my own patients more often than I expected. Part of that may be proving to the attendings that I actually can, but I don't know that my experience is that atypical.
 
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