need help choosing a core site for yr 3/4

[donkeykong1]

DO student here. currently i have a broad range of specialties i'm looking at from surg, em, im..

site A: major level 1 trauma center (600+ beds), run down urban area, very cheap coa. tons of residencies [acgme and aoa]

site B: level 3 trauma center (220 beds), great area though expensive, few residencies all accredited by the aoa


Will I get to see enough pathology on IM rotations at site B?

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[JediZero]

You don't seem to express any reason not to do Site A. What's your thought process?

As for IM pathology, there's always plenty of COPD, DKA, CHF etc. no matter where you go, and that's the bread-and-butter stuff that will be 90% of what you deal with, anyway. Get real-world familiar with that during medical school and apply book knowledge to the zebras later.

For what it's worth, my rotations were all in hospitals/clinics far away from any major centers, and I didn't set eyes on a resident for my entire third year. There were obviously some drawbacks, but it does mean working more closely with attendings. So smaller is not necessarily worse.

 

[evilbooyaa]

If you do surgery at a site that doesn't have residents, you will probably get to do more surgical techniques than if there are residents. Same with any procedures on IM. Check to see if there are residents at the level 3 place. If there aren't in surgery or IM, I'd highly consider doing it there, as you will be working closer with attendings at non-resident sites. Also, as a DO student, you will have a connection to that sites AOA residencies if you end up interested in one of those specialties. May not be the same if you are at a site that has ACGME residencies.

You will see mostly the same basic pathology (besides high level traumas and some random zebras) at the level 3 facility.

 

[donkeykong1]

dont most md students rotate thru large teaching hospitals? ive always thought the bigger the better

 

[cabinbuilder]

dont most md students rotate thru large teaching hospitals? ive always thought the bigger the better

Really? For me the larger the place I rotated, the more I was pushed to the side and didn't really do anything. Too many med students, too many residents, never saw an attending except for morning report. Hated it, super boring.

The smaller places I rotated I got to see a lot of pathology (patients tend to wait longer to come in), usually was the only student so I was with the attending the whole time. Got to learn injections and suturing since there was no one else to fight for it.

 

[donkeykong1]

i think the argument is that at most tertiary centers the complex cases just get shipped out to larger hospitals so u dont get to see wat fully happens from admit--discharge [like in IM or surg]

 

[evilbooyaa]

dont most md students rotate thru large teaching hospitals? ive always thought the bigger the better

Most MD schools are affiliated with teaching hospitals. I worked on one service that didn't have residents at my hospital, and it was the one where I got to do the most (granted 2 weeks of it was NICU so we didn't get to really touch any of those babies).

 

[donkeykong1]

the level 1 center i can choose is a teaching hopsital for an md school, our do schoo has an affiliation with it thats why im leaning towards. still not sure yet though

 

[Anastomoses]

Okay, so what you're all saying is try to go to places where there aren't residents so you can get more hands on experience? Is that the way to go on this?

 

[evilbooyaa]

Okay, so what you're all saying is try to go to places where there aren't residents so you can get more hands on experience? Is that the way to go on this?

In the specialties that you do not want to possibly pursue as a life goal, 100% yes.

The benefits of no residents:
Get to do more in terms of procedures/responsibilities
More face time with attendings

Benefits of residents:
More people to ask questions/show interest in the specialty to.
More people covering your ass in case you miss something.
Better/bigger names for LoRs (if an academic hospital)
If you're interested in X specialty, you can try to get a letter from the chairman or PD of X specialty from that academic location - This obviously helps you in getting a residency at that particular location, but also in other locations (as it seems like many chairmen/PDs of the same department across multiple locations seem to know each other).

I have never had any desire to do surgery. However, I was at an academic hospital for my surgery rotation. Hearing about people at community locations getting to be first assist on nearly every case that walked in through the door made me super jelly.