chevaliermalfet

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I participated in my school's second look weekend a few days ago, and sometime in between the wining/dining and the slip 'n slide party, I realized while it's pretty easy to see what a medical school has to offer, it's kinda hard to decide whether what it's offering is actually what you want. So school X gives you personal lockers and school Y has an espresso machine in the student lounge . . . but who cares? So I thought I would share with you guys what I've found to be (in retrospect) important questions to ask yourself when you are thinking about your choice of medical school.

Does the school have a strong sense of community?

I've found that having a real sense of community and team work among my classmates have had a hugely positive impact on my medical school experience so far. The fact of the matter is, medical school is hard, and having a closely knit group of people around you makes the difference between sweating it by yourself, or as part of a larger group with whom you can share both your successes and your set-backs. There is something very therapeutic about playing intramural soccer with the same people who are dissecting next to you in the anatomy lab. Medical school is a pretty high pressure environment no matter how you cut it, but that environment has the potential to make amazing relationships if you can find one that fits you. I suppose what I am saying here is you should be able to see yourself belonging not just in an academic sense, but in a social one as well.

What type of grading system does the school use?

At my school, we use a pass/no pass system. There is no curve, and no grade recorded aside from whether or not you passed a given class. I know this is a radical departure from that gunner-ish mind-set we've all grown to know and love, but please bear with me! Because of this non-competitive type system, it makes it so much easier for you to help each other out. There's no need to be wary of sharing notes or to hoard information about the next quiz. In fact, there are quite a few people who post their study notes online before quizzes (saving the collective academic a$$es of many a fellow student). Because this sort of system reduces competition between classmates, I feel like it also helps foster that sense of community I was referring to in the previous question. I suppose it can be argued that the pass/no pass system makes all the students look more or less the same academically, and this is true . . . to a point. At least here, the third and fourth years are graded on a high pass/pass/no pass scale, and your attendings/residents write evaluations of your performance. Also, everyone is unique, and what you do in your 'free' time reflects that. Things like involvement in clubs, your hobbies, volunteer work, etc all help to reflect your individual student self even if all you've got on your report card is a string of uniform 'passes.'

What sort of early (1st/2nd year) clinical experience does the school offer?

One thing I've learned in my 8 or so months as a first year medical student is how important it is to have contact with real patients during your first two years. I think there are plenty of reasons why this is good for your clinical skills; you get an early start on learning the physical exam, you get good practice in interviewing, practice writing a SOAP note, etc etc. However, the real positive thing for me has been the chance to do what I entered medical school for, right from the get-go. Even your fledgling clinical skills can be put to great use, and even if you can't tell the difference between a stethoscope from a reflex hammer, you represent a sympathetic ear that a lot of patients wouldn't usually get. The thing is though, a lot of the experience depends on the context in which you are seeing patients. That is why it is important to take a real look at what your school is offering for it's early clinical experiences. If all you're doing is seeing model patients, or have a few days out of the year following around a preceptor, then you won't get nearly the same gratification or practice you would if you were volunteering at a student run clinic twice a month. So when you consider your schools, remember to look at just what it is they mean by "early patient contact," and whether it sounds like you can find gratification and good practice from what they are offering.

These are three questions I think you should be asking yourself when you are applying to medical school. This is in no way a comprehensive list, and the thing is, when you walk into the place that is right for you, the chances are you'll know it. Sometimes the place just feels right; trust your instincts about a place, because in my experience they rarely steer you wrong. Also, if I get another brain wave in the shower this morning or something I'll be sure to add to the list, and if there is anyone else out there with advice to add, please do! And don't hesitate to ask questions or what have you.

Good luck with your decisions you guys, and be happy, the hardest part is over :)
 

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Good advice, but as for the last point...I think most schools now offer patient exposure during the first two years...It seems like its the new thing.

But honestly, how meaningful will it be to our education if we see a few patients during our first two years???
 

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Good advice, but as for the last point...I think most schools now offer patient exposure during the first two years...It seems like its the new thing.

But honestly, how meaningful will it be to our education if we see a few patients during our first two years???

I say early clinical exposure is overrated, but the other points made are very good ones.
 
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Good advice, but as for the last point...I think most schools now offer patient exposure during the first two years...It seems like its the new thing.

But honestly, how meaningful will it be to our education if we see a few patients during our first two years???


From most accounts I've heard, very little. Especially for people who have already worked closely with patients before, as I can really only surmise that "early patient exposure" in years 1 and 2 serves to familiarize students with talking and interacting with sick strangers. I suppose a little could be learned as far as taking a history or performing a CPE, but without the proper knowledge base, a lot of what you do will seem confusing and won't make a lot of sense to you.
 

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maybe it is there to remind you why you are really reading all those books and studying for, patients.

And also to just show how little you truly know about medicine at that point. That would motivate me for sure, i dont like being a bumbling fool when it comes to things im depended upon for.
 

wally47

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From most accounts I've heard, very little. Especially for people who have already worked closely with patients before, as I can really only surmise that "early patient exposure" in years 1 and 2 serves to familiarize students with talking and interacting with sick strangers. I suppose a little could be learned as far as taking a history or performing a CPE, but without the proper knowledge base, a lot of what you do will seem confusing and won't make a lot of sense to you.

Yep, agreed. I would much rather spend those extra hours during the week studying for Step I. I know why I want to be a doctor, I don't need to be motivated everyday.
 

chevaliermalfet

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Good advice, but as for the last point...I think most schools now offer patient exposure during the first two years...It seems like its the new thing.

But honestly, how meaningful will it be to our education if we see a few patients during our first two years???

I work at one of the student run clinics at my school, which means I am in a clinic around twice a month. I genrally end up seeing 2 or 3 patients on each of those days, and so after doing it for two years, the numbers (and sheer practice) start to add up.

But the real reason I think the 'early patient contact' is a good idea is because (at least for me) it's really easy to get lost in the school work and forget the whole point of why you went into medicine. By going into the clinic and actually seeing real people, and (in my small MS-I way) helping them, it puts all the classwork into perspective. Not just in an academic, classroom to practice way, but also in the sense that there is more to med school than just studying.

Also, it is true that a lot of schools will pay lip service to early clinical exposure, but it's important that you take a close look at what they mean. There is a big difference between practicing on model patients and following around a preceptor, verses actually getting to see patients on your own, etc. Hope this helps guys!
 

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I wouldn't use any of those 3 to pick a school. The first has some merit, the others seem irrelevant from my side of the match.

Consider learning about:

What was the experience of people applying to (preferred specialties X, Y, Z). Surely you have some vague idea of a field you might want to go into. Find out if people were able to connect with big names, get the right phone calls, land research projects of significance, etc.

How prepared do 4th years feel they are for internship? For a career in their specialty of choice?

Is 3rd year hard? If so, does it hinder learning? If not, is there adequate exposure to educational experiences? How much autonomy do 3rd years get?

Are the residents smart? Do residents and faculty have time to teach? Do they enjoy teaching?

Now that it's all over, would you do it again? What was particularly good/bad?

Do the residency programs show a preference for the local med students? Are these residency programs desirable?

Does the curriculum cater to a particular learning style? If so, what is that style?

You will need to hunt down some fourth years to get this kind of info. Any office of admissions worth its salt should be able to get you some contact info.
 

notdeadyet

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Yep, agreed. I would much rather spend those extra hours during the week studying for Step I. I know why I want to be a doctor, I don't need to be motivated everyday.
I think early meaningful patient exposure is important. But not necessarily for the why-I-want-to-be-a-doctor thing.

There are two basic approaches to medical school: schools in which you have patient experience a part of the first two years' curriculum and schools in which you have little/none and starting with your first rotation, you start to learn how to take a history, come to differential diagnosis, present to attendings, perform physicals, etc.

Like chevaliermalfet, I prefer to get my clinical experiences early. Learning how to function effectively during the first two years makes you much more effective later than when you're trying to do heart sounds on your internal medicine rotation never having listened to any other than 15 hearts in healthy 23 year old bodies.

For the premeds who'd rather have the time to study for their Step 1, I'd recommend buying a few good review books and blocking time. If your school only allows a couple of weeks of prep, lobby for more. If you have four weeks or more, you're golden. At my school we have 8 weeks allowed and most students take it earlier because you just max out. And if you learned the material right the first time and are applying the knowledge early in clinical settings, four weeks is enough full-time review.

But again, to each their own. I looked at two schools who moved to a more clinical exposure setting and their Step 1's were all solid. I've never heard of someone in medical school complain, "I wish I had less patient experience and more time to make flash cards".
 

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Good advice, but as for the last point...I think most schools now offer patient exposure during the first two years...It seems like its the new thing.
On that third point, you need to bird dog what the schools are actually doing. Lots of schools know that students want patient experience so they set up a few shadowing sessions so that they can print in the MSAR "clinical exposure from day 1".

Other schools actually integrate building doctoring skills into the curriculum as its own course. You learn about how to listen to heart/lung sounds and whta to listen for. You practice on each other. Then in your clinical setting you put it to use with actual sick patients. Any student who figures hearing murmurs is a snap has very little experience.
 
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I guess everyone has different criteria for choosing a med school, but everything the OP mentioned is REALLY important to me and are big factors in my decision. I know that no matter where I go I have to work hard, and I'm going to learn the same material as everyone else. I just really want to be as happy as possible during the grueling years of med school. I think that can be accomplished if: the grading/learning system fits me, I get along with my classmates, and I actually get to see patients during the pre-clinical years (instead of 2 straight years of sitting on class).
 

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The last thing I want when I leave the classroom/hospital is to hang out with more med students/doctors. I'll want a break from the crazies.
Unless you go to med school in your hometown, odds are very good that most of your social network will be made up of med students/doctors. The big bulk of the time you have will be spent with medical students. The amount of time to spend with clubs, teams, etc. outside of medical school will be pretty small.

Even if you try to avoid it, expect much of your social circle to be fellow med students. Sorry.
While P/F sounds nice, it's not a big enough factor to sway me one way or another. You're going to have to separate yourself from the pack sooner or later (step I, clinical grades, LORs, etc.)
Folks have a misunderstanding about P/F. They get the impression that P/F encourages slacking and that it somehow makes Step 1 harder.

It's the other way around, from my experience. When you're in classes and need to worry about hitting 90% each time, you're focusing all of your energies on mastering your professor's material. Smart folks in P/F schools work on mastering their professor's material well enough, but don't sweat the extra 25% of work needed to bump you up that last 5% in the class. Instead, they use that extra time to focus on preparing for the boards. No matter how much your school teaches to the boards, there's a lot of time spent on stuff that is not emphasized enough/too much compared to how the boards will hit it.

There are a lot of reasons to like grades, but the idea that they'll better prepare you for the boards isn't one of them.
 

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I work at one of the student run clinics at my school, which means I am in a clinic around twice a month. I genrally end up seeing 2 or 3 patients on each of those days, and so after doing it for two years, the numbers (and sheer practice) start to add up.

But the real reason I think the 'early patient contact' is a good idea is because (at least for me) it's really easy to get lost in the school work and forget the whole point of why you went into medicine. By going into the clinic and actually seeing real people, and (in my small MS-I way) helping them, it puts all the classwork into perspective. Not just in an academic, classroom to practice way, but also in the sense that there is more to med school than just studying.

Also, it is true that a lot of schools will pay lip service to early clinical exposure, but it's important that you take a close look at what they mean. There is a big difference between practicing on model patients and following around a preceptor, verses actually getting to see patients on your own, etc. Hope this helps guys!
Good point, Its still not gonna be high up on my list of choosing a school, but good point.

*not like imma be one of the ones that can pick and choose anyways, lol
 

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I think early meaningful patient exposure is important. But not necessarily for the why-I-want-to-be-a-doctor thing.

There are two basic approaches to medical school: schools in which you have patient experience a part of the first two years' curriculum and schools in which you have little/none and starting with your first rotation, you start to learn how to take a history, come to differential diagnosis, present to attendings, perform physicals, etc.

Actually I don't think there are any allo schools I've ever heard of that do not have at least some form of exposure to patients in the first two years. At one time you could differentiate schools as you describe, but not pretty much all of them start their students taking histories in first year and starting to learn physical diagnosis skills in second (or some variation of this). But honestly, you won't get good at any of it until third year because it is one of those skills that you need to do daily to get good (or more importantly quick) at, and most basic science year clinical courses are only an hour or two a week. In third year you learn how to put together all the pieces, learn to present to attendings, learn to write notes, and a few procedures.

The clinical exposure stuff in the early years, as someone mentioned earlier in the thread, serves the same purpose that PBL does -- it tries to take the unrelated basic sciences and put them into a clinical context, to keep you interested. You are less likely to go through the "what am I doing here angst" if the schools give you a small taste of the fun stuff that's to come, rather than keep you in the science books. Most people would rather see a patient with liver cancer rather than just learn about it in pathophys. So these courses are very much a "look what you'll get to do third year" dog and pony show. That's their sole purpose. Nobody shows up to third year knowing what they are doing regardless of how much of this earlier clinical exposure they had -- you got a taste, not a meal. And that's fine because you will learn to get it right in third year -- that's the whole point of third year -- to learn to take a good history, do a decent physical, present to attendings, write it up, and all the while seem interested and enthusiastic.
 

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It's the other way around, from my experience. When you're in classes and need to worry about hitting 90% each time, you're focusing all of your energies on mastering your professor's material. Smart folks in P/F schools work on mastering their professor's material well enough, but don't sweat the extra 25% of work needed to bump you up that last 5% in the class. Instead, they use that extra time to focus on preparing for the boards. No matter how much your school teaches to the boards, there's a lot of time spent on stuff that is not emphasized enough/too much compared to how the boards will hit it.

There are a lot of reasons to like grades, but the idea that they'll better prepare you for the boards isn't one of them.

For better or for worse, i think this is true.

Advantages of focusing on the boards include a good score (obviously), and not stressing over nit-picky crap that some professors obsess about.

However, I think that preparing for the boards is not the optimal angle for learning preclinical material in preparation for a career in medicine. The boards emphasizes its own set of useless crap (although much of the material is important). I found that my school's curriculum spends a lot of time emphasizing clinical angles that are not "high yield" for boards but produce a better level of understanding when you hit the wards.
 

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Unless you go to med school in your hometown, odds are very good that most of your social network will be made up of med students/doctors. The big bulk of the time you have will be spent with medical students. The amount of time to spend with clubs, teams, etc. outside of medical school will be pretty small.

Even if you try to avoid it, expect much of your social circle to be fellow med students. Sorry.



AGREED! For one, why would you not want to hang out and get to know your fellow students???? You're all in this together and you will end up relying on each other, whether you like it or not. You're only kidding yourself if you plan on getting through med school by just going to class and then somehow putting it out of your head by getting away from the "crazies"? By the way...aren't you (being a fellow med student and all) included in that phrase.."crazies"? :p Sometimes I wonder if people just say things on here for shock value...
 

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Actually I don't think there are any allo schools I've ever heard of that do not have at least some form of exposure to patients in the first two years.
Agreed. That's why I'd distinguish between any clinical exposure and meaningful clinical exposure. I woudn't make any decisions based on the field for "first patient encounter" in the MSAR.

But I do think a school that teaches practical physician skills and requires you regularly to put those skills to practice in a clinical setting is extremely helpful, especially when these skills are taught and structured in a way to reinforce the book learning you're covering at the time.

Again, it's a personal preference. It won't impact the education of some folks. For me, i remember information a lot better when I put it to use than from staring at flashcards until my blood beads on my forehead.

Though that said, I have to do that too...
 

notdeadyet

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Advantages of focusing on the boards include a good score (obviously), and not stressing over nit-picky crap that some professors obsess about.

However, I think that preparing for the boards is not the optimal angle for learning preclinical material in preparation for a career in medicine.
Couldn't agree more.

I think med students have a tendency at most schools to beg more and more for professors to "teach to the boards". Which, really, is not far from the high schooler raising the hand and asking "Will this be on the test?".

I think the best way to prepare for any standardized test is to know your $hit cold. Little tricks and all the rest to ace a test are great, but learning material well will trump it every time.

Listen to your instructors, learn their stuff, but also learn to develop a bulll$hit detector and weed out what is completely extraneous fluff (or unending data from what looks suspiciously like it was from their PhD dissertation) from the core learning. Use extra time to bone up for the Step 1 to keep an eye on how your knowledge will be tested later.
 

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I have a question for all of you current or past medical school'ers. Did any of you heavily weight your choice based on the reputation of a department? For instance, if you were thinking about specializing in neurological surgery would you choose a school like Mayo for medical school because of the amazing neurp reputation or would you pick a school like upenn (assuming you got accepted into both)?

I'm not in this situation, it's just hypothetical. Is it even possible to get known by the attendings in a highly touted program like that? I guess if the endgame is getting your choice residency it would be a heavy factor, right?

(For background info, I'm shooting for acceptances at both Ohio State and Cincinnati. While OSU is a bigger program, I've been told Cinci is better for those thinking neuro in the long run?)

And finally, start the flaming. I'm ready.
 

chevaliermalfet

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I have a question for all of you current or past medical school'ers. Did any of you heavily weight your choice based on the reputation of a department? For instance, if you were thinking about specializing in neurological surgery would you choose a school like Mayo for medical school because of the amazing neurp reputation or would you pick a school like upenn (assuming you got accepted into both)?

I'm not in this situation, it's just hypothetical. Is it even possible to get known by the attendings in a highly touted program like that? I guess if the endgame is getting your choice residency it would be a heavy factor, right?

(For background info, I'm shooting for acceptances at both Ohio State and Cincinnati. While OSU is a bigger program, I've been told Cinci is better for those thinking neuro in the long run?)

And finally, start the flaming. I'm ready.

I don't know if this is going to help you at all, but in the spirit of my original post, my advice is that you should choose the school that you like the most on ALL it's merits together, rather than heavily weighting the research being done there over all other things you think are important in a school. The fact of the matter is, you are going to be there for four years, and even if you are working on the coolest research project of all time, you still are going to be attending medical school the other 80% of your life there.

Additionally, if you are looking to become a neurosurgeon or what have you, what is probably going to matter most regarding whether or not you go into a given specialty is what residencies you match into, not the reputation of the medical school from which you graduate, as that will probably be the biggest determinant of your future career. Having a hot-shot neurosurgery attending running around might help you because they'll write you a letter of reccomendation, but that and the research you do with them will only part of your entire medical school record that residencies will look at. I guess what I am saying is that the residency you match into is more important than the medical school for setting a particular course for your career. There are things you can do at just about any medical school to prepare yourself for trying to match into a neurosurgery residency, and it doesn't need to be done only at a particular medical school.

Finally, people are notorious for wanting to go into a particular specialty, and then changing their minds a bazillion times before they finally put together a final match list in the fourth year. So basing your choice of school off of what sort of doctor you want to be probably isn't such a good idea. That said, if you are really interested in research, and are more interested in becoming an academic physician or are in an MD/PhD program, then looking at the research being done at the school is probably more important (ie selecting what lab you want to do your thesis research in, etc). However, I really can't speak to that because I haven't looked too hard into the nuts and bolts of how academic medicine works.

Keep in mind as well I am only an MS-I who is interested in clinical medicine and not research, but hopefully all that was helpful. Good luck with your choice!
 

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Finally, people are notorious for wanting to go into a particular specialty, and then changing their minds a bazillion times before they finally put together a final match list in the fourth year.
Very good advice here ^^^. The odds are that whatever specialty you think you are going to go in to will not be the specialty you end up in. I'm sure you're sure, but stats back this up (I can't remember the average number of changed specialty plans, but I think it's in Iverson).

You probably would advise a high school senior not to choose their undergrad based on the fact that they want to be a firefighter or actor or actuary. It's good advice to tell folks not to chooose a medical school based on specialty.
 
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