OPSC email re: University of California rotations

[SLC]

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I hope that after the merger, LCME/ACGME schools and residencies realize that they are the official path to GME for osteopathic medical students. While I support the merger, I understand the concerns of some that we will continue to be treated as an 'other' by the only organization that represents our post-graduate opportunities.

Listing DO students as 'US Seniors' on ERAS would go a long way to helping mitigate this. If not that, at the very least, separate categories should be created for US Allopathic seniors, US Osteopathic seniors, and Independent Applicants. We shouldn't be grouped in with IMGs when we ourselves are constituents of the ACGME.

If we were lumped in with LCME school grads I'd bet it would go a long way to helping things. The ACGME probably wouldn't stand for a drop in the match rates for "US seniors".

 

[Bea5T]

VSAS conveniently summarises the eligibility and requirement for each participating programs on their website (https://www.aamc.org/students/medstudents/vsas/119290/article_for_host_institutions.html). Very good resources to narrow down the school list for away rotations.

Seems like you need a "COMPLEX" score to be eligible at many of these areas. Bummer....

 

[DopaDO]

I applied for a rotation somewhere that doesnt allow DOs to rotate per VSAS.

I called the program and asked why DOs couldnt rotate and they didn't know why it said that on vsas. They let me apply for the rotation anyway and I was accepted to rotate - I decided not to rotate there for other reasons (I was offered an interview later though).

Moral of the story: if there is a program you are particularly interested in rotating at, but vsas says no DOs or there is a fee - call them and ask what up. Good things happen when you are proactive.

 

[67552931811]

I hope that after the merger, LCME/ACGME schools and residencies realize that they are the official path to GME for osteopathic medical students. While I support the merger, I understand the concerns of some that we will continue to be treated as an 'other' by the only organization that represents our post-graduate opportunities.

Listing DO students as 'US Seniors' on ERAS would go a long way to helping mitigate this. If not that, at the very least, separate categories should be created for US Allopathic seniors, US Osteopathic seniors, and Independent Applicants. We shouldn't be grouped in with IMGs when we ourselves are constituents of the ACGME.

I hope that future NRMP charting the outcomes documents will keep DOs separate, while including all statistical numbers like they do for US MDs (and even FMGs/IMGs, though this is a separate document). This way DO students can look at X speciality and X USMLE score/ X research experiences/ etc. and determine their approximate chances based on the data available. Further, changing the current layout to present it as: US MD seniors, US DO seniors, and Independent applicants makes the most sense given the state of things. That would be a huge step going forward.

Edited for grammar, 😱.

 

[AlteredScale]

I hope that the NRMP charting the outcomes document would keep DOs separate, while including all statistical numbers like they do for US MDs (and even FMGs/IMGs, though this is a separate document). This way DO students can look at X speciality and X USMLE score/ X research experiences/ etc. and determine their approximate chances based on the data available. Further, changing the current layout to present it as: US MD seniors, US DO seniors, and Independent applicants makes the most sense given the state of things. That would be a huge step going forward.

I wonder if that is how it's going to be come 2019. NRMP will consider MD and DO grads to be internal applicants while the rest are independent.

 

[kenjixshadow]

x

 

[user3]

I hope that after the merger, LCME/ACGME schools and residencies realize that they are the official path to GME for osteopathic medical students. While I support the merger, I understand the concerns of some that we will continue to be treated as an 'other' by the only organization that represents our post-graduate opportunities.

Listing DO students as 'US Seniors' on ERAS would go a long way to helping mitigate this. If not that, at the very least, separate categories should be created for US Allopathic seniors, US Osteopathic seniors, and Independent Applicants. We shouldn't be grouped in with IMGs when we ourselves are constituents of the ACGME.

I don't see what would be stopping them from doing this right now (or, next match cycle). Seems like a very simple change...

 

[GUH]

I don't see what would be stopping them from doing this right now (or, next match cycle). Seems like a very simple change...

Yes; it would be.
I suspect that it is a pretty clear indication of their attitudes towards DOs.

 

[AlteredScale]

I don't see what would be stopping them from doing this right now (or, next match cycle). Seems like a very simple change...

They're probably waiting for more of the AOA programs to become accredited (which probably entails numerous site visits) before they consider DO grads to be internal applicants perhaps?

 

[GUH]

They're probably waiting for more of the AOA programs to become accredited (which probably entails numerous site visits) before they consider DO grads to be internal applicants perhaps?

I doubt it, since a lot of AOA programs had already either undergone dual accreditation or switched over to ACGME before the takeover agreement was even signed. They've had plenty of chances to become familiar with osteopathic medical education.

 

[NurWollen]

This should have been a sticking point during negotiations, rather 'preserving the integrity of COMLEX' and so on.

 

[Kevin Baker]

Yes; it would be.
I suspect that it is a pretty clear indication of their attitudes towards DOs.

I think it's more of a reflection on our variable rotation quality and significantly lower match rate. Better to improve internally imo than claim bias. I know I'm ashamed to share a degree with some of these newer schools. Can't blame the ACGME for distancing themselves.

 

[GUH]

I think it's more of a reflection on our variable rotation quality and significantly lower match rate. Better to improve internally imo than claim bias. I know I'm ashamed to share a degree with some of these newer schools. Can't blame the ACGME for distancing themselves.

If they discriminate against DOs in the match, they can't use a lower match rate as a reason to discriminate against DOs. That's circular reasoning.

 

[NurWollen]

I think it's more of a reflection on our variable rotation quality and significantly lower match rate. Better to improve internally imo than claim bias. I know I'm ashamed to share a degree with some of these newer schools. Can't blame the ACGME for distancing themselves.

There's a difference between recognizing our perceived weaknesses and saying we deserve discrimination because of our perceived weaknesses. As has been said already on this thread, many newer MD schools have similar problems. You don't see them labeled as "other" in the match.

 

[meliora27]

There's a difference between recognizing our perceived weaknesses and saying we deserve discrimination because of our perceived weaknesses. As has been said already on this thread, many newer MD schools have similar problems. You don't see them labeled as "other" in the match.

With respect to the new MD schools, LCME accreditation standards still provide a "minimal standard" that is deemed acceptable to PD's. PD's don't question the preclinical education of DO's when they have USMLE Step 1 scores to go off of. The focus of their concern seems to surround the clinical training (which is where COCA and LCME accreditation standards come into effect).

 

[GUH]

With respect to the new MD schools, LCME accreditation standards still provide a "minimal standard" that is deemed acceptable to PD's. PD's don't question the preclinical education of DO's when they have USMLE Step 1 scores to go off of. The focus of their concern seems to surround the clinical training (which is where COCA and LCME accreditation standards come into effect).

I am not aware of any specific differences between COCA and LCME standards on clinical rotations. Could you please describe them?

 

[meliora27]

I am not aware of any specific differences between COCA and LCME standards on clinical rotations. Could you please describe them?

3.1 Resident Participation in Medical Student Education

Each medical student in a medical education program participates in one or more required clinical experiences conducted in a health care setting in which he or she works with resident physicians currently enrolled in an accredited program of graduate medical education.


Source: http://www.lcme.org/publications/2015-16-functions-and-structure-with-appendix.pdf

 

[NurWollen]

3.1 Resident Participation in Medical Student Education

Each medical student in a medical education program participates in one or more required clinical experiences conducted in a health care setting in which he or she works with resident physicians currently enrolled in an accredited program of graduate medical education.


Source: http://www.lcme.org/publications/2015-16-functions-and-structure-with-appendix.pdf

My school meets this requirement, FWIW.

 

[hallowmann]

I think it's more of a reflection on our variable rotation quality and significantly lower match rate. Better to improve internally imo than claim bias. I know I'm ashamed to share a degree with some of these newer schools. Can't blame the ACGME for distancing themselves.

Its not the ACGME distancing themselves, its the NRMP publishing the stats.

People need to stop perceiving this as a slight to DOs to be lumped into independent applicants. We represent 10-15% of applicants in the NRMP match. When one group represents >50% of relatively homogenous applicants and that group has historically been the main applicants to the match, its not surprising that they'll separate out that group.

Up until recently, they didn't even publish info on the international applicants, despite their size being 2-3 times that of DOs. If enough DOs apply through the NRMP match (i.e. there's enough demand from paying applicants), I would be surprised if they didn't create a separate group for them.

There are slights against DOs in the NRMP match, but being grouped into "independent applicants" when it comes to statistical reports isn't a particularly big one (no matter how much harder it makes it for us to estimate our chances).

My school meets this requirement, FWIW.

Most DO schools meet this requirement work most rotations. I think the problem is that it's not always true about all rotations at every school. Even so, I'd be surprised if this specific point is the reason for DO discrimination. Seems more like an excuse than anything else.

 

[SLC]

3.1 Resident Participation in Medical Student Education

Each medical student in a medical education program participates in one or more required clinical experiences conducted in a health care setting in which he or she works with resident physicians currently enrolled in an accredited program of graduate medical education.


Source: http://www.lcme.org/publications/2015-16-functions-and-structure-with-appendix.pdf

I was told on one interview by the associate PD that they notice that DO applicants tend to struggle more in acclimating to inpatient work, which I think is a crock of crap to be honest). He also said that they haven't traditionally recoeved a whole lot of interest from DO applicants, I think it's because it's FM and they require USMLE.

He did however say that he "tries to have one DO in each class if he can" because he's a Sports Med guy and he recognizes the difference in skills that DO's bring to the table in that realm.

I didn't want to be his "token DO" after that though.

 

[GUH]

3.1 Resident Participation in Medical Student Education

Each medical student in a medical education program participates in one or more required clinical experiences conducted in a health care setting in which he or she works with resident physicians currently enrolled in an accredited program of graduate medical education.


Source: http://www.lcme.org/publications/2015-16-functions-and-structure-with-appendix.pdf

I have not met a single DO student or physician who has not done at least one rotation in a setting with residents.
Is there any school where this is normal? If so, then we should change it.

 

[NurWollen]

I have not met a single DO student or physician who has not done at least one rotation in a setting with residents.
Is there any school where this is normal? If so, then we should change it.

I'll be having at least two residency- affiliated, ward-based rotations 3rd year. Hopefully three. Maybe most MD programs have more than that, but that still definitely meets the requirement quoted above.

Contrary to what people here on SDN say, I really don't think ward-based > preceptor every time always. It's certainly good to have a mixture of both.

Upperclassmen to me regarding preceptor-based rotations: 'Meh, hit or miss.'

Upperclassmen to me regarding ward-based rotations: 'Meh, hit or miss.'

 

[hallowmann]

I'll be having at least two residency- affiliated, ward-based rotations 3rd year. Hopefully three. Maybe most MD programs have more than that, but that still definitely meets the requirement quoted above.

Contrary to what people here on SDN say, I really don't think ward-based > preceptor every time always. It's certainly good to have a mixture of both.

Upperclassmen to me regarding preceptor-based rotations: 'Meh, hit or miss.'

Upperclassmen to me regarding ward-based rotations: 'Meh, hit or miss.'

Agreed. In 3rd year alone I'll have 7 rotations in 4 different services that have residents. FM was more my choice because of where I wanted to do it, as most people do their FM with a preceptor and often times it is exclusively outpatient. Everyone I personally know is going somewhere for 3rd year with residents on at least one of their rotation services.

I'm surprised anyone is able to get through 3rd year without having at least 1 residency affiliated, wards-based rotation, but I did hear rumors of 1 student at my school that managed to have all their cores as preceptorships in out-patient settings (even IM). They did have rotations in 3rd year that were wards-based and with residents, but they were electives. I'm sure this is very rare though, and honestly that student apparently planned his rotations that way.

 

[PlasticBag]

I'll be having at least two residency- affiliated, ward-based rotations 3rd year. Hopefully three. Maybe most MD programs have more than that, but that still definitely meets the requirement quoted above.

Contrary to what people here on SDN say, I really don't think ward-based > preceptor every time always. It's certainly good to have a mixture of both.

Upperclassmen to me regarding preceptor-based rotations: 'Meh, hit or miss.'

Upperclassmen to me regarding ward-based rotations: 'Meh, hit or miss.'

I read somewhere on SDN that if you do a rotation in a non-teaching hospital, that hospital is not insured against student malpractice so you end up doing only shadowing. If it's surgery, you'd never get a chance to learn suturing, assisting during surgeries, etc. Is that true?

 

[NurWollen]

I read somewhere on SDN that if you do a rotation in a non-teaching hospital, that hospital is not insured against student malpractice so you end up doing only shadowing. If it's surgery, you'd never get a chance to learn suturing, assisting during surgeries, etc. Is that true?

I doubt that's true. As far as I know, the med school pays for its students' insurance (with tuition money, of course.) Now, it might be that doctors and nurses at a non-teaching hospital are less familiar with what to do with students, and therefore end up being overcautious, but I'm sure it's not an institutionalized rule.

 

[PlasticBag]

I doubt that's true. As far as I know, the med school pays for its students' insurance (with tuition money, of course.) Now, it might be that doctors and nurses at a non-teaching hospital are less familiar with what to do with students, and therefore end up being overcautious, but I'm sure it's not an institutionalized rule.

Thanks, this made me feel better. I know that the quality of rotations may be variable but not ever learning how to suture or having an NP as a preceptor or a master's level psychologist for a psychiatry rotation (horror stories from SDN) would make me really worried about starting a DO school in a few months.