preceptor-based vs. ward-based clinical rotations

[seabreeze811]

what are the differences between preceptor-based and ward-based rotations? Could someone clarify that? thanks!!!

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[Gpan]

what are the differences between preceptor-based and ward-based rotations? Could someone clarify that? thanks!!!

I think preceptor-based is like shadowing. There's only you and the teaching doctor, an attending in this case. Ward-based is the traditional rotation style where there are a group of students with interns, residents and attending physicians going around teaching stuffs, pimping you out. I am not 100% sure on these. Someone correct me if I'm wrong.

 

[DragonWell]

I think preceptor-based is like shadowing. There's only you and the teaching doctor, an attending in this case. Ward-based is the traditional rotation style where there are a group of students with interns, residents and attending physicians going around teaching stuffs, pimping you out. I am not 100% sure on these. Someone correct me if I'm wrong.

That sounds about right to me, although the ward-based as you describe it with interns and residents would only be true in a teaching hospital. If your preceptor practices in a hospital you could end up on a ward w/o all those folks around.

In the bigger picture, each one has pros and cons. Being in a teaching hospital means you will have lots of interactions with interns and residents, who can really help you learn, since they're closer to being where you are. Most teaching hospitals also have morning report and various didactic programs for students. On the downside, you could end up on a team with 3 residents, 2 interns and 2 med students for example, and have a hard time getting to do a lot of procedures and more in depth patient care.

With the preceptor, there is no one between you and the attending, so you may get to be a more active player, but you are completely dependent on them for all your learning during the rotation, which could be good or bad.

Obviously, there are a lot of variables here you will have no control over, and a lot will depend on your preceptor, intern, etc, so there is really no way to say one method is better than the other. Talking to students who've been through that rotation is a good idea.

Hope that helps.

 

[ATrain]

I thought Preceptorships were more during 1st and 2nd years as part of "early clinical exposure"

 

[DragonWell]

I thought Preceptorships were more during 1st and 2nd years as part of "early clinical exposure"

True, but it's a pretty general term for anytime you're attached to a specific doc.

 

[seabreeze811]

is it better to have ward-based rotations over preceptor-based? which one would prepare you better for residency? or it doesn't matter?

 

[DragonWell]

is it better to have ward-based rotations over preceptor-based? which one would prepare you better for residency? or it doesn't matter?

Didn't read my post above, eh? sigh...

Obviously, there are a lot of variables here you will have no control over, and a lot will depend on your preceptor, intern, etc, so there is really no way to say one method is better than the other. Talking to students who've been through that rotation is a good idea.

Hope that helps.

 

[slim78]

Didn't read my post above, eh? sigh...

And then they all wonder why their verbal scores are so low.

 

[seabreeze811]

Didn't read my post above, eh? sigh...

i added that in so i can get opinions from others, not just yourself...but thank you for your post...

 

[spicedmanna]

is it better to have ward-based rotations over preceptor-based? which one would prepare you better for residency? or it doesn't matter?

Well, I don't think I can categorically say which one is better than the other. If you have a preceptor that is a good teacher and very committed to your learning at each turn, then you'll do well. However, if you have a preceptor that doesn't give two-cents about you, then you'll have a much harder time getting what you need. I think that ward-based rotations are a safer bet, perhaps. It seems like you are more likely to get the education that you need with ward-based rotations since there isn't a single point of failure, like in preceptor-based ones.

...Well, these are just my thoughts, really. I don't have experience yet with either, so take what I am saying with a few grains of salt.

 

[scpod]

If you go to the areas of SDN where 3rd and 4th years hang out right now you'll hear a bunch of them bitching about how little they get to do. They feel like they are so far down the food chain that they are useless. These are people in those "wonderful" teaching hospitals saying this. OTOH, there are also some people with crappy preceptors who get to do next to nothing too. It all depends on the individual rotation. I think you really need a balance of both before you can determine which one you like the most.

I was really lucky because I have a great group of attendings I'm working with who LOVE to teach students. I get to do everything there is to do and they pimp me unmercifully. I get assignments and reading every single night to do. But, I also talked a lot with a 4th-year student about these rotations before I went on them. I knew what to expect. If you use your upperclassmen extensively, you can create a wonderful scenario for yourself and tailor your studies to meet your goals.

 

[Spooner13]

I recently asked the D.O. that I shadow which is better...clinical rotations in the rural or urban setting. He said that if you do a ob/gyn rotation in a rural setting you might be able to do 20 deliveries. You probably will not get this type of hands on in the urban setting. However, he did say that rotations at an urban/teaching hospital you will get more formal instructions and didactic style learning (as DragonWell said above). He went on to say that he believes that rotations at teaching hospitals are better overall because in rural rotations you will not learn the material behind the procedures you are performing as well.
I would guess that the best route is a mixture of the two (but I'm just a pre-med). Can any med students comment on what my D.O. said. Was he correct? Will you be ill-equipped if you do the majority of your rotations in the rural setting?
I'm sorry that I'm asking for broad generalizations about rotation experience. As several of you have stated above, it depends on the particular hospital or preceptor, but I would appreciate your experience.

Thanks

 

[scpod]

....He went on to say that he believes that rotations at teaching hospitals are better overall because in rural rotations you will not learn the material behind the procedures you are performing as well....

You are confusing rural and urban with teaching/non-teaching hospitals. There are large, rural teaching hospitals and small, urban non-teaching hospitals as well.

You don't learn all you need in a few hours of didactics a week. You have to read a whole lot to get the most out of your rotations. How much you learn is up to you, not where you are. At a large, teaching hospital you might be learning about a surgical procedure, but at a smaller, preceptor-based ospital you will be in the surgery right next to the surgeon gaining practical experience.

You learn a lot more in medicine from doing a procedure, than being lectured about it in my estimation. You learn a lot more when you are more involved. Many preceptor-based rotations are like doing sub-I's all the time. YOU have the same responsibilities in many cases that an intern or resident might have. Now, that's depending on the particular rotation, because it won't always be the case. That's why it's important (like someone mentioned) to talk to your upperclassmen who've been there before.

Some people have the mistaken notion that small hospitals don't get the variety of cases that the big teaching hospitals do. From what I've seen so far, that's a load of crap. My little 200-bed hospital is full of amazing pathology. I've seen quite a few "once-in-a-lifetime" diseases here. In fact, the only case hemorrhagic west nile virus in the US was found in my little hospital not too far back.

Your rotations, like everything in med school, is what you make of them. If you are the lazy type, who does little independent study, then those didactics are probably important to you. Everybody learns differently. You gotta decide that on your own.

 

[Spooner13]

You are confusing rural and urban with teaching/non-teaching hospitals. There are large, rural teaching hospitals and small, urban non-teaching hospitals as well.

Yeah, I guess I was confusing the two. Thanks for clearing me up. And thanks for all the other advise.

I've heard a lot of people say that you really need to consider the quality of the clinical rotations when choosing a medical school. I'm just worried that I will end up at a school that will not prepare me well. But I think you're probably right, rotations are what you make of them.

Thanks Tired for sharing your opinion too. That's pretty much what the D.O. that I shadow said.

 

[MJ2008]

Does anyone know if these schools are preceptor or ward based?

AT STILL AZ
AZ MIDWESTERN
AT STILL MO/KCOM
TOURO NV
UNTHC/TCOM
RV CO
PCOM GA
PCOM PA
KCUMB

Also, is it true that if a school isnt fully accredited than federal grants and loans will not be available until they graduate their first class of physicans? This would only be true for RV right? Not for sister schools like touro-nv or pcom-ga...

 

[DragonWell]

Preceptor or ward-based rotations are not things a school just decides to either have or not have. Unless, perhaps, they are one of the rare DO schools with a large teaching hospital attached, most schools end up placing students into some combination of both types of rotations. Even folks I know at large university-based allo programs have done some preceptor-based rotations. Most teaching hospitals don't have residency programs in every specialty, so if you want to do a rotation in something the hospital doesn't offer a residency/fellowship in, you will likely be with a preceptor.

As far as the loans go, I believe your statement is correct: branch campuses have access to federal loans. I would check the website of schools you are interested in for the most accurate info.