Recent RCSI grad, my thoughts

[macslater]

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I am a US citizen who graduated from RCSI in 2006. Here are my thoughts. Take them for what they are.

The college is on par with other irish medical schools however it is way more expensive. I think these days it works out to about 60,000 USD for tuition alone. And dublin is an expensive city. Stop and consider that for a second.

Preclinical years: good
Clincal years: not so good. You don't feel part of the team, you have no responsibility, you constantly feel in the way..You get yelled at quite a bit. Having now been in residency in the US, I have seen how medical students are treated as very much part of the team and actually given a lot of respect. It's not really that way in Ireland. And for the money you pay, it should be..

In terms of getting into residency back in the states:

They don't really help you here, and i think that the atlantic bridge program says that they do, but they don't.. I skipped an entire 2 months during final med for STEP 2 ck,cs, and interviews. I heard that it is hard to skip time now to do this.

Living in Ireland:

Absolutely fantastic. You will make friends from all over the world, get opportunities to travel, be under less pressure for most of your years. You have to go there with an open mind though and stop comparing ireland to the US which a lot of north americans do on a daily basis.

Bottom Line:

1. Expensive- if I am not mistaken, this could be the most expensive medical school in the world. Less and less americans are going there because of this. Who is going you ask? A lot of rich canadian kids who it seems have a small interest in doing medicine but were really pushed there by their rich parents (again, my opinion). Having said that, there are a lot of great canadian students there who work really hard and do well.

If you are a rich kid, this place will suit you very well and you will love it. If you are paying yourself and taking out loans. You will probably be extremely frustrated with what you are getting for your dollar. You will also have a large sum of debt when you graduate - obviously, and may be trying to pay this off for at least a decade.

2. Getting into a residency in the States: you will have to work very hard during your last years and organize your time properly. And not only pass your steps on the first try but do well. You will also need experience (electives) in the states. Expect to get resistance during all parts of the match process from your friends at RCSI. If you are focused, however, you will match..

What types of residencies did my fellow RCSI students get? I'll name a few:

Plastics, Optho, Anesthesia, Medicine, Gen Surgery, Family Med, Pediatrics , Med-Peds, Radiology to name a few...

3. Experience:

You will get a different perspective. See how medicine works in other countries. Get great clinical skills. But will have to teach yourself a lot.

Thanks for listening and good luck.

 

[Lawliet2008]

"Clincal years: not so good. You don't feel part of the team, you have no responsibility, you constantly feel in the way..You get yelled at quite a bit. Having now been in residency in the US, I have seen how medical students are treated as very much part of the team and actually given a lot of respect. It's not really that way in Ireland. And for the money you pay, it should be.."

Is this true for RCSI or for all med schools in Ireland in general? By the way, thanks for the post, it is really educational

 

[ocularphd]

Hmm..I went to UCC. I wouldn't say "get yelled at" but more "humiliate"...
doesn't make it right and NOT all consulants (attendings) do that 🙂

 

[leorl]

It's not particular to RCSI, it's all schools. Now, I don't think many students get yelled at, but particularly in final year there will be points when everyone feels like a *******. It's to be expected. A particularly good scare tactic to get you to study even though no matter how much you study you'll still feel like you don't know anything.

Clinical teaching isn't great. Now that I'm an intern, I try to teach the students who rotate with my team some things that I wish I'd learned then, and try to engage them in the daily tasks. But because it's not in a logical fashion and it's sporadic, it just doesn't stick that well. Students don't get much respect, that is true. And it makes you even less motivated to turn up to rotations in which people don't show an interest in teaching you, no matter how eager you try to be (that just annoys them).

But what I have to say is that somehow, you do end up learning your medicine! I'm really quite puzzled as to how it happens, but you do somewhere along the way learn how to be competent clinicians.

I don't really think there is too much different in the way clinical rotations work here vs. the US except the big thing of US students absorbing patient management duties along the way. It might seem like a big thing, but US students would generally manage 2-3 patients from their admission. Irish students wouldn't be in charge of management but would go take histories and practice examination, then presentation, and then may be lectured in terms of further investigations/treatment. Either way you end up covering the same information. The US student might learn it better the first time around because they're actually doing it, but the Irish student will learn it again when it's reinforced during final year lectures/study.

The scary thing is that at the moment, it seems RCSI provides the most support for their students taking USMLEs and doing electives. I can tell you it is virtually non-existent in other schools, and as students we work around it by lying through our teeth and skipping stuff. My year in particular...we suffered for it.

 

[macslater]

I agree with Leorl. Eventually you will know your medicine/management skill very well if you are in Ireland. American med school students seem to be more prepared management wise at the end of their final year though. I have seen this first hand during residency.

To answer your question: It is all medical schools in Ireland where you don't feel like part of the team..We rotate through a lot of the same hospitals and I had friends from trinity and ucd.

Let me give you a couple of examples:

1. At the beginning of my final year I was on the Professor of Medicine's team at beaumont hospital. On my first ward round with him, he did not even look at me or my two other classmates for about an hour. What did I do? I left the ward round... When he found out, he had someone call me back, and then began to seriously pimp the hell out of me in front of the entire team . This i quite enjoyed because I answered every single question correctly having been studying hard for step 2. What was weird was that it seemed to disappoint him when i answered the questions right. This is the PROFESSOR of Medicine..

2. About a month later I was on another team. I hadn't met the consultant until the first friday of the week. Wednesday of that week I had step 2 to take. So hadn't seen him the whole week. He yelled at me for 5 straight minutes again in front of the team, telling me that I was training to be a doctor in ireland not the US. He then said later during the ward round to me "Medical students are like undescended testes do you know why? Because they are late showing up, and when they do show up , they are good for nothing!"

-Now that is funny I agree, but he was totally serious when he was saying it and he was very pissed off at me. It was like I ruined his day or something. He then slammed the door when he went into his office.

Driving to the hospital for the next few weeks, I just felt uncomfortable.. Am I going to get humiliated today in front of my classmates? Is this what I get for showing up every day, while some of my classmates are at home playing playstation? Is this the kind of learning environment you want?

As I look back having compared this with what I saw on ward rounds with students in the US during my intern year, I am just amazed at how much more supportive attendings are towards the students.


These are just some of my experiences, and of course there were a lot of good ones(including my final exam where I was praised by a consultant). In the end, I supposed I wouldn't change of those experiences as they do make for good stories, But for 60 grand a year!

 

[Unch]

Bottom line is that it may bite at times getting from A to B but the motivated students do learn just as much in the end. (Really, you have to teach yourself no matter where you are.) Another way of looking at it...a friend I have who went to Trinity and is now in 2nd year of ++ prestigious EM residency in Canada thinks of the harsh environment in clinical years (esp final med) as brilliant. In his view, it's an entire year of essentially bedside teaching that students at home don't get (they're too busy "managing" their few patients). He sees the sometimes humiliating "teaching" here as the stuff that can really stick and says he's consistently felt at least as solid if not more-so than the Canadian residents in his program.

I admit that clinical rotations can be hit or miss but in the six I've had so far at UCC, one has been truly superb, two quite good, one pretty good and one so-so. And in the so-so one, I still learned a lot, even if it was because I ran around finding things to do and fill in unsupported time. And I'd say that none of the rotations were at all scripted but by hanging around and "networking" my way through, I got access to a lot and learned an almost dizzying amount. And all this as an ultra-lowly third med. I don't know that I'd expect much better anywhere else. Will I have some crappy rotations? I'm counting on it but I'll have formulated some plan of my own by then and will make the most of my time. We'll see.

 

[Sage880]

I've said this before but I'll repeat it here: Pre-clinical years are fine. Pretty much everything up to and including Pathology is just lock yourself in the library and read, read, read anyway.

Clinical years are an actual joke. Every day you're here you'll do 5% of what medical students at home get to do and see. If you're especially keen and do everything you can to seek out learning opportunities to "make the most of it" you can raise this to 10% maybe. This lost exposure and lack of integration into a medical team is irreplaceable by trying to teach yourself.

You could do worse than coming to Ireland to medical school for sure but don't delude your self before hand that the experience will be on par with what you would have gotten in the States.

Thanks for posting your experience macslater.

 

[Badkarma25]

bravo to everyone who has posted in this regard. it's a really funny thing. friends of mine who were here studying medicine before i came to dublin told me how the clinical training setting was, and i didn't believe them. only after being here and being immersed in it did i believe it. it hasn't made me regret coming, but it just really highlights how poor the value for your dollar is when you go home to do electives and don't know how to write notes or put in an i.v. and look like an idiot compared to the canadian student halfway through their first year of medical school. i know it's like comparing apples and oranges but it's really demoralizing. the clinical training is COMPLETELY do it yourself and people should come in knowing that. you just have to try to see the funny side of it when it happens to you, which isn't always easy. it does make for good stories to tell north american students and doctors, who generally have trouble believing that kind of thing goes on. most importantly though, i think it really helps you develop a thick skin, and if you end up working in the states or canada you will be the most stalwart, non-complaining resident because they won't treat you anywhere near as bad as you got treated here.