Teaching Hospital Vs Distributive Model

[Honey_Bunny27]

Hello! I have a few interviews this cycle and am really banking on getting in (second time applicant)! However, this is something that has been on my mind. 2 schools I applied to use the distributive model and the others have a teaching hospital. I am all over the place when people compare teaching hospital and distributive models for clinical years. What are pros and cons to each type of clinical year experience? Besides the cost of the schools, is this often used as a deciding factor when choosing a school?

---

Members don't see this ad.

 

[zenarcade]

Personally I would choose a teaching hospital over the distributive model (setting aside cost for this discussion). While I'm sure both types of schools provide a good education in the end, it's nice having the teaching hospital on site. Here at WSU, students are able to shadow in the VTH starting year 1 if they want, and there's also job opportunities for people to work 1-3 year at the hospital, so you are able to get clinical exposure before 4th year, and make connections with clinicians if you choose. And I can't help but wonder, with the distributive model, how the quality of all the rotation sites is assessed? I just imagine it's more difficult to ensure consistency of quality with so many off-site locations to assess. And here, while there are some rotations you need to travel for, most of them are on campus, so there's less traveling for 4th year required. I don't know if this holds true for all schools on the distributive model, but most of the ones I've looked at charge the same tuition rate for 4th year, even though students are travelling for all their rotations and presumably wouldn't actually be at school most of the time? That just kind of rubs me the wrong way.

But obviously lots of people attend schools with distributive models and enjoy the experience, and graduate as good doctors. I'm sure there's pros to that model that I'm unaware of because I don't attend one of those programs.

 

[Honey_Bunny27]

Those are some really valid points. I did not think about the cost aspect of it. I see that cost can increase for 4th year due to having clinical rotations elsewhere. Do you think the teaching hospital prepares you well for real clinic work outside of a more controlled setting?

 

[WildZoo]

As a caveat, I think there is going to be some bias in the answers you get because nobody experiences both models. So most people will probably favor the type of program they experienced.

For me, having the teaching hospital on site was amazing. I spent time in the clinic starting first year. That's both incorporated into the curriculum and something we were able to do in free time. I worked in the large animal hospital during 2nd and 3rd year, volunteered in the ER, volunteered in the exotics department. And since I want to specialize, it was beneficial to be able to form those relationships with clinicians early on.

Now, if you know from the outset that you want to work in GP, I can see where the distributive model would be beneficial. You can spend a lot of time in the kind of clinics that you'll end up working in, you can basically use your rotations as working interviews both for clinics to get to know you and for you to get a really good idea of how the clinics operate. At most schools with teaching hospitals, you're not going to get as much time doing the things that are really the nuts and bolts of GP, because you're mostly going to be on specialty rotations.

The one big thing that bothers me about distributive model schools is that they tend to be just as expensive as schools with teaching hospitals, and I really don't understand how they justify that.

 

[Honey_Bunny27]

@WildZoo, I am currently interested in small animal GP and ECC. Also, I worked with an exotics vet before and I could see myself building a deeper interest for Avian/Pocket pets. Any recommendation for if a teaching hospital better suits my interest or if distributive model is sufficient?

 

[zenarcade]

Those are some really valid points. I did not think about the cost aspect of it. I see that cost can increase for 4th year due to having clinical rotations elsewhere. Do you think the teaching hospital prepares you well for real clinic work outside of a more controlled setting?

I'm only a first year so I don't know that I'm the best person to answer this; obviously the teaching hospital experience is pretty different from the average GP office, although some of them have GP rotations. I think it's valuable to be exposed to gold standard, speciality medicine, even if you aren't planning on practicing in that kind of environment. Also, even at schools with a teaching hospital, there are rotation slots for off-site externships, so you can still get some more "real world" experience. I'm not really sure how the teaching hospital or distributive model compares for ECC and exotics as you mentioned, here at least we have an ICU and an exotics department, I imagine most schools do as well. But I assume that even on the distributive model you could try to seek out specific locations that fit your interests.

 

[WildZoo]

@WildZoo, I am currently interested in small animal GP and ECC. Also, I worked with an exotics vet before and I could see myself building a deeper interest for Avian/Pocket pets. Any recommendation for if a teaching hospital better suits my interest or if distributive model is sufficient?

I really am not sure. You might ask current/past students from the schools you're interested in if they know where other students and classmates ended up - for example if they know anyone who ended up in ECC or exotics and how beneficial they felt their exposure and education was during school. I do think that either will probably suit you fine - if you find good clinics at a distributive model school then I'm sure you'd get good experience. From my limited perspective (just from speaking with LMU externs and grads since I'm in the area), it seems like you kind of have to do some of your own legwork there, but there is flexibility in finding locations that would fit your interests. All schools with a teaching hospital are going to have an ER, so you're guaranteed to get exposure to that. They might not all have a decent exotics caseload, but exotics is one of those things that I think for most people you only get super comfy with after graduation anyway. I think in general it just seems like there's less of a guarantee and uniformity in education with a distributive model - I don't think the oversight in evaluating rotation locations is all that great sometimes. But I think it can work out for people. At the end of the day my main concern for most people is going to be cost of attendance.

 

[MixedAnimals77]

FWIW as @WildZoo said alot of bias considering no one can attend both 100% . However, we just interviewed a new grad from a distributive model and I went to a VTH. As far as like CYA and where vetmed is going, I think going through a VTH is beneficial in the fact that you get exposed to the ivory tower even if you never end up practicing ivory tower medicine. For example I know alot of what you can accomplish with an endoscope in small and large animals. Said grad had no idea all the things you could do with a scope. So it's nice to have that knowledge so you can talk to clients more indepth about referral, why it's important, and is a great CYA in GP and even in ECC if you end up in a place that may not have all the things.

QOL and things you might get to do is likely more in a distributive model, but it really is practice dependent. On the other hand you get great exposure to a variety of practices and how things can be done.

As far as preparedness, N1 experience, I ended up basically solo 1 week into my first job and it's been fine, but I really think it depends on you as a person and your previous exposure to vet med. Going through school I knew I was likely going to end up solo and having to figure things out on my own, just wasn't necessarily expecting to be on my own so soon. Most of my mentorship is on the level of sending pictures and phone consults. However, it's what I'm comfortable with because I knew I was likely going to end up on my own. I paid alot of attention at my old clinic (pre-vet and during school) and participated in clubs, classes, asked to do things in clinic where I learned the extra things I knew I would need. Some of my classmates are still very hands on with mentorship and I think the same would be true no matter a VTH or distributive model because it's so individal dependent.

 

[Honey_Bunny27]

I appreciate all of the input. I really need to spend time introspecting for the next 2 months and see which type of school would be a better fit for me and my goals.