What are some less obvious factors to consider when selecting a school?

[xkcd6330]

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Want to preface this by saying that I recognize that most people in this process get zero or one acceptance, so this is usually a moot point. That said, when comparing schools, everyone knows to look at things like cost, location, P/F, preclinical length, etc; I might make a help-me-decide post later on, but right now I'm struggling to make a choice on the basis of those (admittedly more important considerations). So:

What are some subtle factors that most applicants wouldn't know to look for, but that in retrospect many med students would say have an impact on their experience? Examples of what I'm thinking about might include things like whether preclinical exams are NBME or made in-house, or what the exam schedule is like (frequent exams with less content on each, or vice versa).

Current med students and/or grads might be better equipped to answer this, but I wasn't sure if posting this in the med student forum was allowed. Thanks!

 

[Destalchemy]

I wont apply to a school if their wellness lecture isnt at least an hour and a half per week

 

[Cornfed101]

Take a look through some of the questions that Goro recommends asking in your interview and it will give you a good idea of what you should be looking for.

Goro’s guide to YOUR interview questions-2018 edition

Many thanks to Affiche for prompting this!


Congratulations to all of you who have interviews! With them coming up, I know a lot of you are focused on doing well and getting accepted. But keep in mind that the interview process is a two-way street. You need to interview the school as much as they need to interview you. You’re going to dump what, $200K-500K into this school…are they deserving of your money and four years of your life? So I’m thinking like a dad...I'd want to know all this stuff if my kids were heading off to an interview!


Here are the two greatest posts on this subject, from Med Ed and SouthernSurgeon. These are MUST READS!:

http://forums.studentdoctor.net/threads/how-to-tell-strength-of-clinical-years.1048294/

see post #2 from SouthernSurgeon in the above


http://forums.studentdoctor.net/threads/choosing-a-medical-school-an-insiders-perspective.1208264/



Here are some things to consider asking when you interview. I can’t begin to stress enough that you especially ask these questions of the students, since they made the choice already. You’ll want to hear something other than “it’s the only school that accepted me!”



Campus life


If the current students turned down other acceptances, why?


How tight are the students? Do they lose the gunner mentality? (Mine lose theirs as soon as they set foot on campus).


Are the Admissions folks nice? Helpful?


Is it hard to get loans? Easy? Help with the process available? (probably!) How about scholarships???


How's the anatomy lab? Stink of formaldehyde??? (Ours is great, BTW)


Faculty have open door policy? Why are the Faculty there and not at some other med school (or college)? Is teaching a nuisance that they have to get out of the way before they can run back to their labs? Do Faculty teach more about their own research than stuff you need to know for Boards??


Cost of living


People say location is everything. You should find out how easy it would be to get a place to live, where do most students live? Any places to avoid? Any resources for finding a place to live? How are commute times? Is the locality friendly to minorities or GBLT?





Education



Do students have time to do research? Volunteer with community? See patients? For help with studying? Tutoring available?



Type of curriculum: PBL? Classic Flexner? Systems based?


Attendance? Required? I would shy away from schools like these. Adult learners can figure out their best learning style. Mandatory lecture can be a time sink. If lecture works for you, great, but it's nice to have the choice to not attend too.


Dress code? Again, you're adults...you don't need prompting for playing the part.


Tuition. There's a reason why people put up with the dress code at LECOM.


Lectures taped?


Grading: P/F? ABCDF? 1/2/3/4.0?


Textbooks? How much required reading? Any Faculty who exclusively test from the textbook(s)?


Are textbooks available a ebooks via the Library?


Class size?


Research opportunities? Some schools are definitely better at this than others.


Exam scheduling? Every week? Every other week? Blocks? Midterm + final only?


New school? Students tend to have a harder time on rotations because the Clinical Education people are new at this. Sometimes rotations get lost and students are left holding the bag for rent, or training, and have to scramble. This is less of a problem at established schools.


Further, a graduate of a new school may be an unknown commodity to PDs. However, some people like being pioneers and helping shape something from the ground up. New schools can also change bad policies faster than the older schools, which tend to have the mindset of "that's how we've always done it"!


Board prep time? If you can dig up the school's academic calendar, you can figure out the time for Board prep by looking at when their MS2 class schedule ends. My own students get about 4-6 weeks, depending upon when they schedule their exams. Weaker students take longer.


Step I scores and pass rates? Are they posted anywhere? The DO schools are now mandated to post their 1st time pass rates for COMLEX, FYI.


What Board prep resources are available to students?



I know that lots of people look at match list and get all starry-eyed. But Keep in mind that match lists are like reading tea leaves.


And where do their graduates go? For example, how many PCOM grads do residencies in MA??? How about Drexel grads in FL? Keep in mind that many students do have regional preferences.



Here's the most important thing to consider for those of you considering DO schools: Rotations. Preceptor or ward based? The former damage the profession because students need to learn how to DO things, not merely sit at the feet of the master and hear how to do things. This poorer training reinforces the poor perception of DO graduates that some PDs have. it's not the "cult of Still" mindset anymore...it's about how ready you are for residency.


- Do students feel like an active part of the team during their rotations? This question is best for MS4s. Are students mostly shadowing (bad), or actually assisting?


- What kind of "scut" work is there and how much of it are students doing on rotations?


Consulting patients and wheeling them around is "good scut", but being a fax mule is "bad scut".


- Are there scheduled electives during 3rd year, or are they only available 4th year?


- Are there mandatory away rotations? If you're near family/married, this can be hard.


- Are students getting clinical experience in both community and university hospitals?


- How are rotations graded? Is there a standardized grading rubric?


- Is there a limit on how many students can earn honors in each rotation?


- Is location of rotations up to a lottery?



I strongly suggest that you go through the school specific thread and see what the current students are saying about their school. I've noticed that in a good number of threads someone will post a negative, which then gets refuted in detail by current or former students. Some students are also very honest about the plusses and minuses of their schools.


From the wise LizzyM:

How, and how often, is feedback provided from your preceptor? Is there peer and/or self-assessment built into the clerkships? How is that operationalized? Is there a system for evaluating the preceptor? Is the school responsive to negative reports about preceptors?
Is there a mechanism for advising and mentoring that pulls what one is learning during various clerkships, helps to identify gaps in competency, and helps you plan to fill those gaps?

Are there enough slots in the most desirable electives for students to get what they want or is there stiff competition for elective rotations?
How "hands on" do you get to be? Is the student given sufficient opportunity to "do" or are students most often off to the side while residents and fellows engage in tasks that could be done by the student with supervision?

Are there opportunities for students to decompress and speak about experiences on clerkship with a faculty member who is not responsible for assessment?

BTW, don't ask these questions at an admissions interview... ask them at second look.



I'll probably think of more...but search through the forums........plenty of people have been through this already! But trust your gut first and foremost.

 

[Ganon]

One important thing is what their policy on failures is. Some schools are pretty generous, and some are a little harsher!

At the end of the day, we all go where we get accepted, but if you have a choice and one of the schools makes you retake an entire year if you fail, go with the other option.

 

[FalconSlice]

There're a multitude of things, I'll add more if I remember. These might seem random with no flow because they're literally flight of ideas.

Some things off the top of my head:
1. How much free time during M3 year (for interviews, relaxing, weddings, etc... do you have to sprint through all clerkships back to back?)
2. How many "required" lectures during pre-clinicals
3. M3 curriculum (e.g. do you have chance to explore specialties other than the "core" ones during this time or is that no viable. Might not be important to you, but it sucks to end up applying to internal medicine only to find out you didn't have the chance to explore radiology or something that you truly would love). Separate from #1 as this is for more of your career planning
4. How much Step I dedicated study time do they give?
5. How many small groups are there and how much time/effort do they take in preclinicals?
6. (if interested in research) what are the venues to be funded during this time? Are there fellowships available or do you have to scrounge to get $?
7. What are the criteria for AOA consideration at that school? (e.g. does Step I score matter? does preclinical performance matter?)
8. How many off-site rotations do they make you do? Do you want to? How far away? How to get there and back?

 

[hellanutella]

I found interview days to be largely preclinical focused, likely because most students you'll meet will be MS1-2s. However, there's only so many ways you can slice-and-dice preclinical material and, for better or worse, a majority of preclinical will be self-taught.

MS1-2 I'd prioritize the basics: P/F grading, lenient attendance policies, flex time for shadowing/research/service/self-care. Know your learning style. A strong auditory learner may thrive at a mandatory attendance school. For me, it'd be like beating my head against a wall. For those without a defined learning style or do not know their optimal modality, a curriculum that gives a little bit of each – lecture, PBL, independent study – will hopefully grant that liberty. However, lenient attendance policies grant you the most liberty.

Research: If there's required research during the summer, is it funded? For research years, is there an institutional process for funding or is it "apply for outside grants and hope for the best?" If you're ride-or-die X specialty, pubmed stalk the folks in the department. How often do they publish with med students?

MS3: Clerkships are where you get to build your real clinical foundation and, for many, is the laboratory where you get to try on different specialties for size. Unfortunatley, the (arguably) most critical part of your med school time is the most challenging to convey on an interview day. I'd second @Goro 's questions for parsing out quality. (I'd especially echo the team vs. preceptor question). It can be kind of hard to phrase these critical questions on interview day so, when in doubt, just ask about their favourite experiences. If their favourite experience sounds very hands-off or lacklustre, you've kind of answered a question there.

What is everyone's fav rotation site? Their least fav? (Why are these fav/least fav? How many people are sent to fav/least fav site?). Ask what their average day on medicine or surgery was like and what their roles/responsibilities were. If you're interested in a non-core rotation specialty (ex: GAS/EM/surg subsepcialty/rads) does the school afford you time during MS3 to actually rotate through and see for yourself, or do you have to do a "leap of faith" subI at the beginning of MS4?

MS4: How flexible is MS4? (How supported are students in seeking out aways?) Do you have required classes jammed from January through to graduation? Do you get time off for interviews? Tell me about some of the electives people pursue in MS4. What are your post-match plans? (If their post-match plans are "required classes" then big oof).

Because it isn't all peaches and cream: The med students you meet will likely know someone who has failed (if not themselves personally). Some of these questions are likely best geared to a host or current student you know through the grapevine. (Or ask away in the school specific threads). What is the policy for remediation? Did anyone struggle with the Match? Why? And how were they supported? If life suddenly goes all pear shaped – be it illness, death, what have you – what does the admin do to support their students in the face of tragedy?

 

[Jungkookie]

Definitely things like curriculum style (compatible with your own learning style), and also things like the overall culture of the institution, student involvement opportunities etc

 

[aldol16]

Look into the clinical years. Many pre-meds have no clue what clinical rotations looks like and what factors to consider so you'll do yourself a favor by learning early. Look at the sites the school rotates through and see if you can get a sense of how strong that school is clinically. Everything you mentioned, i.e. cost, location, pre-clinical curriculum, etc., is all for your experience. But the strength of your clinical training is what is reflected come residency time, when graduates from your school have reputations at other places that have influenced other programs' experience of students from your school. Obviously you want to have solid clinical training. Some schools also send students elsewhere for certain rotations so you should find out if your school does that too.

 

[Angus Avagadro]

I'm actually puzzled by the number of responses indicating they should ask about failure and remediation policies. I never considered that I might fail a course in med school, and didnt. I'm not saying there aren't issues that can lead to a course failure, family crisis, illness,(mono, etc.) I naturally felt the school would be supportive in those cases, allowing a W or I on my transcript. Not being able to handle the course material if an applicants stats are bonafide, I would think would be a relatively rare aoocurenc. 1 to 2% I would think .
Probably something to ask a student interviewer and not a Faculty. It might lend the impression the student might not be well prepared.

 

[deleted936470]

I'm actually puzzled by the number of responses indicating they should ask about failure and remediation policies. I never considered that I might fail a course in med school, and didnt. I'm not saying there aren't issues that can lead to a course failure, family crisis, illness,(mono, etc.) I naturally felt the school would be supportive in those cases, allowing a W or I on my transcript. Not being able to handle the course material if an applicants stats are bonafide, I would think would be a relatively rare aoocurenc. 1 to 2% I would think .
Probably something to ask a student interviewer and not a Faculty. It might lend the impression the student might not be well prepared.

I don't think the question implies that the applicant would struggle in medical school. The interviewer's response is informative.

"What kind of support or students services are available to those who are struggling?"

If the response is that everyone should be perfect, no one gets tutored, or "why would you ask that?" then I'd hope to get accepted elsewhere.
GPA + MCAT are used to assess risk of board failure or remediation, seeking a support system at medical school is prudent and healthy.

 

[Angus Avagadro]

I don't think the question implies that the applicant would struggle in medical school. The interviewer's response is informative.

"What kind of support or students services are available to those who are struggling?"

If the response is that everyone should be perfect, no one gets tutored, or "why would you ask that?" then I'd hope to get accepted elsewhere.
GPA + MCAT are used to assess risk of board failure or remediation, seeking a support system at medical school is prudent and healthy.

I think you phrased it better and would definitely be a better way to approach other issue. I also think it quite an appropriate question, better framed the way you suggest.The OP just seemed a rather negative way to phrase it.

 

[deleted936470]

I think you phrased it better and would definitely be a better way to approach other issue. I also think it quite an appropriate question, better framed the way you suggest.The OP just seemed a rather negative way to phrase it.

Agreed, I don't think it'd be too smart to frankly ask "what happens if/when I fail?" or "how many times can I remediate?"

 

[Select All That Apply]

@Angus Avagadro There is a more native antagonistic relationship between students and school administrators that started growing over the past decade or so within school institutions. A lot of it likely correlates with tuition hikes, student debt being a nationalized issue, and raising questions over the inherent value of educators and the education provided within institutions especially with the proliferation of online/third party resources. Asking an administrator about a school's failure policy is in the interest of the student as an individual if they need to hedge against a bad scenario where have to come into Step 2 with a sore throat and fever or a situation where they fail a class by one point. Students are afraid of being screwed over by systems that have seemingly low parameters for identifying their actual learning needs and want to know what the contingency plans are in case they aren't able to pass all the goal bars within the 4 year time frame required of them. There is a high investment that has been put into getting in, therefore to be concerned about losing a return on that investment from the four year commitment of medical school is a natural concern to most students.

 

[Angus Avagadro]

I totally get the investment. I also think we pretty much are saying the same thing. This is a case maybe of not so much what you say but how you say it. @camoixu said it in a much better way. Asking about support resources for students is indeed an appropriate question. I felt asking about remediation and failure policies was a bit too negative way to get the same information. If accepted, the school believes you have the qualities and skills necessary for success. For most of us, it's not our first rodeo and have helped students adjust to med school for quite awhile. My school is pro active to a fault about actively engaging students early in the semester. We would rather error by supplying support too early rather than allowing a student to get tsumanied.