What aspects of M3 and M4 should I consider when researching schools?

[pepes1lv1a]

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Pretty self-explanatory. I want to have an informed opinion about how the experience can differ from school to school, but I don't really know where to start. I asked one of our DO residents the other day what he would do differently if he had to apply again and he said something to the effect of, "Considering the third and fourth year clinical rotations in choosing schools."

 

[Lya]

M3:

The richness of pathology, patient diversity and volume coming into hospital. The more diverse it is, the more you will learn.


M4:

Flexibility. The more flexible you get to do away rotations of your specialty of interest and other electives, the more you will have a control over what you want to do.

 

[pepes1lv1a]

M3:

The richness of pathology, patient diversity and volume coming into hospital. The more diverse it is, the more you will learn.


M4:

Flexibility. The more flexible you get to do away rotations of your specialty of interest and other electives, the more you will have a control over what you want to do.

This is exactly what I was looking for. Thank you! So it sounds like when researching schools, this translates to focusing on the specific hospitals that the school does rotations at and the policies regarding electives?

 

[jeghaber]

Here's a thread that I've saved from a few years ago. The first post is excellent as are many of the comments that follow:

http://forums.studentdoctor.net/showthread.php?t=820524

 

[JJMrK]

A couple things, in no particular order:
- Number, location, distance between and patient population (VA, county, VIP, trauma, etc- the more the better) at various hospitals.
- Flexibility built into the schedule, electives during MS3 (the more the better), number of required rotations during MS4 (do they make everyone do a subi in everything, or is it one and done?)
- Strong department and residency program in field(s) you are interested in
- Time off for step 1/2
- Grading system (Does everyone get honors or only 5% of the class?)
- Ability of school to match people into your field(s) of interest (this is really student dependent, but if you see multiple competitive specialties at well known programs, the school is likely doing something right)
- Is there AOA?

Having said that, mandatory lecture MS1/2 years trumps some of these, IMO.

 

[willen101383]

A couple things, in no particular order:
- Number, location, distance between and patient population (VA, county, VIP, trauma, etc- the more the better) at various hospitals.
- Flexibility built into the schedule, electives during MS3 (the more the better), number of required rotations during MS4 (do they make everyone do a subi in everything, or is it one and done?)
- Strong department and residency program in field(s) you are interested in
- Time off for step 1/2
- Grading system (Does everyone get honors or only 5% of the class?)
- Ability of school to match people into your field(s) of interest (this is really student dependent, but if you see multiple competitive specialties at well known programs, the school is likely doing something right)

Having said that, mandatory lecture MS1/2 years trumps some of these, IMO.

This.

Id add the ability to rotate in some community hospitals if you wish. I personally had much better experiences at community hospitals vs academic. Academic hospitals are important because they teach you how to be an intern, and the hierarchy and flow of the hospital. Community hospitals are important because you have more ability to learn how to do procedures, and have some autonomy during late m3/m4. A good mix of both is key IMO.

 

[Doudline]

Free lunch at the hospital's cafeteria.

 

[RogueUnicorn]

M3:

The richness of pathology, patient diversity and volume coming into hospital. The more diverse it is, the more you will learn.


M4:

Flexibility. The more flexible you get to do away rotations of your specialty of interest and other electives, the more you will have a control over what you want to do.

you're not going to get a good answer to any of these

 

[kyamh]

Here's a thread that I've saved from a few years ago. The first post is excellent as are many of the comments that follow:

http://forums.studentdoctor.net/showthread.php?t=820524

Thank you! This was a great read!

 

[Lya]

you're not going to get a good answer to any of these

Any particular suggestions or advice, besides other posts above?

 

[mvenus929]

My $0.02:

For M3:
- Where do you do rotations? All in one hospital system, or varies? Where do you do outpatient rotations (private practice vs resident clinic, etc)? How many away (away from home institution) rotations are you required to do?
- How much flexibility do you have in selecting the services you rotate on? Most schools require that you do Surgery, IM, Peds, OB, etc, but can you choose to rotate on Trauma surgery instead of colorectal surgery (also, how many services are there) or stroke service vs epilepsy on Neurology, etc?
- How much exposure to subspecialties do you get (for surgery, neurosurgery, urology, ortho, etc; for medicine/peds, pulm, cardio, endocrine, etc)? If you only rotate on the general services, how much exposure do you get to subspecialty patients (on peds wards, do you take care of the cardiac kids, the heme/onc kids, and the endocrine kids, or just the general peds ones? On IM, is there a separate service for cardiac, pulm, GI, or are they all on the same team)?
- How do you decide the order of rotations? Is it a set order and you pick what you start with? Is it predetermined? Can you do things in whatever order you want?
- Outside of the core rotations (IM, Surgery, OB, Peds, Psych/Neuro), what 'electives' or other specialties do you rotate on during third year?

M4:
- How long is the year? (this pretty much goes back to how long the first two years are, because often if they're shortened, the extra time gets added to fourth year) When does it start?
- What are the requirements you need for graduation (how many AI's, any other elective requirements?)
- How much time off do you get, and how is it scheduled?
- What sort of electives are offered?
- Can you make your own electives?
- Are international electives available, and if so, what sort of funding is available for them?

Some of these questions may matter to some people more than others, but it's still good to know about them across different schools.

 

[VisionaryTics]

you're not going to get a good answer to any of these

Why not? If I were a med student doing a tour or interviewing a pre-med, I would absolutely answer all of those questions honestly to the best of my knowledge.

 

[pietachok]

Pretty much as mentioned above:

MS 3: Where do you do your rotations?
1) Specifically, do they have guaranteed rotation sites at a home/local institution for all of the required rotations.
Some schools send you on tons of away rotations -- they don't have enough local arrangements to ensure you can stay in the area for all of your mandatory rotations. This can be good in terms of your ability to essentially use your rotation to get known at a hospital you might want to attend for residency, but really, you can't impress anybody for much of your 3rd year. And each time you go to a new hospital, the first week has an awful learning curve for the logistical stuff like getting to use the medical records system. Going through that is a waste of several days of your rotation.
2) How many of the sites they use are outpatient clinics? With the exception of family med, I would make sure that there is an option to do everything at a hospital if you want to, because the exposure in clinics can be limited, and you want to make sure that's not going to happen to you in the field you want to pursue (e.g. if you want to be a neurologist, you want to do your rotation at a hospital).
3) What rotations are mandatory and when? Some schools have all required surgery as an MS3, some have neuro in MS3 versus others in MS4 and some don't require it at all, some have required Emergency Med and some do not. Someone else said you want lots of electives in your 3rd year, but I don't know how you'd do that and still have your core rotations done by 4th year -- a lot of programs require core rotations to be completed before you can do a visiting rotation (obviously not talking about away rotations that are to fulfill core rotation requirements that your school doesn't offer at your site). I think 1 or 2 electives in 3rd year is sufficient -- 1 to take time off at the beginning of MS3 to study for step 1 if you need it, and one towards the end for an elective in the field into which you will be applying, but that second one is really not necessary given the 4th year (tons of elective time everywhere) often starts as early as April.

MS 4:
This is a harder one to answer, b/c we aren't done with the year if we're an MS IV right now. Pretty much everybody I've met has plentiful elective time in their 4th year, because your school wants you to get into good residencies for the sake of their own reputation, and they know some residencies virtually mandate multiple away rotations. Additionally, they know you may not be able to do a rotation while interviewing. I guess you can ask what the structure is, but I can't imagine someplace really screwing their students on this.
1) How do they determine the schedule for your required rotations? Is it by lottery? If so, is there a chance you'll get screwed and have all of the mandatory ones early in your 4th year when you need to be doing advanced electives or audition rotations. My school does this, but if you're really hurt by the lotto, they'll fix it to some extent.
2) Find out from students how effective their advising is for residency applications. This is hard to gauge, b/c even MS IV's may not realize where the weaknesses are until later in the year. You can tell a bit of this by looking at the match list for the school -- how many people have only a pre-lim or transitional year? You can try asking how many had to SOAP/scramble, but I'm not sure they'll tell you. Some schools do a terrible job of advising, and I had no idea until I met people on away rotations who came from schools that never told students they had to apply for prelim positions if not applying to categorical residencies, so they matched to an advanced program beginning in PGY-2 but had to forfeit it b/c they had nowhere to do PGY-1.