What does it mean to have "good" 3&4th yr rotations?

[donkeykong1]

After researching sdn posts on the topic of choosing/ranking/finding the best osteopathic medical school, the answer usually centers on desires, cost, location, and most importantly clinical rotations. others say rotations are what you make of them, and that there isnt really a difference between rotations at different schools, since after all they are required to have affiliated hospitals.


Granted state osteopathic medical schools like umdnj, msucom, unt-com, osucom, oucom, i would assume would have the advantage of keeping their rock solid sites since they are state funded. but still as match lists indicate their students' success is comparable to private schools.

I guess this is why some schools like LECOM-Erie and LECOM-B attract so many applicants, they have great cost, great location choices cool erie and sunny LECOM-B. regarding rotations well obviously they know what they are doing just look at their match lists.

Lastly, i was looking at the do-online residency opportunities website, and i noticed quite a few times that many of their residencies are spread out. so for example if you were interested in pm&r, turns out that nycom maintains i think 2/3 sites, so would nycom students who were interested in pm&r have the edge over students at other schools. i know you can schedule away rotations, but would nycom give you an "edge" for that pm&r residency of making connections over another school?

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[drctother]

To answer your general question, I believe its really what the person wants. So a school that has 3rd and 4th year rotations that can get you into a residency YOU want.

The quality can also be based off quality of hospitals that the rotations occur at and the hospitals that residents match at based off these rotations

Location is probably another key part in "quality" because most people dont want to be stuck doing rotations at some ghetto rural hospital (just saying)

 

[Cheshyre]

"Good rotations" - I'd say it's a pretty loose term on SDN. I'm pretty sure it can be applied to just about any school that has a stable, adequate number of rotations and at least one decently sized hospital listed as an affiliated site.

Personally, I think the rest is up to you. Some people say that rural hospitals show you just as many cool cases and are more hands-on. Some people want to see a busy urban center (also to see cool cases and to get more experience). I looked for a school with a good amount of elective time so that I would be able to go see whatever I would want to in the future.

 

[TexasTriathlete]

It is subjective to some degree, but I'd say that "good rotations" are rotations where you will learn a lot of medicine. So in some ways, it will be what you make of it, and in other ways, the attendings/residents and the environment will determine the quality.

Now there are a wide range of places to rotate, and I will use two extremes as examples:

1. I did my research at Grady, which is a massive Level 1 trauma center, along the same lines as places like Cook County Hospital, Parkland, Jacksonville-Shands, New Orleans Charity, Ben Taub, and every other major inner-city teaching hospital that you're thinking of.

At Grady, it is awesome. You'll see everything under the sun. I really love being there. But as a student, it could probably be better. They are so busy and so crowded, and there are a million people from every service down there, that the students can kind of get lost in the shuffle, at times. My PI on my project says that he actually prefers to have students at Emory Midtown (another hospital that Emory uses) because it isn't quite as busy, and he has more of an opportunity to teach.

At places like this, you're likely to have attendings who really want to teach though. The question is: will they have time?

2. Community-based hospitals - a smaller place might not get any trauma, and if you're on their EM service, you won't see a huge amount of variety. However, don't sell short the interesting medicine cases that can present at places like this. If you're on the surgery service, you may just be doing a bunch of gallbladders and appys.

However, you won't have a million students and residents and off-service providers and witch doctors and medicine men consulting. A lot of times, it might just be you and the attending. So you've got a good opportunity to learn how to do the common things very well. And you may actually see a surprising amount of interesting medical cases.

I think both are important, and there are places where you may be able to get a good mix of both.

Now I don't know for sure, but I don't think there are any schools out there whose hospitals are simply inadequate. There may be services that you aren't in love with, or you think you didn't get much out of it, but I think these will be the exception, rather than the rule.

I have recently become familiar with the rotation sites that I will be using for my clerkships at GA-PCOM, and I'm pretty happy with them. I signed up for a neurology rotation that I wasn't too thrilled about, but after talking to Dr. Craver (the person who runs our clinical education), I'm actually pretty excited about this one.

I'm sure there will be places I like more than others, but I think I'm positioning myself to be well educated. And I would imagine that this opportunity exists at most schools.

 

[Skippygonenuts]

It is subjective to some degree, but I'd say that "good rotations" are rotations where you will learn a lot of medicine. So in some ways, it will be what you make of it...

....I'm sure there will be places I like more than others, but I think I'm positioning myself to be well educated. And I would imagine that this opportunity exists at most schools.

I think TexasTriathlete pretty much hit the nail on the head. A "good" residency is defined by what your looking for in a residency. If you'd like to serve a small rural community one day, then maybe rotating in a rural ghetto hospital would be good for you. All depends on what it is you're interested in...

 

[Dr Skeptismo]

...if the rotations are in Chicago.

I chose CCOM(obviously), but mainly because IMO it has the strongest rotations. If you need more reasons though:

1. I like the fact that I'll be able to do all my rotations in and around one city. The fact that it's also the most happening city in the world, is a happy coincidence. Some schools require doing rotations in other states which isn't really an option for me. For instance, I really liked Nova until I found out there was a chance I'd have to do rotations in NY.

2. Being able to do these local rotations at sites that have residency programs is also a plus. Lots of those in Chicago, and it's very likely (when the time comes) I'll be applying for a residency at many of these well known programs.

3. Call me old-fashioned, but I also like having established rotation sites. I'll be under enough stress studying for boards w/o having to find and set up rotations on my own. Compounded further if I also have to figure out where to live and how to afford living in a different city/state during the rotation.

4. I want to do rotations at places that are accustomed to having med students. This way I can be confident in getting a more standardized education from doc's that are used to teaching. I'm sure you can find great sites that don't normally have students, but I'd be worried to find a place that had no idea what to do with me.

5. Lastly, having opportunities to do a lot of electives/selectives was important. I can make sure to either have broad exposure to all the fields I'm interested in, or just have a lot of time for audition rotations at several different programs in my one field of interest. Some schools have mandatory rural rotations, but if you're not interested in rural medicine this could be time lost.

 

[donkeykong1]

you all make great points. the main implication for me however when choosing schools is cost. however i do not want to compensate lower costs for low standard rotation sites. being a native New Yorker, a school like nycom is an attractive option since it has the types of quality rotation sites you mentioned. i know they are quality rotations since i have been to these sites myself and have shadowed physicians and hung out with ms-3 and ms-4s.

but schools like ccom and nycom have one major drawback-TUITION! what is it now at nycom~48,000? and at ccom close to 60,000?

all of this makes me turn to a school like LECOM, great location, great cost, shouldnt really stop me from coming back to NY for residency since its on the east coast, but rotation sites that i'm not really familiar with, not really sure how "strong" [whatever that means] millcreek community hospital and other LECOM sites are, in comparison to NYCOMs north shore-lij, nyhq, st.vincents.

i'd be curious to see what LECOM-E students have to say about their experiences with their rotations, although imo both schools will most probably get you into where you want to go after graduation.


[note i have not yet applied to schools yet, just trying to research schools and get more info]

 

[J1515]

you all make great points. the main implication for me however when choosing schools is cost. however i do not want to compensate lower costs for low standard rotation sites. being a native New Yorker, a school like nycom is an attractive option since it has the types of quality rotation sites you mentioned. i know they are quality rotations since i have been to these sites myself and have shadowed physicians and hung out with ms-3 and ms-4s.

but schools like ccom and nycom have one major drawback-TUITION! what is it now at nycom~48,000? and at ccom close to 60,000?

all of this makes me turn to a school like LECOM, great location, great cost, shouldnt really stop me from coming back to NY for residency since its on the east coast, but rotation sites that i'm not really familiar with, not really sure how "strong" [whatever that means] millcreek community hospital and other LECOM sites are, in comparison to NYCOMs north shore-lij, nyhq, st.vincents.

i'd be curious to see what LECOM-E students have to say about their experiences with their rotations, although imo both schools will most probably get you into where you want to go after graduation.


[note i have not yet applied to schools yet, just trying to research schools and get more info]

Look very carefully at all of LECOMs affiliations. Some of their hospitals are as small as 80 beds. Then find out how much of a choice you have in where you want to go for 3rd/4th year rotations (ie - will you be forced to go to this 80 hospital bed for a medicine/surgery rotation). This is not to say a small hospital is necessarily bad since attendings often have more time to teach. But when I think of small, I think 200-300 beds. I don't know if you will have enough pathology of even the common everyday stuff in an 80 bed hospital. All stuff to consider.

 

[p30doc]

I've heard that PDs for more competitive ACGME programs like your rotations to have been done in the traditional med student -> intern/resident -> attending teaching structure. Sometimes schools will have rotation sites where there are no residents, where it is just med student(s) -> attending. The merits of each setup is debatable.

 

[TexasTriathlete]

Every program will have something different that they're looking for. Some places might not like the way your rotations were set up, and that is their prerogative. But I don't think its necessarily a deal breaker if you're good.

 

[Donvb]

all of this makes me turn to a school like LECOM, great location, great cost, shouldnt really stop me from coming back to NY for residency since its on the east coast, but rotation sites that i'm not really familiar with, not really sure how "strong" [whatever that means] millcreek community hospital and other LECOM sites are, in comparison to NYCOMs north shore-lij, nyhq, st.vincents.

i'd be curious to see what LECOM-E students have to say about their experiences with their rotations, although imo both schools will most probably get you into where you want to go after graduation.

I matched into Radiology in Tulsa, Oklahoma and am a student from LECOM-Erie. To be very honest, no matter which school you attend YOU make the most of your opportunity and will be able to match wherever you are interested to go. (Granted YOU get good board scores, rotate well, and get good grades) A huge part of your success in medical school, and in getting the residency of your choice, is your own personal decision making/hard work!

One huge benefit of LECOM-Erie for me was that they give us numerous elective rotations and I was able to travel the country doing Radiology rotations, getting to see numerous different residency programs. But, most schools allow you to at least do some elective rotations...

In the end, tuition IS a big deal, and i'm not sure how much you can base your decision on "good rotations."

Another thing, Millcreek hospital totally sucks! It does have a lot of residencies, but the competitive residencies (ENT, Ortho, Optho) spend very little time at the hospital. But as a LECOM student you won't have to spend to much time at that hospital if you don't want to, and there are some rotations that are decent.

Any other questions let me know!