What is the difference between rotating at a community hospital vs an academic hospital?

[thequackisreal]

Can someone give me some insight?

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[risperdoll]

Still varies by site policy and preceptor preference, but for the most part, community = more hands on exposure and student responsibilities, academic = chance to work with residents and make connections with residency programs. Academic hospitals may or may not also have more diverse cases since they tend to be where research and money are. But at my little community hospital, our medicine team sees all kinds of weird stuff from patients who live in the middle of nowhere and never see a doctor.

 

[Dr. Death]

Depends on what is meant by "community" and "Academic" as there are community hospitals with a full complement of residency programs.

 

[thequackisreal]

Depends on what is meant by "community" and "Academic" as there are community hospitals with a full complement of residency programs.

Would you please elaborate on more on that from a medical student standpoint and from a resident standpoint in terms of the type of experience received, cases seen, skill-set needed, type of doctor produced?

 

[Dr. Death]

Would you please elaborate on more on that from a medical student standpoint and from a resident standpoint in terms of the type of experience received, cases seen, skill-set needed, type of doctor produced?

From a residency standpoint, you won't see much difference. There are community programs that train you better than a lot of academic places and there are both academic and community programs that I wouldn't be caught dead at. The major difference is going to be access to research and fellowships. Some community programs have strong research and fellowships and some do not. Most of the fellowships are at academic centers and they usually have strong research infrastructure.

From a medical student standpoint, programs that have residents (whether academic or community) are going to give you better preparation for 4th year as well as residency. The experience will more closely mirror what you'll see in residency. Hospitals that don't have residents can give you great training, but often you will end up shadowing. Some people will point to procedural rotations (gen surg) as being good to not have residents because you'll get to do more procedures. However, the value of working with residents is that you learn how to be a resident. Your job as a med student is not to learn to be an attending, it is to learn to be a good resident. If you show up 4th year never having worked with residents, you will be miles behind your colleagues and look absolutely clueless, even if you got to suture 1000 port sites on your gen surg rotation.

As far as cases seen, skill-set needed and type of doctor produced. This is going to be program by program and not covered by a large blanket like academic vs community

 

[thequackisreal]

From a residency standpoint, you won't see much difference. There are community programs that train you better than a lot of academic places and there are both academic and community programs that I wouldn't be caught dead at. The major difference is going to be access to research and fellowships. Some community programs have strong research and fellowships and some do not. Most of the fellowships are at academic centers and they usually have strong research infrastructure.

From a medical student standpoint, programs that have residents (whether academic or community) are going to give you better preparation for 4th year as well as residency. The experience will more closely mirror what you'll see in residency. Hospitals that don't have residents can give you great training, but often you will end up shadowing. Some people will point to procedural rotations (gen surg) as being good to not have residents because you'll get to do more procedures. However, the value of working with residents is that you learn how to be a resident. Your job as a med student is not to learn to be an attending, it is to learn to be a good resident. If you show up 4th year never having worked with residents, you will be miles behind your colleagues and look absolutely clueless, even if you got to suture 1000 port sites on your gen surg rotation.

As far as cases seen, skill-set needed and type of doctor produced. This is going to be program by program and not covered by a large blanket like academic vs community

This is extremely insightful and informing! THANK YOU!

 

[akwho]

I did gen surg at a VA hospital with no residents as a 3rd year med stud and absolutely loved it. First assist for every single surgery. Since, it was a VA I could function as an intern write notes and orders to be cosigned by attending. I got a great letter from my gen surg mentor due to working with her so closely. I learned more on that rotation than any other. My other classmates who did gen surg at the academic mothership were up at 0430 prerounding and maintaining lists, couldn't write notes or orders and were quadruple scrubbed.

I recommend considering a site with no residents for surgical rotations, always better to be one step closer to doing the procedure.

 

[hungrydoc710]

I did gen surg at a VA hospital with no residents as a 3rd year med stud and absolutely loved it. First assist for every single surgery. Since, it was a VA I could function as an intern write notes and orders to be cosigned by attending. I got a great letter from my gen surg mentor due to working with her so closely. I learned more on that rotation than any other. My other classmates who did gen surg at the academic mothership were up at 0430 prerounding and maintaining lists, couldn't write notes or orders and were quadruple scrubbed.

I recommend considering a site with no residents for surgical rotations, always better to be one step closer to doing the procedure.

I feel like this mentality is true and extends to all rotations, not just surgery.

I say 3rd year rotate at a hospital without residents, and the 4th year do aways at hospitals with residents.

 

[deleted688779]

I say 3rd year rotate at a hospital without residents, and the 4th year do aways at hospitals with residents.

I’m new to this...but we have a choice?

 

[hungrydoc710]

I’m new to this...but we have a choice?

You have a choice in rotation location at many DO schools - so many students in a class does not allow for the entire class to be in the same hospital or even city for 3rd year - so class gets broken up.

For example, my school has many rotations sites in various places in SC and NC, but also in Florida.

I chose (along with my gf) to go to a bigger city in SC (Charleston) at a hospital without residents. Hopefully I will acquire skills during third year that I can showcase during my away rotations 4th year back home in my city of Detroit.

End of the day OMS3 is what you make of it.
Stay the hour late, ask questions, show up early, do presentations, get involved with research, and grind for Step 2.
You'll be good.

 

[BocephusTim]

I'd agree with all previous posts. It's important to get a nice mix of both large academic centers and small community hospitals and clinics. There are advantages and disadvantages to both. I did a vascular surgery clerkship with an attending at a small hospital where there were no other students or residents on his service so I got to first assist on every case he did. But he didnt really teach me the basics of suturing so I was mostly just holding retractors for hours on end. When I did a general surg. rotation at a large urban center, I didnt get to first assist on any case but the residents took time to teach me basic knots and other techniques.

I agree with the person who said your MS4 year should mostly be at places where you're training side-by-side with residents and seeing how they function on a daily basis since you will be one in a few short months. You're not supposed to function like an attending until your final year of residency or fellowship.