What makes a school more primary care oriented?

[ocwaveoc]

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I'd like to know.
What I don't want to hear is how "it is up to the student which specialty he/she goes into as long as you perform" statement that I read often on this site. That is a given in ANY circumstance. For an example, even if you were born in the most destitute part of Africa, if you work hard, prove yourself, and apply yourself, you can give yourself a different life. But, the odds for him are not so great. As such, obviously there is a tendency for certain schools (some of the DO schools, for an example) to emphasize primary care. How is this emphasis manifested during the 4 yrs in med school?

1) Is the 1st 2 yr program geared more towards primary care issues? Certain classes?
2) Are there differences in the 3rd and 4th yr clinical emphasis?
3) If not, what is it?

If you look at certain schools, they produce 82% of primary care physicians. Why is this so?

 

[TheRealMD]

Funny thing is that primary care really just means less of a focus on research.

 

[ADeadLois]

1. Less Research

2. They actively select people who want to do primary care.

3. Statistical aberration.

It's hard to make the education itself "primary-care oriented", as medical education is extremely standardized. A lot of schools offer early clinical experience with internists, but this really doesn't orient people to the field so much that it teaches people how to do physicals, take histories, etc.

 

[Rotinaj]

So does that imply that other specialties already know what a primary care physician does and then they specialize through further studying? I'm not trying to knock PCPs by any means, just wondering.

 

[ADeadLois]

So does that imply that other specialties already know what a primary care physician does and then they specialize through further studying? I'm not trying to knock PCPs by any means, just wondering.

No. Internal medicine is its own specialty.

 

[ocwaveoc]

1. Less Research

2. They actively select people who want to do primary care.

3. Statistical aberration.

It's hard to make the education itself "primary-care oriented", as medical education is extremely standardized. A lot of schools offer early clinical experience with internists, but this really doesn't orient people to the field so much that it teaches people how to do physicals, take histories, etc.

Less research during the 1st 2 yrs? Hmm..would you elaborate? The reason I don't understand is that even at a very research oriented school, not everyone researches (probably a minority of the people research?). How does less research orientation of the school produce more primary care physicians?

Basically my concern is that I've been invited to interview at a school which churned out 82% primary care residents a few years back. I have nothing against primary care. I just don't want to goto a place where your chance of doing something different than what most people go into from that school is only 18% (for an example). I mean, if a certain school churned out 82% of say only 4-5 specialties but you are still not sure what to go into, would you want to goto this school or goto a school which gives you more of an option. Again, please do not respond "it's up to the student". Of course it is. But, the school you goto seems to have a significant effect in this case.

 

[TheRealMD]

Less research during the 1st 2 yrs? Hmm..would you elaborate? The reason I don't understand is that even at a very research oriented school, not everyone researches (probably a minority of the people research?). How does less research orientation of the school produce more primary care physicians?

Basically my concern is that I've been invited to interview at a school which churned out 82% primary care residents a few years back. I have nothing against primary care. I just don't want to goto a place where your chance of doing something different than what most people go into from that school is only 18% (for an example). I mean, if a certain school churned out 82% of say only 4-5 specialties but you are still not sure what to go into, would you want to goto this school or goto a school which gives you more of an option. Again, please do not respond "it's up to the student". Of course it is. But, the school you goto seems to have a significant effect in this case.

The goal of the school, not the education itself. The education is all the same since people who still would to go a "primary care" school will match in non primary care specialties.

In fact, it's not the education that's different. It's the school's mission and the people they would like to train. However, since no one is going to hold you to your app after you are admitted, it really doesn't matter that much.

 

[ocwaveoc]

A research-oriented school markets the side of the college that the med students barely see, namely the basic science departments that pull in NIH grants based on the credibility of their faculty. Primary care schools (typically in the DO realm) market themselves as PCP producers. If you know of an allo school with 82% matching in primary care, holla here or via PM.

Cute statistic--UTSW has 4 Nobel Laureates, basically quasi-retired scientists who choose to hold offices on the campus. Great billboard, nothing to do with the education you get.

Rest assured that regardless of where you go, you will still learn anatomy from Netter/Moore, physiology from Costanzo, and pathophys from Harrison/Robbins/Goljan.

Ultimately your medical destination is up to you. We all take the same USMLE, and all accredited schools cover the material that it is based on. You're making a serious mistake if you calculate odds with a matchlist.

If you really believe that "your medical education is really up to you" and the school really doesn't have to do with the type of medicine you'll likely practice, you are naive. Obviously you didn't read my posting completely. This is a public forum, so I suppose you can post what you want to say. But, I don't need your type of advice. You guys are the types who point out that Bill Gates didn't graduate from prestigious college (did he even goto a college?). So, as long as one applies himself, college isn't even necessary...type of a bs. You like to talk of exceptions rather than what is more prevalent.

I just want to get ideas on what makes school primary care and why so many of those school's grads go into primary care. Some of other posters' comments have been helpful. Thank you.

 

[ChubbyChaser]

No my friend I think You are the naive one.

 

[Doublecortin]

If you really believe that "your medical education is really up to you" and the school really doesn't have to do with the type of medicine you'll likely practice, you are naive. Obviously you didn't read my posting completely. This is a public forum, so I suppose you can post what you want to say. But, I don't need your type of advice. You guys are the types who point out that Bill Gates didn't graduate from prestigious college (did he even goto a college?). So, as long as one applies himself, college isn't even necessary...type of a bs. You like to talk of exceptions rather than what is more prevalent.

I just want to get ideas on what makes school primary care and why so many of those school's grads go into primary care. Some of other posters' comments have been helpful. Thank you.

I honestly think it has to do with how they pick their class. If school's administration thinks their mission should be to churn out primary care docs, then they'll try to look for indicators in people's applications of desire to be in primary care and serve underserved communities, and crap like that. Most top ten schools are very heavy on research because their primary mission (I know Yale for sure) is to produce academic physicians. So I guess they are gonna look for people with tons of research and an interest in academic medicine.

 

[ocwaveoc]

No my friend I think You are the naive one.

I am not your friend, grasshopper.

 

[ChubbyChaser]

Fair enough.

 

[TheRealMD]

A research-oriented school markets the side of the college that the med students barely see, namely the basic science departments that pull in NIH grants based on the credibility of their faculty. Primary care schools (typically in the DO realm) market themselves as PCP producers. If you know of an allo school with 82% matching in primary care, holla here or via PM.

Cute statistic--UTSW has 4 Nobel Laureates, basically quasi-retired scientists who choose to hold offices on the campus. Great billboard, nothing to do with the education you get.

Rest assured that regardless of where you go, you will still learn anatomy from Netter/Moore, physiology from Costanzo, and pathophys from Harrison/Robbins/Goljan.

Ultimately your medical destination is up to you. We all take the same USMLE, and all accredited schools cover the material that it is based on. You're making a serious mistake if you calculate odds with a matchlist.

Actually, sometimes the Nobel Laureates pop out of their labs to do a lecture or two in their field, but other than that, it's not all too often that med students see them. I'd still have to agree that you shouldn't go to a school based on how many Nobel Laureates they have (even UTSW pointed that out when I interviewed there) but other reasons that are purely up to you.

 

[Law2Doc]

1) Is the 1st 2 yr program geared more towards primary care issues? Certain classes?
2) Are there differences in the 3rd and 4th yr clinical emphasis?
3) If not, what is it?

If you look at certain schools, they produce 82% of primary care physicians. Why is this so?

The answers to your first two questions are no. First and second year are pretty standard at all US med allo med schools. Each school will try to work in a bit of "clinical exposure" which usually means you learn how to take a history and do a very basic physical exam from real live patients. But the basic science courses are all the same and people have to take and pass the same board exam, usually at the end of those years. Then 3rd year is basically the core rotations (surgery, medicine, OBGYN, psych...) and so that too is going to be the same -- everyone will be in the wards and clinical exposure will be pretty equal. Then 4th year you will have some electives, be interviewing, take the same Step 2 etc etc. So the answer is that med school is pretty standardized. There will be some schedule variations, some PBL, but otherwise pretty comparable curricula wherever you go. Do some people learn clinical skills better? Sure, but it is going to be individual and faculty specific, and bears virtually no relationship to the number of people from that school who actually go into primary care. The best clinical skills student is frequently a student who goes into a non-primary care field.

The schools that crank out lots of primary care physicians for the most part aren't better at primary care, they are simply not placing as high a percentage of its class into the non-primary care specialties. (Which is why no one on the pre-allo/allo boards puts as much stock in the US News primary care list, and instead looks to the research list which more accurately represents prestige (the one with Harvard and Hopkins at the top, and only uber competitive allo schools in the top 20). Putting more people into primary care is really putting fewer people into other things. Not that some people don't love primary care and choose it over other things (top students frequently choose IM to get to subspecialties), but because it is relatively non-competitive, so it is often the route of least resistance for the non-high-flyers of med school.

 

[ADeadLois]

If you really believe that "your medical education is really up to you" and the school really doesn't have to do with the type of medicine you'll likely practice, you are naive. Obviously you didn't read my posting completely. This is a public forum, so I suppose you can post what you want to say. But, I don't need your type of advice. You guys are the types who point out that Bill Gates didn't graduate from prestigious college (did he even goto a college?). So, as long as one applies himself, college isn't even necessary...type of a bs. You like to talk of exceptions rather than what is more prevalent.

I just want to get ideas on what makes school primary care and why so many of those school's grads go into primary care. Some of other posters' comments have been helpful. Thank you.

Believe what you want, but Ice Nine is dead-on.

 

[JSB235]

If you really believe that "your medical education is really up to you" and the school really doesn't have to do with the type of medicine you'll likely practice, you are naive. Obviously you didn't read my posting completely. This is a public forum, so I suppose you can post what you want to say. But, I don't need your type of advice. You guys are the types who point out that Bill Gates didn't graduate from prestigious college (did he even goto a college?). So, as long as one applies himself, college isn't even necessary...type of a bs. You like to talk of exceptions rather than what is more prevalent.

I just want to get ideas on what makes school primary care and why so many of those school's grads go into primary care. Some of other posters' comments have been helpful. Thank you.

Bill Gates went to a little known school in the east called Harvard. Ever heard of it?

 

[smq123]

If you really believe that "your medical education is really up to you" and the school really doesn't have to do with the type of medicine you'll likely practice, you are naive. Obviously you didn't read my posting completely. This is a public forum, so I suppose you can post what you want to say. But, I don't need your type of advice. You guys are the types who point out that Bill Gates didn't graduate from prestigious college (did he even goto a college?). So, as long as one applies himself, college isn't even necessary...type of a bs. You like to talk of exceptions rather than what is more prevalent.

* Try not to be so rude. It will keep you from matching in the specialty that you want because, guaranteed, your residents will pick up on it and comment on it in your 3rd year evaluations.

Basically my concern is that I've been invited to interview at a school which churned out 82% primary care residents a few years back. I have nothing against primary care. I just don't want to goto a place where your chance of doing something different than what most people go into from that school is only 18% (for an example). I mean, if a certain school churned out 82% of say only 4-5 specialties but you are still not sure what to go into, would you want to goto this school or goto a school which gives you more of an option. Again, please do not respond "it's up to the student". Of course it is. But, the school you goto seems to have a significant effect in this case.

In ONE PARTICULAR YEAR, this school churned out "82% primary care residents"? Some questions to think about:

1) Do they routinely churn out ~80% primary care residents? Or was that just what happened in that particular year? At my school, 2 people tried to match in OB/gyn last year. This year, 15 people are trying for it, which is more typical. But if you looked at last year's match list ONLY, you'd think "Wow, they don't produce a lot of OB/gyns there, do they?"

2) What percent of that 82% went into internal med or peds? If they went into internal med or peds, how many of them want to specialize in non-primary care stuff like heme/onc, cardiology, GI, ID? YOU CAN'T KNOW THAT BY LOOKING AT A MATCH LIST.

If you don't want to do primary care -

• Don't go to a school in the boondocks. Schools in rural locations were founded for the specific purpose of creating primary care doctors who will stay in rural underserved areas.
• Similarly, do not go to a DO school, many of which include primary care as their mission statement.
• Schools with large university hospitals that have well-known "specialty" departments MIGHT also create a lot of student interest in those fields. MIGHT.