What's the real difference between schools?

[Sage880]

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Hey, I was just reading this post (about which medical schools were on the rise) and started wondering what the difference is really?

Is a doctor from Harvard really that much better then from one from like a 50th placed school? They might have a better chance at getting the specialty they want but right after they graduate, will there be any difference? I guess average marks on USMLE's would tell that story. Is there a big gap between the schools?

I'm wondering about this because I'm Canadian and going to school in Europe and I was wondering what my education would be like compared to US schools. I've heard it's good (but a little less USMLE focused) but I wanted to know if people thought there was really any difference between the schools?

 

[8744]

Hey, I was just reading this post (about which medical schools were on the rise) and started wondering what the difference is really?

Is a doctor from Harvard really that much better then from one from like a 50th placed school? They might have a better chance at getting the specialty they want but right after they graduate, will there be any difference? I guess average marks on USMLE's would tell that story. Is there a big gap between the schools?

I'm wondering about this because I'm Canadian and going to school in Europe and I was wondering what my education would be like compared to US schools. I've heard it's good (but a little less USMLE focused) but I wanted to know if people thought there was really any difference between the schools?

I think different schools have a vastly different institutional cultures. I bet that Harvard is a good deal more "politically correct" then LSU. Other then that I don't think there's that much difference. On the other hand, I have only attended one medical school so I really don't know.

Never mind. The only bad medical school is the one that rejects you.

 

[IndyZX]

i really doubt there is any substantial difference in the first two years. the third and fourth years are what really differentiate medical schools, so you probably stand a chance of being taught the clinical stuff better at the more prestigious schools, since they tend to have the best and the brightest.

other than that, its probably all reputation. which matters quite a bit for getting your residency of your choice. you can argue that any advantage might end there, but getting an advantage in choosing what you want to do for the rest of your life is pretty appealing.

 

[SaltySqueegee]

NO. LCME accreditation dictates what the fundamental education (years 1-2) that is required for all to take before taking the standardized boards.

So, no.

Go where you want to go, where it is cheaper, etc.

Now where to do research or clinicals, that's a different story... Whether or not a school offers preceptors during the beginning years... etc.

 

[8744]

i really doubt there is any substantial difference in the first two years. the third and fourth years are what really differentiate medical schools, so you probably stand a chance of being taught the clinical stuff better at the more prestigious schools, since they tend to have the best and the brightest.

other than that, its probably all reputation. which matters quite a bit for getting your residency of your choice. you can argue that any advantage might end there, but getting an advantage in choosing what you want to do for the rest of your life is pretty appealing.

Whoa, Nelly! You stand a better chance of being taught the clinical stuff better if you attend a school attached to a large, busy, charity hospital with plenty of patients to go around. I know an intern who went to a prestigious medical school who had never done a pelvic exam, a Pap smear, delivered a baby, done a DRE, or inserted any kind of line. At my school we do these things routinely.

 

[Sage880]

Whether or not a school offers preceptors during the beginning years... etc.

Sorry, what does that mean? What are preceptors?

 

[adamj61]

What do they call the worst doctor that graduates from the WORST med school...


























Doctor? 👍

 

[IndyZX]

i wouldnt call the worst doctor from the worst med school, doctor. just my hardass opinion.

 

[SaltySqueegee]

Sorry, what does that mean? What are preceptors?

Preceptor is to Medical Student as
Willing-Physician to anxious Pre-Med Volunteer.

Basically a one on one experience with a doctor that will show you the ropes early on. Allow you to get your hands "dirty" so to speak, in a very controlled way. These experiences can range from once a month all day experience, to multiple shadowings per week, depending on the school. Definitely important if you consider early clinical exposure a must.

i.e. You will observe physical examinations, maybe take a few vitals, observe any pathologies that the Preceptor notices.

Basically a glorified Pre-Med Student with extra privileges because you're on your way to becoming a doctor in 4 or so years. 👍

 

[smokeycat]

Whoa, Nelly! You stand a better chance of being taught the clinical stuff better if you attend a school attached to a large, busy, charity hospital with plenty of patients to go around. I know an intern who went to a prestigious medical school who had never done a pelvic exam, a Pap smear, delivered a baby, done a DRE, or inserted any kind of line. At my school we do these things routinely.

I have to agree with you Panda Bear. I picked my schools based on reputation, but most importantly, what school would give me the most interesting clinical experience. I also looked at schools with good research centers nearby, too.

A former childhood classmate of mine went to a prestigious medical school and cried everyday of his residency (he did a peds residency at a children's hospital) b/c he was soooo stressed out. Apparently, he was never exposed the "crazy stuff" in med school. Eventually, it was suggested that he should change programs.

Where do you go to school Panda Bear?

 

[smokeycat]

Speaking of differences in medical schools...
I was reading this article about medical school that don't use cadavers in anatomy class.

http://www.wired.com/news/medtech/0,1286,58733,00.html?tw=wn_story_related

there are some other links listed with the article.

 

[skiz knot]

Location! Location! Location!

 

[skiz knot]

What do they call the worst doctor that graduates from the WORST med school...

Ya kinda screwed it up a little bit...

It's "what do you call the person who graduates last in their class of the worst medical school?"

 

[skiz knot]

i wouldnt call the worst doctor from the worst med school, doctor. just my hardass opinion.

You aren't gonna call me doctor?


Seriously, if they pass all required exams, and manage to stay board certified, why wouldn't you call them Dr?

 

[skiz knot]

The article is a little stupid, and is missing some vital information.

Do you think UCLA might be using cadavers less because of the recent scandal involving their cadaver program?

a quote from the article states, "And while UCSF's Patterson considers the "fumbling around" in dissection to be a waste of time, others say the classes allow students to learn on their own, a rare opportunity in the top-to-bottom world of medical school."

Have they ever been to medical school? No! How do they know how many opportunities students have to learn on their own? I would hardly say it is "rare."

 

[IndyZX]

You aren't gonna call me doctor?


Seriously, if they pass all required exams, and manage to stay board certified, why wouldn't you call them Dr?

well, i was responding to the "worst doctor from the worst medical school" thing... why would that incompetance demand any respect?

 

[adamj61]

Still doctor, you might be in those shoes someday. Just like the last guy drafted in NFL or NBA...still got drafted.

I'll break it down for you...3 ounces and 2 vehicles (sorry, couldn't help it with the title of this thread)

 

[skiz knot]

well, i was responding to the "worst doctor from the worst medical school" thing... why would that incompetance demand any respect?

There are minimum standards that are set up by physicians' peers. If they are able to maintain those minimum standards, they deserve respect. They are, by definition, not incompetent if they meet these minimum standards. If you feel that they still do not demand your respect, you are in turn disrespecting the physicians that have determined the standards.

If you feel that you will be/ are immune to making mistakes, just wait. Odds are that you will make a mistake in your career as a physician. God willing, it will not have serious consequences, but it is almost certain to happen. Will you then quit medicine due to your own "incompetence?"

 

[MedicationWorks]

Speaking of differences in medical schools...
I was reading this article about medical school that don't use cadavers in anatomy class.

http://www.wired.com/news/medtech/0,1286,58733,00.html?tw=wn_story_related

there are some other links listed with the article.

Not doing dissections yourself is probably the stupidest idea i've heard in awhile. It's amazing ANYONE would consider UCSF's idea adequate. There is so much variation in anatomy between cadavers, and pro-sections are not the same as the real thing since they have been "cleaned up" significantly. Doing the dissection yourself gives you a better mental picture than two-dimensional images ever could. as to pro-sections , you learn a lot more working through the dissection yourself, trying to figure out what things are.
Having the connective tissue and accessory structures present, is a must for getting a true picture of the layout / anatomy. I'd like to see one of the UCSF students take an exam practical on real non-prosected cadavers to see if they have the same competency as someone who did their own dissection. 100$ says they won't. They will probably think an accessory structure is a key one , since they never saw accessory structures before. They will have no ability to deal with normal variation.

The article implies an ENT surgeon does not need to know anatomy of the foot in such detail. Why teach an ENT biochem or neuroanatomy? Part of being an MD is having at least a minimal level of competency in all areas of medicine.

 

[WatchingWaiting]

Not doing dissections yourself is probably the stupidest idea i've heard in awhile. It's amazing ANYONE would consider UCSF's idea adequate. There is so much variation in anatomy between cadavers, and pro-sections are not the same as the real thing since they have been "cleaned up" significantly. Doing the dissection yourself gives you a better mental picture than two-dimensional images ever could. as to pro-sections , you learn a lot more working through the dissection yourself, trying to figure out what things are.
Having the connective tissue and accessory structures present, is a must for getting a true picture of the layout / anatomy. I'd like to see one of the UCSF students take an exam practical on real non-prosected cadavers to see if they have the same competency as someone who did their own dissection. 100$ says they won't. They will probably think an accessory structure is a key one , since they never saw accessory structures before. They will have no ability to deal with normal variation.

The article implies an ENT surgeon does not need to know anatomy of the foot in such detail. Why teach an ENT biochem or neuroanatomy? Part of being an MD is having at least a minimal level of competency in all areas of medicine.

The appropriate test would not be to see how they did on a practical with a cadaver (boy, that sure is relevant to being a surgeon), but to see if there is any difference in their performance on surgical or radiology rotations. An awful lot of dissection was very carefully hacking through layers of fascia and lard without really knowing where what you were looking for was (because you were rather overwhelmed with material and weren't really able to go through the day before and memorize where the next day's lab dissection structures were to be found). The reality is, my knowledge and most of classmates' knowledge of structures (outside of lecture and reading an atlas) overwhelmingly came not from dissecting but from spending two or three hours a week with the dissected bodies quizzing each other on structures.

Frankly, I doubt our final knowledge of the material would have suffered if professionals had been hired to dissect five or six bodies region by region which would then be studied by the students on a weekly basis after lectures. I wouldn't have minded the extra 12-15 hours a week in saved dissection time, and my knowledge would probably if anything have been increased by having extra time to study the structures on an already dissected cadaver rather than dissect.

I also don't see how you think doing a dissection gives some particularly good understanding of normal variation-- that also comes from looking at other bodies. By definition, you will only have one particular structure for all the parts of your body. I suppose there is a certain novelty to finding you have a rare variant, but it's not like there is some big difference in understanding in finding it yourself versus looking at it on a body dissected by someone else in your class.

 

[MedicationWorks]

looking at a dissected body is more passive than doing the dissection yourself. More active thought is needed when you are doing the dissection, as opposed to looking at a pro-section (professional dissection). Part of this process is useful in getting your 3-dimensional appreciation for the body and all of the accessory structures. If it's a pro-section, with some accessory structures/tissues partially dissected, it might be more difficult finding your bearing when you look into an undissected body for the first time.

I'm sure you won't argue that the inside of an undissected body looks very different from pro-sections. Dissecting out these tissues helps you know how to relate the pro-section to the original body.

I'm totally in favor of pro-sections. But I don't feel they should replace the dissection its self.

 

[smokeycat]

The article is a little stupid, and is missing some vital information.

Do you think UCLA might be using cadavers less because of the recent scandal involving their cadaver program?

a quote from the article states, "And while UCSF's Patterson considers the "fumbling around" in dissection to be a waste of time, others say the classes allow students to learn on their own, a rare opportunity in the top-to-bottom world of medical school."

Have they ever been to medical school? No! How do they know how many opportunities students have to learn on their own? I would hardly say it is "rare."

The article may be stupid, but that's besides the point. I was more focused on the fact that some schools are moving away from cadaver dissection...would this change how someone would rank a school? Personally, I wouldn't apply to a school that didn't have cadaver dissection. I don't see how you can truly understand anatomy if you don't dissect a cadaver.

 

[IndyZX]

There are minimum standards that are set up by physicians' peers. If they are able to maintain those minimum standards, they deserve respect. They are, by definition, not incompetent if they meet these minimum standards. If you feel that they still do not demand your respect, you are in turn disrespecting the physicians that have determined the standards.

If you feel that you will be/ are immune to making mistakes, just wait. Odds are that you will make a mistake in your career as a physician. God willing, it will not have serious consequences, but it is almost certain to happen. Will you then quit medicine due to your own "incompetence?"

Well, I don't have this exalted view of physicians that you seem to have. Some are incompetant and some are not. Simply having minimum standards that everyone has to meet doesn't equate everyone.

I'm fully aware that I'm not immune to making mistakes, I've made plenty, and I'll continue making them -- I'm human. All I'm saying is that I personally don't care if someone has an MD or whatever next to their name, I'll make my judgements on their performance.

This talk is too serious for me, though. I need to go to another thread.

 

[elias514]

In response to the OP, I don't believe there is any significant difference in the overall quality of education offered by prestigious medical schools and middle or lower tier schools. All allopathic medical schools in the US are subject to rigorous accreditation standards and they all offer an excellent medical education. In addition, I've been told by so many medical students, residents, and practicing physicians that basically medical school is what you make of it--i.e., the quality of your education will depend almost entirely on your own leg work, talent, and tenacity.

However, there are differences between medical schools, particularly with respect to curriculum. Some schools emphasize PBL more than others; certain schools have systems-based sequences while others have discipline-based didactic blocks. Also, the amount of time devoted to primary care in the clinical years varies among medical schools--certain medical schools have required preceptorships in family medicine or some other primary care specialty. Finally, many schools' curricula have truly unique features. For instance, Michigan has this thing called the "Family-Centered Experience" in which pairs of students are assigned to a patient and his/her family, in order to learn more about how illness affects family and social dynamics, among other things (e.g., how patients perceive doctors). Regardless of the curricular differences, all schools get the job done, it's just that one approach might better suit your own learning preferences, aptitudes, career goals, etc.

So my best advice to you as a future applicant is to choose a medical school where you think you would thrive academically, emotionally, and spiritually. Don't worry about prestige--it's a dumb reason to choose a school.

Good luck in the admissions process!

 

[Premedtomed]

I'm fully aware that I'm not immune to making mistakes, I've made plenty, and I'll continue making them -- I'm human.

Great quote

 

[Sage880]

Thanks Elias, good response.

I'm going to med school in Ireland because I love Ireland and want to see more of it before I settle down, get married, have kids, etc.

Medicine is a huge part of my life but things like travelling are important too. Reading all these SD.net posts kinda freaked me out because people seem to make a big deal about the smallest differences between schools. Made me start to second guess my choice.

 

[exmike]

The article may be stupid, but that's besides the point. I was more focused on the fact that some schools are moving away from cadaver dissection...would this change how someone would rank a school? Personally, I wouldn't apply to a school that didn't have cadaver dissection. I don't see how you can truly understand anatomy if you don't dissect a cadaver.

I've been told by many many MSIII+ students that the amount of time spent dissecting in gross anatomy is the by far the lowest yielding in terms of the boards. Apparently straight gross anatomy material is miniscule on the boards. In addition, students often botch their dissections and ruin important structures or hard to find ones.

Not having dissection should NOT be a reason you dont apply to a school. Anatomy is more "old school" medicine. As you well know, medicine is becoming increasingly molecular and the knowledge yield from dissection is declining. This is why many elite schools such as UCSF are prosection.

 

[smokeycat]

I've been told by many many MSIII+ students that the amount of time spent dissecting in gross anatomy is the by far the lowest yielding in terms of the boards. Apparently straight gross anatomy material is miniscule on the boards. In addition, students often botch their dissections and ruin important structures or hard to find ones.

Not having dissection should NOT be a reason you dont apply to a school. Anatomy is more "old school" medicine. As you well know, medicine is becoming increasingly molecular and the knowledge yield from dissection is declining. This is why many elite schools such as UCSF are prosection.

Appreciate the advice, but don't agree with it (based upon what doctors have told me).