What's wrong with Osteopathic Medicine....

[MyBloodyValentine]

Alright. You've probably never seen me on these boards before. But I used to be on, circa, 1996-7 (w/ a diff. name). Before I got into D.O. school...like many of you, I used to hit the board at least twice a day. I only HOPED to get an email as honest/explicit as what I'll say.

I post this here b/c I want to tell the prospective D.O. students and not the "general" (read: M.D.) audience.

1. D.O.'s don't have Pathology labs during system courses. This is a disadvantage b/c, as everyone knows, "pictures are worth a thousand words". if we don't see the pic's...the path just isn't as meaningful- and you won't learn it as strong. Also, if you plan on taking the USMLE, there's going to be plenty of glossy histo-path pics. to look over. best of luck remembering Reed-Sternberg cells from a plasma cell. ha.

1b. On a related note, have you all noticed (in brochures, web page) that many of our school's 2nd yr. curriculums are "bundled" in such a way that it's almost impossible to discern how many hours are spent in lab or lecture? that's why I never knew we wouldn't have path lab during 2nd yr. it's a slick move, bundling. instead of saying how many hours of Pharmacology, Pathology etc... they'll just call it Cardiology..GI...Endocrinology. Sure, it's presented like that during system lectures but shouldn't they have a break down as well?


2. Osteopathic Medical schools don't have paid Clinical Professors in their teaching hospitals. In fact, they don't even OWN teaching hospitals. In fact they have "volunteers" at "community hospitals". What's the differences? A paid clinical professor is obliged to teach you b/c of a financial tie w/ the school you're at. In most tradional medical programs, the school owns the hospital next door to it. Not so w/ D.O. schools. That's not a bad thing, in and of itself. However, our schools simply go out and signs up "volunteers" at conveniently located "community hospitals". At these hospitals, if you learn anything - surprise, you do it on your own (like basic science) b/c a volunteer attending physician will place your learning priorities at the very bottom for the most part (though I'm sure there are some good doc's). I guess THAT'S why we still have that outdated Internship huh?

3. Many of the schools will have rotations which are not at a hospital but in a clinic! this is not unlike what many m1/m2 students go thru w/ a physician mentor, following the doctor as s/he sees patients. you may not mind this, but realize that you won't be allowed to do ANYthing remotely involved w/ medicine (i.e anything invasive). instead, you will simply be left to history taking and physical examination. physician mentoring for months! I know you'll say "H&P is 90% of the diagnosis! so it IS good." well H&P will only go so far when you're a 4th year trying to look good in an elective, and you've got to catheterize someone.

4. in many D.O. school(s), there are mandatory classes, with examinations, which have little to do w/ anything related to medicine. the Osteopathic schools do this because they recieve cash-money grants from various sources to fill up their coffers and nothing else. Most importantly though, they take away time for more important studying.

5. Osteopathic Medicine is just not cost effective. Once you hit the real world, those 2 words, "cost effective" will hit hard. Now think about it in terms of your own personal future. Consider this: where the hell is our money going? If you're paying $18K - $25K in tuition, and you don't have a Path Lab (or Micro lab I forgot to mention (at most D.O. schools)), you don't have paid clinical staff, your school is getting extra grant money...where is the $ going and why does it still cost you 18-25K? it's simply not worth it. yet, tuition amazingly continues to rise, while quality doesn't.

6. Finally, don't ever get your hopes too high for D.O visibility. The AOA is far too busy trying to get all of us to pursue D.O. internships and residencies (oh never mind that there are more students than D.O. residencies available). No, instead the AOA will foolishly squander your dues and at the end of the year say among it's members "Yes, we have a fine advertising plan ahead of us...yes we do...". well what good is it to toot your own horn amongst yourselves? nobody in a room full of D.O's is going to argue about visiblity...go out and inform the crowd that knows nothing about it - TV Advertising! the AOA even has an ad set up ...but they they haven't put it out (except for, maybe, in Kirksville). but the AOA is too busy doing other things.


I will probably come across as someone who's bitter b/c they've failed, or they've been kicked out, or b/c they're a senior who wasn't accepted to any med school at all. The honest truth, though, is that I'm a 2nd year D.O. student who is winding up basic science and realizes they would've done things different given a 2nd chance (to go D.O or not).

I'm not disgruntled, I'll get by, but I just want people to know what I wish I knew at the time of decision-making. I'm not biting the hand that feeds me b/c what I'm saying are facts, and not opinions.

-MBV, DO2002



[This message has been edited by MyBloodyValentine (edited 04-20-2000).]

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[UHS03]

Where do you go to school? Your generalizations certainly don't apply to UHS (I can't speak for other schools.) I know the New Jersey school has their own hospital, though. I'm curious why you would generalize all osteopathic schools based on your experience (which, if true, I do not blame you for being upset over.)

 

[Jkeum22985]

Listen Mr valentine:

Do u think MD schools are not on a business basis too. What do you think Hospitals do??
They bill millions of dollars on a daily basis. Even medical education has a high price.

You are not going to find an ideal school.

I have greater respect for those you attempt to the best out of their education than just complaining all day long.

You should be lucky b/c you had made into DO school and hopefully you are getting some sense out of your future responsibility as a Physician. Life is short man Try to make the best of it beside just complaining about things you don't have any solutions for it.

Now for those aspiring Physicians:
DO or MD work hard, be compassionate and become the best Physician you can be. If you go around chasing cats and mices you become a cat and mice at the end...hehehehehe

Jacob Keum
4th year NYCOM

 

[12R34Y]

I appreciate candid opinions, but man I really hate them when they are soooooo bad. I'm at a really huge point in my life where I am taking the MCAt in August and I'm going to apply for school next year. I want all of the info I can stand on D.O.'s, but that really sours everything. is it true that no osteopathic schools have path labs? no hospitals? Only clinic work? please tell me of people who have had different (better) experiences and where you go to school. thanks

 

[peiyueng]

To MYBLOODYVALENTINE,
I am sorry to hear about your experience. But what you described above does not fit my school (Western U./COMP).
-Path, Histo, and Micro labs during 2nd year
-Rotations in major hospitals (including county hospitals)
-and about DO visibility, someone in class just brought in a newspaper (LA Time? Daily Time?)with a full page of ad promoting D.O. by the AOA.
I am interested in where you go to school. It's not good when the school is not giving the students what they expected from a medical school.

Pei

 

[drusso]

Just can't relate to what you're saying. We were hammered in path (with labs) and micro. The chairman of the path dept is also the county medical examiner. Plenty of rotations (at the osteopathic hospital across the street), the county hospital 12 minutes from here, and all around the metroplex.

Our tuition is $6500 in-state, $19500 out of state. Plenty of MD schools have way higher tuition than DO schools---upto $40,000 at some places (such as Boston University).

By the way, the path on the USMLE is a piece o'cake. If you can't recognize ventricular hypertrophy, read a gram stain, spot a barr body, interpret the flouroence pattern on a kidney slide, or stage a reticulocyte by now, then you never will...

[This message has been edited by drusso (edited 04-20-2000).]

 

[12R34Y]

drusso, where do you go to school? thanks

 

[Doc2004]

MBV,
I am sorry to hear about your experiences, but you have not even started clinicals yet. I have always lived by the philosophy that your education is what you make of it. I know many excellent DO's that have all been through this process, and they are some of the best physicians I know. As far as the newspaper Ad by the AOA, it was in the April 13th edition of the USA Today, it is all part of AOA Campaign 2000. There is more to come as well, please check it out for yourself on the AOA website. I dont know what school you attended MBV, but not all DO schools are like that, UHS has an excelent Path and Micro lab. I would recomend to anyone do your research on the schools find what works best for you and your future goals.
Good Luck Everyone,

Eric
UHS04

 

[Navy Corpsman]

For the sake of honesty, and since you are trying to "help" people out, I beg you to name the school that you attend. Doing so will only verify your claims, as I promise you that I will look into your school's program. Help us all, give us the name of your institution.

 

[amyb]

Sounds like a big fat FLAME to me, but I'll play along because the accusations you make are way out in left field as far as I am concerned. If you are going to make such claims from your limited experience, i.e. only attending one school, maybe you should say where you go to school. None of what you are saying, espeically the points about pathology and paid physician faculty are even remotely true at PCOM. (if that is where you attend, which I highly doubt, maybe you should go to class

) We are hammered with so much path in lecture that it is hard to forget the really important things. Not only micro path, but gross from autopsies and we even have separate radiology courses 1st and second year. I sometimes think here we may even have too many classes and hours of important information! As far as rotations being mainly at clinics, maybe you are at a school in a rural location, because we are quite evenly divided, and if you wish more hospital time, do it on you electives.

As far as most osteopathic schools not owning their own hospitals, you should check the administration of many of the affiliated hospitals around the country, allopathic and osteopathically affiliated, because hospitals are just pretty damn expensive to run these days.
There are three faculty members at our institution who are not paid, with some it is apparent, that may be true, but I can tell you some of the best researchers in the country who are physician faculty members, and are way over-paid, SUCK at teaching.
I guess here's the point, no matter where you go to school, no matter what field you get into, medical education is going to be self taught from here on out, meaning after the classroom didactics. You will be required to learn and seek knowledge for yourself and the betterment of your patient treatment protocols for the rest of your career because medicine is a progressive dynamic field. If you want to bitch about YOUR isolated experience, maybe you should start with the source, "what am I missing here?" If your school doesn't set up or require certain rotaions, it is your job to seek out those that are beneficial. Either way, YOU are the one who is going to make or break your learning curve directly by how much you are willing to put into it.
IT seems as though you did very limited research before you applied to schools and chose the one you did. Osteopathic exposure is completely dependent on where you are, and even then, most D.O.'s don't feel the NEED to jump up and scream "D.O. and proud!" They are just good doctors who want to practice the good solid medicine that they were competently and completely taught at their respecive institution.



[This message has been edited by amyb (edited 04-21-2000).]

 

[Kent Ray]

Valentine is right. I am a 4th year DO student. I have posted here many times in the past. I will graduate from DMU in June. Although our school had extensive path labs and an excellent education in the first and second years (better than most of my MD friends) our clinicals suck. The truth is that if the Osteopathic community wants to continue to run subquality residency programs than the AOA has no right to promote the profession. I have been to several osteopathic hospitals and the teaching was subpar at all of them. You cannot ask a private physician who is not paid to sit down with the residents and interns for an hour a day. To compare this I have also spent many months at alliopathic institutions. The difference is outragous.
I saw a posting from a UHS student that says his clinicals are not like this, please. Who are you a first or second year. All midwest school are the same and have the same clinical experience (Kansas city, Kirksville, Des Moines, Arizona, Chicago,...) If your clinical intructors are not paid to teach you , you will not receive a quality education, period!
Like Valentine, I am not bitter about being a DO. I am a realist. I wish things were different but the facts are that we are suffering
In the future things could be different. When you go out on clinicals don't put your blinders on and say everything is ok. Voice your opinion so that future generations of DO's can benifit. HCFA(Health care financing agency) funds all alliopathic and osteopathic residencies. The big alliopathic residencies get more per resident than the osteopathic hospitals do. Their is a bill to change this.
I did most of my rotations in Michigan and don't know about the rest of the country but I am sure it is all the same. If you are going to Michigan and want to do a DO residency there are some good ones. The best is probably Botsford, followed by Mt. Clemens, and Genesys. But the best is Henry Ford. You can do rotations here by going through BI county. This is a 1000 bed inner city research oriented hospital that is very DO friendly. The teaching is excellent in every rotation I did their. To be honest I leaned more in one month at Henry Ford than three to four months on my Osteopathic rotations. If you go through BI county the only rotation worth doing their is ER and you only get hands on with no teaching.
Don't worry, things will change and if they don't than DO's are in trouble.

 

[ni]

i'm not sure where you are going- but please tell those of us who are in the applocation process-

I've seen the UMDNJ, PCOM, NYCOM, and the one in west virgina. I also know people at these schools and in california's osteopathic med. They all have enjoyed their experiences. sure - every college has its downfalls but ....

 

[lecomdo]

I'm glad this thread started. I have some questions regarding the clinical years at LECOM. Is anyone out there familiar with LECOM's Pittsburg rotation sites. Specifically:

Allegheny General Hospital

Healthsouth/Harmerville Rehab

Mercy Hospital

St. Clair Hospital

St. Francis Central Hospital

U of Pitt Med Center- Horizon

West Penn Hospital

I know mostly M1+2 are on this site, but if there are any M3+4s (orM1+2 who know) familiar with these sites please answer.
Can you do all core and electives at Pittsburg sites? Is the faculty paid or volunteer? Is the quality of any of these sites not so good, if so which ones and why. Are any of these site very good, why? Do any of the concerns posted previously in this thread apply. Also, I think at either Allegheny of Mercy, Temple students rotate through- if there are any Temple students out there please give impressions of the sites.

And finally, how difficult is it to do all of your rotations in Pittsburg. In my interview they said rotation selection was not done by lottery or merit-based. They said students worked it out themselves. What does that mean? I really want to do all of my rotations in Pittsburg. Is this going to be a problem?

 

[Jkeum22985]

if DMU is so bad than how come I have seen one of your guys in one of NY's best hospital as categorical in surgery and this guy is on his 4th year making into that steep pyramid...

That tells something about the individual nature of becoming a Physician..Some wish to be spoon fed all the way to graveyard...Hopefully you guys are not given the opportunity to lead a big hospital...b/c there is not spoonfeeding way up there...

Grow up guys!!!

Jacob Keum
4th year NYCOM

 

[ewagner]

Doesn't your whole "allopathic vs. osteopathic" teaching hospital crap go to pot if both MD and DO students rotate in the same hospitals and have the same attendings?!!!

Dude your logic is for ****. I am tired of this same lame ass excuse for not learning. You don't learn if you don't take the time to get your damned hands dirty!!

 

[ADRIANSHOE]

Lot of truth on both sides of this argument.
(argument not discussion, since there is a lot of silly commentary directed when more logical discussion is preferred)

On the one side, we have a person who seems to be speaking of their unique experiences at their particular school.

Where I go to school, our pathology and microbiology Lab (practical) coursework is quite rudimentary. so in a specific sense i agree that at least one school that HAPPENS to be a DO school conforms to MBV's statements. I do not assert that ALL schools conform to his statements.

Where I go to school there are mainly volunteer clinicians at many of the REQUIRED rotations which DO NOT have MD and DO students rotating together.

I also agree with the statements that medical education is a lot about what WE do to ensure OUR education.

An issue worthy of discussion isn't WHAT IS, but WHAT should be IMPROVED.

The following areas could use improvement:
1. More focus on disease recognition, differential diagnosis, treatment, of the COMMON DISEASE STATES.

2. More accountability and proactive involvement of the university during the third and fourth year. To wit: WHAT EXACTLY DOES your SCHOOL do to ensure that THEY are turning out a quality EDUCATED student. In other words, how is your tuition money working for you in the third and fourth years. Also, WHAT WORKS AT OTHER PLACES and how can we approach researching, and implementing positive changes based upon the community wide experiences.

3. How should students work to improve their clinical education IN ADDITION to the obvious facts that no one will argue with, ie: students obviously are responsible for thier own motivation and learning, but how can they also work to improve quality of attendings, hospitals and school accountability.

4. How can students learn to work together for positive change and improvement when they get caught up in name calling and assumptions about each other? It is a poor assumption that because someone realizes that a school isn't doing much for them during the second two years of school that this person is an unmotivated person who is unwilling to get their hands dirty, that is nonsense. It is also nonsense to project to the entire community of osteopathic education one's own personal experience within the microcosm of their rotations nested within their school.
a way to avoid this is to assume the best about each person's motives and stick to the basic facts and specific experiences which you have been exposed to and then ASK about how things are done at other places.

5. Sadly, due to the "supposed" stress that many young medical students think is unique to their postgraduate experience, these conversations seem almost predestined to become personal attacks. If medical students were only exposed to the stresses that PA students or PHD students are exposed to, they might find that their "supposed" stress levels pale in comparison to many programs, and that the demands upon them are actually quite light. Not having the constant work schedule of ongoing and several research projects, while taking TRUE postgraduate courses such as advanced and variate statistics and being EXPECTED to perform to an 85 percent on all courses, while also preparing a professionally written and juried dissertation in an area of unique research is MUCH MORE DIFFICULT and further required MUCH MORE PERSONAL MOTIVATION than taking undergraduate type courses which basically survey a particular aspect of human health which is what didactic medicine currently consists of. Once we recognize that our external stresses due to the course work are really quite small, we can look at WHAT IS CAUSING OUR STRESS? usually it has seemed to me to be one of the following:
1. our own expectations or those of our parents or friends.
2. The fear of the unknown or not learning something that may be important later.
3. Looking bad in comparison to our classmates.
4. Not getting a good enough score to nudge out lenny lipshootz from the last open derm spot.
5. C'mon everyone lets list some of our own personal ones.....Lack of sex or realizing that the sex you are getting is with a stressed out medical student who is calling out the name of a preprohormone instead of your own.
6. Child custody battles
7. Marital strife.
8. Sick kinfolk
9. Asinine behavior of the occasional attending who seems to think that because they know more medicine than you the lowly student that nothing of a world scope that you have to talk about has any wieght and everything they wish to talk about is uttered from the lips of god.
10. expectations of the great attending who you wish to please.
11. the realization that you are doing nothing but brownnosing a major percentage of the time to get a good evaluation to nudge out lenny lipshootz for that derm spot.

Ok, thats enough satire for one morning, hope you get the point, if you don't that's ok too.

Its assinine to think that because someone raises a question that they are whining, unmotivated nonhands on people.
Its also assinine to project one's personal experiences to the greater whole without substantially documenting these projections.
Therefore, the common ground is in the FACTS not in the personal assumptions or stupid personal attacks.

 

[Nanook]

Interesting that MBV has not returned to defend his original statement.

As a prospective applicant to DO and MD schools (this year), I am exactly the target audience MBV is trying to reach. My question, for anyone who gives a rip, is this:

The most important item that he (MBV) brought up is the idea that DO schools don't pay their attendings and don't have their own hospitals (ie, so they don't exert any real influence over their rotations). The other stuff was mostly subjective.
Does anyone out there know if any DO schools (which ones?) deal with their attendings on a non-volunteer basis? Don't schools have to pay a fee to teaching hospitals to have students rotate there? And finally, do any of the schools own their own hospital? I thought PCOM had its own--?

The most important part of a medical education is probably the clinicals. The book stuff, anyone intelligent enough to get into med school can learn. But without good clinicals, you may never get the chance to actually start IV's, intubate, catheterize, or whatever in a real situation.

Anyone care to respond?

 

[Navy Corpsman]

The thing that bothers me most is the fact that this guy, "MyBloodyValentine," took the time to post a very persuasive and entertainingly informative message without mentioning the name of the school that he attends. He may have been factual, that I will [never] know--no school name given, no chance to verify his claims. Moreover, one students, "Kent Ray," shared a similar opinion regarding his clinical education, but he at least had the sense to name his institution, something that is very, very informative. I am quite baffled here. If this guy is genuine about helping those in the application process, wanting improvement that leads to "accountability and proactive involvement," as ADRIANSHOE has put it, then why not give the name of his institution? Verifying his claims is something that any sensible person would want to do. By choosing not to respond--as I do not yet see a reply from him--he basically denied anyone and everyone the opportunity to verify his claims. His unverifiable input is like screaming under murky water: we can never help him--or help ourselves, as some of us are still applicants--because we do not know where he is located. So please, tell us what God damn institution you are attending or, if you so choose otherwise, drown in your sorrow.

 

[Test Boy]

Yes, I believe we all want to know what school he attends. I mean no path labs, that just seems ridiculous!!! I know at NYCOM that practically pound that into you.

 

[Lennox]

Perhaps Kent Ray has a point, but the woman who interviewed me at MSUCOM, a urologist, would probably argue that Des Moines' school is pretty good. After all, getting a residency in urology is very difficult indeed. I suspect that one or both of these people posted just to play with us. Don't let it worry you; if DO is your choice, then by all means go for it.

 

[drusso]

It's been my observation that the public DO schools: WV, Texas, Ohio, New Jersey, and Michigan tend to have more control over their rotations.

I also think that some of the larger private ones such as NYCOM, PCOM, Kirkesville, and UNECOM also keep pretty tight reigns over their clinical educators.

Kansas, Western U, LECOM, DMU, and Nova seem to be a bit more laissez faire in their approach to clinical education, but this is only my subjective assessment.

For a new school, Pikesville seems to be getting a good foothold in the region in terms of setting up good quality rotations. I haven't heard to much about Touro.

I've rotated with students from some of the schools I call "laissez faire" and believe their students to be highly motivated and OTB---on the ball. I asked a local ophthamology preceptor about his experiences with students from different DO schools: Especially UHS-COM (where he went to school) versus TCOM (my school). He described his perceptions as such: UHS students having had more experience setting up their own rotations consistently show up "on time and dressed to play." They've done the reading, they've called ahead to get instructions, relevant orientation material, etc. TCOM students tend to wander into his office in the middle of the AM on the first day of rotations, not really knowing what's up, generally pretty bright, but a little clue deficient...

I know someone from one of the "laissez faire" schools who while interviewing for residencies recieved this feedback from a residency director: "Oh, you're from school ___, we like your students---they have good survival skills."

It's trite sounding, but true: You will get out of rotations what you put into them. You will not learn everything, or even 1% of everything during your third and fourth years. If the first two years of medical school amounts to only a giant vocabulary lesson in the language of medicine, then the last two years is a brief visit to the smorgasboard of clinical medicine.

[This message has been edited by drusso (edited 04-23-2000).]

 

[Jkeum22985]

I am sick in tired of your crying babies!!!

Either you complain or not there are many students from all these DO schools getting very good residencies in the area of their interest.

BloodyVAlentine must be a bloody non-DO caribbean training medical student who is really out there for a piece of attention...
From RBorhani: He is not! Based on his IP address he is from a DO school

it may be more productive to engage in some meaningful reading than complaining like a little kid...




[This message has been edited by RBorhani (edited 04-23-2000).]

 

[A-DOG]

Jkeum,

You seem to have an egocentric "I know everything view" about medicine. You don't know what experiences others have had in osteopathic medical schools, so you have no right to judge others who may want to help some confused pre-med make an informed decision based on his/her experiences whether they be positive or negative. I think that it is important to respect the opinions of others and not automatically dismiss them when you disagree. I hope, as physicians, we open are minds to the views and experiences of others. I think doctors who are capable of doing this are among the cream of the crop. Arrogance and closed mindedness do have any place in medicine.

 

[Jkeum22985]

Call me whatever

 

[Jkeum22985]

I am open-minded but immaturity is worse than disease really!!!

If you are in DO school, you should be thankful better than many others who are pursuing medicine in other countries cuz they could not get in here...

PLus what would you be doing if you were not in huh????
research lab slave for some obscure figure????

Be thankful of what you have!!!

Jacob Keum
4th year NYCOM

 

[RBorhani]

I think this thread is no longer being productive.. we are all going off the topic and arguing with one another...

Do you think we should close this thread? Yes or NO or similar threads when they reach this point of people arguing with one another?


[This message has been edited by RBorhani (edited 04-24-2000).]

 

[guylon07]

Hello,
I don't knwo if I have the right to post this reply or not, but I am going to anyway.
I am not yet a D.O. student, but I am going to be starting this fall. I do however have some experience with this topic. I have worked as an RN at a teaching hospital for the past several years, and let me add to the popular phrase "you get what you give". Please stop this arguing, you are doing nothing but discouraging prospective students. This arguing is saying nothing for the field of Osteopathy. You are doing nothing but giving some allopathic student the pleasure of seeing you get your feathers ruffled. Like I said, I have been the charge nurse on a trauma unit caring for both ICU and stable patients. I have dealt with both allopathic and osteopahtic students and residents, and I am be proud to say that the better talents have come from osteopathic programs. This is one of the reasons I chose the osteopathic program over the allopathic. Don't get me wrong, I have seen good and bad come from both fields of thought, but I have had first hand experience in helping teach some of these students procedures and policies. Let me say that there are students who "want" to learn; that will come looking to learn. Yes, from what I have seen it is true that the D.O. students (in general) have to work a little harder sometimes to establish a clinical setting, but I believe that this says something for osteopathy. I feel that those who truly believe in the D.O. philosophy are there to learn because they want to learn, and we will work to learn. Just try to remember who we are there for, the patients (remember?), and do your best to bring a good learning experience out of every situation. Remember that there is always something to do both in a clinic and a hospital setting, and if your instructor does not have all the time in the world for you on a particular day learn from the nurses, because believe it or not some of have a vast medical knowledge. As far as as the instructors go, two of our doctors (MD's) that were affiliated with the institution and precepted students were not paid, and were the two best preceptors we had. They knew who wanted to learn. There was always that primadonna that wanted spoonfeeding and cried everytime something wasn't handed to them, but the instructors and faculty saw this I am sure that their rotations reflected this attitude, but if you are wanting to learn you will learn. Just give that little extra effort and look on the bright side, if your program is not affiliated with a specific clinical site at least you get to basically pick where you want to go and want you want to do. Now that I have gotten my two cents in please close this thread,because it is getting us nowhere. Lets pull together to make this a positive experience.

JK

 

[ADRIANSHOE]

Rborhani, Why close the thread now? right after your posting, a very cogent argument was made by a former RN regarding this topic. yes, its an argument and yes there are SOME (many) counterproductive statements being made, immature students crying out against the immaturity of others as justification for their own approach, etc...etc.. etc...
but...let it run its natural course as these things do and it will die out on its own as these things naturally do...now that I have my two cents worth in, i welcome all dissenting views. I really am kinda lost about why YOU are stepping in to close this thread, Derek is the moderator, right? so where do you fit it to this? what are the politics of being able to close threads? is anyone affiliated with sdo allowed to close any thread they choose? is this by committee or by your personal degree? I really don't care which, I just am curious now that sdo has entered into a censorship mindset about how the specifics of the censorship is going to be applied. I am not trying to be argumentative or abrasive, I am simply asking someone to spell out the groundrules and since you are obviously actively involved in scouting out postings throughout the different forums and making decisions regarding closing them, you are the perfect person to ask. by the way, work on the back hand but stay to the forehand side of the table.

 

[MyBloodyValentine]

I've been on spring break, which is why I haven't replied.

AdrianShoe can relate to my experiences b/c we've walked on the same campus (hint hint as to where I go).

Maybe I was wrong to include EVERY D.O school, but of all the basic science curriculums I've seen (about 8 D.O. schools) I've noticed no path labs. When I say no path labs, I mean there IS a general path lab, but once the system courses start up, no more path labs...only "pictures" from an atlas the prof puts up.

someone brought up the point that there can't be a diff. in clinical if we're rotating at the same sites as M.D's. well, that event occurs during 4th year on ELECTIVE. as for 3rd yr, we are at osteopathic "sponsored" (?) sites which do not have paid faculty. I believe this happens at all D.O. facilities.

to the schools that DO have all path labs: do you have it for each system? do you have a practical exam for each system as well? interested to know.

some of your attempts at being computer sleuths make me laugh. drop the IP tracing and stick to rote memorization, yeah?

If there's any specific q's I'll answer them since I'm back now.

-MBV



[This message has been edited by MyBloodyValentine (edited 04-24-2000).]

 

[ewagner]

I am not going to speak about the curriculum of schools, all I can say is that UHS has a great path lab and pathology dept. I would put it up against any school.

But once again, many of our students rotate with allopathic students in 3rd year rotations...yes that is right 3rd year. That is why I said your argument was poor. I am very sorry that you feel cheated, but I can't do anything about that, all I can do is report the facts from my perspective. Perhaps you should've researched your school more thoroughly prior to attending?!

 

[RBorhani]

MBV: Welcome back. I agree that this thread is getting back on its main track.

For [Adrianshoe]As far as closing threads, moderators and administrators can do this. I only do it when it is an obvious "flame" thread or when it turns into one (i.e. people just arguing with one another on a personal level). If I am not sure,like this post, I ask people what they like to do and do what the majority of people want ... There are no committees and no censorship, but we do try to keep the garbage out (i.e. companies pretending to be med students and trying to lure us into their web site with posts on this forum)..I am doing my rural rotation and for the past couple of months I have not had much to do thus my increased activity on this forum....



[This message has been edited by RBorhani (edited 04-24-2000).]

 

[RollTide]

Oh no, another one! MBV and John , I don't think I can take it

I have a few questions for you guys who are so unhappy with your clinical education at NSU.

MBV- You mention that you feel this is a problem with osteopathic training programs and hospitals and yet I was under the impression that the only osteopathic hospital in Florida was Sun Coast. I have heard only good things about Sun Coast so I do not think you are referring to rotations at this location. Many of the other rotation sites including Miami Children's, Mount Sinai, Jackson also have students from MD schools schools rotating through them so I do not understand where you get that this is a problem with osteopathic training. I could understand if you were saying that it is a problem with medical education in general but your not.

MBV and John- Are the North Broward rotations the ones that you feel have cheated you or do you include Palmetto and the others as well?

I wish someone would please explain to me how someone who is a faculty member of a University gets paid extra for teaching students and residents. I have no clue as to how this works. I assumed that you are paid a salary just like anywhere else and included in your duties was that of teaching students. I did not think that you were paid something different for each student or resident. I also thought that the salary for many specialties is much lower at academic institutions than in private practice.

The point I am trying to make is this( and I admit my ignorance on this subject), why is there such a huge difference in teaching between paid and non-paid faculty if most people go into academic medicine for reasons other than money (research, love to teach, ect.)?

I know that my personal experiences do not reflect that of a third or fourth year medical student, but I have volunteered with a DO for more than a year now, worked with and volunteered with several MDs in various specialties and they have all taken 1-2 hrs at the end of the day to discuss each patient with me at length. They took the time to teach me procedures, point me in the direction of reading material and answer all of my questions without being paid. In fact, most understood that I was a student with little money, and took every opportunity to offer me free lunches and dinners, attend CME conferences with them, introduce me to drug reps who would offer me all kind of goodies, and most of all they used their free time to teach ME. Maybe my experiences are unique but I do not think so. Most people do not teach for the extra income, they just enjoy teaching. But once again, this is just my opinion.

I am interesting in hearing from MBV and John about what rotation locations they had problems with and what they are doing to improve things.

-Joshua
NSU-COM 2004

 

[mj]

Wow, Rolltide, an open invitation to Adrianshoe to expound on one of his favorite subjects! What have you done to us

Seriously, though, why you're at it Adrianshoe, I do have a question. I respect that one of the messages you have continually driven home, even in light of cries for administrative improvements, is personal responsibility. You get what you give. But hindsight being 20/20, knowing what you do now, even if you had approached things differently, do you think your opinion of your experience would be the same? At some point is there only so much someone can do on their own, or is that personal motivation really enough to overcome shortfalls on the schools part?
mj

 

[unsure]

Originally posted by Jkeum22985:
I am open-minded but immaturity is worse than disease really!!!

If you are in DO school, you should be thankful better than many others who are pursuing medicine in other countries cuz they could not get in here...

PLus what would you be doing if you were not in huh????
research lab slave for some obscure figure????

Be thankful of what you have!!!

Jacob Keum
4th year NYCOM

I feel this type of mentality is dead wrong. I for one do not feel grateful, or that osteopathic medical school is doing me a "favor". I worked very hard to get where I am and expect excellence in all areas of my education. And if there are concerns about the clinical education of some schools I would like to hear them. This decision is a very serious one. Once accepted to a school, the roles are reversed. The school is there to serve us- the student. I remember my Dad telling me that when he was in medical school, a lecturer came in once unprepared and delivered a horrible lecture. And the entire class responded by booing!

 

[ADRIANSHOE]

Unsure, you done got promoted to lead supporting actor, see, a little hard work and casting couch time does pay off!!!!!!!

you have just said the exact words (although much better) that i was saying four years ago when some yokel was claiming we "owe"
the school some kind of gratitude.
the only thing i owe has a shotload of george washington pictures on it. and i owe that to the government.

cant really comment any more on rolltides questions, having answered them at least four times already and not wanting to rerererepeat myself.

as for volunteer vs. paid faculty, let me just say, it CAN be a problem at certain places if there is a lack of oversight. Explaining "paid" vs "unpaid" faculty frankly bores me, call the school and talk to them about it, they will give you a pretty good idea of how it works and no one can accuse me of fabricating or being disgruntled since i trust they will tell it like it is, having no reason to deceive you.

 

[RollTide]

John,

If the problem is with oversight, how does this relate to paid vs. nonpaid faculty. Can there also be problems with lack of oversight involving paid faculty? Are you saying that if the school is spending money on the faculty they are more likely to control how much time the faculty spends actually teaching the students? I still think that if a physician accepts a faculty appointment, they should take the appointment seriously enough to carry out the duties of that apppointment, paid or not. I am also curious to hear your reply to mj's question about hindsight. I have a feeling that you would rather make smart remarks than anwser my questions but I thought I would ask you a few questions anyway. I regret that the topic of my questions are too "boring" for a response. Most of us on this website fall into one of two categories or both. Those seeking information and those who have information to share. I assumed that since you are close to completion of medical school that you were here to provide information to those who seek it. Once again, if you could indulge me and take a few seconds of your time to answer my questions I would appreciate it.

-Joshua

[This message has been edited by RollTide (edited 04-24-2000).]

 

[ADRIANSHOE]

Originally posted by RollTide:
John,

"If the problem is with oversight, how does this relate to paid vs. nonpaid faculty."

Ok, yawn.... stretch...., here goes, to humor you...
if a faculty is VOLUNTEER, then the school often has to accept what they get, they have less bargaining power with the volunteer, plus since it is the hospital that is setting up the rotations the school can simply pass the buck (it has in the past, but hopefully the dean is committed to changing this) The school in the past has divorced itself to a large degree from involving itself in who the attendings are at various hospitals. that is a cop out, and it allows the DME a lot more power over the student since the school isn't backing the student up if there is a problem. which at times with 150+medical students there will be (and sometimes it is the student who is at fault). In a paid system, there is accountability, there are repercussions for abusive attendings and there is a carrot to offer the attendings to teach that isn't present in a volunteer system. Volunteer systems often work very well, and if they are subjected to good oversight, then you can still work to bring in better attendings provided you can find volunteers (anyone been to the food bank lately?).
Did you know there are a plethora of jobs in america but a dearth of volunteers? why is that do you think?????????????????

BUT, if you have a volunteer hospital teaching staff AND the school refuses to oversee the curricula that is being used (if there is in fact one, often there isn't) then WHY are we paying the school?????? what are they doing for us? the hospital is setting up the rotation, the attending is teaching for free, where is OUR money going???? see the picture yet? juxtapose that with paying an attending and making that pay contigent on performance (as is the case at most universities in other fields than medicine) the attending then has a direct positive reason for teaching, can have more legitimate expectations placed upon them and more oversight. Do you think a lot of people DISAGREE with this? As the dean said "paying our faculty is a no brainer, i wish we could"
HE IS RIGHT, its a no brainer, arguing against paid faculty is just silly, thats why this conversation bores me...get it?
I would like to start a meaningful conversation on how best to FUND a paid faculty, what type of curriculum development the school could mandate for the hospitals to follow, standardizing didatics courses during clinicals, oversight committees to follow up and change poor rotations...etc.

In an earlier post you said something about me not liking my clinical rotations...those are not my words, that is your poorly understood interpretation, as i have said numerous times, I enjoyed my rotations, I just happen to have enough knowledge of the education process to recognize that there are major flaws and wish to point these flaws out so that others can also see them,(most of the time they already see them so its an easy conversation...of course these folks have already been there done that)
now an alternative is: i could just say something blatantly stupid like: oh well its my school and i'm just lucky to be here, or oh well, thats just how medical education is and it'll never change...but those are immature and shallow mindsets for a physician to have and i reject them out of hand.

"Can there also be problems with lack of oversight involving paid faculty? "
Josh, thats a really weak question, OF COURSE there can, but since most of our clinical faculty isn't paid its not germaine to the specifics of this conversation and i am not going to generalize about other schools when it isn't within my knowledge to do so.

"Are you saying that if the school is spending money on the faculty they are more likely to control how much time the faculty spends actually teaching the students? "

ummmm....yep....
Its called INCENTIVE pay....are you saying you will work for free? If someone tells me they will give me 20 grand for educating ten students as long as i dont use them for scut and as long as i teach and document that i did so and how, then that is a heck of a lot more incentive than ASKING me if i want to take on a few students and then never really checking to see if the students are just wasting time following me around and I (the attending) never bother to teach them or ask them if they read anything or correct their misconceptions regarding my treatment plans....certain things are common sense aren't they?

"I still think that if a physician accepts a faculty appointment, they should take the appointment seriously enough to carry out the duties of that apppointment, paid or not."

I agree with your idyllic thoughts, but what you think or i think isn't the issue, its what a few bad attendings without oversight think...and some disagree with you quite strongly regarding how seriously they ought to take their appointment and whats more they continue to be attendings because there isn't enough oversight and/or volunteer attendings to stop it. saying you think they ought to act a certain way isn't going to MAKE them act that way, you have to ENSURE that they don't act that way, you have to follow up and change attendings that act that way and you have to be vigilant...failing this you (the school) are just taking the student's money.

" I am also curious to hear your reply to mj's question about hindsight. I have a feeling that you would rather make smart remarks than anwser my questions but I thought I would ask you a few questions anyway. "

actually i prefer to reply to smart remarks but....
hmm, should i get all bent outta shape, nope not worth it....MJ, I would have done nothing different in hindsight...here's why.
On those rotations that were weak, I spent a shotload of time in the library (feel free to research and ask anyone who was at Columbia West palm beach which student spent the most time in the library reading) or at the computer learning what i could, I utilized my time as best i could to make each rotation a positive experience. If the rotation was weak on didactics, i taught myself out of journals (its a poor substitute and I need experience, i dont feel at all confident simply from reading an article). If a rotation was weak on patients then I hung out at the ICU or the ER and picked on the pulmonologist and the ID physician...so no, i wouldn't do much different except maybe be a bit more demanding on my surgery rotation and more aggressive follow postop patients, it would have been personally helpful in my own situation now (this rotation was very early before I caught on to the idea that NOTHING was expected of me on the rotation), my issue isn't with any specific rotation or month, it is with a system that has some flaws in it, therefore I took what I could get from it and more and now I feel its a proper time to suggest positive changes to IMPROVE it, sorry that is such a perverted mindset, but its the only one i got.


"
Once again, if you could indulge me and take a few seconds of your time to answer my questions I would appreciate it.

-Joshua
"

there you have it josh,
you touched my tender educational weak spot and thus i bestow my wisdom and advanced knowledge upon you. while in some places it will hit rocky soil and others barren unfertile ground, hopefully a few seeds will hit on the fertile mind and grow into positive fruit. hopefully it isn't pearls before the swine. shoey
(well mj any semantics here....lol...im just kidding!)

 

[peiyueng]

This is just to answer MBV's question:
Western U./COMP is the school with path lab. Yes, we do have path lab for every system (Neuro, Derm, Cardio, Endo, GI...), and we have practical exam on those lab hours, too.

Pei
DO 2002

 

[mj]

No shoey, no semantics, as long winded and monotonously detailed as anticipated. I tried to tell Josh not to give you free rain like that, but he just wouldn?t listen.

You said ?the dean said paying our faculty is a no brainer, i wish we could. HE IS RIGHT, its a no brainer, arguing against paid faculty is just silly?

And then: ?Can there also be problems with lack of oversight involving paid faculty? Josh, thats a really weak question, OF COURSE there can, but since most of our clinical faculty isn't paid its not germaine to the specifics of this conversation and i am not going to generalize about other schools when it isn't within my knowledge to do so.?

This will undoubtedly confuse our Joshua. You are proposing a solution (paying faculty) that you admit can equally have problems, but then don?t want to address those problems based on the argument that the system doesn?t currently exist so you can?t properly analyze it. Can you please help Josh understand why you would propose an admittedly flawed system without proposing the necessary corrections to the implementation, that potentially could end students back in the same boat you are in ? feeling the system is flawed? I know Josh will view that as upsetting.

The politics of dancing?

I?m very inclined to agree with your comment on the other post that most of these arguments have way more to do with politics than philosophy. Given that and knowing you are committed to proposing and working for changes, what I?m very curious about is why you think you will be successful (not that I don?t applaud the effort). Where is the political incentive for change to take place?

You have been very vocal about the flaws in Nova?s system, yet Nova could hold you out as a poster child for the effectiveness of that very system, couldn?t they? You worked harder because of their system, you were more creative because of their system, more self reliant, you became a good doctor in their system. And they have the added benefit of having saved all those cost. Sure you can argue it could have been easier, you might have learned more, but all in all, Nova administration will probably view your stay there as successful, because in the end you became a good doctor.

You can shout the need for improvements from the rooftops, but until there is some political motivation for them to do anything differently, I doubt you will see change.

?I agree with your idyllic thoughts, but what you think or i think isn't the issue?

That?s an extremely intelligent line shoey.

mj
(how?d I do with my semantics

)

 

[ADRIANSHOE]

MJ, the reason i didn't go into solutions is because I already asked in the previous post for people to give up some ideas on how to come up with a paid faculty model.

Its my guess that one way would be by improving alumni relations, which hasn't been a very strong aspect of the admin. in the past. Another would be to weed out a lot of the dead space (people just filling up space and not earning a salary) anyone who has been here knows exactly what i am talking about. Another way would be to increase clinical research and fight harder for clinical grants...these are just some of my thoughts, i obviously welcome others.

regarding whether i feel i will be successful or not in helping change things....I really choose not to focus on whether i am successful or not in that regard, rather i focus on what is RIGHT and what isn't (DONT YOU START WITH ME, LOL)

so, out of my continued respect for your righteaous opinions i have kept this one short.

 

[mj]

if jlcarlk could hear you now! You remember him -- Mr. Motivation. Mr. Absolute truth. Mr. Right for right sake. lol

mj

[This message has been edited by mj (edited 04-25-2000).]

 

[ADRIANSHOE]

I asked you not to do that MJ LOL!

you brought up a couple other things I didn't avoid i just didn't read close enough:

i reread your post and it seems you asked me about oversight- I think the best thing would be to have review committees made up of a panel of the attendings with the best reputation for teaching and professional behavior vis-a-vis the students from a variety of hospitals, these could set up minimum acceptable standards of behavior for attendings, recommend curricula changes, investigate problem attendings and work with "problem students" also. There are three big advantages to this...By choosing attendings that have a reputation for professionalism and education, you put pressure on ALL the attendings to live up to a certain amount of peer pressure. By making the committee diverse you avoid to a small degree the problem of committee members having to be professionally adjacent to attendings they may have censored. By having a committee of respected attendings from a variety of sites you make the "problem student" prove their position against RESPECTED attendings, rather than a small committee of attendings at the site where the student rotated. The student is not so free to claim prejudice or conflict of interest against the committee.


Regarding politics of change, ALUMNI PRESSURE, ALUMNI FUNDS....thats where the pressure is needed.
Some people might even say "open public expressions of displeasure by graduates" that may be a LAST RESORT, First some folks just need to sit down together and calmly discuss what is really in the school's best interests, and then discuss how to get there.

Regarding the "POSTER CHILD" theorem:
They can say that if they wish, but I would openly respond to that by saying:
I am who I am DESPITE your system not because of it.

hope that clears up some areas. Shoey.

 

[Sharagim Shokry]

MBV - Of course you are allowed to voice your opinion, no one can deny you that right (although there are a few of us who wish that were possible). But you are ONE person, with experience at ONE Osteopathic school. There are thousands of us who are very happy with our schools and with our education. I agree with all others who have stated that education is what we make of it. I am truly sorry for you if your experience has been as bitter as your commentary states. I truly pity you, you have forgotten the entire reason we are in this educational process - to learn to help others. I urge you, MBV, to help yourself first before you consider helping others.

 

[mj]

Sorry, Shoey, just couldn't resist

But I must say, I'm at least flattered I rated a reread.

So you start building your small panel, but everyone has a different idea of who has the "best" reputation. So there is compromise. The attendings view the "minimal acceptable standards" as insulting and big brotherly. So there is compromise. Attendings don't like the increased paperwork. So there are compromises. Getting it yet? In the end, you probably just swap one set of problems for another, don't you?

I think our Joshua would claim the most "respected" attending you will find is the one who would willingly volunteer their time for the love of teaching, and be good at it because it is the RIGHT thing to do. Sounds familiar doesn't it

Yes, you could hit them in their pocket book, but it would take a big hit to motivate political change. Unless you find the cure for cancer or suddenly become worth millions, you really aren't worth their time. As unfortunate as it is, the out cries of "successful" students will probably be noted as complaints from those who are their own worst enemy -- the zealots (not my opinion, but I've heard you called worse on this board). Until tragedy strikes, or someone gets caught in an uncompromising position that forces the political pawn to be moved, things will remain status quo, maybe a little increase in lip service.

Of course you will openly respond to the Poster Child theorem that way. I would expect nothing less from you. But I also know, they would probably respond by saying they chose you for who you are: a guy who would perform outstandingly within their set up, a justification for their admission procedures. As long they keep choosing people with a similar drive, why should they change anything -- it works.

A little jaded of me? Perhaps. And this really is one time I hope I'm wrong (although I forbid you to ever quote me on that).

Best of luck to you in your pursuit for your absolute truth

mj

 

[RollTide]

I agree with much of what mj said, but I think the larger problem would arise in attempting to get attendings to monitor themselves and those whom they work with. I think that this could cause problems for everyone. That is why there is an administration at both the hospital and the school. You can not expect an attending to provide oversight on those whom he/she works with. Too many conflicts would arise from a situation like this. I think that students should evaluate the rotations(already being done right?) and the administration should pass these evaluations onto the attendings who should use this information to improve what they are doing. If the administration feels that the attendings are not attempting to improve the conditions at a particular rotation, then you could have the sanctions passed down to the attendings. But the faculty would have to be paid for the sanctions to work I would think.

 

[ADRIANSHOE]

Originally posted by mj:
Sorry, Shoey, just couldn't resist

But I must say, I'm at least flattered I rated a reread.

So you start building your small panel, but everyone has a different idea of who has the "best" reputation. So there is compromise. The attendings view the "minimal acceptable standards" as insulting and big brotherly. So there is compromise. Attendings don't like the increased paperwork. So there are compromises. Getting it yet? In the end, you probably just swap one set of problems for another, don't you?

"No, thats a reductionist argument, its not a necessary inference. What you are doing is taking the cynical approach to my idealistic one and so we are juxtaposed into an arena with only two exits. Of course your scenario is one scenario, but its not the necessary scenario.
Flexner proved that already, albeit temporarilily.
on the flip side, with your argument you also imply the need for a strong central character with vision (isn't that the only way to avoid such beaurocracy?...Have you been reading your AYN RAND??...you are arguing against change by committee, therefore I am starting to sense a little fountainhead coming out, if this is your tack, i think we have a lot of common ground here. But, i am not going to succumb to fatalism just...yet.

"
I think our Joshua would claim the most "respected" attending you will find is the one who would willingly volunteer their time for the love of teaching, and be good at it because it is the RIGHT thing to do. Sounds familiar doesn't it

"

That's not a bad attending for the committee is it? So we let josh appoint a couple of teachers he really loves...ok...but, you do raise a valid issue here also, WHO appoints the committee...this is where a strong central educator comes in.

Yes, you could hit them in their pocket book, but it would take a big hit to motivate political change. Unless you find the cure for cancer or suddenly become worth millions, you really aren't worth their time. As unfortunate as it is, the out cries of "successful" students will probably be noted as complaints from those who are their own worst enemy -- the zealots (not my opinion, but I've heard you called worse on this board). Until tragedy strikes, or someone gets caught in an uncompromising position that forces the political pawn to be moved, things will remain status quo, maybe a little increase in lip service.
-----i don't disagree, so either a pawn has to be forced or someone with a voice close to an ear has to show how certain things are beneficial to all...neither has to be mutually exclusive...The politics of change often require a fork not a scalpel.

Of course you will openly respond to the Poster Child theorem that way. I would expect nothing less from you. But I also know, they would probably respond by saying they chose you for who you are: a guy who would perform outstandingly within their set up, a justification for their admission procedures. As long they keep choosing people with a similar drive, why should they change anything -- it works.
Hmmmmmmmmm.....got me on that one don't you.

A little jaded of me? Perhaps. And this really is one time I hope I'm wrong (although I forbid you to ever quote me on that).

Best of luck to you in your pursuit for your absolute truth

mj

MJ...this is where we agree wholeheartedly, Jaded isn't the term...REALISTIC is the term.
there are two aspects to a personality that if exposed others will attempt to ridicule you for. REALISM-which will get you called jaded everytime, and Idealism-which will get you called WORSE NAMES more often than it will get you called idealealistic...which is really pretty funny.
The old political statement is THINK GLOBALLY AND ACT LOCALLY...this really applies here...In a global sense We can be idealistic (this being somewhat of a global forum) IN a local sense we have to work within a more forced set of parameters and certain pragmatism comes into play....the enemy of my enemy is my friend...Specific TACTICS are dictated by the local terrain, while overall strategies can be planned along idealistic lines...it doesn't mean you are comprimising as much as it means you are accepting smaller immediate gains while using the truce to probe for future actions.

 

[mj]

Originally posted by ADRIANSHOE:

"No, thats a reductionist argument, its not a necessary inference. What you are doing is taking the cynical approach to my idealistic one and so we are juxtaposed into an arena with only two exits. Of course your scenario is one scenario, but its not the necessary scenario. Flexner proved that already, albeit temporarilily. on the flip side, with your argument you also imply the need for a strong central character with vision (isn't that the only way to avoid such beaurocracy?...Have you been reading your AYN RAND??...you are arguing against change by committee, therefore I am starting to sense a little fountainhead coming out, if this is your tack, i think we have a lot of common ground here. But, i am not going to succumb to fatalism just...yet.

Yes, reductionist and Flexner, granted. Seems to me though, the only viable solution you offer is for this "perfect visionary" to come run rotations at Nova. Barring that, any solution will have flaws, and the dedicated like yourself will always be reaching in the name of righting the wrongs. Fountainhead enough? Give in to my fatalism yet, or have you started believing God will walk among us

The old political statement is THINK GLOBALLY AND ACT LOCALLY...this really applies here...In a global sense We can be idealistic (this being somewhat of a global forum) IN a local sense we have to work within a more forced set of parameters and certain pragmatism comes into play....the enemy of my enemy is my friend...Specific TACTICS are dictated by the local terrain, while overall strategies can be planned along idealistic lines...it doesn't mean you are comprimising as much as it means you are accepting smaller immediate gains while using the truce to probe for future actions.

Well, hail Shoey, our conquering hero, changing the world one mind at a time! I would bet you could enlist Captain Freedom and his Freedom fighters for your subversive ops. missions

And now I'll take one of those two exits out of our arena. We've bored the readers enough. Thanks for the spar Shoey.
mj

 

[ewagner]

Yes, you have bored all of the readers. Next time you to should get each others phone numbers and just chat for a while, either that or get a room together.

Your arguments are so self absorbed and egotistical, I wonder if you two are just the same person posting under 2 equally dumb identities.

 

[RBorhani]

This thread has turned into a long conversation between two people and I think the use of email is best for this purpose. If you want to create a new post specifically for Nova's clinical rotations (as the majority of people posting are from NOVA)..please do so. I do suggest that you keep your posts short and to the point. (Just a suggestion though)..

[This message has been edited by RBorhani (edited 04-27-2000).]

 

[RBorhani]

Because of the popular demand and the anger expressed by some members at closing of this thread..this thread is once again open.

[This message has been edited by RBorhani (edited 04-29-2000).]