Why are DO schools promulgating the idea that the residency merger is of benefit to DO students?

[IslandStyle808]

---

Members don't see this ad.

I agree.

You are right that some PDs don't want DOs and that while there is bias at some places, much of this isn't bias at all.

From my experience with DO residents, I have found that the clinical education is very unstandardized. Some schools have their own hospital while others send their students off into the wind to do rotations at tiny hospitals/practices not set up for education. When one compares the clinical education between different MDs, they are nearly indistinguishable. A PD has to hope that a given DO student won the lottery and was able to get a strong clinical education while they don't have the same kind of worry with MD students.

A few years ago I met a former DO student (who was a resident at a strong mid-tier program) who told me prior to residency, he didn't have a single inpatient rotation in medical school! His transition was a very rough one. Many other DO residents discussed how they never had rotations with residents!

Why would a PD choose these students when they basically have to remediate some of them. Is that bias or is it rather reasonable caution? Depends on which side of the fence you fall on i guess...

The problem with the system is that it doesn't judge by school in the case of DO schools, but judges by degree. So those DO schools that do a good of putting people in hospitals with good clinical training are lumped in with the rest of schools that have poor training.

If an MD school wasn't up to snuff for certain residency programs, then the students as a whole are not taken. Its meant as a way to push medical schools to do a better job training their students. Now because DOs are judge by an entire degree and not by schools individually. Then the schools that do a good job won't realize that they are and the bad schools will think they are doing just as good of a job (since they are matching similarly to the good schools overall). There is no real incentive created because of this situation.

It would only get resolved not just simply by improving clinical education, but by integrating DO schools into the LCME. So they can be judged school by school.

 

[DrfluffyMD]

The problem with the system is that it doesn't judge by school in the case of DO schools, but judges by degree. So those DO schools that do a good of putting people in hospitals with good clinical training are lumped in with the rest of schools that have poor training.

If an MD school wasn't up to snuff for certain residency programs, then the students as a whole are not taken. Its meant as a way to push medical schools to do a better job training their students. Now because DOs are judge by an entire degree and not by schools individually. Then the schools that do a good job won't realize that they are and the bad schools will think they are doing just as good of a job (since they are matching similarly to the good schools overall). There is no real incentive created because of this situation.

It would only get resolved not just simply by improving clinical education, but by integrating DO schools into the LCME. So they can be judged school by school.

Blaming COCA. I think if DO school are absorbed by LCME things will get a lot more even

 

[deleted831695]

I am well aware why my statements may not be well recieved. Providing a different opinion that is congrugent with facts (such as NRMP match outcome data) is not trolling. If mod want this forum to be an echo chamber, I am more than happy to stop posting on this thread.

Nice deflection. You've bragged about your scores/outcomes, suggested getting into an MD isn't that difficult (implying some of us [yes, believe it or not, some of us did get into MDs as well] were too awful not to), proposed DOs only market themselves as PCPs and are only fit for primary care, and other subtle jabs under some throwaway line of 'but I believe they are equal (not)'.

Now because DOs are judge by an entire degree and not by schools individually. Then the schools that do a good job won't realize that they are and the bad schools will think they are doing just as good of a job (since they are matching similarly to the good schools overall). There is no real incentive created because of this situation. It would only get resolved not just simply by improving clinical education, but by integrating DO schools into the LCME. So they can be judged school by school.

This. People don't realize there is disparity, and that it should be evaluated on an individual school basis. Heck, some people are still surprised that there are DO schools with higher matriculant class averages than some MD schools.

 

[68PGunner]

The problem with the system is that it doesn't judge by school in the case of DO schools, but judges by degree. So those DO schools that do a good of putting people in hospitals with good clinical training are lumped in with the rest of schools that have poor training.

If an MD school wasn't up to snuff for certain residency programs, then the students as a whole are not taken. Its meant as a way to push medical schools to do a better job training their students. Now because DOs are judge by an entire degree and not by schools individually. Then the schools that do a good job won't realize that they are and the bad schools will think they are doing just as good of a job (since they are matching similarly to the good schools overall). There is no real incentive created because of this situation.

It would only get resolved not just simply by improving clinical education, but by integrating DO schools into the LCME. So they can be judged school by school.

Sigh... this here is the truth even for DO schools w/ attached hospitals. Always about 15-25% of the people have to do rotations at places w/ less than 80 beds. However, it’s not an issue if these people want to do rural primary care in the first place.

 

[Gray Fox]

Well for starters I am DrfluffyMD, not mcfluffykin.


I am well aware why my statements may not be well recieved. Providing a different opinion that is congrugent with facts (such as NRMP match outcome data) is not trolling.

If mod want this forum to be an echo chamber, I am more than happy to stop posting on this thread.

C'mon man. It's not just stating a different opinion--your responses come off a little insensitive. Also, if you look at the average family income of the average medical student, you know the vast majority of medical students are very well off and come from well-to-do homes. And you know California kids are doubly screwed.

I didn't realize you were my senior (a practicing doc), otherwise I would've replied more respectfully. You remind me of @MeatTornado whom I actually really like, because he provides great insights into the whole process, albeit a little harshly sometimes. Yo Meat, stay on man! I really, really like you! SDN needs posters like you!

I hope this forum and SDN NEVER becomes an echo chamber--even if we disagree, I really appreciate posters like you, because you're honest, and you have insights into the process that we, your juniors, don't have and can learn from. Whatever your motivations, presumably good with an intention to pay it forward, we benefit from you taking your time to lend your opinion.

 

[Gray Fox]

I agree.

You are right that some PDs don't want DOs and that while there is bias at some places, much of this isn't bias at all.

From my experience with DO residents, I have found that the clinical education is very unstandardized. Some schools have their own hospital while others send their students off into the wind to do rotations at tiny hospitals/practices not set up for education. When one compares the clinical education between different MDs, they are nearly indistinguishable. A PD has to hope that a given DO student won the lottery and was able to get a strong clinical education while they don't have the same kind of worry with MD students.

A few years ago I met a former DO student (who was a resident at a strong mid-tier program) who told me prior to residency, he didn't have a single inpatient rotation in medical school! His transition was a very rough one. Many other DO residents discussed how they never had rotations with residents!

Why would a PD choose these students when they basically have to remediate some of them. Is that bias or is it rather reasonable caution? Depends on which side of the fence you fall on i guess...

I know I will get crapped on (and already do get crapped on by my MD colleagues) for this opinion, but post-merger, if a DO applicant matches into an academic, traditionally MD program, and an MD matches into a community, traditionally DO program, isn't the DO more MD than the MD, and the MD more DO than the DO? Let's be honest, you learn to be an independent doc in residency, not med school. That's where practicing behavior is really ingrained into you.

More reason for MD and DO schools to be overseen by one regulating body, and more reason to have just 1 unified medical degree.

 

[Ho0v-man]

A few years ago I met a former DO student (who was a resident at a strong mid-tier program) who told me prior to residency, he didn't have a single inpatient rotation in medical school! His transition was a very rough one. Many other DO residents discussed how they never had rotations with residents!

Why would a PD choose these students when they basically have to remediate some of them. Is that bias or is it rather reasonable caution? Depends on which side of the fence you fall on i guess...

That kind of blows my mind. At my school the only folks who get a third year like that are the ones who seek it out (either a) chose an “easy” site or b) just chose the place closest to where they want to live). That kind of thing goes back to what island style was saying though about how the whole degree gets punished because of random stuff like that. One good thing is that with the new changes with COCA that this won’t happen anymore.

 

[Instatewaiter]

I know I will get crapped on (and already do get crapped on by my MD colleagues) for this opinion, but post-merger, if a DO applicant matches into an academic, traditionally MD program, and an MD matches into a community, traditionally DO program, isn't the DO more MD than the MD, and the MD more DO than the DO? Let's be honest, you learn to be an independent doc in residency, not med school. That's where practicing behavior is really ingrained into you.

More reason for MD and DO schools to be overseen by one regulating body, and more reason to have just 1 unified medical degree.

I don't think it's becoming more MD or more DO but rather maximizing your chances of being a good clinician... but you are exactly right, the foundation of your clinical education is laid during third year but the true structure of your clinical acumen is created during resdiency/fellowhsip. This is one of the reasons why people are so hurt that there is more difficulty getting a strong residency from DO schools

 

[deleted407021]

I don't think it's becoming more MD or more DO but rather maximizing your chances of being a good clinician... but you are exactly right, the foundation of your clinical education is laid during third year but the true structure of your clinical acumen is created during resdiency/fellowhsip. This is one of the reasons why people are so hurt that there is more difficulty getting a strong residency from DO schools

Certainly this residency quality disparity ought to be less of a factor after The Merger™️

 

[68PGunner]

...

 

[NurWollen]

Sigh... this here is the truth even for DO schools w/ attached hospitals. Always about 15-25% of the people have to do rotations at places w/ less than 80 beds. However, it’s not an issue if these people want to do rural primary care in the first place.

I can see both sides here. 80 bed hospitals can still be very busy depending on their staffing. For example, there are plenty of ACGME peds residencies at hospitals with fewer than 80 peds beds, and I know of a few ACGME IM and FM programs that are at 80ish bed hospitals as well. In med school I rotated at 80 bed hospitals and 500 bed hospitals and I don't think there was a consistent theme as to which provided better rotations.

Where the clinical rotation aspect of DO schools does get dicey is when you have people doing all their IM rotations at outpatient clinics.

Ironically, there were people at my school who had their FM rotations with FM-trained hospitalists and had inpatient FM exposure.

Sent from my SM-G930V using SDN mobile

 

[Instatewaiter]

Sigh... this here is the truth even for DO schools w/ attached hospitals. Always about 15-25% of the people have to do rotations at places w/ less than 80 beds. However, it’s not an issue if these people want to do rural primary care in the first place.

I can see both sides here. 80 bed hospitals can still be very busy depending on their staffing. For example, there are plenty of ACGME peds residencies at hospitals with fewer than 80 peds beds, and I know of a few ACGME IM and FM programs that are at 80ish bed hospitals as well. In med school I rotated at 80 bed hospitals and 500 bed hospitals and I don't think there was a consistent theme as to which provided better rotations.

One thing that always gets me is that people love to make things up (or perhaps make uneducated guesses) and post it on SDN. Please post even a handful of the 'plenty' of ACGME peds programs that only rotate at hospitals which are < 80 beds. (Hint- I was curious and looked through 1/4 of the list and couldn't find a single one. I subsequently lost interest).

Similarly, please post the handful of those ACGME IM programs at those programs with < 80 beds. I found only 2 which were at hospitals of 200 beds or less

With only 80 beds in your hospital (realize this is going to be other specialties other than your own) your education is going to suffer.
- you wont have a large volume of patients
- you wont have access to various specialities (which means these patients are going somewhere else)
- you wont have many modalities to offer complex patients
- you will always transfer out complex patients

 

[NurWollen]

One thing that always gets me is that people love to make things up (or perhaps make uneducated guesses) and post it on SDN. Please post even a handful of the 'plenty' of ACGME peds programs that only rotate at hospitals which are < 80 beds. (Hint- I was curious and looked through 1/4 of the list and couldn't find a single one. I subsequently lost interest).

Similarly, please post the handful of those ACGME IM programs at those programs with < 80 beds. I found only 2 which were at hospitals of 200 beds or less

With only 80 beds in your hospital (realize this is going to be other specialties other than your own) your education is going to suffer.
- you wont have a large volume of patients
- you wont have access to various specialities (which means these patients are going somewhere else)
- you wont have many modalities to offer complex patients
- you will always transfer out complex patients

When you were looking at the list of peds programs, were you looking on FREIDA? Because that might be listing all the beds a hospital has, which, unless the program is a freestanding children's hospital, isn't going to reflect the number of beds relevant to peds.

Sent from my SM-G930V using SDN mobile

 

[Deecee2DO]

1000%

Or just put omm in physical therapy where it belongs.

 

[TheaterOfTheme]

1000%

If we did that then we couldn't have the religious aspect to it. God forbid we stop worshipping AT Still for being the inventor of essentially touching people and doing nothing. Real talk--my main homie I study OMM with had literally the same sacral "somatic dysfunction" for the entire first year of med school. We are all sublexing, muscle energy-ing, etc. etc. on each other and we change NOTHING. Massages are nice and help sometimes--but you ain't fixing anything major by poking at each other's pressure points or touching someones sacrum.

 

[Black Coffee 24/7]

If we did that then we couldn't have the religious aspect to it. God forbid we stop worshipping AT Still for being the inventor of essentially touching people and doing nothing. Real talk--my main homie I study OMM with had literally the same sacral "somatic dysfunction" for the entire first year of med school. We are all sublexing, muscle energy-ing, etc. etc. on each other and we change NOTHING. Massages are nice and help sometimes--but you ain't fixing anything major by poking at each other's pressure points or touching someones sacrum.

Keep stretching, homeboy.

You might look as young as Jesus when you're in your 80s.

 

[sab3156]

If we did that then we couldn't have the religious aspect to it. God forbid we stop worshipping AT Still for being the inventor of essentially touching people and doing nothing. Real talk--my main homie I study OMM with had literally the same sacral "somatic dysfunction" for the entire first year of med school. We are all sublexing, muscle energy-ing, etc. etc. on each other and we change NOTHING. Massages are nice and help sometimes--but you ain't fixing anything major by poking at each other's pressure points or touching someones sacrum.

Did you first try using a spell or prayer to invoke the power of AT Still? If you didn't, then that is your problem. I don't want to hear any nonsense like "I couldn't fix my friend's head using the magic of the V-spread" until I start seeing evidence that you also have utilized the resources that we have from the unseen world. I started reciting incantations that I learned from some of the Harry Potter movies while doing OMM, and now it finally seems to be resolving somatic dysfunctions. It was also only until I began avoiding stepping on cracks on the ground while walking to school that I can finally feel the cranial pressure waves during labs. I will be publishing these case reports in the JAOA.

 

[deleted950463]

The merger sucks! We used to have special spots in ortho, derm and neurosurgery where all that was needed was good audition rotations and decent COMLEX which is far easier than the USMLE

 

[fldoctorgirl]

Did you first try using a spell or prayer to invoke the power of AT Still? If you didn't, then that is your problem. I don't want to hear any nonsense like "I couldn't fix my friend's head using the magic of the V-spread" until I start seeing evidence that you also have utilized the resources that we have from the unseen world. I started reciting incantations that I learned from some of the Harry Potter movies while doing OMM, and now it finally seems to be resolving somatic dysfunctions. It was also only until I began avoiding stepping on cracks on the ground while walking to school that I can finally feel the cranial pressure waves during labs. I will be publishing these case reports in the JAOA.

I low key appreciate you so much ever since I started school and I am sorry for all the crap I gave you before 😛

 

[sab3156]

I low key appreciate you so much ever since I started school and I am sorry for all the crap I gave you before 😛

I may be harsh but I have your back.

 

[DarkHorizon]

The merger sucks! We used to have special spots in ortho, derm and neurosurgery where all that was needed was good audition rotations and decent COMLEX which is far easier than the USMLE

You better gear up if you want that spot at NYP, there’s nothing easy about that, merger or no merger.

 

[BorntobeDO?]

The merger sucks! We used to have special spots in ortho, derm and neurosurgery where all that was needed was good audition rotations and decent COMLEX which is far easier than the USMLE

While I partially agree, I think for the majority, at this moment, the merger is a good thing. We will see if that is still true by 2026 tho.

 

[BorntobeDO?]

I low key appreciate you so much ever since I started school and I am sorry for all the crap I gave you before 😛

You can always tell the premeds/early first years by how high and mighty they get when defending DO. Then magically most transform into the whiners they complained about by 2nd year.

 

[FCMike11]

I agree with the merger being great overall (standardization of GME = AWESOME) and that the competitive specialties are still competitive (whoa. shocker. wow.) Will DO's lose "reserved" seats at DO-specific programs? Sure. Whatever. But if you have a strong application I don't think you have anything to worry about.

If you planned on squeaking through with a mediocre application into a competitive specialty because the MD students can't apply to a certain subset of seats, then honestly you don't deserve that seat and you SHOULD be weeded out.

One of the main points of this merger is leveling the playing field across the board; standardizing both GME and quality of physicians; demonstrating that DO's and MD's are different but equal. If you can't outcompete an MD applicant for a surgical/derm/NSG/*insert competitive specialty here* seat, then you don't deserve it.

Take the USMLE, score well, build a strong application, and apply for whatever residency you feel you'll be competitive for, JUST LIKE THE MD's DO. If that means you have to outscore an MD applicant because you're a DO and the residency director of your desired residency program has some kind of archaic, biased mindset, don't complain, just do it.

I cannot stand all these doomsday mentality individuals talking about the merger (in general; not referring to anyone on this thread.) Work hard and sacrifice; show residency programs you belong there, and you'll be alright. This merger is great for everyone.

Sure, but you KNOW it isn't this linear.

You seem to state, very factually, that if a DO student has a higher step 1 score they WILL match to whatever spot. Do you believe this to be true?

That would be really interesting if the merger automatically removed the DO stigma. It won't. This is NOT good for today's DO graduates. Maybe in years to come (as demand for quality increases).

 

[Osminog]

That would be really interesting if the merger automatically removed the DO stigma. It won't. This is NOT good for today's DO graduates. Maybe in years to come (as demand for quality increases).

The merger will eventually reduce the stigma. The stigma has largely stemmed from the fact that DOs applying to residencies are held to a different standard because of their DO-exclusive matching option; DO graduates with less-than-stellar credentials can break into orthopedic surgery and dermatology by going through the AOA match. Now there are going to be no more special backdoors, and DOs will have to compete directly with MDs. This will improve the reputation of DOs in the medical community.

 

[Black Coffee 24/7]

The merger will eventually reduce the stigma. The stigma has largely stemmed from the fact that DOs applying to residencies are held to a different standard because of their DO-exclusive matching option; DO graduates with less-than-stellar credentials can break into orthopedic surgery and dermatology by going through the AOA match. Now there are going to be no more special backdoors, and DOs will have to compete directly with MDs. This will improve the reputation of DOs in the medical community.

ROFL

Going to be fun when you find out that you need to bust at least a 220 Step 1 to do anything that's not FM or BFE IM.

 

[AnatomyGrey12]

Going to be fun when you find out that you need to bust at least a 220 Step 1 to do anything that's not FM or BFE IM.

Lol... but you don't

 

[NecrotizingFasciitis]

Sure, but you KNOW it isn't this linear.

You seem to state, very factually, that if a DO student has a higher step 1 score they WILL match to whatever spot. Do you believe this to be true?

That would be really interesting if the merger automatically removed the DO stigma. It won't. This is NOT good for today's DO graduates. Maybe in years to come (as demand for quality increases).

Tempting, but I'm not gunna bite. Sorry.

 

[sab3156]

The merger will eventually reduce the stigma. The stigma has largely stemmed from the fact that DOs applying to residencies are held to a different standard because of their DO-exclusive matching option

This is absolutely not true. The stigma exists because osteopathy is generally seen as having inferior medical training. A large part of it stems from the teaching of osteopathic pseudoscience during preclinical years, and also people viewing osteopathic clinical training to be subpar at best. The stigma will NOT be reduced just because DOs lost their protected residency spots. I don't even see how you can think that.

 

[Chibucks15]

This is absolutely not true. The stigma exists because osteopathy is generally seen as having inferior medical training. A large part of it stems from the teaching of osteopathic pseudoscience during preclinical years, and also people viewing osteopathic clinical training to be subpar at best. The stigma will NOT be reduced just because DOs lost their protected residency spots. I don't even see how you can think that.

Cmon man...literally everything about being a DO is like the sky is falling with you. If more residencies see more DOs, and those DOs relatively impress or even just go to the similar level as MD, then the stigma fades. It will take longer at the higher up places but eventually it'll all be the same with a class in OMM as an elective. Almost every physician that comments on here (that I've seen) and the ones I've talked to have said that for the most part they can't tell the difference where you train (unless you're at one of the new ones that actually have terrible sites). There is no way you can say a grad of KCU or the big DO schools is that much worse then some MDs. Talking to certain students from MD schools, they have almost as many crap rotations as DO students I've talked to. The curriculum (besides OMM) isn't as different as you seem to think it is.

Again this is for the more established, solid DO schools, not the branch of a branch of a branch campus in the middle of nowhere.

 

[sab3156]

Cmon man...literally everything about being a DO is like the sky is falling with you. If more residencies see more DOs, and those DOs relatively impress or even just go to the similar level as MD, then the stigma fades. It will take longer at the higher up places but eventually it'll all be the same with a class in OMM as an elective. Almost every physician that comments on here (that I've seen) and the ones I've talked to have said that for the most part they can't tell the difference where you train (unless you're at one of the new ones that actually have terrible sites). There is no way you can say a grad of KCU or the big DO schools is that much worse then some MDs. Talking to certain students from MD schools, they have almost as many crap rotations as DO students I've talked to. The curriculum (besides OMM) isn't as different as you seem to think it is.

Again this is for the more established, solid DO schools, not the branch of a branch of a branch campus in the middle of nowhere.

Your post is cute and really inspiring to the pre-med world, but has nothing to do with what I said.

 

[Chibucks15]

Your post is cute and really inspiring to the pre-med world, but has nothing to do with what I said.

It directly counters your 'DO biases exist because we all suck' point

EDIT: my anecdotal evidence is just as good as yours bud

 

[sab3156]

It directly counters your 'DO biases exist because we all suck' point

EDIT: my anecdotal evidence is just as good as yours bud

Was your MCAT low only due to poor verbal reasoning? I think you should re-read with a clear head and without emotions about AT Still clouding your thinking.

 

[Chibucks15]

Was your MCAT low only due to poor verbal reasoning? I think you should re-read with a clear head and without emotions about AT Still clouding your thinking.

See I feel like I read exactly what it said...love the outrageous personal attacks when you know nothing about me though! Par for the course for the almighty sab though.

Many MD students I've heard from, in addition to several attendings that I've talked to (and post on here) have said that there isn't as much difference as you seem to think there is in clinical education. (Obviously besides OMM and bad rotation here and there for the new guys, but most are fine). So I'm gonna use that as my 'verbal reasoning' and say that yes, with more exposure, the DO stigma will fade to a degree. Never said it would go away completely, also I mentioned it would take longer at the higher up places.

Anything I'm missing o wise one? I'd love it instead of immediately attacking my intelligence, you try to have an actual discussion about where I was wrong. That way instead of laughing at your short temper, I can learn something from your infinite wisdom.

 

[AnatomyGrey12]

Was your MCAT low only due to poor verbal reasoning? I think you should re-read with a clear head and without emotions about AT Still clouding your thinking.

You wouldn’t come across as such an a$$ if every third post wasn’t an ad hominem attack... people might actually listen to you. Just a thought.

 

[sab3156]

You wouldn’t come across as such an a$$ if every third post wasn’t an ad hominem attack... people might actually listen to you. Just a thought.

View attachment 240386

Damn, sorry about hurting your feelings SDN!

 

[AnatomyGrey12]

Damn, sorry about hurting your feelings SDN!

🙄

 

[BorntobeDO?]

Cmon man...literally everything about being a DO is like the sky is falling with you. If more residencies see more DOs, and those DOs relatively impress or even just go to the similar level as MD, then the stigma fades. It will take longer at the higher up places but eventually it'll all be the same with a class in OMM as an elective. Almost every physician that comments on here (that I've seen) and the ones I've talked to have said that for the most part they can't tell the difference where you train (unless you're at one of the new ones that actually have terrible sites). There is no way you can say a grad of KCU or the big DO schools is that much worse then some MDs. Talking to certain students from MD schools, they have almost as many crap rotations as DO students I've talked to. The curriculum (besides OMM) isn't as different as you seem to think it is.

Again this is for the more established, solid DO schools, not the branch of a branch of a branch campus in the middle of nowhere.

Disagree, DO schools have most students at sites with no academic residency exposure at all in 3rd year, whereas I know no MD student who isn't getting at least one decent teaching rotation in third year. It makes it hard to do audition rotations when everyone else has been getting pimped like crazy all third year, and your just trying to help your preceptor catch up so they can teach you something.

How are you supposed to look good in what is basically your first academic rotation when you haven't been in that environment? You can't, you basically have to waste the first one, and who wants to waste a program? MD's don't have to deal with this stuff. They always have a home court, and a training camp, while your getting called up from the D-league.

 

[DNC127]

Disagree, DO schools have most students at sites with no academic residency exposure at all in 3rd year, whereas I know no MD student who isn't getting at least one decent teaching rotation in third year. It makes it hard to do audition rotations when everyone else has been getting pimped like crazy all third year, and your just trying to help your preceptor catch up so they can teach you something.

I go to one of the DO schools that is arguably the most similar to MD schools, honestly going into school I took great pride in the fact that every one of my rotations would be "wards based" and with residents in a single academic medical center. Now that I am a 3rd year, I am attempting switching my rotations to the more rural spots. Getting pimped by residents is cool and all until you fall to 7th in line behind the residents and auditioning students and you are basically just a scut bucket. Then you hear about your friends at rural sites doing skin-to-skin appys and driving 30+ colonoscopys in a month and you realize that the good training is preceptor based (if quality preceptor), and the wards based rotations in academic centers are over rated. Ya it may be a gold star to be with residents for all your rotations, but its boring as **** and you don't get even a fraction of the experience you would 1on1 with a preceptor.

 

[DNC127]

I go to one of the DO schools that is arguably the most similar to MD schools, honestly going into school I took great pride in the fact that every one of my rotations would be "wards based" and with residents in a single academic medical center. Now that I am a 3rd year, I am attempting switching my rotations to the more rural spots. Getting pimped by residents is cool and all until you fall to 7th in line behind the residents and auditioning students and you are basically just a scut bucket. Then you hear about your friends at rural sites doing skin-to-skin appys and driving 30+ colonoscopys in a month and you realize that the good training is preceptor based (if quality preceptor), and the wards based rotations in academic centers are over rated. Ya it may be a gold star to be with residents for all your rotations, but its boring as **** and you don't get even a fraction of the experience you would 1on1 with a preceptor.

Also, I will add that there was NOTHING that the residents loved to pimp on in my rotations that wasn't also considered high yield in a question bank or book. Its not like resident pimping is magic information you can't get anywhere else.

 

[BorntobeDO?]

I go to one of the DO schools that is arguably the most similar to MD schools, honestly going into school I took great pride in the fact that every one of my rotations would be "wards based" and with residents in a single academic medical center. Now that I am a 3rd year, I am attempting switching my rotations to the more rural spots. Getting pimped by residents is cool and all until you fall to 7th in line behind the residents and auditioning students and you are basically just a scut bucket. Then you hear about your friends at rural sites doing skin-to-skin appys and driving 30+ colonoscopys in a month and you realize that the good training is preceptor based (if quality preceptor), and the wards based rotations in academic centers are over rated. Ya it may be a gold star to be with residents for all your rotations, but its boring as **** and you don't get even a fraction of the experience you would 1on1 with a preceptor.

IMO, you are misunderstanding your role as a 3rd year. Its good that you are used to the pimping, cause that is what makes you look good on auditions. Not skin biopsys or colonoscopy's, those come later. And medicine is all about hierarchy, and you know your role. You need to present, SOAP, and answer pimp questions. I might be better at writing notes cause I do 10 a day, but I literally get maybe 5 pimp questions a day, so how much am I really able to learn when I am just pumping out those notes doing my best imitation of an attending?

Its something, but its not like I am really even doing extensive differentials or workups. I put in an assessment, basic plan, and then spend maybe a minute discussing my plan with my preceptor. I have to think if he didn't have 20 outpatients and 10 inpatients that I would be getting alot more time.

Its so funny, I have what you think you want, and you have what I think is better. Ironic.

 

[AnatomyGrey12]

I go to one of the DO schools that is arguably the most similar to MD schools, honestly going into school I took great pride in the fact that every one of my rotations would be "wards based" and with residents in a single academic medical center. Now that I am a 3rd year, I am attempting switching my rotations to the more rural spots. Getting pimped by residents is cool and all until you fall to 7th in line behind the residents and auditioning students and you are basically just a scut bucket. Then you hear about your friends at rural sites doing skin-to-skin appys and driving 30+ colonoscopys in a month and you realize that the good training is preceptor based (if quality preceptor), and the wards based rotations in academic centers are over rated. Ya it may be a gold star to be with residents for all your rotations, but its boring as **** and you don't get even a fraction of the experience you would 1on1 with a preceptor.

Also, I will add that there was NOTHING that the residents loved to pimp on in my rotations that wasn't also considered high yield in a question bank or book. Its not like resident pimping is magic information you can't get anywhere else.

This is why the best clinical training is probably a mix of both. You need to learn how to work on an academic team for auditions and residency but being a scut monkey for everything isn’t going to teach you very much. Clinical skills are also important.

Obviously these are generalizations and not all wards rotations are “scut” and not all preceptor rotations are “learn loads.”

 

[Neopolymath]

This is why the best clinical training is probably a mix of both. You need to learn how to work on an academic team for auditions and residency but being a scut monkey for everything isn’t going to teach you very much. Clinical skills are also important.

Obviously these are generalizations and not all wards rotations are “scut” and not all preceptor rotations are “learn loads.”

True. Ultimately, functioning within the team and being a good intern are not the exact same thing as being a good future physician and that's why programs seek out people who have experience in academic training 3rd and 4th year because the most important thing is to get someone who isn't going to suck intern year. Programs feel that they can coach the residents up on the other stuff. Aside from being less boring and fun, learning to do clinical stuff really doesn't matter 3rd year unfortunately if you want to go to an academic program.

 

[AnatomyGrey12]

Aside from being less boring and fun, learning to do clinical stuff really doesn't matter 3rd year unfortunately if you want to go to an academic program.

I agree to a large extent. However, having talked to residents in multiple fields over the last bit programs do notice if you are good clinically. Obviously you have to know how to present, write notes, work in the team, etc. However, if you can do those things AND you can show up and know your basic clinical stuff for that field cold? Programs notice.

For example if you show up for a surgical audition or away, you had better know your basic knots and how to suture, have the clinical exam skills needed for basic surgical patients, how to handle yourself in the OR, etc. Obviously you can teach yourself these skills if you had to but standing 7th in line and never getting to touch a patient on your surgery rotation won’t help. That’s why I said a mix of both types is likely best, you need both to be successful.

Disclaimer: I’m not talking about resident level skills, I’m talking compared to your 4th year peers.

 

[Black Coffee 24/7]

Also, I will add that there was NOTHING that the residents loved to pimp on in my rotations that wasn't also considered high yield in a question bank or book. Its not like resident pimping is magic information you can't get anywhere else.

I agree with this 1,000%. Resident pimping is overrated. Wiwa/Zanki Step 2 Anki Decks are more than sufficient to answer 90% of the pimp questions out there.

IMO, you are misunderstanding your role as a 3rd year. Its good that you are used to the pimping, cause that is what makes you look good on auditions. Not skin biopsys or colonoscopy's, those come later. And medicine is all about hierarchy, and you know your role. You need to present, SOAP, and answer pimp questions. I might be better at writing notes cause I do 10 a day, but I literally get maybe 5 pimp questions a day, so how much am I really able to learn when I am just pumping out those notes doing my best imitation of an attending?

Its something, but its not like I am really even doing extensive differentials or workups. I put in an assessment, basic plan, and then spend maybe a minute discussing my plan with my preceptor. I have to think if he didn't have 20 outpatients and 10 inpatients that I would be getting alot more time.

Its so funny, I have what you think you want, and you have what I think is better. Ironic.

I'm on my third rotation right now. 1st one and 3rd one are at academic center. My 2nd one was with a preceptor in a rural location.

My presentation skills along with my clinical acumen are miles ahead of my classmate due to 10-12 x clean presentations under 3 minutes /day to a rural preceptor on my 2nd rotation.

I'm straight up destroying pimping questions on the ward thanks to Wiwa/Zanki decks. Questions are almost like child plays.

However, my technical skills especially in surgery are severely lacking. For anyone who's reading this post and is gunning for a surgical specialty, you should be shooting for a rural surgical rotation.

Having seen 4th rotation students who have auditioned through my program, I can honestly say that the ability to present, compose ddx and plan, play nice with others, and show competency in the OR are the ingredients toward acing auditions. From my observation, the thing that separates the superstar 4th year from the good 4th year student is actually OR competency.

 

[Goro]

I go to one of the DO schools that is arguably the most similar to MD schools, honestly going into school I took great pride in the fact that every one of my rotations would be "wards based" and with residents in a single academic medical center. Now that I am a 3rd year, I am attempting switching my rotations to the more rural spots. Getting pimped by residents is cool and all until you fall to 7th in line behind the residents and auditioning students and you are basically just a scut bucket. Then you hear about your friends at rural sites doing skin-to-skin appys and driving 30+ colonoscopys in a month and you realize that the good training is preceptor based (if quality preceptor), and the wards based rotations in academic centers are over rated. Ya it may be a gold star to be with residents for all your rotations, but its boring as **** and you don't get even a fraction of the experience you would 1on1 with a preceptor.

I agree with this 1,000%. Resident pimping is overrated. Wiwa/Zanki Step 2 Anki Decks are more than sufficient to answer 90% of the pimp questions out there.
I'm on my third rotation right now. 1st one and 3rd one are at academic center. My 2nd one was with a preceptor in a rural location.
My presentation skills along with my clinical acumen are miles ahead of my classmate due to 10-12 x clean presentations under 3 minutes /day to a rural preceptor on my 2nd rotation.
I'm straight up destroying pimping questions on the ward thanks to Wiwa/Zanki decks. Questions are almost like child plays.
However, my technical skills especially in surgery are severely lacking. For anyone who's reading this post and is gunning for a surgical specialty, you should be shooting for a rural surgical rotation.
Having seen 4th rotation students who have auditioned through my program, I can honestly say that the ability to present, compose ddx and plan, play nice with others, and show competency in the OR are the ingredients toward acing auditions. From my observation, the thing that separates the superstar 4th year from the good 4th year student is actually OR competency.

Damn, guys....I've been on SDN form some 6-7 years, and this is the first I've heard about these bon mots!

Filing away for future reference.

BTW, here's what Memorial Sloan-Kettering Cancer Center (they of Jim Allison 2018 Nobel Laureate fame) has to say about that pseudoscientific OMM:
Osteopathic Manipulative Treatment (OMT) | Memorial Sloan Kettering Cancer Center

 

[VA Hopeful Dr]

Damn, guys....I've been on SDN form some 6-7 years, and this is the first I've heard about these bon mots!

Filing away for future reference.

BTW, here's what Memorial Sloan-Kettering Cancer Center (they of Jim Allison 2018 Nobel Laureate fame) has to say about that pseudoscientific OMM:
Osteopathic Manipulative Treatment (OMT) | Memorial Sloan Kettering Cancer Center

Huh, a hospital that has people offering OMT thinks OMT is great.

Linus Pauling had TWO Nobel Prizes but his Vitamin C and chelation ideas were still nonsense.

 

[Goro]

Huh, a hospital that has people offering OMT thinks OMT is great.

Linus Pauling had TWO Nobel Prizes but his Vitamin C and chelation ideas were still nonsense.

Only the world's best cancer center!

 

[VA Hopeful Dr]

Only the world's best cancer center!

Only the world's only person to win 2 Nobels in different fields!

 

[Goro]

Only the world's only person to win 2 Nobels in different fields!

So did Marie Curie! (Chemistry and Physics)

I think Kary Mullis is one of the best examples of a Nobel Laureate not only getting something wrong, but being absolute whacko as well. Well, then there's the Nazi war criminal Reiter.