Why are new DO schools a bad idea?

[jkhamlin]

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That dude really is soooooooo wrong.

Here's a link from the AAMC explaining Medicare's role in funding the vast majority of residency positions in this country.

http://www.aamc.org/advocacy/library/gme/gme0001.htm

The payments (which I understand are around $80k-$100k per residency spot) are for the resident's salaries, as well as compensation for other costs associated with training the resident. No medicare (or reduced medicare payments), no system for residency training as we know it.

And that's also part of the reason we might be struggling with residency issues. (I'm surprised this hasn't been talked about on this forum.) The allocation of residency spots have been *frozen* since 1996 thanks to federal government shananigans, meaning that there've been essentially no change for 10 years. That means all of the schools created since 1996, to date, hasn't had a single residency spot paid for by medicare.

As of July 1st of this year, there's going to be a very significant reallocation of residency spots based on proven need/ability to fill spots.

That means parts of the country growing in population (special priorities given for rural and small-city programs) should see a dramatic boost in residency programs next year. And I'm sure that means all the newer schools (especially in communities with large/growing populations) will be getting the funding to set up many, many more residency spots.

Reading that brochure, one discovers that this is to pay for the Medicare patient load handled by the residents. Also, Medicare limits the number of residents covered on this, but it does not dictate how many residency positions there are. You can spin that how you want, but Medicare is only doing what it is designed to do and nothing more. It also mentions that funding comes from many other sources, it is just that they are often the largest single source.
This is similar to the argument where people say the insurance company won't let them get an organ transplant. The insurance company doesn't say that, they just say they won't pay for it if you do.

 

[UHS05]

I'm not quite sure of what you mean. I was talking about an existing school in my example (and within a few percentage points of each value, true for more than one private current DO schools)...the point is that if we cannot manage what we already have, setting up a host of new institutions is only going to make things worse...

In any case, I proudly represented my osteopathic heritage during the recent interview season and answered several completely asinine questions and clarified "what is a DO" to even more people (since there are very few in rad-onc), so I really do think that I am a proud DO-to-be. However, I do believe that we must all work together toward making the profession more recognizable and respected not just by sheer numbers, but by the QUALITY of our training programs.

Good luck to all of you embarking on this remarkable journey and I look forward to working with you as colleagues in 4-5 years 👍

Try 150 students, 24k/yr, and 80+ rotation sites. If you want to find the schools you speak of, look at the pre-existing schools not the new ones.

 

[Docgeorge]

This dude jkhamlin, was the same guy who was agrueing with med-students as to what would best prepare you for MEDICAL school anatomy as a pre-med. nuf said?

 

[Docgeorge]

I'm not quite sure of what you mean. I was talking about an existing school in my example (and within a few percentage points of each value, true for more than one private current DO schools)...the point is that if we cannot manage what we already have, setting up a host of new institutions is only going to make things worse...

In any case, I proudly represented my osteopathic heritage during the recent interview season and answered several completely asinine questions and clarified "what is a DO" to even more people (since there are very few in rad-onc), so I really do think that I am a proud DO-to-be. However, I do believe that we must all work together toward making the profession more recognizable and respected not just by sheer numbers, but by the QUALITY of our training programs.

Good luck to all of you embarking on this remarkable journey and I look forward to working with you as colleagues in 4-5 years 👍

He's talking about FLECOM with it's 80 affiliation sites. But how many students does each site take, what is there geographical distrabution. It's going to be interesting to see whats going to happen 250 something 3rd years from LECOM and however many from FLECOM trying to get 3rd year rotations.

 

[OSUdoc08]

This dude jkhamlin, was the same guy who was agrueing with med-students as to what would best prepare you for MEDICAL school anatomy as a pre-med. nuf said?

Yeah, he argued with me about that quite a bit.

It makes you wonder.

 

[heech]

You can get into all the semantic debates you'd like jkhamlin, but let's talk about the real world. The fact that Medicare is the largest source of funding for residency positions means that very few residency positions are created in the absence of such funding. Yes, hypothetically I could establish a hospital tomorrow and establish an accredited residency program in neurosurgery and fund it out of my own pocket... but very, very few programs choose to do so.

Hypotheticals aside, let's just get the facts out of the way: residency positions, by and large, are not run as a source of profit for hospitals. They are conducted as an investment in the future, period.

And you still have a fundamental misunderstanding of the Medicare payments mentioned above. Medicare is already billed for the procedures performed on their patients. Medicare then uses this number to calculate an *additional* contribution expressly for the purpose of training new doctors to serve the Medicare population; this money is *not* the payment delivered to a resident for treating the patient in the first place.

 

[jkhamlin]

Yeah, he argued with me about that quite a bit.

It makes you wonder.

OK, genious, one of my professors taught Anatomy and Histo at a med school. He supports comparative anatomy and says it is better to prepare for med school.
Your problem is that you believe everything you think.
I really hope that you aren't as disrespectful to everyone in person as you are on this message board, I'm glad you won't be my doctor.

 

[jkhamlin]

You can get into all the semantic debates you'd like jkhamlin, but let's talk about the real world. The fact that Medicare is the largest source of funding for residency positions means that very few residency positions are created in the absence of such funding. Yes, hypothetically I could establish a hospital tomorrow and establish an accredited residency program in neurosurgery and fund it out of my own pocket... but very, very few programs choose to do so.

Hypotheticals aside, let's just get the facts out of the way: residency positions, by and large, are not run as a source of profit for hospitals. They are conducted as an investment in the future, period.

And you still have a fundamental misunderstanding of the Medicare payments mentioned above. Medicare is already billed for the procedures performed on their patients. Medicare then uses this number to calculate an *additional* contribution expressly for the purpose of training new doctors to serve the Medicare population; this money is *not* the payment delivered to a resident for treating the patient in the first place.

That's funny, when I was licensed in insurance and finance, none of the regulators that administered the tests I took thought I had such a fundamental misunderstanding. I don't seem to have such a fundamental misunderstanding at the hospital pharmacy I work at either. Perhaps you should take a look at yourself.

 

[OSUdoc08]

OK, genious, one of my professors taught Anatomy and Histo at a med school. He supports comparative anatomy and says it is better to prepare for med school.
Your problem is that you believe everything you think.
I really hope that you aren't as disrespectful to everyone in person as you are on this message board, I'm glad you won't be my doctor.

When you get into medical school, then we can discuss whether or not your professor was correct.

Until then, you don't really know.

The professor doesn't actually take the exams, nor does he take the boards.

 

[jkhamlin]

When you get into medical school, then we can discuss whether or not your professor was correct.

Until then, you don't really know.

🙄 You are quite conceited.

 

[Docgeorge]

OK, genious, one of my professors taught Anatomy and Histo at a med school. He supports comparative anatomy and says it is better to prepare for med school.
Your problem is that you believe everything you think.
I really hope that you aren't as disrespectful to everyone in person as you are on this message board, I'm glad you won't be my doctor.

probabally not half as glad as Osu Doc is.

 

[OSUdoc08]

🙄 You are quite conceited.

Nope, just call it like I see it.

Stick to giving advice on information that you have experience with, and not what some professor tells you.

 

[jkhamlin]

Nope, just call it like I see it.

Stick to giving advice on information that you have experience with, and not what some professor tells you.

Or what someone on a message board with a bad attitude and claims to be a med student tells me? Might be good to take your own advice.

 

[OSUdoc08]

Or what someone on a message board with a bad attitude and claims to be a med student tells me? Might be good to take your own advice.

Instead of trying to argue with medical students about how medical school really is, shouldn't you be studying for the MCAT?

It's coming up in August, you know.

 

[Idiopathic]

Reading that brochure, one discovers that this is to pay for the Medicare patient load handled by the residents. Also, Medicare limits the number of residents covered on this, but it does not dictate how many residency positions there are. You can spin that how you want, but Medicare is only doing what it is designed to do and nothing more. It also mentions that funding comes from many other sources, it is just that they are often the largest single source.
This is similar to the argument where people say the insurance company won't let them get an organ transplant. The insurance company doesn't say that, they just say they won't pay for it if you do.

Actually, an insurance company not paying for your organ transplant is tantamount to denying you the procedure, just as the funded number of residency spots will be the de facto number of residency spots. You cant get a heart on credit, and you cant train a resident for free.

Here is an interesting article:

http://www.ama-assn.org/amednews/2004/09/27/prl10927.htm

Im not accusing you of not knowing what you are talking about but I'm sure there isnt an individual anywhere that couldn't stand to learn a little something now and then.

 

[jkhamlin]

Instead of trying to argue with medical students about how medical school really is, shouldn't you be studying for the MCAT?

It's coming up in August, you know.

I'm multitasking (and actually I have a micro exam coming up sooner than that, but thanks for the concern). 😛
How did your big neuro exam go?

 

[OSUdoc08]

I'm multitasking (and actually I have a micro exam coming up sooner than that, but thanks for the concern). 😛
How did your big neuro exam go?

It's ok.....i'm actually cramming for a big micro test tomorrow myself....

the neuro went fine, but the phys test kicked my butt for some reason....

 

[Idiopathic]

It's ok.....i'm actually cramming for a big micro test tomorrow myself....

the neuro went fine, but the phys test kicked my butt for some reason....

Get a room.

 

[stomper627]

He's talking about FLECOM with it's 80 affiliation sites. But how many students does each site take, what is there geographical distrabution. It's going to be interesting to see whats going to happen 250 something 3rd years from LECOM and however many from FLECOM trying to get 3rd year rotations.

Well it is rather interesting....considering his "big brother" (as a student here I still think of LECOM as a new school) is now pushing out 250 students a year, at 24K/yr (it is erie....you can still by a decent house for <100k...cost of living is very low). Now FLECOM has opened and its PBL only....150 students and not having to pay PhDs for lecturing? LECOM has struggled to get more rotation slots during the past few years. The thought of what is going to happen kinda scares me....Im glad I get that diploma in 53 days.....done with rotations in 16 days!!!!
stomper

 

[(nicedream)]

Well it is rather interesting....considering his "big brother" (as a student here I still think of LECOM as a new school) is now pushing out 250 students a year, at 24K/yr (it is erie....you can still by a decent house for <100k...cost of living is very low). Now FLECOM has opened and its PBL only....150 students and not having to pay PhDs for lecturing? LECOM has struggled to get more rotation slots during the past few years. The thought of what is going to happen kinda scares me....Im glad I get that diploma in 53 days.....done with rotations in 16 days!!!!
stomper

There are PhD/DO/MD facilitators, who also do lectures for anat/histo/embryo/neuro. I'm not sure what they pay them compared to lecture-based professors - but they have to be at school pretty much everyday for PBL meetings.
They've formed affiliations with 6 new hospitals here in Florida - hopefully that will help if there is in fact a shortage of slots.

 

[stomper627]

There are PhD/DO/MD facilitators, who also do lectures for anat/histo/embryo/neuro. I'm not sure what they pay them compared to lecture-based professors - but they have to be at school pretty much everyday for PBL meetings.
They've formed affiliations with 6 new hospitals here in Florida - hopefully that will help if there is in fact a shortage of slots.

Outta curiosity what are these hospitals like? Most likely community. LECOM had the opportunity to get Louisville as a major affiliate (one of my classmates father was the chief of surg there) but LECOM didnt want to pay Louisville. Instead, I think they ended up with another affiliate with less than 150 beds. Excellent trade.
Your not fully grasping the problem. Its NOT just the number of affiliates....its the QUALITY that counts when your learning.

 

[Docgeorge]

Louisville in Kentuky? Home of Hiram Polk?

 

[(nicedream)]

Outta curiosity what are these hospitals like? Most likely community. LECOM had the opportunity to get Louisville as a major affiliate (one of my classmates father was the chief of surg there) but LECOM didnt want to pay Louisville. Instead, I think they ended up with another affiliate with less than 150 beds. Excellent trade.
Your not fully grasping the problem. Its NOT just the number of affiliates....its the QUALITY that counts when your learning.

No, I understand and agree. But I also know most of the students, either because they just want to do family practice or pediatrics, or don't realize the importance of rotations, don't care what kind of hospitals they do rotations at - they are just interested in location. Most will want to just stay around Florida, or go back to their homestates - hopefully that will leave the good places open to me.