Will DO schools eventually build teaching hospitals?

[AlteredScale]

From what I've gathered, it seems that the use of affiliated hospitals can be a "hit and miss" for clinical clerkships. So will DO schools eventually focus their funds toward building their own teaching hospitals? Does anyone have information regarding any DO schools who have a plan like this? And are there certain inhibitory factors (funds, MD competition) for doing such?

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[hse]

its economics and hospitals have been consolidating ... just not practical is my guess

 

[Major]

It would be nice if they could transition from a bunch of random rotation sites to having a solid partnership with one or two hospitals and expand off that partnership

 

[hallowmann]

OP, right now there is no real demand/reason for it (besides making a better and more consistent clinical education experience). Schools won't do it unless they're forced to. At best we have OPTIs that at least force schools to have tight affiliations with numerous residencies, but these are really variable from school to school.

It would be nice if they could transition from a bunch of random rotation sites to having a solid partnership with one or two hospitals and expand off that partnership

I really hope this sort of thing will happen. My school recently added a decent regional hospital that's part of a big health system as a regional site for like 15-20% of their students. With the addition, more than half of the students will be rotating at 4-5 specific hospitals for all of their cores. Its not perfect and there are still some people going to random sites with only a handful of spots, but its a step in the right direction. To me, this came out of nowhere (I had heard rumblings, but didn't expect there to be so many spots there), so hopefully its something responsible/established schools are moving towards on their own.

 

[AlteredScale]

OP, right now there is no real demand/reason for it (besides making a better and more consistent clinical education experience). Schools won't do it unless they're forced to. At best we have OPTIs that at least force schools to have tight affiliations with numerous residencies, but these are really variable from school to school.



I really hope this sort of thing will happen. My school recently added a decent regional hospital that's part of a big health system as a regional site for like 15-20% of their students. With the addition, more than half of the students will be rotating at 4-5 specific hospitals for all of their cores. Its not perfect and there are still some people going to random sites with only a handful of spots, but its a step in the right direction. To me, this came out of nowhere (I had heard rumblings, but didn't expect there to be so many spots there), so hopefully its something responsible/established schools are moving towards on their own.

Do you think a large part of it has to just do with funding? I feel like a lot of hospitals that are built or expansions that occur happen because of a large donation.

I also wonder what the likelihood would be for a school to not only partner with an affiliated hospital but also assimilate it ("University" hospital name instead of the old name).

I also heard about this from your school and think that is awesome they did that. The partnership seems really strong.

 

[hallowmann]

Do you think a large part of it has to just do with funding? I feel like a lot of hospitals that are built or expansions that occur happen because of a large donation...

Honestly its an issue of more work and money for little foreseeable benefit from the administration. If the argument could be made that doing so would make both the hospital and the school more money then it might get done, but its not like DO schools are hurting for applicants/matriculants because of the variability of their clinical training.

...I also wonder what the likelihood would be for a school to not only partner with an affiliated hospital but also assimilate it ("University" hospital name instead of the old name).

I also heard about this from your school and think that is awesome they did that. The partnership seems really strong.

I'm really not sure about that. I have seen something similar happen with a low-tier MD school that didn't have a hospital, so I suppose it could happen, I just don't know if it will. Maybe after the merger, connections like this will become more important, so we might see it. It would be nice.

Yeah, the partnership does seem strong. Its a smart move by the school and hospital system. Hopefully it'll make both stronger. Its crazy that they're building a student lounge and all these facilities just for our students, but I'm not complaining.

 

[AlteredScale]

Honestly its an issue of more work and money for little foreseeable benefit from the administration. If the argument could be made that doing so would make both the hospital and the school more money then it might get done, but its not like DO schools are hurting for applicants/matriculants because of the variability of their clinical training.

I'm really not sure about that. I have seen something similar happen with a low-tier MD school that didn't have a hospital, so I suppose it could happen, I just don't know if it will. Maybe after the merger, connections like this will become more important, so we might see it. It would be nice.

Yeah, the partnership does seem strong. Its a smart move by the school and hospital system. Hopefully it'll make both stronger. Its crazy that they're building a student lounge and all these facilities just for our students, but I'm not complaining.

Hmm good insight! I can't imagine the costs the go in to building a teaching hospital and you're definitely right about it coming down to financial benefit. I also think that with building a hospital comes the need to also bring apart a strong biomedical research division to bring in a lot of physician scientists and clinician investigators.

It would be really nice. Is it OSUCOM and TCOM that both have their own teaching hospitals right now? Isn't that TCOM assimilated a hospital into their system?

Oh yeah I remember the student lounge part standing out from the video. That's pretty neat honestly! So are you then trying to rotate there?

 

[hallowmann]

Hmm good insight! I can't imagine the costs the go in to building a teaching hospital and you're definitely right about it coming down to financial benefit. I also think that with building a hospital comes the need to also bring apart a strong biomedical research division to bring in a lot of physician scientists and clinician investigators.

It would be really nice. Is it OSUCOM and TCOM that both have their own teaching hospitals right now? Isn't that TCOM assimilated a hospital into their system?

Oh yeah I remember the student lounge part standing out from the video. That's pretty neat honestly! So are you then trying to rotate there?

I think most if not all of the public schools have a teaching hospital. I mean even my school technically owns one, but its too small to support more than 17% of our students, so its not what you would think of as a real teaching hospital.

I won't say whether or not I'm going there, but I have been there, and I have friends & family that have worked/are working there. Its a solid hospital, part of a a good sized system and all the attendings I know there are good teachers that you can tell really love to teach. I will say that even before I started med school, I planned to apply to AHN residencies. Its the second biggest in the city (second to UPMC) and its got plenty of ACGME programs as well as a few AOA ones.

 

[cliquesh]

.

 

[AlteredScale]

I think most if not all of the public schools have a teaching hospital. I mean even my school technically owns one, but its too small to support more than 17% of our students, so its not what you would think of as a real teaching hospital.

I won't say whether or not I'm going there, but I have been there, and I have friends & family that have worked/are working there. Its a solid hospital, part of a a good sized system and all the attendings I know there are good teachers that you can tell really love to teach. I will say that even before I started med school, I planned to apply to AHN residencies. Its the second biggest in the city (second to UPMC) and its got plenty of ACGME programs as well as a few AOA ones.

Ah that makes sense. Is their conflict with the other DO schools in your location regarding clerkhip spots?

I think if there was a bigger I guess "movement" by the DO students to push towards building teaching hospitals that it would be more of a focus but there would need to be some huge hoops to jump through in regards to avoiding potential conflicts between MD teaching hospitals perhaps? Idk. More opinions on this thread by residents and/or attendings will help.

 

[hallowmann]

Ah that makes sense. Is their conflict with the other DO schools in your location regarding clerkhip spots?

I think if there was a bigger I guess "movement" by the DO students to push towards building teaching hospitals that it would be more of a focus but there would need to be some huge hoops to jump through in regards to avoiding potential conflicts between MD teaching hospitals perhaps? Idk. More opinions on this thread by residents and/or attendings will help.

There are actually very few other DO students that rotate around here. A handful from PCOM come all the way out here, but Drexel and Temple definitely send their students to sites in Pgh. Jeff sends some to some of the smaller hospitals nearby. Generally it's just a lot of competition with MD students. We don't really rotate at CORE sites and OU-HCOM covers their students pretty well with those sites.

Depending on which site you go to, you'll bump into other DO students, like the NY state sites, you start seeing NYCOM and Touro-NY students, central to eastern PA, you see more PCOM students (and randomly DMU and KCUMB students), but in the immediate area its mostly instate MD students.

 

[DoctorSynthesis]

NSU com is building a small hospital and is building a research center.

http://www.sun-sentinel.com/local/b...antation-general-decision-20141205-story.html

 

[breezy124]

Doesn't Rowan already have its own?

 

[Awesome Sauceome]

Some things to think about:
Just because they have a teaching hospital doesnt necessarily mean it the place to go. So for instance when I first started looking at DO school I was really eyeing OSU (nevermind the fact that they only take like 15% from OOS). One of my major reasons for wanting to go there was that they have their own teaching hospital. But upon further inspection I found out that this hospital is not very good and they have actually had some issues with money and then rumors start popping up on whether the place will even still be open 10 years down the road.

Another thing to mention that you actually brought up:
So long as they have a strong relationship with OPTI places and/or just a strong core hospital then thats good enough in my eyes. So they dont necessarily need to own a hospital/have the hospital named after them or whatever, but so long as they are putting in the money to have their students there then matches will be decent. A good example of this is VCOM-VA. They have a super strong relationship with Carilion which has really helped their students out immensely (from what I have heard on here).

 

[DoctorKrieger]

Clarification on OSU's teaching hospital:

The point of near-shutdown was ~7 years ago, when it was managed by a different, for-profit, company. Since this hospital largely serves the indigent population of the region, that didn't work out too well and that management company planned on shutting it down. It has been under different management for a while and now has a management agreement with Mercy Health, who I believe plans on dropping $50 million in improvements once they have the reigns. That's in addition to a lot of money spent on improvements and renovations by OSU and other organizations, trusts, etc. since 2007. It's not going anywhere, and rumors to the contrary are very outdated.

As for 'not very good,' that could be measured in countless ways.

 

[Awesome Sauceome]

Thanks for the clarification, I only did minimal research into it and it was over a year ago. I ended up not going too much further when I found out they only took like 10-15% from OOS.

But the official info is definitely good for others who are looking into it.

 

[AlteredScale]

Doesn't Rowan already have its own?

Yes they do but I'm pretty sure it isn't a teaching one because Novant Health (Rowan Medical Center) doesn't seem to have any GME opps. They do have graduate training for pharm and RN however.

Also what's confusing is Rowan also has Cooper Medical School of Rowan University (MD) but Cooper has their own health system.

 

[deleted407021]

Also what's confusing is Rowan also has Cooper Medical School of Rowan University (MD) but Cooper has their own health system.

Yeah, I noticed that. Is it all under the same university?

 

[AM508]

While this may have already been covered in this thread (aka I am too lazy to re-read all the posts), I think a lot of the DO schools are in areas that are not conducive to a big medical center. If we think about it, the vast vast majority of MD schools with teaching hospitals are in large metropolitan areas. Many of our DO schools are in rural and suburban areas that are large enough to sustain a few community hospitals but definitely do not have the population to sustain a major medical center and these community hospitals already exist in these areas so a DO teaching hospital would be trying to fill a niche that does not exist. I think the key for DO schools would be to put additional effort into standardizing the rotation experience within and between schools; that is, more stringent criteria for sites so no DO student "loses" the rotation lottery and gets a terrible 3rd and 4th year through no fault of their own.

 

[AlteredScale]

Some things to think about:
Just because they have a teaching hospital doesnt necessarily mean it the place to go. So for instance when I first started looking at DO school I was really eyeing OSU (nevermind the fact that they only take like 15% from OOS). One of my major reasons for wanting to go there was that they have their own teaching hospital. But upon further inspection I found out that this hospital is not very good and they have actually had some issues with money and then rumors start popping up on whether the place will even still be open 10 years down the road.

Another thing to mention that you actually brought up:
So long as they have a strong relationship with OPTI places and/or just a strong core hospital then thats good enough in my eyes. So they dont necessarily need to own a hospital/have the hospital named after them or whatever, but so long as they are putting in the money to have their students there then matches will be decent. A good example of this is VCOM-VA. They have a super strong relationship with Carilion which has really helped their students out immensely (from what I have heard on here).

Definitely agree with this. Perhaps down the road LCME will try and merge COCA that will prevent mass school expansion without have strong OPTIs and clinical affiliates. And I just realized that some of these top tier MD schools like HMS don't have their own teaching hospital per se but it seems that the distance between said medical school and the hospital make it a great teaching resource.

So if anything it could be that DO schools may be required to be built within a certain distance of a hospital affiliate and that there will be exceptions for those DO schools who really emphasize primary care and rural medicine. Idk I am super naive about this stuff but it's always an interesting topic.

 

[AlteredScale]

Yeah, I noticed that. Is it all under the same university?

I believe so! So Rowan acts as the academic liaison between the two medical programs.

... so a DO teaching hospital would be trying to fill a niche that does not exist. I think the key for DO schools would be to put additional effort into standardizing the rotation experience within and between schools; that is, more stringent criteria for sites so no DO student "loses" the rotation lottery and gets a terrible 3rd and 4th year through no fault of their own.

Couldn't agree with you more! I think a petition to COCA which requires students to rotate their third year at affiliate teaching hospitals and bar this whole "cold call" third year rotations will help tremendously.

I think @user3 and @johnamo may have some say in this convo if they aren't getting rocked with finals right now.

Because most DO schools are private, it may also be that they cannot gain the funds to build a university hospital (in addition to the non existed niche to build such a hospital as @AM508 said),

 

[costales]

You might want to Google UMDNJ-SOM (University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine), the old name for Rowan:

UMDNJ-SOM's principle clinical affiliate is the three-hospital, 600-bed Kennedy Health System (KHS), which began when three separate osteopathic hospitals merged in 1981. UMDNJ-SOM is also affiliated with Our Lady of Lourdes Medical Center, a tertiary, 437-bed hospital in Camden, New Jersey. All four hospitals are within a 15-minute drive of the school's main campus in Stratford, New Jersey. The KHS Stratford Division adjoins the school's campus. Most of the school's full-time faculty have hospital privileges at one or both institutions. The system allows all core clinical rotations to have full-time faculty members as clerkship directors. These clerkship directors meet regularly so that learning issues, administrative issues, and learning outcomes can be monitored and continuously improved.
http://www.medscape.com/viewarticle/705550_5

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[costales]

Clarification on OSU's teaching hospital:

The point of near-shutdown was ~7 years ago, when it was managed by a different, for-profit, company. Since this hospital largely serves the indigent population of the region, that didn't work out too well and that management company planned on shutting it down. It has been under different management for a while and now has a management agreement with Mercy Health, who I believe plans on dropping $50 million in improvements once they have the reigns. That's in addition to a lot of money spent on improvements and renovations by OSU and other organizations, trusts, etc. since 2007. It's not going anywhere, and rumors to the contrary are very outdated.

As for 'not very good,' that could be measured in countless ways.

From OSU grads I know, it is not in any danger of closing. OSU and local politicians will not allow it. That hospital has many good programs and has trained thousands.

 

[Goro]

Highly unlikely. This is not a good economic model these days. I once asked our University President about this and that's the answer I got.

From what I've gathered, it seems that the use of affiliated hospitals can be a "hit and miss" for clinical clerkships. So will DO schools eventually focus their funds toward building their own teaching hospitals? Does anyone have information regarding any DO schools who have a plan like this? And are there certain inhibitory factors (funds, MD competition) for doing such?

 

[AlteredScale]

Highly unlikely. This is not a good economic model these days. I once asked our University President about this and that's the answer I got.

That totally makes sense. TBH I really am content with the clinical training that is offered (otherwise I wouldn't have applied) but there's always those rare stories of students who had their rotations slip through and are left high dry to find one on their own which at the core of it comes down to more stringent guidelines within the administration who are responsible for clinical clerkship affiliations.

 

[AM508]

That totally makes sense. TBH I really am content with the clinical training that is offered (otherwise I wouldn't have applied) but there's always those rare stories of students who had their rotations slip through and are left high dry to find one on their own which at the core of it comes down to more stringent guidelines within the administration who are responsible for clinical clerkship affiliations.

My thoughts exactly, even though I will be attending an extremely well-established school, that fear (irrational or not) of inadvertently getting a bad rotation site, still pops up every now and then.

 

[costales]

It would be really nice. Is it OSUCOM and TCOM that both have their own teaching hospitals right now? Isn't that TCOM assimilated a hospital into their system?

OSU owns the OSU Medical Center, which is now under management contract with Mercy.

TCOM has never owned a hospital, except UNT Health which has a specialty physician network and teaching clinics. There was a rather decent 265-bed osteopathic hospital on campus (one among 35 osteopathic hospitals in Texas - believe it or not) which was a Fort Worth institution and had been in existence for 58 years. It had no financial connection to TCOM, but had several AOA residency programs and provided rotations for TCOM students - although many TCOM students preferred to rotate at the official teaching hospital JPS, which is a 547-bed county hospital and Level 1 trauma center. The osteopathic hospital experienced management problems and went under 10 years ago. TCOM subsequently bought the property, held a farewell ceremony, demolished it, and used the land for a new building. Nowadays TCOM students rotate at JPS and other large hospitals in the neighborhood including Cook Children's, or at other hospitals in East Texas if they want to be near family there. Yes, JPS and UNT Health recently agreed to a merger where both JPS physicians and UNT Health physicians will be combined under a new umbrella. From personal experience, I can say that rotations in Fort Worth are highly demanding and absolutely top notch.

 

[AlteredScale]

OSU owns the OSU Medical Center, which is now under management contract with Mercy.

TCOM has never owned a hospital, except UNT Health which has a specialty physician network and teaching clinics. There was a rather decent 265-bed osteopathic hospital on campus (one among 35 osteopathic hospitals in Texas - believe it or not) which was a Fort Worth institution and had been in existence for 50 years. It had no financial connection to TCOM, but had several AOA residency programs and provided rotations for TCOM students - although many TCOM students preferred to rotate at the official teaching hospital JPS, which is a 547-bed county hospital and Level 1 trauma center. The osteopathic hospital experienced management problems and went under 10 years ago. TCOM subsequently bought the property, held a farewell ceremony, demolished it, and used the land for a new building. Nowadays TCOM students rotate at JPS and other large hospitals in the neighborhood including Cook Children's, or at other hospitals in East Texas if they want to be near family there. Yes, JPS and UNT Health recently agreed to a merger where both JPS physicians and UNT Health physicians will be combined under a new umbrella. From personal experience, I can say that rotations in Fort Worth are highly demanding and absolutely top notch.

Thank you for that information! Do you think getting experience in a level 1 trauma center is beneficial for a medical student or will level 2 suffice??

 

[Awesome Sauceome]

Highly unlikely. This is not a good economic model these days. I once asked our University President about this and that's the answer I got.

Then how do MD schools do it? Why can they afford it but DO schools can't? Genuinely curious.

 

[Goro]

Haven't a clue.

Then how do MD schools do it? Why can they afford it but DO schools can't? Genuinely curious.

 

[meliora27]

Then how do MD schools do it? Why can they afford it but DO schools can't? Genuinely curious.

MD schools are usually part of public universities run by states. States have economies of scale that private DO schools simply don't.

I think there may also be a bitter pill element here. Hospitals like to partner with MD schools, MD is the name brand. See LIJ +Hofstra

 

[Awesome Sauceome]

Fair enough, that seems reasonable for sure.

Still doesn't asnwer for private MD, but meh whatever

 

[babdoc]

Not all MD schools have their own hospital. We have an ACGME residency program run by the university; our principle teaching facility is a large private hospital. Even large research and state MD programs, Wash U and IU come to mind, are affiliated with hospitals they don't directly own. Wash U is affiliated with the Barnes-Jewish system and IU goes through the deceptively and similarly named IU Health.

 

[costales]

Yep, if you look at some new MD schools: UC Riverside didn't build a new hospital - they're using Riverside County Regional Medical Center in Moreno Valley; UT Austin will be taking over slots at Seton Brackenridge & Dell Children's from UT Galveston & UT Southwestern; UT Rio Grande Valley will start new programs at Doctors Hospital in Edinburg (the hospital in Atul Gawande's "The Cost Conundrum").

New hospitals are not cheap. The average construction cost is something like $2 million per bed.

 

[DoctorSynthesis]

Fair enough, that seems reasonable for sure.

Still doesn't asnwer for private MD, but meh whatever

I think goros wily old admissions dean isn't completley telling the truth (speculation). MD schools have more money in general (i think) so that couod explain it. However I think the reason isn't economic. I think hospitals rather partner with MD schools. More of a name brand (lij-hofstra). I see this as more of a prestige thing. I could be wrong though I'm speculating. Maybe the merger fixes it. Who knows!

But DO schools could build hospitals (NSU com is doing it). Even with NSU com having an AOA hospital nearby to takeover and relocate it was still hard for them. Its not easy getting a hospital nor necessary. Most schools probably figure why bother?

 

[Shinobiz11]

Yeah, I noticed that. Is it all under the same university?

Yes. It's weird because there were two UMDNJ's, MD and DO. The MD joined Rutgers and DO joined Rowan in 2013.

 

[AlteredScale]

I think goros wily old admissions dean isn't completley telling the truth (speculation). MD schools have more money in general (i think) so that couod explain it. However I think the reason isn't economic. I think hospitals rather partner with MD schools. More of a name brand (lij-hofstra). I see this as more of a prestige thing. I could be wrong though I'm speculating. Maybe the merger fixes it. Who knows!

But DO schools could build hospitals (NSU com is doing it). Even with NSU com having an AOA hospital nearby to takeover and relocate it was still hard for them. Its not easy getting a hospital nor necessary. Most schools probably figure why bother?

I think that reputable DO schools are making a huge impact on creating partnerships with really strong community hospitals but the idea of assimilating them into a university hospital is as you said not necessary haha.

But can someone explain why lij-Hofstra keeps getting brought up as the example for hospitals wanting to stay with MD schools?

 

[DoctorSynthesis]

I think that reputable DO schools are making a huge impact on creating partnerships with really strong community hospitals but the idea of assimilating them into a university hospital is as you said not necessary haha.

But can someone explain why lij-Hofstra keeps getting brought up as the example for hospitals wanting to stay with MD schools?

Its a new example. There is a DO school (nyit) they could have partnered with (I guess it being acgme and nycom being DO is a problem) but they went with a new unproven medical school. Idk it kinda just shows how much easier it is to get a hospital at MD places IMO.

 

[user3]

I think most if not all of the public schools have a teaching hospital. I mean even my school technically owns one, but its too small to support more than 17% of our students, so its not what you would think of as a real teaching hospital.

I won't say whether or not I'm going there, but I have been there, and I have friends & family that have worked/are working there. Its a solid hospital, part of a a good sized system and all the attendings I know there are good teachers that you can tell really love to teach. I will say that even before I started med school, I planned to apply to AHN residencies. Its the second biggest in the city (second to UPMC) and its got plenty of ACGME programs as well as a few AOA ones.

OP, right now there is no real demand/reason for it (besides making a better and more consistent clinical education experience). Schools won't do it unless they're forced to. At best we have OPTIs that at least force schools to have tight affiliations with numerous residencies, but these are really variable from school to school.

I really hope this sort of thing will happen. My school recently added a decent regional hospital that's part of a big health system as a regional site for like 15-20% of their students. With the addition, more than half of the students will be rotating at 4-5 specific hospitals for all of their cores. Its not perfect and there are still some people going to random sites with only a handful of spots, but its a step in the right direction. To me, this came out of nowhere (I had heard rumblings, but didn't expect there to be so many spots there), so hopefully its something responsible/established schools are moving towards on their own.

I think DO schools could offer a much better clinical experience if they trimmed their class sizes. Unfortunately, it seems like most schools tend to rely on bigger class sizes to make financial ends meet (or to simply bring in extra $$?). They ultimately resort to larger numbers of questionable rotation sites as they struggle to find space their students-- and on top of that, often constantly deal with gaining and losing sites, nevermind ensuring their quality.

I'm not sure about "teaching hospitals", but if DO schools focused on cutting their class sizes and/or developing stabler relationships will smaller numbers of affiliates, students could get a much better education.

 

[jl lin]

Yea. Healthcare is in a merge or die state, and it has been so for a while.

 

[AlteredScale]

I think DO schools could offer a much better clinical experience if they trimmed their class sizes. Unfortunately, it seems like most schools rely on bigger class sizes to make financial ends meet (or to simply bring in extra $$?). They ultimately resort to large numbers of questionable rotation sites as they struggle to find space their students-- and on top of that, must constantly deal with gaining and losing sites, nevermind ensuring their quality.

I'm not sure about "teaching hospitals", but if DO schools focused on cutting their class sizes and/or developing stabler relationships will smaller numbers of affiliates, students could get a much better education.

Why isn't this more strictly enforced by COCA?

 

[IslandStyle808]

Not all MD schools have their own hospital. We have an ACGME residency program run by the university; our principle teaching facility is a large private hospital. Even large research and state MD programs, Wash U and IU come to mind, are affiliated with hospitals they don't directly own. Wash U is affiliated with the Barnes-Jewish system and IU goes through the deceptively and similarly named IU Health.

Same thing with my state MD school. Almost all rotations are done in community hospitals, except for one which is at a private hospital (our army hospital also, but I am not sure if this is also for core rotations). There are definitely MD schools that only have affiliations or contracts with the local hospitals near by and have no university hospital.

 

[NontradCA]

.

Good point.

 

[user3]

Why isn't this more strictly enforced by COCA?

The same COCA that turned a blind eye to nurse preceptors? The same COCA that turns a blind eye to certain schools where it is possible to go your entire 3rd and 4th year with no inpatient IM experience?

 

[hallowmann]

The same COCA that turned a blind eye to nurse preceptors? The same COCA that turns a blind eye to certain schools where it is possible to go your entire 3rd and 4th year with no inpatient IM experience?

Wait, what? The nurse preceptor, I remember that case and sylvanthus complained and they fixed it. But how can you go through without any inpatient IM? How does that even work? Was that an exaggeration?

 

[reapplicanthelpme2014]

Doesn't PCOM have one too?

 

[AlteredScale]

The same COCA that turned a blind eye to nurse preceptors? The same COCA that turns a blind eye to certain schools where it is possible to go your entire 3rd and 4th year with no inpatient IM experience?

So what can we do then? Have there been actions taken to stop this?

 

[NontradCA]

DO schools exist to make money, and having a dedicated teaching hospital would cause schools to lose money.

 

[babdoc]

It's interesting that our preceptors/attendings during third and fourth year were almost universally volunteers. I wondered where my tuition was going for those years. At best a portion went to the staff coordinating our rotations and exams with the rest covering the costs of the first two years...

 

[Awesome Sauceome]

I think DO schools could offer a much better clinical experience if they trimmed their class sizes. Unfortunately, it seems like most schools tend to rely on bigger class sizes to make financial ends meet (or to simply bring in extra $$?). They ultimately resort to larger numbers of questionable rotation sites as they struggle to find space their students-- and on top of that, often constantly deal with gaining and losing sites, nevermind ensuring their quality.

I'm not sure about "teaching hospitals", but if DO schools focused on cutting their class sizes and/or developing stabler relationships will smaller numbers of affiliates, students could get a much better education.

Sounds like the most legit answer I have read so far.