Worried about 3rd and 4th year!

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dendrites

dendrites

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After reading several threads like this: http://forums.studentdoctor.net/showthread.php?t=489765&highlight=buyer+beware I am worried about 3rd and 4th year.

I know a lot of people say that you should really look into the clinical rotations that a school offers before deciding on a school to attend. However, I feel that most applicants are not sure what to look for. Most schools just give you a list of random hospitals they are affiliated with. Does this mean that everyone will get a spot in one of those hospitals or will some people be left in the dust? What are some important factors to ask about??

Which schools have their OWN hospital?? I didnt realize that it's considered a bad thing/inconvenient to be put at different sites throughout the clinical years.

(ive had interviews at PCOM and DCOM so info on the rotations at those schools would be nice too)
 
Only a handful of DO schools have their own hospitals, I believe PCOM is one of them. At most schools you will be shuffled around a bit. I think enrollment numbers are also one thing to look for in a school. AZCOM used to enroll between 120 to 150 students per class but now doubled that number and many students will have to leave Arizona for clinical rotations. A good number will be shuffled to Southern California and Ohio for the third and fourth and year. At my school the rotations are spread out around California, with some in Michigan and Colorado, a few in New York but they are soon going to be all California rotations.
 
bacchus does PCOM have more sites they own..aside from that healthcare center on henry in rox?
 
Unfortunately, I seem to have lost the name of the original poster, but the following was posted by an M3 at Touro NY, regarding these issues. Touro NY is probably the worst case scenario when it comes to rotations (i.e. the first class got to third year and had pretty much nothing available to them). But these are some good questions to ask pretty much anywhere you go.

I'm very skeptical of any "confirmation" handed out by Touro.

They will give you a list of hospitals. They will say "its not a problem, we have the rotations."

BE SKEPTICAL. Ask the tough questions:

How many students are taken at each of these hospitals? (They'll often throw in the name of a respectable hospital to distract you, but not tell you that only one student/year rotates there.)

How many students will be assigned to a particular rotation? (30 students assigned to the same surgery rotation means you won't get to scrub in on cases.)

Is it a teaching hospital with supervision for students to assist with procedures? (if its not you'll never put in an IV, never assist with a central line placement, never do an ABG, never learn to suture a laceration. You'll stand there, watching, for two years b/c students aren't covered by hospital insurance policy.)

How many times will you have to move 3rd and 4th years? (If you have to move every 3 months from upstate to downstate to Michigan to get all your required rotations in, you'll be so displaced it will be nearly impossible to focus on learning.)

Will my rotations be inpatient? (An OG/GYN "rotation" at an outpatient clinic means you'll never see a delivery, let alone assist with one. A Medicine rotation at an outpatient clinic means you'll never do an admission, never work-up a patient for MI or Stroke or Afib or GI bleed, or anything else.)

Does the hospital count DOs and Carribean students together? Hospitals/DO schools have started to do this sneaky thing to pack students on rotations. The have quotas on the number of med students they can have on a rotation, but they count DO students separately from MD students (Caribbean) allowing them to take twice as many students.

Is there an organized didactic program at the hospital in which med students can participate? Students sent to hospitals without residency programs in that department. No residency program means no lectures, no teaching rounds, no attendings willing to round on their patients with students. No interns/residents there to help students along.

Does the school compensate attendings to teach? No $$ = no teaching. Attendings are busy people. If you don't pay them to take the time out of their day to teach, they have no incentive to teach.

What rotations are required? What is available? No required neurology rotation means they had such a hard time finding neurology rotations for students that they couldn't require students do one. No neurosurg rotation available means no chance to see neurosurg. No child psych rotation means you won't be seeing child psych.

Which professors from years 1&2 will be continuing to teach students years 3&4? No continuity in teaching means a massive disconnect in your education.

Investigate your field of interest. If you have an interest in peds, ask to speak to someone in the pediatrics department about the rotation. Ask them what the rotation is like for med students. If you can't talk to anyone at all for even a few minutes, this is a red flag.

Ask the tough questions. Don't be fooled by vague promises and a "list of hospitals."

Don't rely solely on admissions personnel. Talk to 4th year students who can tell you their experience with trying to arrange their rotations. Find out what its really like.
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I understand exactly what you mean about not knowing what to ask about the third and fourth years. Hopefully this can help us all start thinking about asking the right questions.
 
Thomas Hearns said:
That guy was from Touro CA
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I'm pretty sure he was NY... he was addressing Carib students, too, which as far as I know tend to rotate in NY and not CA...

In any case, I've got a little more faith in the Mare Island campus than the Harlem one...
 
JediZero said:
I'm pretty sure he was NY... he was addressing Carib students, too, which as far as I know tend to rotate in NY and not CA...

In any case, I've got a little more faith in the Mare Island campus than the Harlem one...
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It was CA, he was forced to rotate in NY, if I remember correctly.

His name is bht7 or bth7 I believe.
 
JediZero said:
Unfortunately, I seem to have lost the name of the original poster, but the following was posted by an M3 at Touro NY, regarding these issues. Touro NY is probably the worst case scenario when it comes to rotations (i.e. the first class got to third year and had pretty much nothing available to them). But these are some good questions to ask pretty much anywhere you go.


I understand exactly what you mean about not knowing what to ask about the third and fourth years. Hopefully this can help us all start thinking about asking the right questions.
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Thanks!! this helps a lot!
 
willen101383 said:
bacchus does PCOM have more sites they own..aside from that healthcare center on henry in rox?
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I think there are 5 healthcare centers that PCOM has? I would look it up, but I'm in the middle of studying 🙂

Anyway, 1st year we have to shadow at 1 of the health care centers. 3rd and 4th years you will be at various hospitals in the area.

As far as PCOM goes my understanding is that you can stay in the area for rotations if you want. They have plenty of places for students to rotate through and the process is very organized.
 
I'm not worried, but then again that's why I chose my school. Also I will say that even though a large part of your education is dependent on you (1st two years) the rotations are where you will see the biggest difference between schools. I'd even say this is the biggest difference between MD and DO schools (meaning MD schools have a higher standards cut off, not that ALL MD schools have better rotations than DO).
 
bth7's post is obviously very important and well put, but I honestly don't understand how you possibly figure all of this out. I mean, call every hospital that the school provides you with?? Ask the same people he states can be deceiving in the first place??? Ask 3/4th year students who are in the heat of it right now and probably don't have too much knowledge outside their own PERSONAL experience with the school (IE someone's could have been good when someone else's could have been bad).

Here is what confuses me about 3/4th years ... audition rotations. I'm going to throw around some terms and stereotypes that I normally don't use here, but simply take that as stabs in the dark because reading up about all the 3/4th year stuff as a pre-med is overwhelming. Okay here we go .....

Say you are trying to get a competitive AOA residency. One that is really an advantage to DO students. I'm going to use dermatology here as an example, simply because I've been in so many arguments on this site with pre-meds claiming DOs can't be dermatologists that I'm very familiar with the AOA programs. So say I go to a school with extremely solid 3/4th years. I have the pre-clinical grades and step I that is necessary, but this school only allows 8 weeks (two rotations-ish) of electives in the same subject. So I do two derm audition rotations (or transitional year rotations at programs that have derm because it's a PGY 2 match/sometimes unofficial offer while matching trans rotation internship) and apply. NOW, say I go to a school that doesn't have as solid 3/4th years but has unlimited elective rotations in the same subject. I'm a hardworker (whatever) so I still have solid pre-clinical and step scores. Now, however I'm able to do a rotation 3rd year, get LORs, then do a few more or a lot more during 4th year, and match derm.

Now, in this hypothetical ... I have a few questions 1. What is the point in these amazing 3/4th year rotations if they are so structured that you get great exposure, but aren't able to get out there and network for future residency 2. How many of these audition rotations are even able to be squeezed in before residency applications 4th year???

Any input would be great. I'm positive I'm off on a lot of points here and would love some clarity. I think it's really one thing to say 'you need to look for "good" 3/4th year rotations' and to actually dissect what these phrase means and set yourself up for the best situation possible.
 
JaggerPlate said:
bth7's post is obviously very important and well put, but I honestly don't understand how you possibly figure all of this out. I mean, call every hospital that the school provides you with?? Ask the same people he states can be deceiving in the first place??? Ask 3/4th year students who are in the heat of it right now and probably don't have too much knowledge outside their own PERSONAL experience with the school (IE someone's could have been good when someone else's could have been bad).

Here is what confuses me about 3/4th years ... audition rotations. I'm going to throw around some terms and stereotypes that I normally don't use here, but simply take that as stabs in the dark because reading up about all the 3/4th year stuff as a pre-med is overwhelming. Okay here we go .....

Say you are trying to get a competitive AOA residency. One that is really an advantage to DO students. I'm going to use dermatology here as an example, simply because I've been in so many arguments on this site with pre-meds claiming DOs can't be dermatologists that I'm very familiar with the AOA programs. So say I go to a school with extremely solid 3/4th years. I have the pre-clinical grades and step I that is necessary, but this school only allows 8 weeks (two rotations-ish) of electives in the same subject. So I do two derm audition rotations (or transitional year rotations at programs that have derm because it's a PGY 2 match/sometimes unofficial offer while matching trans rotation internship) and apply. NOW, say I go to a school that doesn't have as solid 3/4th years but has unlimited elective rotations in the same subject. I'm a hardworker (whatever) so I still have solid pre-clinical and step scores. Now, however I'm able to do a rotation 3rd year, get LORs, then do a few more or a lot more during 4th year, and match derm.

Now, in this hypothetical ... I have a few questions 1. What is the point in these amazing 3/4th year rotations if they are so structured that you get great exposure, but aren't able to get out there and network for future residency 2. How many of these audition rotations are even able to be squeezed in before residency applications 4th year???

Any input would be great. I'm positive I'm off on a lot of points here and would love some clarity. I think it's really one thing to say 'you need to look for "good" 3/4th year rotations' and to actually dissect what these phrase means and set yourself up for the best situation possible.
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Very well-put with a lot of good points. Yes, it's nice to have that list of questions; but no, it's very difficult to get them answered properly. And it is very true that taking responsibility for most of your rotations does give you some more flexibility in figuring them out.

However, it all boils down to your personality and what you want to do. Are you gunning for that competetive residency? Are you a big networker? Are you a type A that loves to go out there and pursue big things? If so, then you're probably better off doing this sort of thing on your own. On the other hand, if you're looking at going into primary care (as many DO students are) and you just want to focus on developing your clinical skills rather than stress about getting impressive rotations, then you're probably better off at a school that sets things up for you.

There's also the question of quality. If you arrange a rotation on your own, what guarantee do you have that the doctors you're working with will actually teach you or let you perform any procedures? If you're going to a rotation that the school has set up, they will know how to handle students and will be prepared and focused on how to educate you.

Really, I think your best option is to talk with multiple students heading down a path you want to follow (or think you might want to follow). See what they think. Some, as you point out, might have good experiences and some might be bad, but look for the objective truth in what they're saying and figure out what might work best for you.
 
I don't necessarily agree, exactly... for me, I want my core rotations very structured, with lots of free time and freedom for electives. I don't want to be having to set up my own core rotations.
 
UMDNJ-SOM I believe has their own hospital. they are affiliated with the Kennedy health system and the hospital is right next to the school on the same campus.
 
Thomas Hearns said:
I don't necessarily agree, exactly... for me, I want my core rotations very structured, with lots of free time and freedom for electives. I don't want to be having to set up my own core rotations.
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That's the problem though. I've found it's difficult to have both. Most of the well established schools have very structured, good 3/4th, but only a few slots for electives and only two that can be done in the same field. This is why, for me, it's difficult to figure out what is best in the end.
 
JaggerPlate said:
That's the problem though. I've found it's difficult to have both. Most of the well established schools have very structured, good 3/4th, but only a few slots for electives and only two that can be done in the same field. This is why, for me, it's difficult to figure out what is best in the end.
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Hmm... I don't know about that

PCOM and DMU have a lot of elective time, if I recall correctly, Western as well. I don't feel like looking up the numbers right now, though.
 
Thomas Hearns said:
Hmm... I don't know about that

PCOM and DMU have a lot of elective time, if I recall correctly, Western as well. I don't feel like looking up the numbers right now, though.
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DMU has essentially the whole 4th year, but from what I understand, you are pretty much on your own to set it all up. A lot of students see this as a plus, others (who really like the structure) do not. They also have essentially unlimited (by doing some tweaking) electives in any given field.

PCOM - I don't know.

Western has 12 weeks (basically 3 rotations), but again, I'm not sure how many can be done in the same field. It could only be two or something.

I'm still unsure what is the most important though ... I'm doing my best to figure it out. My guess would be a balance. Like you said, something structured and well established, but with plenty of free time.
 
Western has 24 weeks, I'm pretty sure. Looking for the link

28 in 4th year, and 4 in 3rd year, but I'm not sure on the limits of how many rotations in a specialty you can do.
 
Thomas Hearns said:
Western has 24 weeks, I'm pretty sure. Looking for the link

28 in 4th year, and 4 in 3rd year, but I'm not sure on the limits of how many rotations in a specialty you can do.
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Maybe it's 12 in the same field I'm thinking of.
 
For what its worth, someone in the Touro-CA thread for this year's app cycle posted this link. http://www.tourospin.com/index.html

It gives lists and numbers of all rotations sites associated with Touro-Ca. Its obviously not official but it did ease alot of my concerns with the campus. While the lottery system obviously sucks it looks like a large majority of students do stay in California and it does seem to be more organized than I had led myself to believe. Having read the horror stories about Touro-Ca I had all but ruled it out entirely but I am going to go to the interview if invited and pursue it just like I will any other school at this point
 
DbDan said:
For what its worth, someone in the Touro-CA thread for this year's app cycle posted this link. http://www.tourospin.com/index.html

It gives lists and numbers of all rotations sites associated with Touro-Ca. Its obviously not official but it did ease alot of my concerns with the campus. While the lottery system obviously sucks it looks like a large majority of students do stay in California and it does seem to be more organized than I had led myself to believe. Having read the horror stories about Touro-Ca I had all but ruled it out entirely but I am going to go to the interview if invited and pursue it just like I will any other school at this point
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When you see lists of rotation sites... you don't necessarily know how many of each student goes where.
 
Thomas Hearns said:
When you see lists of rotation sites... you don't necessarily know how many of each student goes where.
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The site I listed lists not only the rotation site list but the number of spots available for TOURO-CA students....
 
DbDan said:
The site I listed lists not only the rotation site list but the number of spots available for TOURO-CA students....
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OK I didn't even read it:laugh:

It says for Class of 2012, though... I guess I wouldn't be able to comment on the accuracy of it!

The following are the site information numbers for the class of 2010. Please keep in mind that these numbers apply to the class of 2010 ONLY! They are subject to change, and WILL CHANGE for your class.

I guess you can never be sure until you get there... actually pretty thorough information site. I haven't seen anything like that for any other schools.
 
Thomas Hearns said:
OK I didn't even read it:laugh:

It says for Class of 2012, though... I guess I wouldn't be able to comment on the accuracy of it!

The following are the site information numbers for the class of 2010. Please keep in mind that these numbers apply to the class of 2010 ONLY! They are subject to change, and WILL CHANGE for your class.

I guess you can never be sure until you get there... actually pretty thorough information site. I haven't seen anything like that for any other schools.
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Obviously it will likely change year to year but it at least gives me the idea that Touro-Ca has a much more structured clinical rotation program than I originally thought. It sounded to me from stories I had read that students were essentially left on their own to find rotation spots and were often left floating throughout the state, which does not at all seem to be the case. Maybe I was more reading to negatively into comments but it seems like the only floating is done by ~20 students (at least for this class) throughout the bay area, which does not necessarily seem to be a horrible thing. i wish I was able to find a website that thorough for all schools, it would definitely help to calm my fears from school to school :laugh:
 
DbDan said:
Obviously it will likely change year to year but it at least gives me the idea that Touro-Ca has a much more structured clinical rotation program than I originally thought. It sounded to me from stories I had read that students were essentially left on their own to find rotation spots and were often left floating throughout the state, which does not at all seem to be the case. Maybe I was more reading to negatively into comments but it seems like the only floating is done by ~20 students (at least for this class) throughout the bay area, which does not necessarily seem to be a horrible thing. i wish I was able to find a website that thorough for all schools, it would definitely help to calm my fears from school to school :laugh:
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Looks like about half get to stay in the area... just gotta hope you get picked if that's where you want to stay. And, it's hard to tell from that if you're going to have to be in Nor Cal for one rotation, go to So Cal for the next, to Michigan for the next, etc.
 
dendrites said:
After reading several threads like this: http://forums.studentdoctor.net/showthread.php?t=489765&highlight=buyer+beware I am worried about 3rd and 4th year.

I know a lot of people say that you should really look into the clinical rotations that a school offers before deciding on a school to attend. However, I feel that most applicants are not sure what to look for. Most schools just give you a list of random hospitals they are affiliated with. Does this mean that everyone will get a spot in one of those hospitals or will some people be left in the dust? What are some important factors to ask about??

Which schools have their OWN hospital?? I didnt realize that it's considered a bad thing/inconvenient to be put at different sites throughout the clinical years.

(ive had interviews at PCOM and DCOM so info on the rotations at those schools would be nice too)
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DCOM has affliated hospitals where you do your core rotations...so they are school run. As for electives/selectives, there is a list of docs affliated with the school, so if you do a rotation with them, the school sets it up for you, you just sign up for it. If you do a rotation outside the list, then you set it up yourself.

As for the number of electives/selectives per year, you get to have 2 months of electives and 2 months of selectives (1 in surgery and 1 in medicine). For 4th year, you get 4 months of electives and 3 months of selectives (1 in surgery, 1 in medicine, 1 in either). So, you have a lot of opportunities to figure out what you want to do and where you want to go.
 
You know ... something has been bothering me lately, and I'd LOVE some clarification from med students. SDN is essentially a breeding ground for catch phrases. One of the most popular phrases on SDN with regards to choosing a DO school is 'look at 3/4th year rotations,' and it is simply left at that. My question is ... why??? Is it simply because if you are in smaller outpatient clinics or moving a lot you will miss out on crucial parts of the education?? Or is it something more? Can it lead to lower Step II scores? Or can it even affect residency placement??? I have been guilty of throwing the phrase around a lot, and even looking at 3/4th year rotations at schools without even thinking, why?
 
JediZero said:
There's also the question of quality. If you arrange a rotation on your own, what guarantee do you have that the doctors you're working with will actually teach you or let you perform any procedures? If you're going to a rotation that the school has set up, they will know how to handle students and will be prepared and focused on how to educate you.
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Yes, they will know how to handle having students around, but some doctors will allow students to do more procedures, whereas other doctors may want to you to observe and consult privately with them more. Since I'm only a pre-med this is my observation through shadowing various doctors and volunteering in a clinic that had med/pa students rotate through.

Again through discussions with a doctor I shadowed who is a part-time instructor at a DO school and did a competitive fellowship in a non-DO friendly institute--so I trust his advice--his basic advice on this topic is to make your electives count. If you are in a rural school/or do most of your core rotations at a community based hospital then do your electives at major hospitals so that you can see how the heirarchy of medicine works so that when applying to those types of programs they recognize that you are comfortable in that situation. The benefit to some of the smaller community based core rotations is that typically with so few bodies around you get to do more procedures.
 
JaggerPlate said:
You know ... something has been bothering me lately, and I'd LOVE some clarification from med students. SDN is essentially a breeding ground for catch phrases. One of the most popular phrases on SDN with regards to choosing a DO school is 'look at 3/4th year rotations,' and it is simply left at that. My question is ... why??? Is it simply because if you are in smaller outpatient clinics or moving a lot you will miss out on crucial parts of the education?? Or is it something more? Can it lead to lower Step II scores? Or can it even affect residency placement??? I have been guilty of throwing the phrase around a lot, and even looking at 3/4th year rotations at schools without even thinking, why?
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I think its moreso how the 3rd and 4th year are conducted. Do you have to fend for yourself or does your school help you? Are the sites reliable or are they subject to termination at any time? Does your school give you a lot of elective time to explore interests and audition or are you restricted? The nice thing about a few of the DO schools is that 3rd year elective time. Residency apps are a little into the 4th year and if you didn't have a chance to audition you may very well not match where you want to... not auditioning will not completely render that program out of your league, however.
 
JaggerPlate said:
You know ... something has been bothering me lately, and I'd LOVE some clarification from med students. SDN is essentially a breeding ground for catch phrases. One of the most popular phrases on SDN with regards to choosing a DO school is 'look at 3/4th year rotations,' and it is simply left at that. My question is ... why??? Is it simply because if you are in smaller outpatient clinics or moving a lot you will miss out on crucial parts of the education?? Or is it something more? Can it lead to lower Step II scores? Or can it even affect residency placement??? I have been guilty of throwing the phrase around a lot, and even looking at 3/4th year rotations at schools without even thinking, why?
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3rd and 4th year are the beginning of your clinical career. If you are planning on being a physician, this will likely continue for the remainder your career.

It's a special time. You will see patients as a physician, for the first time. You will examine them, talk to them, counsel them, prescribe them medicine, for the first time.

You will pick up habits (good and bad) that will stay with you for the rest of your career. You will have inspiring moments, like the first time a new born takes its first breath, in your arms. You will witness things most of your friends could never imagine, let alone emotionally handle - the first time someone dies under your care, the first time a family members blames YOU for the death of their loved one, the first time someone thanks you for being a good doctor, the first time you see a group of doctors fight like hell to save a patient during a code (not a bull**** code where they are just going through the motions) and they ask you to fight with them, for a patient's life you all think is worth saving.

The first time you experience how innocent mistakes and a poor understanding of human physiology can lead to death in medicine. Like an IV saline bag left dripping too quickly in a CHF patient . . . until you walk into the room to find the patient gasping for air. And you try to push IV furosemide into them fast enough to get the excess fluid off before they drown in their own lungs.

There's a first time when it isn't someone else, its you.

Where you are, who your mentors are, what kind of facility you are at, how the patients are treated, who the patient population is . . . all of these things will impact the nature of that critical, first impression you'll get during your first years of clinical medicine: your 3rd and 4th year of medical school.

bth
 
bth7 said:
3rd and 4th year are the beginning of your clinical career. If you are planning on being a physician, this will likely continue for the remainder your career.

It's a special time. You will see patients as a physician, for the first time. You will examine them, talk to them, counsel them, prescribe them medicine, for the first time.

You will pick up habits (good and bad) that will stay with you for the rest of your career. You will have inspiring moments, like the first time a new born takes its first breath, in your arms. You will witness things most of your friends could never imagine, let alone emotionally handle - the first time someone dies under your care, the first time a family members blames YOU for the death of their loved one, the first time someone thanks you for being a good doctor, the first time you see a group of doctors fight like hell to save a patient during a code (not a bull**** code where they are just going through the motions) and they ask you to fight with them, for a patient's life you all think is worth saving.

The first time you experience how innocent mistakes and a poor understanding of human physiology can lead to death in medicine. Like an IV saline bag left dripping too quickly in a CHF patient . . . until you walk into the room to find the patient gasping for air. And you try to push IV furosemide into them fast enough to get the excess fluid off before they drown in their own lungs.

There's a first time when it isn't someone else, its you.

Where you are, who your mentors are, what kind of facility you are at, how the patients are treated, who the patient population is . . . all of these things will impact the nature of that critical, first impression you'll get during your first years of clinical medicine: your 3rd and 4th year of medical school.

bth
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Great post. 👍
 
JaggerPlate said:
You know ... something has been bothering me lately, and I'd LOVE some clarification from med students. SDN is essentially a breeding ground for catch phrases. One of the most popular phrases on SDN with regards to choosing a DO school is 'look at 3/4th year rotations,' and it is simply left at that. My question is ... why??? Is it simply because if you are in smaller outpatient clinics or moving a lot you will miss out on crucial parts of the education?? Or is it something more? Can it lead to lower Step II scores? Or can it even affect residency placement??? I have been guilty of throwing the phrase around a lot, and even looking at 3/4th year rotations at schools without even thinking, why?
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Because the clinical education component varies greatly amongst DO schools.

There are some schools where it is possible to go through all of 3rd and 4th year and not have any extensive inpatient experience

There are schools where having rotations at major tertiary care centers are rare

If you never had any significant amount of time on an inpatient side, do you want July 1 of your intern year to be your first inpatient experience? What if you never truly taken care of a sick individual, and on July 1, you're on an inpatient team at a tertiary care medical center and have 10+ truly sick patients to care for?

Can it affect residency placement? Yes. If all of your rotations are outpatient or unknown small community hospitals, what are your chances at matching at an acgme university hospital program? what about university-affliated major medical centers?

Also, tertiary care medical centers usually have some sort of academic affliation OR likes to conduct some sort of research (clinical or bench) - the attendings may even have academic appointments, are on faculty at a medical school, or may have been former faculty/academics. Their LOR, along with where it came from, may mean more to a PD than a private attending's LOR. An LOR saying you're a great medical student will mean more coming from an attending with an academic appointment and experience with many medical students, versus a private attending with limited experience with students (and medical education).

Also, major medical centers usually are teaching hospitals, with residents and students. There will be organized lectures or some educational component. It may not necessarily be true at a small community hospital.

Should all rotations be at a large medical center? No. I believe in a well-rounded education with exposures in outpatient private offices, clinics, community hospitals, and major medical centers. To not experience all of them as a student is a great injustice to a student's education. It's not just boards, LORs, and textbooks. It's knowing what's out there, what resources are available, how hospitals differ in their functions and operations, etc. It's part of learning the non-medical aspect of medicine (which no lectures, videos, studyaid, or internet forum) can provide.
 
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group_theory said:
Because the clinical education component varies greatly amongst DO schools.

There are some schools where it is possible to go through all of 3rd and 4th year and not have any extensive inpatient experience

There are schools where having rotations at major tertiary care centers are rare

If you never had any significant amount of time on an inpatient side, do you want July 1 of your intern year to be your first inpatient experience? What if you never truly taken care of a sick individual, and on July 1, you're on an inpatient team at a tertiary care medical center and have 10+ truly sick patients to care for?

Can it affect residency placement? Yes. If all of your rotations are outpatient or unknown small community hospitals, what are your chances at matching at an acgme university hospital program? what about university-affliated major medical centers?

Also, tertiary care medical centers usually have some sort of academic affliation OR likes to conduct some sort of research (clinical or bench) - the attendings may even have academic appointments, are on faculty at a medical school, or may have been former faculty/academics. Their LOR, along with where it came from, may mean more to a PD than a private attending's LOR. An LOR saying you're a great medical student will mean more coming from an attending with an academic appointment and experience with many medical students, versus a private attending with limited experience with students (and medical education).

Also, major medical centers usually are teaching hospitals, with residents and students. There will be organized lectures or some educational component. It may not necessarily be true at a small community hospital.

Should all rotations be at a large medical center? No. I believe in a well-rounded education with exposures in outpatient private offices, clinics, community hospitals, and major medical centers. To not experience all of them as a student is a great injustice to a student's education. It's not just boards, LORs, and textbooks. It's knowing what's out there, what resources are available, how hospitals differ in their functions and operations, etc. It's part of learning the non-medical aspect of medicine (which no lectures, videos, studyaid, or internet forum) can provide.
Click to expand...


👍Great post.
 
group_theory said:
Because the clinical education component varies greatly amongst DO schools.

There are some schools where it is possible to go through all of 3rd and 4th year and not have any extensive inpatient experience

There are schools where having rotations at major tertiary care centers are rare
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So can we finally name names so that we will all at the least be forwarned prior to going to a school. I imagine that the statements above are true at Touro-CA, RVU, and Touro-NY as they get their fair share of negative talk on here, but what other schools could this happen at? Or is this something that varies by what part of the lottery you get at a select school? Then how can we plan for that, not apply to that school?
 
group_theory said:
....Can it affect residency placement? Yes. If all of your rotations are outpatient or unknown small community hospitals, what are your chances at matching at an acgme university hospital program? what about university-affliated major medical centers?....
Click to expand...

Big agreement here. Pretty much all the PDs I've interviewed with for ACGME programs have quizzed me about my rotations-- where they were and what I did during them. Were they at academic centers? How involved were you in patient care? What procedures have you been taught? Did you dictate your H&Ps and discharges? They know that all DO rotations are not equal and they want to insure that you are capable of doing something at least on day one of internship.

Now... how do you insure that you can get good quality rotations? You'll never find out on interview day because you'll never talk to anyone that knows jack about rotations. The only people who really know about them are the upperclassmen who did them already. Seek these folks out and ask them questions if you can find them.
 
beckhunter116 said:
So can we finally name names so that we will all at the least be forwarned prior to going to a school. I imagine that the statements above are true at Touro-CA, RVU, and Touro-NY as they get their fair share of negative talk on here, but what other schools could this happen at? Or is this something that varies by what part of the lottery you get at a select school? Then how can we plan for that, not apply to that school?
Click to expand...

Well RVU's rotation reputation has not been established yet, so no one can really say that they fall into that category of having horrible rotations as of yet. Currently, people are wrapped up into attacking RVU's reputation as a traditional medical school and not its academic reputation or at least I haven't seen any negative opinions from current students about their medical education.
 
PunkmedGirl said:
Well RVU's rotation reputation has not been established yet, so no one can really say that they fall into that category of having horrible rotations as of yet. Currently, people are wrapped up into attacking RVU's reputation as a traditional medical school and not its academic reputation or at least I haven't seen any negative opinions from current students about their medical education.
Click to expand...

I thought there was a thread in the osteopathic section that talked about certain DO's being fired from preceptorships. This was during summer so maybe it has passed over and other physicians were obtained. Hopefully someone can comment on this.
 
beckhunter116 said:
I thought there was a thread in the osteopathic section that talked about certain DO's being fired from preceptorships. This was during summer so maybe it has passed over and other physicians were obtained. Hopefully someone can comment on this.
Click to expand...

The only firing I've heard about was the Board of Directors or something like that, but i could be wrong.
 
scpod said:
Now... how do you insure that you can get good quality rotations? You'll never find out on interview day because you'll never talk to anyone that knows jack about rotations. The only people who really know about them are the upperclassmen who did them already. Seek these folks out and ask them questions if you can find them.
Click to expand...

Can everyone please read this and carefully follow this man's instructions?

He speaketh the truth!

bth
 
Ugh, it just keeps getting more and more confusing. Hahaha, I think it would be easier to not research and just complain about rotations in a few years on SDN.
 
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