The board exams are there to see how well students have mastered the basic sciences in their first two years. If DO students rotating at this hospital are lacking in the more intangible aspects necessary for doing well in 3rd and 4th year I don't see why you would correlate this with how the students are being taught at their institutions since the first two years at any medical school are only geared towards didactics and are essentially an extension of undergraduate education. The 3rd and 4th year are when students are supposed to learn to not be grossly incompetent clinically. You seem to imply that some schools are specifically training students to be competent in their clinical years rather than having their explicit goal to be to ensure that the students do well on the boards..
Honestly, I don't know how to respond to that statement because my school absolutely does that. From day 1 of orientation, the focus was professionalism, empathy, etc. in the form of both lectures and practical exercises. Week 1 of classes we learned to take v/s & started learning to take a history and began practicing for the Step 2 CS exam by end of the first month of class. By the end of the first semester, we have learned to take a complete Hx, perform a few physical tests, write up a SOAP note, and (optionally) the basics of procedures such as suturing, EKGs, and injections (IM, IV starts, intraosseus). My inbox is also loaded on a daily basis (as an M1) with opportunities to go use my clinical skills in various free clinic and health screening fair settings. (We are required to obtain a certain number of hours of this during our M1 year outside preceptorships, which we begin second semester of M1.) The thought of M1 being just an extension of pre-med sounds kind of wasteful. Why have it? Why not simply require more pre-reqs and then do quick bridge courses if you're just going to keep at it with a lecture-only format for M1/M2?
How would anyone control for the intangibles that you do mention?
LORs, interviews. No admissions process is perfect, but schools put a lot of time and research into figuring out what correlates with success (and with failure).
Further, how do you propose that somehow these intangibles are being selected for when students are accepted to MD institutions? Regarding critical thinking, that's what the board exams are testing and if they passed the boards that must mean their critical thinking abilities are sufficient to be on the wards since the exam is the only metric that is used to assess this.
What do you mean "the only metric to assess this"?! There are plenty of others -- course grades, M1/M2 preceptorship grades, clinical small group leader interactions, etc.
Anyone can be lacking in common sense/judgment why do you think the students from the DO program at this hospital are particularly deficient?
The mistakes made indicate a lack of judgment and one of apparent carelessness. One that comes to mind required minor surgery to undo an M3's sub-q suturing with proline sutures. That's the sort of careless thing that she should know to ask if she is unsure whether or not a given suture or technique should be used for a given purpose.
What about some of the MD students who are similar?
I am sure there are some but the docs have noticed this as a general trend.
Do they get a free pass? How do you know that the DO students aren't being more scrutinized due to perceived/preconceived inferiority?
Sure, it's possible since we can't really double blind everyone to their condition and test things to be sure....
Also I was under the impression that MD stat averages were 3.65/31. Many DO schools average 3.6/28. The differences are not that large.. It's getting increasingly difficult to be accepted to medical school and I couldn't get into an MD school with a 3.47 and a 32R MCAT.
MD averages have been 3.67/31-32 the last few yrs with each yr getting closer to 3.7/32.
DO programs have a less well-documented set of standards but last I read, it was closer to 3.5/27 or so.
I don't know enough about the DO curriculum to contrast the two, but most MD institutions do not do purely theoretical knowledge or boards prep, and is certainly nothing like undergrad. Most, AFAIK, should have a grasp on how to say, place IVs, suture, understand basic equipment, etc. So perhaps that is where the difference in curriculum lies. The DOs are facing a steeper learning curve, which would be difficult in a new environment like the wards.
This seems like a pretty reasonable assessment of what may be going on. As I mentioned, the physicians that have told me this have mentioned that they suspect it is poor instruction at the M1/M2 level, not a lack of student ability. They simply seem unprepared. A few have said that last year, after 1-2 semesters (read: all of M3), the students were generally at about the level they would be expected to be to begin the M3 year and by 2nd semester of M4, most were "marginally competent" and might be passable for residency.
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