Could any current students comment with their thoughts about the LIC?
The LIC is hard to accomplish, in my opinion, because of the shear amount of driving you have to do, and most of the rotations aren't unified under a single health system / EMR. For example, you might have to drive 35 minutes in the morning to get to place A for a rotation between 8-12pm. Then, you have to drive another 30 min to place B, for a rotation between 1-6pm. You will get used to eating lunch in your car. Then, you have to drive home for 30 minutes. Granted, not all days will be like this, but it is a pain.
Let's take an example of the LIC:
Monday - IM (8A-12P), Surgery (1P-6p)
Tuesday - OBGYN (7:30A-12P), White space afternoon
Wednesday - Psych (7:00A - 12P), FM (1:30p - 6:30p)
Thursday - White space morning, Pediatrics (1P - 6P)
Friday - White space morning, CED (Clinical Education Day) afternoon
Seems confusing, right? It takes a few weeks to really get accustomed to this type of schedule. I am kind of biased here, because I really don't like the LIC. I feel that it's too much of a hassle to study for all 6 subjects at once. Do I read ahead for the next day, where I might have two different subjects to know about? Or, do I read about what I saw today? Or... could I do all 3???
It's hard to round on pts post-op during the LIC. For example, look at the schedule above. Say your surgeon only operates on Wednesday afternoon & Thursday afternoon, you would have to work something out with your FM & Peds rotation. So let's move the FM to thursday morning & peds to friday morning, meaning you have Wednesday PM & THursday PM white space.
Ok. So rounding takes place in the morning. Like 7AM. If you have other rotations, how are you supposed to round & learn about complications???
This is why TCMC moved to a 1/2 block + 1/2 LIC year. Students in previous years complained so much about this.
Some say that it's an advantage having a schedule like this because it really prepares you for step 2, since you are only allowed to take shelves after the beginning of March. See below as to why I think this is a bad idea, especially because NEPA doesn't exactly have a ton of testing centers.
Our preceptors are so-so. Some are great, and really make an effort to teach you what you need to know, and most of those preceptors are in the North campus (main campus). Others, well, you're going to have a nice half year of shadowing. Sometimes it really is the students' faults, and they don't take initiative. But, when you're taking out $80,000 in loans a year, and have no idea how the medical system works, I kind of expect preceptors to 'push' you into the right direction.
One issue with some preceptors is that they never expected to be teachers. That is totally fine, because they chose to go into community practices. I don't blame them for not wanting to teach.
Unlike other schools, TCMC doesn't have morning report or a regular noon conference. Meaning, there is no 'interesting case + presentation' every morning, where residents talk about what happened the night before. And, there rarely are noon lectures on hyponatremia, AIDS, chest pain ddx, etc, etc..
This kinda sucks because the school is totally based on learning from preceptors. There are very rarely any lectures given by doctors. CED lectures are usually student run, and its just students giving presentations on subjects. I wish we had more lectures given by doctors, so they could share their knowledge.
But I will say this. Currently, we have half the year as a block schedule, and the other half as LIC.
If you get the 2nd semester of 3rd year as LIC, it is amazing. Why? You have sooooooo much time to study for shelves / step 2. White space is optional time, and you can really use it however you want to. This gives you an extra 1.5 days of pure studying for the boards. This is huge. Don't let anyone tell you to do the LIC in the 1st semester as a "warm up." Don't. DO LIC 2nd.
Any other questions?
Below is my discussion from page 3...
Current 3rd year just posting to give more info about the school:
Pre-clinical years pro: A new great anatomy professor, great pharmacology lectures, new building, non-gunnerish environment (exceptions of course), Dr. Iobst is a great student advocate
Pre-clinical years con: Path professor was just OK, microbio had me wishing I had taken it before, too many 'professionalism' courses
Pro/con: community weeks (3 per year, where you do some volunteer service, some inter-professional work with other community members, work with a doctor)...blessing because you get a break, but that also means you're cutting out 6 whole weeks of academic preparation for STEP 1--i believe the average step 1 score for the c/o 2016 was a 220-221; national average was 228.
Now onto 3rd year...
TCMC is going through an experiment currently. They split each of the four campuses (Scranton, Wilke-barre, Williamsport, Sayre) into Team A & Team B. There is a Team A-Scranton, Team B-Scranton, Team A-WB, Team B-WB, etc...
"Team A" does a block schedule for the first half of the year...
While "Team B" does the old LIC schedule for the first half of the year...
After winter break...they switch
The block schedule is a truncated version of a traditional block schedule school. Your blocks are assigned at random.
4 weeks of inpatient "adult" medicine (paired with either an IM or FM team)--yes, i am sorry for all of you who despise FM
4 weeks of surgery--you can be with a general or specialist...you kind of just get put with one...not really much choice. A big plus is that there are no residents (unless you are a part of the Wilkes-Barre Geisinger cohort or Sayre), so you get more hands on work
3 weeks OBGYN
3 weeks Psych
2 weeks Peds--none of TCMC campuses have great pediatrics 2/2 parents bringing their sick children to big name hospitals like CHOP
4 weeks of "elective", which can be ANY discipline
2 weeks of "selective", which is radiology, pathology or neurology
In the block schedule, every Friday evening is reserved for CED, where you do quizzes once in a while, students do presentations, not many doctors give presentations
The LIC is what they had years before, for the entire 3rd year...
You will rotate through FM/IM/PEDS/OBGYN/SURG/PSYCH (1/2) each throughout the week. For example,
Monday - Peds 8-12; Surgery (office) 1-5
Tuesday - White Space AM; Psych 1-6
Wednesday OBGYN 8-12; IM 1-6
Thursday - White Space AM; FM 1-6
Friday - White Space AM; CED evenings (same CED as the block schedule kids...you go to the same CED as your respective campus)
CED = clinical education days, where they have lectures/student presentations/quizzes (occassionally)/outside groups present...I think they are kind of a waste of time, but some of my friends love the presentations. It's hit or miss.
White space = free time to explore different things such as surgery (you are scheduled on office days...so you need to use white space to actually see surgeries if that's your interest); this is hard sometimes because you have to work around physician schedules...also during summer alot of physicians are on vacation so you are paired with someone else (i.e., another doc, PA, midwife, etc).
Pro: If you don't like something, you only have it one half-day a week and can just sit there // Lots of white space time to concentrate on fields you have interest in ( IF you can find time that works for your physician to teach you & of course a physician willing to work with you) // No "on-call" technically (but, from what I've heard some people do overnights willingly and that's ok too) // Weekends are pretty much free which is nice because I can drive home on the weekends to see family // if you have the LIC during the 2nd semester, you can use all your white space to just study for shelves (more explanation below) and absolutely murder them (if you have LIC in the first semester, sorry)
Con: HIGH variability in quality of preceptors (i.e., the doctor who shows you how to write notes, lets you see the patient before him, do the physical exam, & come up with a dx & tx plan VS shadowing for half a day VS doctors that openly tell you that they are being made to be preceptors & hate teaching)... Unfortunately, TCMC isn't known for their great clinical faculty...I have a 4th year friend that says that she shadowed the ENTIRE YEAR during her obgyn or peds rotations!!!! // Lots of driving (most likely, each office is at a different location, and yes, it could be far) // Surgery rotation (hard to do morning rounds on patients when you have to be at OBGYN on Wed from 8-12... this is ok if you have white space in the mornings)... but it sucks if you can't switch your schedule & you wanted to be a surgeon, or a hospitalist & only got 1/2 the experience compared to other students at otehr schools // Never get to know the 'day in the life' of a certain specialty (by doing half-days, you see only that portion...you don't ever experience an entire day unless you have a full day of white space)... do you really want to work in surgery from 630A-8P 5 or 6 days a week? // not enough preceptors = BIG CON...some students are paired with a PA, NP, or midwife for their LIC experience, which is lame...
Shelves are national core rotation exams that test clinical knowledge. Because our rotations are kinda weird, they let you take them at any time AFTER february. Kinda stupid, but this is what the administration wanted. Problem is... you have to schedule your own appointment for each shelf test at a prometric center, and there aren't many centers around NEPA. If they are full, you'd likely have to travel to Philadelphia just to take a 2-hr test. I really hope they change it this year, as I believe I could take two shelves during fall.
Onto 4th year from the opinions of my 4th yr friend...
"Does TCMC prepare you for 4th year? Yes and no. It really depends on you, the individual. I had to try really hard to get stuff done and learn medicine. These are community and private practice physicians--they simply don't have the time or want to teach as much as their academic counterparts. I have friends that literally have done nothing during their rotations, and I have friends that have done everything. I think it's probably 2/2 self-motivation, but you could simply just have bad luck and get a really bad preceptor. Having gone through one away audition rotation, I am comfortable to say that I am on the same level as the interns, probably because they took a 6-month vacation before intern year started."
"One thing I wish I knew about tcmc was that the school kind of requires you to do many away rotations, because they don't have enough 4th year rotations. You can do up to 20 weeks of away rotations, and many students do that to get a more "formal" experience. After going to an audition rotation, you can tell the difference between a university vs. community rotation."
