Hopkins

[newgirl]

Looking for opinions. I recently was admitted to Hopkins and noticed a number of posts that were critical of the academic atmosphere. I will have to decide between Hopkins and my state school (with full scholarship) in the next week or two. Is reputation all it's cracked up to be and is Hopkins really that bad? Also curious as to average med school debt.

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[coop]

i'm a jhu undergrad, interacted with many md and md/phd students through my lab at the med school, i did not sense that competitiveness which is spoken of, very nice people, grading is A-F, but it breaks down more like 5-10% A, 85% B, 5-10% C, which basically looks like Honors/Pass/Fail, with different names. I wouldn't worry about it at all. Unless your state school W/ full tuition is somethning like UCSF/UCLA/Michigan i wouldn't pass up the opportunity to go to hopkins, baltimore is a nice town, not as crowded as boston/ny, which is a good thing as well as a bad. But you see some trees, lots of nice areas to live with a free shuttle to the med school, good luck in your decision.

 

[WSU02]

I was in a similar situation years ago, for both undergrad and medical school. I went for the expensive private school for undergrad and the state school for med school. I'd suggest taking the money...I know that I'm getting just as good of an education...but I'm not going as deeply into debt. And don't fool yourself - the debt is a factor in many things for those unlucky enough to have hundreds of thousands of dollars of debt - like how you live in residency, what specialty you can afford to go into.
FWIW,
Kristi

 

[12R34Y]

Since when is JHU's area in Baltimore nice!? It's in a horrible ghetto with a huge knife and gun club.......

later

 

[coop]

Originally posted by 12R34Y:
•Since when is JHU's area in Baltimore nice!? It's in a horrible ghetto with a huge knife and gun club.......

later•

yeah, actually when I go into work tomorrow I pass by 3 gun clubs on the way there, I advise the original poster to take the person from kansas's advice.

 

[melancholy]

While the area around the med school isn't all that great, I can say that you will get plenty of experience there.. and who says you have to live anywhere near the hospital?

 

[osteogal]

I have had some personal experience with Hopkins Hospital and have not been impressed. The staff are highly qualified-from top medical schools, but there is not a lot of close supervision of interns, residents, etc. from senior staff. Probably due to how busy it is being in the heart of hectic Baltimore. A good reference site for the quality of hospitals is www.100tophospitals.com. Hopkins Hospital was only voted 2x and that was back in 93-94. As a research facility-probably one of the best. But would I want to be a resident there? Not me.

 

[MikeS 78]

what kind of ignorant logic is that

a) that is not a ranking of residency quality
b) that is not a ranking of M and M and/or positive outcomes
c) that has absolutely no concept of the fact that most research oriented institutions tend to take on tougher cases than the hospitals listed
d) they don't list MD anderson or sloan kettering....cmon now if you had a drug resistant sarcoma which would you put your money behind....sloan or ball memorial hospital in indiana

that is a ranking of efficiency...primarily bang for buck...truth be told teaching hospitals are not cheap...research hospitals are not cost effective....MGH almost went under for this reason....but to state that cost effectiveness is a legit way to rate how good the training program is....is just crazy....

 

[osteogal]

Ah-a skeptical response from Mikes78. I would like to make a rebuttal! First (subjective point), I would like to say that over the course of a 2yr. personal experience with Hopkins, I was not impressed (to state it simply). Secondly (objective points), from your response, it appears to me that you are not familiar with how the organization, 100tophospitals, ranks its hospitals. They rank hospitals in various different categories, and "teaching hospitals" is one of those categories. You stated in your 2nd point that 100tophospitals is not a ranking of M& M. But, in fact M&M is!! a factor in ranking the hospitals, as well as "Complications rate" & "Average length of stay." You stated in your last point that "cost effectiveness" is not a reason to chose or not chose a residency. And yes, I fully agree. And the 100tophospitals ranking does include "profitablity" as a factor in ranking. But not! as a sole factor. Yes, I think that it is reasonable to say that research hospitals will have more unusual cases, but why does Hopkins have such high M&M statistics? What does this say about their quality of care? If one is looking for a teaching hospital that has a lot of "cool" cases(in other words-cool new procedures to try on really sick people), by all means, Hopkins may be it. But if I'm looking for a hospital that will teach me to give quality care, then I think it is reasonable to use 100tophospitals as one! factor in weighing various hospital statistics.

 

[doepug]

I have to respectfully disagree with osteogal on this one...

As a med student at Hopkins, I believe that there are experiences here that are unparalleled at any other institution. In addition, contrary to osteogal's experiences, there are clinicians who are fantastic teachers. Hopkins is, after all, a teaching institution. While all people involved in patient care have a great deal of responsibility, I think it's somewhat uncommon to get in over your head. I feel very fortunate to study medicine at Johns Hopkins, and I recommend this institution without reservation to anyone seeking a clinical education.

Cheers,
doepug

 

[pcl]

Originally posted by osteogal:
•Ah-a skeptical response from Mikes78. I would like to make a rebuttal! But, in fact M&M is!! a factor in ranking the hospitals, as well as "Complications rate" & "Average length of stay." •

ALOS, Complications, and M & M can also be reflections of the acuity of patients coming in the door. If you have many patients with unusual or difficult cases, they will have longer LOS, more complications, and higher M & M than a patient with relatively straightforward diagnosis/treatment.

Example: Hip replacement

Original, ALOS 3-4 days
Revision, ALOS 7 days

Probably more complications with a revision than the original too.

Just a thought, if the acuity of entering patients are not similar, you really can't compare those stats.

 

[MikeS 78]

good to see there are others who see the flaw in this logic....

more over.....if keeping a hopsital M&M rating low compared to ones peers was the sole driving force behind the day to day decisions of what types of procedures were done at a particular institution then I think it would be rather unlikely that one would have ever tried transplantation, arthoplasty, CABG....I don't think I need to go on and on with this......but it was beleived at one point that anything less than I total mastectomy was insane.....and it is likely that in the early days....hospitals whose physicians performed routene totals had much lower M&M...and had arbitrary internet rankings been around back then...well im sure these hospitals would ranked higher.....

the point I'm trying to make is that these places rank higher, because they are conservative, and the tough cases are immediately told to go elsewhere......not figured in this number is M&M of people at home who are sent home with "Incurable" cancer....when what they have is in fact rather treatable.....or those who die waiting to get an appointment with a physician who actually knows what is going on......those stats are not in the M&M because most community hospitals know to get those people out of the hospital if at all possible.....either sending them home or sending them to what is known as a long term CCU......a euphemism for keeping the failure rates low

what is even more striking is that when you compare the average community hospital to a big name ac. med hospital on similiar procedures....there is no comparison.....the best one I can remember off the top of my head involves a cohort of heart surgery in NY. when mortality of heart surgeries in general were compared....a few community hospitals were at the top.....columbia, cornell and mt sinai were in the middle....

however if one stratified these results for say CABG.....things were different...with the Ac. meds cleaning up......then when the results were further stratified for age, sex, race, risk factors etc.......it was pretty ugly for the community hospitals

the point here is that while we all would like assemble an all encompassing survey that answers all of our questions in life,....most surveys are either some simplified that they have no basis in reality, or they are so complex that nothing really means anything.......I can pretty much assure everyone reading this do not in fact reflect america's best hospitals.......and even more certain is the fact that those are not america's best training programs....if they are good at cutting corners in care....then they are probably pretty good at cutting corners in training doctors

 

[osteogal]

Yes, of course, Hopkins is a high caliber institution. But newgirl requested "opinions" on whether she should be a resident there. Who can definitively outline what qualities an institution should have for one to choose a residency there? I have never stated that I would not want to be a resident there based on the top100hospitals survey. I said I have had negative experiences there--personal opinion. And that the survey gives some facts that I agree with. I do agree with the fact that according to pcl that if "the acuity of entering patients are not similar you really can't compare stats." But I did want to reiterate that this particular survey compares hospitals with similar bed size and teaching status. It is true that surveys should be scrutinized for accuracy. And I am not basing my "opinion" on this survey. Just as I would not base my decisions solely on Consumer Reports rankings or love a movie based on a review. But do I look at rankings and reviews? Sure, just to get some information. Again, no one can deny the high caliber of Hopkins. I'm just giving my opinion.

 

[osteogal]

I thought it was so interesting that Hopkin's federal research funding was withdrawn for several days after the death of a 24 year old female involved in a botched research project. This funding wasn't taken away solely due to the fact this girl died but also due to consistently high morbidity and mortality statistics at Hopkins. I think this wake-up call was timely!

 

[MikeS 78]

I personally find M&M that occurs in the context of research to be significantly more easily to rationalize than M&M that stems from incompetent diagnosis and management of well known diseases, and misuse well studied medications and procedures (as I have frequently seen in community hospitals)

 

[osteogal]

This is going to be my last response b/c I think we are digressing from the initial question that was asked about whether Hopkins is a good place to go for residency. (And I think my opinion in regards to this question is pretty obvious). I think MikeS78's response that research related errors are more justifiable is pretty interesting. Even though the girl who died from the Hopkin's research was a healthy girl in her 20's prior to the research? I can't really understand the reasoning in this. But I have to generally disagree with the whole idea that just b/c some research subjects have an "incurable" illness that they are somehow more dispensable than others. I think Lorenzo (from the based on real life movie "Lorenzo's Oil") disproved this idea. I don't think someone can say that, well, "that person died for a good cause" or "he/she was going to die anyway." And to think that hospital errors caused by "obvious blunders" are more unjustifiable just doesn't make sense to me. Didn't the girl who died from the Hopkins research and any other person who dies from hospital/doctor/nurses' errors both die due to medical mismanagement, accident, negligence, etc.? It is obvious that this sort of laisez-faire attitude (& borderline arrogance) is a reason why statistics for medical malpractice is so high:
Medical errors kill between 44,000 and 98,000 people a year!
(Richardson, W.C., The National Academy of Sciences,
Institute of Medicine Report, 1999.)
...Maybe the entire medical profession needs a wake-up call. And maybe it's becoming more about money & power than about treating patients.

 

[David Orias]

Gee I was wondering if newgirl made up her mind....?

I would just throw this into the equation.

Graduating from Johns Hopkins Medical School will make your application for a residency stand out a little more. Now whether that is fair or not, I can't speak, but unless your state school has as good a reputation, then you should take that into account.

Medical School debt is a big problem and carrying a big debt does "color" decisions you might make with your future. So that will need to be weighed in as well.

Good luck with your choice whatever you choose.