Med school prestige, MD vs DO, specialty arguments are completely toxic

[ciestar]

Same. I wrote notes on IM everyday. But on all of the other rotations combined I probably wrote <15.

My M4 peds rotations were a different story. I had to write the H&P on every patient we admitted. Did all the progress notes and discharges on my own patients. My notes were all cosigned/addended by my senior and attending. My peds outpatient, two of my FM rotations (same clinic, outpatient only, wasnt allowed to do notes on IP), and my outpatient IM my notes were the ones primarily used. Some are realllly good about giving students autonomy and others blow.

For IM, i wrote notes, but nobody ever looked at it as the residents and attending wrote their own notes.

Thankfully feedback on my intern notes is positive. I write a good, comprehensive note.

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[ciestar]

And that is entirely unacceptable. You should be seeing patients independently, at worst by the 2nd week but ideally but the 2nd day. You should write notes at least occasionally (every time if in the teaching hospital, more rarely is OK if you're with a private attending), in the latter case you should still present every patient you see.

My 3rd year peds was split. 4 weeks of outpatient, 2 in the general resident clinic. Saw all my own patients and presented to either a 3rd year or an attending. The 2nd two weeks was cycled through 1-2 days in the various subspecialties. Shadowed in probably 2/3rds of those, but given the short duration with each that wasn't a huge thing. It really was just a "here's what we do here" thing. Then 2 weeks of general wards where we all saw our own patients and then presented to the intern before rounds and attending at rounds then 2 weeks of heme/onc (or PICU or another 2 general) inpatient where we followed our own patients.

It definitely varied with each rotation/attending. On heme/onc, i saw two patients solo over the course of two weeks. Shadowed the rest of the time.

Some were great about letting me see patients on my own and even if i didnt write a note, i was still expected to present them and know my patients.

 

[VA Hopeful Dr]

It definitely varied with each rotation/attending. On heme/onc, i saw two patients solo over the course of two weeks. Shadowed the rest of the time.

Some were great about letting me see patients on my own and even if i didnt write a note, i was still expected to present them and know my patients.

And that's not OK. If I was with an attending for more than 2 days, I saw patients by itself. Except ophthalmology, you can't teach a med student to use their tools in 2 weeks.

 

[ciestar]

And that's not OK. If I was with an attending for more than 2 days, I saw patients by itself. Except ophthalmology, you can't teach a med student to use their tools in 2 weeks.

Definitely wouldnt expect that lol
My classmate who went into ophtho said my amblyopia would have made it impossible for me.

Yeah, it was clinic and not IP. My attending had patients straight through every 15 minutes from 830-5. Still not an excuse and i probably should have had a different place to go. My GI rotation i saw two consults or so a day and presented them all myself

 

[Neopolymath]

And that's not OK. If I was with an attending for more than 2 days, I saw patients by itself. Except ophthalmology, you can't teach a med student to use their tools in 2 weeks.

Do an ophtho rotation 4th year so I don't have to do anything. Got it!

 

[ciestar]

Do an ophtho rotation 4th year so I don't have to do anything. Got it!

That was my radiology rotation lol

 

[VA Hopeful Dr]

Definitely wouldnt expect that lol
My classmate who went into ophtho said my amblyopia would have made it impossible for me.

Yeah, it was clinic and not IP. My attending had patients straight through every 15 minutes from 830-5. Still not an excuse and i probably should have had a different place to go. My GI rotation i saw two consults or so a day and presented them all myself

My outpatient FM was like that. I'd see a patient while the attending saw 2. Worked out pretty well, its what I generally try to do with my students that rotate with me.

 

[Mass Effect]

We could move to a 1.5 year preclinical curriculum and move that six months to the current third year. Cancel 4th year. Boom! 3 year curriculum. Plenty of time for core rotations, and auditions/sub-I’s. I think it’s a myth that we all have to be enrolled in school for them to push paper around while we go on interviews.

You're not going to lose a year. A few months at most. Say you start med school July 2020. Your pre-clinical curriculum is up is in December 2021 under your plan. Where do you put dedicated? Say you put it January and February and take Step 1 in mid to late February. You start clinicals in March 2022. In March 2023, you're done with clinicals and you begin your 6 months of aways and interviews and then the match? Ok. That takes us through September 2023. Now everyone has to graduate, move, and get licensed. So licensing process starts. Say graduation happens in December 2023 (old way would have been May 2024). Great! No one's starting any job until at least January anyway due to licensing. So at most, you've shaved off 5-6 months and good luck getting hospitals to agree to let interns start at the start of the calendar year.

 

[Mass Effect]

You know a lot of schools have 3 yr curriculum + 1 year research right now so they still can get the extra one year tuition $$$. My point is that they should make that research year optional.

Actually, I don't know very many schools who do that. I know a few do, but they always have. It's because they want to graduate physician scientists as they believe every doctor should know enough about research to potentially do it someday. I don't think that's a bad philosophy and students know it going in so these programs do attract a lot of people who enjoy research or are at least open to it. It sure as hell is better a philosophy than the philosophy that states every physician should know how to move the cranial bones around.

4+4 and 3+3. I was referring to 3 yr prereqs and 3 yr of med school instead of 4+4.

No way. It's ridiculous the difference in maturity between the 25 year old "first job" interns and the 30 year old "real adult" interns. Not to say every 25 year old is the same because they're not and some are quite mature, but the last thing I'd want to see is younger, even less experienced med students hitting the wards. Frankly, I think prior work experience should be required of all med school applicants.

 

[Mass Effect]

Why not both? I just feel I’m not going to be much more prepared for intern year between the recent end of third year and July of next year

You don't know what you don't know and trust me, even when you become a resident and look back and wonder "what more could I have learned to prepare?" The answer is always something. You do not learn it all on clerkships. Some of it is on you to learn, but none of it is a waste.

This is a year of my life they’re stealing

No one is "stealing" a year of your life. Come on.

 

[Ho0v-man]

You're not going to lose a year. A few months at most. Say you start med school July 2020. Your pre-clinical curriculum is up is in December 2021 under your plan. Where do you put dedicated? Say you put it January and February and take Step 1 in mid to late February. You start clinicals in March 2022. In March 2023, you're done with clinicals and you begin your 6 months of aways and interviews and then the match? Ok. That takes us through September 2023. Now everyone has to graduate, move, and get licensed. So licensing process starts. Say graduation happens in December 2023 (old way would have been May 2024). Great! No one's starting any job until at least January anyway due to licensing. So at most, you've shaved off 5-6 months and good luck getting hospitals to agree to let interns start at the start of the calendar year.

This is why change will never happen. People who’ve experienced it one way are in charge and too inflexible to see another solution.

If we cut the fluff out of preclinical curriculum we probably don’t even need dedicated, especially under a p/f step 1. And there’s no rule that says you have to take step 1 after preclinical. Plenty do it after the clinical year. Most can hit the average step 2 score with a couple weeks of studying. If you think you can’t pass step 1 without more dedicated, then give up some audition time.

So under my system we start fall 2020. Preclinical ends December 2021. You can take boards then or in a year. Dealers choice. November/December 2022 you got your auditions/electives ready to go. Interview while on those rotations. Finish those and you’re done. Match and move after graduation at the end of spring 2023. So you match up n June. Start in August/September 2023.

This is just one of a million other ways we could do this.

 

[Ho0v-man]

You don't know what you don't know and trust me, even when you become a resident and look back and wonder "what more could I have learned to prepare?" The answer is always something. You do not learn it all on clerkships. Some of it is on you to learn, but none of it is a waste.



No one is "stealing" a year of your life. Come on.

I’m not saying I know it all. I’m saying I’m not going to learn much more in the capacity of a student. And as I said in a previous post, a room full of residents on my last rotation made it seem pointless to try.

Considering it’s a year of my life where I’ll probably learn very little despite my best efforts and none of it will help me in the next stage of my training, I’ll agree to disagree.

 

[Mass Effect]

This is why change will never happen. People who’ve experienced it one way are in charge and too inflexible to see another solution

No, more like those who've experienced it disagree with you about your solution. Not sure why anyone who disagrees is thought of as "inflexible" or all the very valid arguments we make are stomped down to "I did it this way, you need to as well" when it's way more than that.

If we cut the fluff out of preclinical curriculum we probably don’t even need dedicated, especially under a p/f step 1

So you want schools to teach only to Step 1, a test that judges minimal competency? There is more to learning and more to medicine than Step 1. It's this kind of thinking that's the problem with education in general.

And there’s no rule that says you have to take step 1 after preclinical. Plenty do it after the clinical year. Most can hit the average step 2 score with a couple weeks of studying. If you think you can’t pass step 1 without more dedicated, then give up some audition time

So then during this magical 6-month period, you want students to go on aways, go on interviews, take Step 1, take Step 2, take Step 2 CS, and match? Yeah, never going to happen.

So under my system we start fall 2020. Preclinical ends December 2021. You can take boards then or in a year. Dealers choice. November/December 2022 you got your auditions/electives ready to go. Interview while on those rotations. Finish those and you’re done. Match and move after graduation at the end of spring 2023. So you match up n June. Start in August/September 2023

So you get your electives "ready to go" (what does that mean?) in November/December. Does this mean you start them in January? Again, you want people to go on aways, go on interviews, take Step 1, Step 2, and Step 2 CS between January and May? It's a fantasy.

I’m not saying I know it all. I’m saying I’m not going to learn much more in the capacity of a student

There is no cap on learning, even as a student. Most don't want to learn more and that's fine, but then complaining about it doesn't change the fact that whether or not you learn more is almost entirely up to you.

And as I said in a previous post, a room full of residents on my last rotation made it seem pointless to try

Again, most students don't want to learn more. You're not going to learn IM to the level of a resident in med school, true. But you have not tapped out your knowledge of IM on the student level. No one has.

Considering it’s a year of my life where I’ll probably learn very little despite my best efforts and none of it will help me in the next stage of my training, I’ll agree to disagree.

No one is "stealing" it from you. This isn't some scam you fell victim to. You knew med school was 4 years. This "they're stealing a year of my life" nonsense is playing victim when you were an active participant in deciding to take this path in life.

 

[libertyyne]

This might be a radical idea, but Change the MCAT to Step 1, and medical school should be one month boot camp for clinicals then straight to the wards. 1 m3 equivilent and second year should be 4th year.
There is nothing in the first two years that cant be self taught or made up with a month long boot camp.

 

[Lawpy]

This might be a radical idea, but Change the MCAT to Step 1, and medical school should be one month boot camp for clinicals then straight to the wards. 1 m3 equivilent and second year should be 4th year.
There is nothing in the first two years that cant be self taught or made up with a month long boot camp.

So MCAT to Step will be P/F?

 

[Matthew9Thirtyfive]

This might be a radical idea, but Change the MCAT to Step 1, and medical school should be one month boot camp for clinicals then straight to the wards. 1 m3 equivilent and second year should be 4th year.
There is nothing in the first two years that cant be self taught or made up with a month long boot camp.

My school has a whole clinical reasoning curriculum built into our preclerkship curriculum. I’ve learned stuff every single session that I likely wouldn’t or couldn’t have learned on my own, and all that will make me better prepared for clerkship.

Also how would people assess themselves as they learn all this stuff for step? Same way they do for the mcat? By buying a bunch of exams and qbanks? I dunno. Most people study for a couple months for the mcat after taking a bunch of classes. I’m not sure how suddenly we’re supposed to learn a year to 1.5 years of material with zero guidance and then take a huge exam that is a major factor in determining our career options. Or is it P/F? It really can’t be since you then have to still get into a med school.

 

[Ho0v-man]

No, more like those who've experienced it disagree with you about your solution. Not sure why anyone who disagrees is thought of as "inflexible" or all the very valid arguments we make are stomped down to "I did it this way, you need to as well" when it's way more than that.



So you want schools to teach only to Step 1, a test that judges minimal competency? There is more to learning and more to medicine than Step 1. It's this kind of thinking that's the problem with education in general.



So then during this magical 6-month period, you want students to go on aways, go on interviews, take Step 1, take Step 2, take Step 2 CS, and match? Yeah, never going to happen.



So you get your electives "ready to go" (what does that mean?) in November/December. Does this mean you start them in January? Again, you want people to go on aways, go on interviews, take Step 1, Step 2, and Step 2 CS between January and May? It's a fantasy.



There is no cap on learning, even as a student. Most don't want to learn more and that's fine, but then complaining about it doesn't change the fact that whether or not you learn more is almost entirely up to you.



Again, most students don't want to learn more. You're not going to learn IM to the level of a resident in med school, true. But you have not tapped out your knowledge of IM on the student level. No one has.



No one is "stealing" it from you. This isn't some scam you fell victim to. You knew med school was 4 years. This "they're stealing a year of my life" nonsense is playing victim when you were an active participant in deciding to take this path in life.

You’re putting words in my mouth. Did I say anywhere that schools would just teach to step 1? I swear some posters act like everything your school teaches you that isn’t on step 1 is automatically super clinically relevant when that isnt the case at all and you should know that. You and I and everyone else reading this learned a metric crap ton of basic science minutiae for class that has never shown up anywhere ever again.

Im not necessarily saying my way is definitely the most efficient idea. But I think it could work. I mean crap other countries train physicians in less time than we do. Lecom has a 3 year curriculum. So do some other med schools (I don’t know which off the top of my head) so saying it’s a fantasy to do this in 3 years when there’s literally other schools doing it already is ridiculous. But hey I know that you’ve been through it and that’s very commendable. I’m sure if you email the dean there they’ll realize that they can’t effectively train physicians in 3 years and shut the program down.

I agree that in a perfect world I could learn more and make this time worthwhile. But students have a limit to the degree that we’re allowed to be involved in care. And all the stuff with EMRs has only made this worse. If I was allowed to progress in autonomy relative to the time I’ve spent in school it would be better.

I knew med school was four years. But I signed up for four meaningful years of education and I haven’t gotten that. Not for lack of trying.

 

[DO2015CA]

My school has a whole clinical reasoning curriculum built into our preclerkship curriculum. I’ve learned stuff every single session that I likely wouldn’t or couldn’t have learned on my own, and all that will make me better prepared for clerkship.

Also how would people assess themselves as they learn all this stuff for step? Same way they do for the mcat? By buying a bunch of exams and qbanks? I dunno. Most people study for a couple months for the mcat after taking a bunch of classes. I’m not sure how suddenly we’re supposed to learn a year to 1.5 years of material with zero guidance and then take a huge exam that is a major factor in determining our career options. Or is it P/F? It really can’t be since you then have to still get into a med school.

I think... I hope.. he’s being sarcastic

 

[Mass Effect]

You’re putting words in my mouth. Did I say anywhere that schools would just teach to step 1?

People basically already just study for Step 1 from day one of orientation and you want to cut more "fluff" out, so yeah, I do wonder if that's what you're saying.

I swear some posters act like everything your school teaches you that isn’t on step 1 is automatically super clinically relevant

Not sure what your school taught you, but the vast majority of information I received during MS 1 and MS2 was helpful for step 1.

You and I and everyone else reading this learned a metric crap ton of basic science minutiae for class that has never shown up anywhere ever again

I actually didn't. Sure I learned some, but certainly not a "metric crap ton of basic science minutiae." I'm a psychiatrist and I still use things I learned in pre-clinicals on the inpatient unit. Maybe it's because my school had a systems curriculum? I don't know. But I would say the minutiae I've never seen anywhere else was a bare minimum.

I mean crap other countries train physicians in less time than we do. Lecom has a 3 year curriculum

Yes and they extend residency to longer than ours. They also cut out undergrad and make medical school 6 years instead. There are schools right here who have the BS/MD programs. Folks should apply to them if they like.

So do some other med schools (I don’t know which off the top of my head) so saying it’s a fantasy to do this in 3 years when there’s literally other schools doing it already is ridiculous

No, it's not ridiculous. The schools that do it in 3 years put students on one pathway. Those students don't get a comprehensive education and the jury's still out on whether or not that's a good thing. I do agree that everyone knew exactly which specialty they wanted right out of the gate and was already accepted to residency at the time of beginning med school, you could shave off 4th year, but that's about it.

I agree that in a perfect world I could learn more and make this time worthwhile. But students have a limit to the degree that we’re allowed to be involved in care. And all the stuff with EMRs has only made this worse. If I was allowed to progress in autonomy relative to the time I’ve spent in school it would be better

If you're on clinicals, there's nothing stopping you from reading up on every single IM inpatient on your team's list, researching what's going on, proposing treatment plans or even just discussing it with your resident. If you've done that and have time to spare, then I'd argue it's the quality of your clinicals that's the problem.

 

[libertyyne]

My school has a whole clinical reasoning curriculum built into our preclerkship curriculum. I’ve learned stuff every single session that I likely wouldn’t or couldn’t have learned on my own, and all that will make me better prepared for clerkship.

Also how would people assess themselves as they learn all this stuff for step? Same way they do for the mcat? By buying a bunch of exams and qbanks? I dunno. Most people study for a couple months for the mcat after taking a bunch of classes. I’m not sure how suddenly we’re supposed to learn a year to 1.5 years of material with zero guidance and then take a huge exam that is a major factor in determining our career options. Or is it P/F? It really can’t be since you then have to still get into a med school.

The clinical reasoning curriculum could be part of the preclinical boot camp. Step 1 would be scored under this idea.

Get a boards and beyond subscription, first aid, uworld , and some sketchy and you are all set. All the cost of materials required for all of this would be much cheaper than two years at 50K a pop.

At most schools you pay 100K to stay at home and hit the spacebar for two years and then a year of training, and then fluff fourth year.

 

[Ho0v-man]

People basically already just study for Step 1 from day one of orientation and you want to cut more "fluff" out, so yeah, I do wonder if that's what you're saying.



Not sure what your school taught you, but the vast majority of information I received during MS 1 and MS2 was helpful for step 1.



I actually didn't. Sure I learned some, but certainly not a "metric crap ton of basic science minutiae." I'm a psychiatrist and I still use things I learned in pre-clinicals on the inpatient unit. Maybe it's because my school had a systems curriculum? I don't know. But I would say the minutiae I've never seen anywhere else was a bare minimum.



Yes and they extend residency to longer than ours. They also cut out undergrad and make medical school 6 years instead. There are schools right here who have the BS/MD programs. Folks should apply to them if they like.



No, it's not ridiculous. The schools that do it in 3 years put students on one pathway. Those students don't get a comprehensive education and the jury's still out on whether or not that's a good thing. I do agree that everyone knew exactly which specialty they wanted right out of the gate and was already accepted to residency at the time of beginning med school, you could shave off 4th year, but that's about it.



If you're on clinicals, there's nothing stopping you from reading up on every single IM inpatient on your team's list, researching what's going on, proposing treatment plans or even just discussing it with your resident. If you've done that and have time to spare, then I'd argue it's the quality of your clinicals that's the problem.

So just to be clear: you don’t want schools to just teach to step 1 but it sounds like you’re school taught to step 1 pretty well.

I’m not sure in what ways those shorter programs provide an inferior education. Feel free to enlighten me.

Ah yes. Go ahead and call into question the quality of my education or my work ethic. Unless I’m misremembering, didn’t you not even take step 1? I might be confusing you with another poster if so my bad.

 

[Matthew9Thirtyfive]

The clinical reasoning curriculum could be part of the preclinical boot camp. Step 1 would be scored under this idea.

Get a boards and beyond subscription, first aid, uworld , and some sketchy and you are all set. All the cost of materials required for all of this would be much cheaper than two years at 50K a pop.

At most schools you pay 100K to stay at home and hit the spacebar for two years and then a year of training, and then fluff fourth year.

You say that but we have over a year of assessments in school to make sure we’re on track. I’m not sure studying for step by learning 18 months of medical school on your own is really equivalent to studying for the mcat for a few months after two years of college.

 

[libertyyne]

You say that but we have over a year of assessments in school to make sure we’re on track. I’m not sure studying for step by learning 18 months of medical school on your own is really equivalent to studying for the mcat for a few months after two years of college.

I understand that there are assessments, I am not sure on how a person couldnt take assessments on their own, or how they couldnt schedule content by themselves. Taking classes in UG that are pertinent would also be beneficial.
In my experience the value that school provided to me during the first two years was not even positive rather in the negative with excercises that were meaningless at best and time consuming at worst.

Our training model is 100 years old, it needs to change with the times, and we are overdue for flexner 2.0.

 

[Neopolymath]

So just to be clear: you don’t want schools to just teach to step 1 but it sounds like you’re school taught to step 1 pretty well.

I’m not sure in what ways those shorter programs provide an inferior education. Feel free to enlighten me.

Ah yes. Go ahead and call into question the quality of my education or my work ethic. Unless I’m misremembering, didn’t you not even take step 1? I might be confusing you with another poster if so my bad.

Next you're going to hear how a traditional intern year before radiology is important (to provide cheap labor) haha.

 

[Ho0v-man]

Next you're going to hear how a traditional intern year before radiology is important (to provide cheap labor) haha.

Ya know I’m not against shortening residency training in most fields, but yeah that one seems dumb.

 

[Neopolymath]

Ya know I’m not against shortening residency training in most fields, but yeah that one seems dumb.

I'm just laying bait for our resident contrarian. Don't mind me lol.

 

[Matthew9Thirtyfive]

I understand that there are assessments, I am not sure on how a person couldnt take assessments on their own, or how they couldnt schedule content by themselves. Taking classes in UG that are pertinent would also be beneficial.
In my experience the value that school provided to me during the first two years was not even positive rather in the negative with excercises that were meaningless at best and time consuming at worst.

Our training model is 100 years old, it needs to change with the times, and we are overdue for flexner 2.0.

Maybe I'm just lucky, but the amount of stuff in my school's curriculum that I have found worthless or lacking value has been a minority of it. Yes, I don't watch most lectures and learn the pure content from BnB/lightyear, but between our small group activities, clinical reasoning and skills sessions, pathology groups, etc., I feel like I'd be missing out if I didn't get any of that. We definitely have some stuff that I have found to be time wasting, but it has been maybe a few things per module tops.

 

[Matthew9Thirtyfive]

Next you're going to hear how a traditional intern year before radiology is important (to provide cheap labor) haha.

The Navy path residency requires a clinical intern year, and almost every resident I've talked to has said they are glad they had to do it, and I've heard a couple residents from the other branches say the Navy residents are better at relating things to the clinical side and dealing with the clinicians. So maybe it isn't totally worthless.

 

[libertyyne]

Maybe I'm just lucky, but the amount of stuff in my school's curriculum that I have found worthless or lacking value has been a minority of it. Yes, I don't watch most lectures and learn the pure content from BnB/lightyear, but between our small group activities, clinical reasoning and skills sessions, pathology groups, etc., I feel like I'd be missing out if I didn't get any of that. We definitely have some stuff that I have found to be time wasting, but it has been maybe a few things per module tops.

Even if you did have stuff that isnt time wasting, i am betting that all of it could easily be provided in year three or four without discernable decrease in the quality of your overall education.

 

[libertyyne]

Ya know I’m not against shortening residency training in most fields, but yeah that one seems dumb.

I dont know, i feel like 6-9 months of intern year for radiology would be useful considering IR NIR a fellowship option for most, especially a surgical intern year for the interventionalists.

 

[Matthew9Thirtyfive]

Even if you did have stuff that isnt time wasting, i am betting that all of it could easily be provided in year three or four without discernable decrease in the quality of your overall education.

Maybe, maybe not. A lot of it seems to really be serving its purpose prior to clerkship, but it might be possible to do it during. But it's taught me how to write notes, present patients, work things up, etc. That all seems good to know prior to starting.

 

[Neopolymath]

The Navy path residency requires a clinical intern year, and almost every resident I've talked to has said they are glad they had to do it, and I've heard a couple residents from the other branches say the Navy residents are better at relating things to the clinical side and dealing with the clinicians. So maybe it isn't totally worthless.

I tend to agree with you and that line of thinking. But then I think about all the psychiatrists and pathologists that are not out there being subpar docs and I get real pessimistic that it's all bull**** so they can rent a notehoe for a year so we can be considered real doctors by other people (as if I particularly care what an IM doc thinks of me lol). I think the onus is on all of us to seek out how to be a value-adder in specialties that aren't core medical specialties that draw on each other deeply in daily technique.

It was probably there to legitimize the profession in other specialties' eyes back when first aid was 40 pages and radiology wasn't the juggernaut it is today.

 

[libertyyne]

Maybe, maybe not. A lot of it seems to really be serving its purpose prior to clerkship, but it might be possible to do it during. But it's taught me how to write notes, present patients, work things up, etc. That all seems good to know prior to starting.

Trust me, I learned more in one week on the wards than i did anything my school could even possibly offer for the years before.

 

[Matthew9Thirtyfive]

I tend to agree with you and that line of thinking. But then I think about all the psychiatrists and pathologists that are not out there being subpar docs and I get real pessimistic that it's all bull**** so they can rent a notehoe for a year so we can be considered real doctors by other people (as if I particularly care what an IM doc thinks of me lol). I think the onus is on all of us to seek out how to be a value-adder in specialties that aren't core medical specialties that draw on each other deeply in daily technique.

It was probably there to legitimize the profession in other specialties' eyes back when first aid was 40 pages and radiology wasn't the juggernaut it is today.

I mean I guess but it’s not just the people going through it who have told me it’s worthwhile. I’ve actually had pathologists and path residents who didn’t have to do it because they are in a different branch tell me they wish they got to do it.

 

[Matthew9Thirtyfive]

Trust me, I learned more in one week on the wards than i did anything my school could even possibly offer for the years before.

Given how you described your preclerkship experience, I’m sure that’s true. I’ll find out in a few months if that is true for me too.

 

[ciestar]

Given how you described your preclerkship experience, I’m sure that’s true. I’ll find out in a few months if that is true for me too.

I had a similar experience. I learn best by seeing/doing and on clerkships things finally made sense.

 

[slowthai]

I tend to agree with you and that line of thinking. But then I think about all the psychiatrists and pathologists that are not out there being subpar docs and I get real pessimistic that it's all bull**** so they can rent a notehoe for a year so we can be considered real doctors by other people (as if I particularly care what an IM doc thinks of me lol). I think the onus is on all of us to seek out how to be a value-adder in specialties that aren't core medical specialties that draw on each other deeply in daily technique.

It was probably there to legitimize the profession in other specialties' eyes back when first aid was 40 pages and radiology wasn't the juggernaut it is today.

I agree with this. What about all the other specialties like ortho, nsg, and ENT that dropped the surgical intern year requirement? Even ophtho is transitioning to an integrated model.

 

[Matthew9Thirtyfive]

I agree with this. What about all the other specialties like ortho, nsg, and ENT that dropped the surgical intern year requirement? Even ophtho is transitioning to an integrated model.

I mean those are all clinical specialties. I don’t think adding a year of a general surgery internship is going to be very beneficial for someone who will be spending 5 years doing orthopaedic surgery, but a year of clinical medicine might make one a better radiologist or pathologist.

 

[Matthew9Thirtyfive]

I had a similar experience. I learn best by seeing/doing and on clerkships things finally made sense.

That’s why I like our curriculum. There is a lot of doing.

 

[Neopolymath]

I mean those are all clinical specialties. I don’t think adding a year of a general surgery internship is going to be very beneficial for someone who will be spending 5 years doing orthopaedic surgery, but a year of clinical medicine might make one a better radiologist or pathologist.

You are probably right but I have heard many, many dissenting opinions of attending radiologists. I guess we will find out for ourselves.

 

[slowthai]

I mean those are all clinical specialties. I don’t think adding a year of a general surgery internship is going to be very beneficial for someone who will be spending 5 years doing orthopaedic surgery, but a year of clinical medicine might make one a better radiologist or pathologist.

But in DR you don't even have to do a medicine year. You can do a surgical prelim if you want instead. My point is that this setup seems to be historical in nature and not really necessary. Granted, having the clinical experience probably does help, but if it's so crucial, why not just include 6 months of medicine rotations during residency? There's more than enough room for this in a lot of programs, as people routinely do "mini-fellowships" in DR. It's just a huge hassle to uproot yourself an extra time when it's just not necessary.

 

[Neopolymath]

But in DR you don't even have to do a medicine year. You can do a surgical prelim if you want instead. My point is that this setup seems to be historical in nature and not really necessary. Granted, having the clinical experience probably does help, but if it's so crucial, why not just include 6 months of medicine rotations during residency? There's more than enough room for this in a lot of programs, as people routinely do "mini-fellowships" in DR. It's just a huge hassle to uproot yourself an extra time when it's just not necessary.

****, you can even do a peds prelim lol.

 

[slowthai]

****, you can even do a peds prelim lol.

Looool I didn't even know that haha

 

[Ho0v-man]

I dont know, i feel like 6-9 months of intern year for radiology would be useful considering IR NIR a fellowship option for most, especially a surgical intern year for the interventionalists.

I see your point and don’t totally disagree. But there’s so many options for the prelim year. Med, surgery, transitional, peds (apparently lol). You could have a residency full of people who did any combo of these intern years and they’re all going to end up as R4s able to apply to any fellowship. If there were some kind of rads specific intern year where you spent time on different surgical services learning why that post op appearance looks that way for example or were interpreting imaging on patients and then actually going to see the clinical correlation yourself so you understand better what’s going on then I could get on board.

But I’m not in residency yet so I won’t critique its efficiency until I’ve experienced it myself.

 

[Matthew9Thirtyfive]

But in DR you don't even have to do a medicine year. You can do a surgical prelim if you want instead. My point is that this setup seems to be historical in nature and not really necessary. Granted, having the clinical experience probably does help, but if it's so crucial, why not just include 6 months of medicine rotations during residency? There's more than enough room for this in a lot of programs, as people routinely do "mini-fellowships" in DR. It's just a huge hassle to uproot yourself an extra time when it's just not necessary.

Don’t most people do their intern year the same place they do residency? If not then that’s a pretty obvious fix. They can just make them integrated.

 

[Matthew9Thirtyfive]

You are probably right but I have heard many, many dissenting opinions of attending radiologists. I guess we will find out for ourselves.

Yeah I mean most people who go into radiology probably have zero desire to do clinical medicine, so that makes sense. I haven’t talked to an radiologists about it. Maybe it’s a path thing, and even then the only path docs I’ve talked to about it are military so maybe it’s even more narrow haha.

 

[slowthai]

Don’t most people do their intern year the same place they do residency? If not then that’s a pretty obvious fix. They can just make them integrated.

I think most aim for that, but relatively few get it. Yes, they should totally do that.

 

[Matthew9Thirtyfive]

I think most aim for that, but relatively few get it. Yes, they should totally do that.

Yeah that’s dumb.

 

[libertyyne]

Don’t most people do their intern year the same place they do residency? If not then that’s a pretty obvious fix. They can just make them integrated.

My home program in rads does an integrated year, 9 months of medicine and 3 months rad as intern or alternatively 9 months of surgery and 3 months of Rads. The r1s say they hated medicine , but mostly due to the hours. Not sure if there was some educational benefit, but i dont think a few months of medicine is out of line for radiologists.

 

[slowthai]

My home program in rads does an integrated year, 9 months of medicine and 3 months rad as intern or alternatively 9 months of surgery and 3 months of Rads. The r1s say they hated medicine , but mostly due to the hours. Not sure if there was some educational benefit, but i dont think a few months of medicine is out of line for radiologists.

Yeah, from what I understand, those categorical spots are very few and extremely competitive in the match.