No preceptor for General Surgery rotation

[doctor_crane]

I do not know how common this is, but I've started clinical rotations. My first one is for general surgery. Except I do not have a preceptor, I'm usually not even watching general surgery. I shadow surgeons in the OR, I do not scrub in, I am not asked questions, I'm not involved in patient care (pre or post OP). So I spend my day just watching surgeries and I can leave whenever I want. I do not know how they will do evaluations and I'm not even sure if this is legal. DO vs MD never had much of a difference, but it seems going to a DO school may be not good for 3rd and 4th year.

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[Goro]

You're NOT supposed to be shadowing. IIRC, this is now an accreditation violation.

You complain to your clinical education Deans right now!!!

Per chance, is this a new DO school you're at??

 

[MDMechEngr]

Maybe the check to pay the preceptor bounced?

 

[giguerex35]

unfortunately this was the same thing that happened to me on my gen surg rotation. I scrubbed maybe 3 times in a month and 2 of them were a waste because i didnt do anything, not even hold a retractor. I never saw my preceptor and reached out to some random surgeon who I met on the rotation fill out my eval. sucks but thats how it be sometime

 

[Prehealth1011]

Had a similar experience as a DO although I did it to myself. The preceptor at our main site gave horrible evals to 5+ people I knew so I intentionally switched sites

 

[wook]

As Goro stated, I would recommend working with your school to identify this as an opportunity for improvement. If no one says anything, they will not know there is a problem. You are paying a lot of money for the education, and it is very reasonable to not squander any opportunity to learn.

 

[DOVinciRobot]

Yeah that’s garbage.

 

[Ho0v-man]

I’m going to go against the grain and say don’t speak up unless you want to be a surgeon. I could totally see a school punishing the student and making them graduate late to “make up” their surgery rotation. As messed up as it is, they can always hurt you more…

 

[DOVinciRobot]

I’m going to go against the grain and say don’t speak up unless you want to be a surgeon. I could totally see a school punishing the student and making them graduate late to “make up” their surgery rotation. As messed up as it is, they can always hurt you more…

Unfortunately this is the truest comment in this thread

 

[Captain_Falcon]

I’m going to go against the grain and say don’t speak up unless you want to be a surgeon. I could totally see a school punishing the student and making them graduate late to “make up” their surgery rotation. As messed up as it is, they can always hurt you more…

This. Enjoy the chill rotation and use your free time to study for the shelf and get ahead on studying for your next rotation

 

[hellosnd]

I’m going to go against the grain and say don’t speak up unless you want to be a surgeon. I could totally see a school punishing the student and making them graduate late to “make up” their surgery rotation. As messed up as it is, they can always hurt you more…

My school had a similar rotation, we scrubbed in but had very low case count and could leave whenever. Some student reported it and we lost the site. Caused a headache for a lot of people who had to scramble to find a new site/housing

 

[scoopdaboop]

Unfortunately, that sucks. Surgery is a important rotation in hindsight, during it I was miserable. Others need to feel this same experience.

 

[doctor_crane]

Thank you for your feedback. While I do not have an official preceptor, as I have been going through the rotation, at least some of the surgeons are nice and helpful. One of them let me scrub in and do sutures. However, there is more to being a surgeon than just doing surgery and of course, I am missing out on that.
I spoke about this with my school, and they were established as a school like almost 10 years ago btw... but they were polite. They simply said that the preceptor that they had quit and they have no where else to put me. I asked if I could do an elective somewhere else and they suggested that I ask surgeons that I know to be my preceptor because they do not have anywhere to place me. I know a few of them and my only drawback of doing that is having to move several hours away 3-5 (depending on who agrees if any) when I live with my girlfriend who is pretty much my wife, we just live together... Sooo, I do not know what to do yet. I'm thinking maybe I can ask a surgeon that is nice where I am to be my elective preceptor, but I'm not sure if that would be appropriate.
Replied late because I thought I'd get notifications via email but I did not and I have been trying to study for the COMAT.

And yes I would like to be a surgeon, but obviously, this is step 2 dependent and I have yet to take this.

The last 2 weeks of my rotation I do get a preceptor, but the vast majority of it, this is what I do, shadow surgeries.

 

[doctor_crane]

Honestly was just wondering if this was a common thing, it seems it is not and I should try to use my elective for this experience, regardless of if I actually become a surgeon.

 

[War of Arts]

You're NOT supposed to be shadowing. IIRC, this is now an accreditation violation.

You complain to your clinical education Deans right now!!!

Per chance, is this a new DO school you're at??

Ok, I am going to say this is very common and it is good that at least he watches some surgeries not just sitting home watching videos. I am from one of the old five

 

[Goro]

Ok, I am going to say this is very common and it is good that at least he watches some surgeries not just sitting home watching videos. I am from one of the old five

As an aside, I LOVE the screen name!

 

[sylvanthus]

I know a nurse that can precept you.

 

[NotAProgDirector]

I hate to say this, but it's threads / issues like this that will give MD programs pause about taking DO's. Fully virtual or shadow rotations would not be tolerated in LCME programs. I've had the experience of matching DO applicants who struggle, and we come to discover that all of their clerkships were in private offices and they have never worked in an inpatient setting. Now we carefully review documentation to try to sort this out. If it's vague, the app goes in the trash. It doesn't appear to be a school specific issue -- DO schools have many rotation sites so some students seem to get better experiences than others. Some variation in rotation quality happens in MD schools also, but the variation seems much wider for DO.

If it's worse now post-COVID, this might push programs to simply exclude DO students if it's too much work to sort out.

 

[DOVinciRobot]

I hate to say this, but it's threads / issues like this that will give MD programs pause about taking DO's. Fully virtual or shadow rotations would not be tolerated in LCME programs. I've had the experience of matching DO applicants who struggle, and we come to discover that all of their clerkships were in private offices and they have never worked in an inpatient setting. Now we carefully review documentation to try to sort this out. If it's vague, the app goes in the trash. It doesn't appear to be a school specific issue -- DO schools have many rotation sites so some students seem to get better experiences than others. Some variation in rotation quality happens in MD schools also, but the variation seems much wider for DO.

If it's worse now post-COVID, this might push programs to simply exclude DO students if it's too much work to sort out.

I was asked straight up in most of my MD interviews what my 3rd year surgery rotation was like. Followed by comments about how glad they were it was with residents in typical academic fashion. One Pd in particular said his program doesn’t rank people who did a preceptor surgery rotation

 

[FutureDoctor5000]

I was asked straight up in most of my MD interviews what my 3rd year surgery rotation was like. Followed by comments about how glad they were it was with residents in typical academic fashion. One Pd in particular said his program doesn’t rank people who did a preceptor surgery rotation

Couldn’t you just lie about it? say a part of it was residents and part was one on with an attending? Who is gonna call your school and verify that info, especially after the interview? Like even if they asked a bunch of DO’s this question it’d be pretty easy to fake that answer especially if you have done a SUB-I at an academic setting…

 

[DOVinciRobot]

Couldn’t you just lie about it? say a part of it was residents and part was one on with an attending? Who is gonna call your school and verify that info, especially after the interview? Like even if they asked a bunch of DO’s this question it’d be pretty easy to fake that answer especially if you have done a SUB-I at an academic setting…

I personally find it morally objectionable to lie and misrepresent yourself and your experiences. People who lie about small things lie about big things. Residents that lie get fired.

But sure. I guess you could lie

 

[FutureDoctor5000]

I personally find it morally objectionable to lie and misrepresent yourself and your experiences. People who lie about small things lie about big things. Residents that lie get fired.

But sure. I guess you could lie

I definitely understand what your saying.. but if I had a ***** core surgery rotation third year which was absolutely no fault of my own(the school is at fault here) and I did a few academic Sub-I’s 4th year to make up for that experience or due to Covid I could only do 1, and they ask me about my ***** third year core rotation, which should be a moot point anyway, I don’t understand why just making up that experience or rather not expanding upon the terrible third year experience is that big a deal. Keeping that answer vague and short would probably be better than saying something like it was a preceptorship where if did nothing for 6 weeks lol and essentially shoot your own self in the foot lol. Heck I barely even remember my day to day experience of my core surgery rotation in third year, most of it is in the MSPE anyway and if it is the difference between getting ranked vs not ranked and straight up wasting an interview over something that was initially completely out of my control.. I don’t see the major moral objection to that. And quite frankly it’s not even a verifiable thing by a busy surgical residency. It’s all about playing the game that is the match and the interview and we all say stuff they want to hear during interviews anyway. This is no different than an applicant dual applying two specialties and faking their interest in the back up specialty. Or an applicant faking an interest in a program that’s gonna end up like 13-14 on thier list. If they were honest they be like I am just using yall as my back up when they ask “why our program” question.

 

[Captain_Falcon]

I definitely understand what your saying.. but if I had a ***** core surgery rotation third year which was absolutely no fault of my own(the school is at fault here) and I did a few academic Sub-I’s 4th year to make up for that experience or due to Covid I could only do 1, and they ask me about my ***** third year core rotation, which should be a moot point anyway, I don’t understand why just making up that experience is that big a deal. Heck I barely even remember my day to day experience of my core surgery rotation in third year, most of it is in the MSPE anyway and if it is the difference between getting ranked vs not ranked and straight up wasting an interview over something that was initially completely out of my control.. I don’t see the major moral objection to that. And quite frankly it’s not even a verifiable thing by a busy surgical residency. It’s all about playing the game that is the match and the interview and we all say stuff they want to hear during interviews anyway.

Can't you just say it was a preceptorship but you've had 12 weeks on 3 sub-Is in an academic setting?

 

[FutureDoctor5000]

Can't you just say it was a preceptorship but you've had 12 weeks on 3 sub-Is in an academic setting?

You could but they asked about specifically about your core rotation.

 

[h23]

I definitely understand what your saying.. but if I had a ***** core surgery rotation third year which was absolutely no fault of my own(the school is at fault here) and I did a few academic Sub-I’s 4th year to make up for that experience or due to Covid I could only do 1, and they ask me about my ***** third year core rotation, which should be a moot point anyway, I don’t understand why just making up that experience or rather not expanding upon the terrible third year experience is that big a deal. Keeping that answer vague and short would probably be better than saying something like it was a preceptorship where if did nothing for 6 weeks lol and essentially shoot your own self in the foot lol. Heck I barely even remember my day to day experience of my core surgery rotation in third year, most of it is in the MSPE anyway and if it is the difference between getting ranked vs not ranked and straight up wasting an interview over something that was initially completely out of my control.. I don’t see the major moral objection to that. And quite frankly it’s not even a verifiable thing by a busy surgical residency. It’s all about playing the game that is the match and the interview and we all say stuff they want to hear during interviews anyway. This is no different than an applicant dual applying two specialties and faking their interest in the back up specialty. Or an applicant faking an interest in a program that’s gonna end up like 13-14 on thier list. If they were honest they be like I am just using yall as my back up when they ask “why our program” question.

honestly questions like those really make me angry. People can be dealt bad situations. We don't have any control over how our rotations are or if we're with a preceptor versus an academic team based rotation. If I had the choice and if it was the difference that made me more competitive, then I'd try to go for academic team based, but if I wasn't able to get that opportunity, however I went out of my way to get that necessary experience that I was lacking on, like maybe go on additional audition rotations, got letters to show that I'm actually worth something and that I'm not deficient in any way, then I'd argue that's better because it shows initiative and tons of other good qualities. I get why programs might be hesitant, but if a student has done whatever and everything they could try to address whatever, then why punish them for something that's completely out of their control? Why ask questions specifically about 3rd year rotations when a lot of us have to go through preceptor based and outright deny people who do go through preceptor based? No disrespect to anyone, but why waste our time in the first place by giving us that interview if all it takes to deny is whether or not we had a preceptor based surgery rotation for 3rd year?

 

[DOVinciRobot]

I definitely understand what your saying.. but if I had a ***** core surgery rotation third year which was absolutely no fault of my own(the school is at fault here) and I did a few academic Sub-I’s 4th year to make up for that experience or due to Covid I could only do 1, and they ask me about my ***** third year core rotation, which should be a moot point anyway, I don’t understand why just making up that experience or rather not expanding upon the terrible third year experience is that big a deal. Keeping that answer vague and short would probably be better than saying something like it was a preceptorship where if did nothing for 6 weeks lol and essentially shoot your own self in the foot lol. Heck I barely even remember my day to day experience of my core surgery rotation in third year, most of it is in the MSPE anyway and if it is the difference between getting ranked vs not ranked and straight up wasting an interview over something that was initially completely out of my control.. I don’t see the major moral objection to that. And quite frankly it’s not even a verifiable thing by a busy surgical residency. It’s all about playing the game that is the match and the interview and we all say stuff they want to hear during interviews anyway. This is no different than an applicant dual applying two specialties and faking their interest in the back up specialty. Or an applicant faking an interest in a program that’s gonna end up like 13-14 on thier list. If they were honest they be like I am just using yall as my back up when they ask “why our program” question.

honestly questions like those really make me angry. People can be dealt bad situations. We don't have any control over how our rotations are or if we're with a preceptor versus an academic team based rotation. If I had the choice and if it was the difference that made me more competitive, then I'd try to go for academic team based, but if I wasn't able to get that opportunity, however I went out of my way to get that necessary experience that I was lacking on, like maybe go on additional audition rotations, got letters to show that I'm actually worth something and that I'm not deficient in any way, then I'd argue that's better because it shows initiative and tons of other good qualities. I get why programs might be hesitant, but if a student has done whatever and everything they could try to address whatever, then why punish them for something that's completely out of their control? Why ask questions specifically about 3rd year rotations when a lot of us have to go through preceptor based and outright deny people who do go through preceptor based? No disrespect to anyone, but why waste our time in the first place by giving us that interview if all it takes to deny is whether or not we had a preceptor based surgery rotation for 3rd year?

You don’t have to lie. Personally, in that situation I would say “my 3rd year experience was actually very poor and so I have sought out 4th year sub-I’s at tertiary academic centers to make up for that weakness.”

Honestly being vague is a great way to get DNR’d because it makes it look like you’re evading the question.

Some people might still disqualify you. But guess what, that’s life and their prerogative. Residency is a job, and the people hiring for that job can use whatever criteria they want to weed out candidates.

 

[h23]

I'm silently hoping that there could be some chance that LCME could absorb COCA and oversee everything and get as many DO schools up to a LCME standard instead of what we are at now. COCA is way too lax with some of these regulations. The ACGME merger happened anyway, so maybe something like this doesn't have to be imaginary. Don't get me wrong, i'm grateful for the opportunity to get a medical education, these road bumps are just annoying to deal with.

 

[Captain_Falcon]

You could but they asked about specifically about your core rotation.

Right. Say that wasn't but you did complete 12 weeks of Academic sub-i

 

[MDMechEngr]

I'm silently hoping that there could be some chance that LCME could absorb COCA and oversee everything and get as many DO schools up to a LCME standard instead of what we are at now. COCA is way too lax with some of these regulations. The ACGME merger happened anyway, so maybe something like this doesn't have to be imaginary. Don't get me wrong, i'm grateful for the opportunity to get a medical education, these road bumps are just annoying to deal with.

UC Irvine SOM brought their training, research, etc. up to LCME standard and switched to MD. No way in hell COCA will allow LCME to absorb them. The DO schools could do it but it takes money. just saying.

 

[DOVinciRobot]

I'm silently hoping that there could be some chance that LCME could absorb COCA and oversee everything and get as many DO schools up to a LCME standard instead of what we are at now. COCA is way too lax with some of these regulations. The ACGME merger happened anyway, so maybe something like this doesn't have to be imaginary. Don't get me wrong, i'm grateful for the opportunity to get a medical education, these road bumps are just annoying to deal with.

As long as the AOA exists this will never happen. Most DO schools couldn’t ever get to LCME standards as they are currently written. There are research and financial requirements that most DO schools simply couldn’t meet

 

[FutureDoctor5000]

honestly questions like those really make me angry. People can be dealt bad situations. We don't have any control over how our rotations are or if we're with a preceptor versus an academic team based rotation. If I had the choice and if it was the difference that made me more competitive, then I'd try to go for academic team based, but if I wasn't able to get that opportunity, however I went out of my way to get that necessary experience that I was lacking on, like maybe go on additional audition rotations, got letters to show that I'm actually worth something and that I'm not deficient in any way, then I'd argue that's better because it shows initiative and tons of other good qualities. I get why programs might be hesitant, but if a student has done whatever and everything they could try to address whatever, then why punish them for something that's completely out of their control? Why ask questions specifically about 3rd year rotations when a lot of us have to go through preceptor based and outright deny people who do go through preceptor based? No disrespect to anyone, but why waste our time in the first place by giving us that interview if all it takes to deny is whether or not we had a preceptor based surgery rotation for 3rd year?

It’s also a massive misunderstanding that MD rotations aren’t preceptor based or one one one. I know of people at MD schools whose rotations have been one on one with attendings as well. I had several team based academic rotations as well at a DO school. It’s not so cut and dry. DO schools rotations have been historically been poorer but I think coca now requires that atleast one core rotation is with residents. I would just try my best to do that rotation in the specialty I was interested in… But tbh I personally wasn’t asked such questions on any of my academic or any other interviews for that matter and neither were my friends who applied to surgical residencies. It may be extremely program dependent, and only a minority of programs may actually care enough about it to DNR someone because of a perceived poor core rotation.

 

[FutureDoctor5000]

As long as the AOA exists this will never happen. Most DO schools couldn’t ever get to LCME standards as they are currently written. There are research and financial requirements that most DO schools simply couldn’t meet

The research aspect yea but the other stuff like rotations and the financials?, I think most DO schools could do it if forced to. I mean look at some of the new MD schools popping up, they don’t have hospitals and have minimal research too tbh.. especially the new private MD schools.

 

[DOVinciRobot]

The research aspect yea but the other stuff like rotations and the financials?, I think most DO schools could do it if forced to. I mean look at some of the new MD schools popping up, they don’t have hospitals and have minimal research too tbh.. especially the new private MD schools.

Go read those sections of the LCME requirements. The majority of DO schools would have to completely overhaul their financial structure.

 

[Darrow O'Lykos]

Go read those sections of the LCME requirements. The majority of DO schools would have to completely overhaul their financial structure.

Me 30 years from now in my fantasy when the AOA becomes defunct and we see all of those other DO schools close.

 

[FutureDoctor5000]

Go read those sections of the LCME requirements. The majority of DO schools would have to completely overhaul their financial structure.

I agree, though I haven’t read the requirements. If it was shutting down and no $$$ or overhauling the structure then I bet most schools would choose the latter.

 

[FutureDoctor5000]

Me 30 years from now in my fantasy when the AOA becomes defunct and we see all of those other DO schools close.
View attachment 358311

Doubt that would happen. What would be ideal would be COCA and LCME merge AKA LCME absorbs COCA simmilar to how the ACGME and AOA did.. then there would be a 5 year period where DO schools would have to meet the bare minimum LCME requirements in order to not loose accreditation. They can still offer the DO degree and teach OMM but they will atleast be LCME accredited… NBOME and NBME also merge to form a single exam with an added Omm portion for DO’s…or they get rid of the DO degree all together and just retroactively give all DO’s an MD and convert all the DO schools to MD.. but that would create too much of a headache and wouldn’t be practical. I can see the first senario happening though..

 

[FutureDoctor5000]

UC Irvine SOM brought their training, research, etc. up to LCME standard and switched to MD. No way in hell COCA will allow LCME to absorb them. The DO schools could do it but it takes money. just saying.

UC Irvine is also a state (California) funded school, TBH a lot of the new private MD schools are only marginally better IF that than DO schools. I think if given a few years and more ways to get funding/financial restructuring, a majority of DO schools could actually meet the bare minimum LCME requirements.

 

[DrZoidbergDO]

The research requirements are dumb af. That shouldn't be part of the criteria at all.

 

[DOVinciRobot]

I agree, though I haven’t read the requirements. If it was shutting down and no $$$ or overhauling the structure then I bet most schools would choose the latter.

Many of them couldn’t. Most DO schools simply don’t have the same revenue streams MD schools do. The only exceptions are the state schools. Places like PCOM could likely adjust. None of the new schools could, and many of the places like KYCOM and LMU couldn’t either.

Unless there were changes to the LCME requirements roughly half, if not more, of DO schools would be closed. No amount of a grace period would change that

 

[MDMechEngr]

UC Irvine is also a state (California) funded school, TBH a lot of the new private MD schools are only marginally better IF that than DO schools. I think if given a few years and more ways to get funding/financial restructuring, a majority of DO schools could actually meet the bare minimum LCME requirements.

A state funded school does have better finanacial resources to make postive changes to training for their MS. The two new MD schools (CUSM and Creighton Az) that I have connections with have pretty good clinical sites. UC Riverside also has good clinical rotations to IE hospitals. They also have connections to other UC schools such as SD, Davis, Irvine, LA and their students match pretty well through these connections. The newer MD schools seem to be set up a little better than some of the new DO schools that are opening.

 

[Sidus1011]

A state funded school does have better finanacial resources to make postive changes to training for their MS. The two new MD schools (CUSM and Creighton Az) that I have connections with have pretty good clinical sites. UC Riverside also has good clinical rotations to IE hospitals. They also have connections to other UC schools such as SD, Davis, Irvine, LA and their students match pretty well through these connections. The newer MD schools seem to be set up a little better than some of the new DO schools that are opening.

Lol I don't think the argument was newer MD vs newer DO. Schools like Noorda, CHSU, ICOM, are some of the worst models for a medical school I've seen in a while. I think what he's saying is that established DO schools may not be too far behind those of newer MD schools, which shows that COCA isn't the only one becoming more lax in letting schools open. Ultimately nothing will change until the federal government does something akin to a new flexner report. COCA and LCME do not care for medical students, they probably never really did.

 

[FootballAndSkiing]

New & Developing COMs

Select an option below for detailed information: Application for New Colleges of Osteopathic Medicine Candidate Status Directory

osteopathic.org

I know there's more to it, but the application for new COMs always makes me laugh due to its simplicity.

 

[h23]

New & Developing COMs

Select an option below for detailed information: Application for New Colleges of Osteopathic Medicine Candidate Status Directory

osteopathic.org

I know there's more to it, but the application for new COMs always makes me laugh due to its simplicity.

omg, it's only two pages?? while there is probably more to it, i think my brain just stopped functioning at the level of detail this form is asking for. You might as well put a sign in sheet at this point. That's honestly what it feels like lmao. Pretty soon we're going to have Oprah come on, saying "You get a medical school! You get a medical school! You all get a medical school!!!"

 

[War of Arts]

I was asked straight up in most of my MD interviews what my 3rd year surgery rotation was like. Followed by comments about how glad they were it was with residents in typical academic fashion. One Pd in particular said his program doesn’t rank people who did a preceptor surgery rotation

that is bad because I heard from a classmate who is doing the surgery rotation that he only needs to go 4 days a week, and the hours are pretty easy. There are three students under one preceptor so they rotate to scrub in (like only once a week)

 

[Goro]

UC Irvine SOM brought their training, research, etc. up to LCME standard and switched to MD. No way in hell COCA will allow LCME to absorb them. The DO schools could do it but it takes money. just saying.

That was back in 1960s!

 

[Goro]

UC Irvine is also a state (California) funded school, TBH a lot of the new private MD schools are only marginally better IF that than DO schools. I think if given a few years and more ways to get funding/financial restructuring, a majority of DO schools could actually meet the bare minimum LCME requirements.

Other than CNU, can you name some of these new MD schools?

And for the rest of you, let's avoid the fantasy speculation. LCME is not going to take over COCA. Why would they even want to??

If you want things to change for the better, YOU have to take over COCA!

 

[ortnakas]

And for the rest of you, let's avoid the science fiction style speculation. Lcme is not going to take over CICA. Why would they even want to??

Seriously. What motivation would LCME have to want to deal with that? And what motivation would COCA have to give up control?

 

[PapaGuava]

I know how much everyone loves COCA and the LCME but please try to stay on topic

 

[FutureDoctor5000]

Other than CNU, can you name some of these new MD schools?

And for the rest of you, let's avoid the fantasy speculation. LCME is not going to take over COCA. Why would they even want to??

If you want things to change for the better, YOU have to take over COCA!

Umm Nova SE MD school, TCU, University of Houston- these operate very similar to established DO schools.

 

[getfat]

Couldn’t you just lie about it?

Way too risky. The truth always comes out.